Kerse, Ngaire

Islene Araujo de Carvalho and coauthors discuss the WHO guidelines on integrated care for older people.

Summary points:

Objective: This study investigates sex and ethnicity in relationships of care using data from Wave 4 of LiLACS NZ, a longitudinal study of Māori and non‐Māori New Zealanders of advanced age. Methods: Informal primary carers for LiLACS NZ participants were interviewed about aspects of caregiving. Data were analysed by gender and ethnic group of the LiLACS NZ participant. Results: Carers were mostly adult children or partners, and three‐quarters of them were women.

Aim To establish the effectiveness of a restorative home support service on institutional-free survival in frail older people referred for needs assessment. Method A randomised controlled trial of Community Flexible Integrated Responsive Support Team versus usual care in 113 older people at risk of institutionalisation in New Zealand. Primary outcome was death or permanent institutional care evaluated in a Cox proportional hazards model adjusted for baseline prognostic variables.

Background: A key challenge in meeting the palliative care needs of people in advanced age is the multiple healthcare and social service agencies typically involved in their care. The 'patient navigator' model, originally developed in cancer care, is the professional solution most often recommended to address this challenge. However, little attention has been paid, or is known, about the role that family carers play in enabling their dying relatives to negotiate service gaps.

Background: New public health approaches to palliative care prioritise the role of community at end of life. However, little is known about community support for the increasing numbers of people dying in advanced age. Aim: To explore the role of community at end of life for people dying in advanced age from the perspective of their bereaved family caregivers. Design: A constructionist framework underpinned a qualitative research design.