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“Time's Up”: The Experience of Entering Residential Aged Care for Young People with Acquired Neurological Disorders and Their Families

Published online by Cambridge University Press:  13 September 2018

Sandra Barry
Affiliation:
Living with Disability Research Centre, La Trobe University, Victoria, Australia Summer Foundation, Victoria, Australia
Lucy Knox
Affiliation:
Living with Disability Research Centre, La Trobe University, Victoria, Australia Summer Foundation, Victoria, Australia
Jacinta M. Douglas*
Affiliation:
Living with Disability Research Centre, La Trobe University, Victoria, Australia Summer Foundation, Victoria, Australia
*
Address for correspondence: Professor Jacinta Douglas, Living with Disability Research Centre, College of Science Health and Engineering, La Trobe University, Bundoora, Victoria 3086, Australia. E-mail: J.Douglas@latrobe.edu.au
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Abstract

Background and aims: Previous research has highlighted that living in residential aged care (RAC) is associated with a range of negative outcomes for adults with acquired neurological disorders. This study sought to understand the lived experience of entering RAC for young people and their family members and characterise their needs during this process.

Method: Data included 64 written and verbal submissions to the 2015 Senate Inquiry into the Adequacy of existing residential care arrangements available for young people with severe physical, mental or intellectual disabilities in Australia. In line with hermeneutic tradition, text was analysed using thematic analysis.

Results: Entry to RAC was experienced as a complex process that coalesced around three key events: an unexpected health crisis, a directive that time's up and the individual is required to leave the healthcare setting, with a subsequent decision to move into RAC. This decision was made in the absence of time, knowledge of options or adequate support.

Conclusions: Findings suggest that there are both immediate practice changes and longer term policy responses that can support the health and disability systems to uphold the rights of people with acquired disability to choose where and how they will live their lives.

Type
Articles
Copyright
Copyright © Australasian Society for the Study of Brain Impairment 2018 

