Articles: aged.
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To assess Australian hospital utilisation, 1993-2020, with a focus on use by people aged 75 years or more. ⋯ Hospital bed utilisation rates declined although admission rates increased during 1993-94 to 2019-20; the proportion of beds occupied by people aged 75 years or more increased slightly during this period. Containing hospital costs by limiting bed availability and reducing length of stay may no longer be a viable strategy.
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Erikson's theory regarding the existence of an Ego Integrity versus Despair crisis in old age was tested using an interview derived from Whitbourne and Weinstock's application of Marcia's status construct to the ego integrity crisis. Four integrity statuses were defined: integrity achieving, dissonant (in crisis), foreclosed (avoiding crisis), and despairing. These statuses were reliably (80%) identified among forty elderly community-dwelling men and women through the forty-five-minute semistructured interview. ⋯ The pattern of differences suggested that integrity achieving and foreclosed samples differed mainly regarding their degree of introspection regarding the past, but that both appeared to have a high degree of psychological well-being. Dissonant individuals appeared to be unhappy and stressed, but this was seen as a temporary state in contrast to the more chronic nature of the despairing's low sense of psychological well-being. The validity of the integrity status construct and the interview designed to measure it have, therefore, been supported, and provide the basis for suggested refinements within Erikson's description of the Ego Integrity versus Despair stage.
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Challenges associated with translating evidence into practice are well recognised and calls for effective strategies to reduce the time lag and successfully embed evidence-based practices into usual care are loud and clear. While a plethora of nonpharmacological interventions for people with dementia exist; few are based on strong evidence and there is little consideration for programme operationalisation in the complex environment of long-term care. ⋯ The extended preparatory period for implementation, afforded by the COVID-19 pandemic on programme commencement, enabled time for widespread understanding of the programme and necessary upskill of staff. Comprehensive codesign with all stakeholders of programme components identified core and flexible elements necessary for fidelity of implementation.