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References

Appleton, J.V., & King, L. (1997). Constructivism: A naturalistic methodology for nursing inquiry. Advances in Nursing Science, 20 (2), 1322.Google Scholar
Australian Institute of Health and Welfare. (2016). Residential aged care and home care 2014–15. Retrieved from http://www.aihw.gov.au/aged-care/residential-and-home-care-2014-15/data/.Google Scholar
Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3 (2), 77101.Google Scholar
Cameron, G., Pirozzo, S., & Tooth, L. (2001). Long-term care of people below age 65 with severe acquired brain injury: Appropriateness of aged care facilities. Australian and New Zealand Journal of Public Health, 25 (3), 261264.Google Scholar
Colantonio, A., Howse, D., Kirsh, B., Chiu, T., Zulla, R., & Levy, C. (2010). Living environments for people with moderate to severe acquired brain injury. Healthcare Policy, 5 (4), e120.Google Scholar
Colantonio, A., Howse, D., & Patel, J. (2010). Young adults with traumatic brain injury in long-term care homes: A population-based study. Brain Impairment, 11 (1), 3136.Google Scholar
Colantonio, A., Hsueh, J., Petgrave, J., Hirdes, J. P., & Berg, K. (2015). A profile of patients with traumatic brain injury within home care, long-term care, complex continuing care, and institutional mental health settings in a publicly insured population. Journal of Head Trauma Rehabilitation, 30 (6), E18–E29.Google Scholar
Creswell, J.W., & Miller, D.L. (2000). Determining validity in qualitative inquiry. Theory into Practice, 39 (3), 124130.Google Scholar
Crotty, M. (1998). The foundations of social research: Meaning and perspective in the research process. London, UK: Sage.Google Scholar
Cuthbert, J.P., Corrigan, J.D., Harrison-Felix, C., Coronado, V., Dijkers, M.P., Heinemann, A.W., & Whiteneck, G.G. (2011). Factors that predict acute hospitalization discharge disposition for adults with moderate to severe traumatic brain injury. Archives of Physical Medicine and Rehabilitation, 92 (5), 721730.Google Scholar
Dorsett, P. (2010). The importance of hope in coping with severe acquired disability. Australian Social Work, 63 (1), 83102.Google Scholar
Foster, M., Allen, S., & Fleming, J. (2015). Unmet health and rehabilitation needs of people with long-term neurological conditions in Queensland, Australia. Health and Social Care in the Community, 23 (3), 292303.Google Scholar
Fries, B., Wodchis, W., Blaum, C., Buttar, A., Drabek, J., & Morris, J. (2005). A national study showed that diagnoses varied by age group in nursing home residents under age 65. Journal of Clinical Epidemiology, 58 (2), 198205.Google Scholar
Harrington, R., Foster, M., & Fleming, J. (2015). Experiences of pathways, outcomes and choice after severe traumatic brain injury under no-fault versus fault-based motor accident insurance. Brain Injury, 29 (13-14), 15611571.Google Scholar
Knox, L., & Douglas, J. (2018, early online). A scoping review of the nature and outcomes of extended rehabilitation programs after very severe brain injury. Brain Injury, 32 (8), 10001010.Google Scholar
Knox, L., Douglas, J., & Bigby, C. (2013). Whose decision is it anyway? How clinicians support decision-making participation after acquired brain injury. Disability and Rehabilitation, 35 (22), 19261932.Google Scholar
Knox, L., Douglas, J., & Bigby, C. (2015). ‘The biggest thing is trying to live for two people’: Spousal experiences of supporting decision-making participation for partners with TBI. Brain Injury, 29 (6), 745757.Google Scholar
Leith, K.H., Phillips, L., & Sample, P.L. (2004). Exploring the service needs and experiences of persons with TBI and their families: The South Carolina experience. Brain Injury, 18 (12), 11911208.Google Scholar
Liamputtong, P. (2009). Qualitative research methods (3rd ed.). South Melbourne, Victoria: Oxford University Press.Google Scholar
Lincoln, Y.S., & Guba, E.G. (1985). Naturalistic inquiry. Newbury Park, CA: Sage.Google Scholar
Mays, N., & Pope, C. (2000). Assessing quality in qualitative research. British Medical Journal, 320 (7226), 5052.Google Scholar
McIntyre, D., Fleming, J., Foster, M., & Tweedy, S. (2016). Experiences of adults with high-care needs and their family members with housing and support pathways in Australia. Disability and Rehabilitation, 39 (18), 18291839.Google Scholar
McMillan, T.M., & Laurie, M. (2004). Young adults with acquired brain injury in nursing homes in Glasgow. Clinical Rehabilitation, 18 (2), 132138.Google Scholar
MRC CRASH Trial Collaborators. (2008). Predicting oucome after traumatic brain injury: Practical prognostic models based on large cohort of international patients. BMJ, 336 (12 February), 425.Google Scholar
Muenchberger, H., Sunderland, N., Kendall, E., & Quinn, H. (2011). A long way to tipperary? Young people with complex health conditions living in residential aged care: A metaphorical map for understanding the call for change. Disability and Rehabilitation, 33 (13–14), 11901202.Google Scholar
O'Reilly, K. & Pryor, J. (2002). Young people with brain injury in nursing homes: Not the best option! Australian Health Review, 25 (3), 4651.Google Scholar
Patton, M.Q. (2002). Qualitative research and evaluation methods (3rd ed.). Thousand Oaks, CA: Sage.Google Scholar
Persson, D.I., & Ostwald, S.K. (2009). Younger residents in nursing homes. Journal of Gerontological Nursing, 35 (10), 2231.Google Scholar
Productivity Commission. (2011). Disability Care and Support (Report no. 54). Canberra, ACT: Author.Google Scholar
Ryan, R., Lopata, T., & Yeomans, J. (2010). Mid-term review: Younger people in residential aged care program. Sydney, NSW: Urbis.Google Scholar
Schutz, R.E.C., Coats, H.L., Engelberg, R.A., Curtis, J.R., & Creutzfeldt, C.J. (2017). Is there hope? Is she there? How families and clinicians experience severe acute brain injury. Journal of Palliative Medicine, 20 (2), 170176.Google Scholar
Smith, M. (2004). Under the circumstances: The experiences of younger people living in residential aged care facilities. Contemporary Nurse, 16 (3), 188198.Google Scholar
Summer Foundation. (2017). NDIS report card: Outcomes for younger people in residential aged care. Retrieved from https://www.summerfoundation.org.au/resources/ndis-report-card-april-2017/.Google Scholar
Turner-Stokes, L. (2008). Evidence for the effectiveness of multi-disciplinary rehabilitation following acquired brain injury: A synthesis of two systematic approaches. Journal of Rehabilitation Medicine, 40 (9), 691701.Google Scholar
United Nations General Assembly. (2007). Convention on the rights of persons with disabilities: Resolution/adopted by the General Assembly (A/RES/61/106). Retrieved from http://www.unhcr.org/refworld/docid/45f973632.html.Google Scholar
Van Manen, M. (2016). Researching lived experience: Human science for an action sensitive pedagogy (2nd ed). New York, NY: Routledge.Google Scholar
Winkler, D., Farnworth, L., & Sloan, S. (2006). People under 60 living in aged care facilities in Victoria. Australian Health Review, 30 (1), 100108.Google Scholar
Winkler, D., Sloan, S., & Callaway, L. (2007). Younger people in residential aged care: Support needs, preferences and future directions. Melbourne, VIC: Summer Foundation Ltd.Google Scholar
Winkler, D.F., Farnworth, L.J., Sloan, S.M., & Brown, T. (2011). Young people in aged care: Progress of the current national program. Australian Health Review, 35 (3), 320326.Google Scholar
Winkler, D., Holgate, N., Sloan, S., & Callaway, L. (2012). Evaluation of quality of life outcomes of the Younger People in Residential Aged Care initiative in Victoria. Melbourne, VIC: Summer Foundation Ltd.Google Scholar
Winkler, D., Callaway, L., Sloan, S., & Holgate, N. (2015). Everyday choice making: Outcomes of young people with acquired brain injury after moving from residential aged care to community-based supported accommodation. Brain Impairment, 16 (3), 221235.Google Scholar
Wright, C.J., Muenchberger, H., & Whitty, J.A. (2015). The choice agenda in the Australian supported housing context: A timely reflection. Disability and Society, 30 (6), 834848.Google Scholar
Wright, C.J., Zeeman, H., & Whitty, J.A. (2017). Design principles in housing for people with complex physical and cognitive disability: Towards an integrated framework for practice. Journal of Housing and the Built Environment, 32 (2), 339360.Google Scholar