Poster Abstracts 8-13

In the Scottish Government’s 2022 Healthcare Framework for Adults Living in Care Homes, activities – including music – were argued to be essential in improving lives of care home residents (Scottish_Government, 2022). Activity providers are key facilitators of music activities in care homes, but they may face barriers such as time, support from other staff members, and a lack of specialist knowledge (Woodhead et al., 2021). There is limited research on the role and responsibilities of these staff members, particularly relating to their motivations and experiences implementing music activities.

In order to better understand what influences how activity providers use music in their role, I am conducting a PhD research study in Scottish care homes. This will be a mixed-methods study, using an exploratory sequential design. In the first phase, six care home activity providers will be interviewed and observed in care homes in Midlothian, Scotland. The interviews will be analysed using thematic analysis, and the findings will inform a subsequent survey, which will be delivered to activity providers in care homes across Scotland. The results of this research will provide a more detailed understanding of the role and work of activity providers, with the potential to influence how these professionals are perceived in policy and practice. This research could also generate insights regarding successful music implementation approaches, including guidance for activity providers who would like to use music in their work and guidance for training activity providers.

In June 2022, the Scottish Government published the Healthcare framework for adults living in care homes – My health, My care, My home (Healthcare framework). The document outlines guidance and advice on a best practice approach to accessing healthcare, the impact of wider determinants of health, as well as focusing on fundamental aspects of what older adults in care homes need to live well. It is a broad and complex document that aims to reflect the varied, complex and oftentimes nuanced needs of our ageing population living in care homes. I undertook a small-scale stakeholder engagement, co-designed with the Healthcare framework team at Scottish Government. The aim was to explore care home managers’ experiences of engagement in Government policy/framework development. This poster illustrates the findings of the engagement process, highlighting care home managers’ views on how the sector is currently, or has previously been involved in general policy/framework processes, and then specifically in relation to involvement in the Healthcare framework. The project supported the broader plans of the Healthcare framework team’s implementation phase to improve involvement across the sector, as well as a broader policy goal to improve general links with care homes.

In Western societies, intimacy and sexuality are taboo topics that people prefer to silence and ignore, especially when it involves female older adults living with care needs. Although there is a growing awareness that intimacy is part of human life when providing person-centred care and should therefore be respected and protected. In practice, care homes often lack policies, guidelines, and training to address intimacy and sexual pleasure with residents. Because, how can you discuss such a sensitive topic as intimacy when you never learned to talk about it? This research aims to explore the taboo of intimacy in care homes and contribute to the acceptance of female sexual pleasure in later life. The study will create a deeper understanding of how intimacy is described and experienced in care homes through creative and participatory design interventions with female residents and staff. The results will inform possible communication tools and inclusive service approaches to support residents and staff when addressing intimacy in care environments.

This poster shares the findings of a qualitative study carried out with and by ACRC PhD students, to explore our perceptions and attitudes towards ageing. Findings show that students have a nuanced and critical approach to ideas of ageing well, and a strong desire to improve experiences of ageing, now and in the future, motivated by a strong ethic of justice and care. Conversations about difficult aspects of ageing – especially to do with dependence, marginalisation, and death – are still challenging, and more could be done to create supportive, reflective spaces for students to explore these subjects. This study addresses a gap in research around attitudes towards ageing, which so far has focused on health and social care professionals; and considers possible recommendations for the future of interdisciplinary research on ageing and care.

People of all ages take on unpaid caring roles for family members or friends. However, most research and policy in the UK tends to focus on working-age carers, while the experiences and needs of young and older carers are less well-understood. We carried out a literature review aimed at understanding how “older carers” are conceptualised by researchers: what dimensions of the caring role do researchers explore, in qualitative and quantitative studies? How and why, if at all, are the needs of older carers seen to differ from those of their working-age counterparts? And what does this mean for future research and policy aimed at addressing the needs of older carers in the context of an ageing population? This poster shares insights from a broad snapshot of quantitative literature related to older carers, as well as a deep dive into the qualitative literature. Although focused primarily on the UK, we draw on a global evidence base to open up diverse perspectives on carers, care-giving, and what it means to provide care in later life.

Delirium is common in hip fracture patients, but large-scale routine data studies examining the prevalence and associations of delirium at the time of initial presentation with a hip fracture are rare. This study described the prevalence and outcomes of delirium on initial presentation in a large national population sample.

Analysis of routine national clinical registry data for all people in Scotland aged ≥50 years presenting with a hip fracture between July 2019-December 2021. Delirium was assessed prospectively by clinicians using the 4 ‘A’s Test (4AT; www.the4AT.com), a validated two-minute tool. Associations of 4AT score with mortality and return home within 30 days were analysed using logistic regression models adjusted for confounders.

Of 18,040 patients (mean age 80 years; 70% women), 16,476 (91%) had a 4AT assessment on presentation; 3,386 (21%) had a score suggestive of delirium. These patients were older, more likely residing in care homes and had higher American Society of Anesthesiologists (ASA) grades (p’s<0.001). Delirium was independently associated with a two-fold increased mortality risk as an inpatient (adjusted odds ratio (aOR) 2.26, 95% confidence interval (CI) 1.79-2.84) and at one year (aOR 2.05, 95%CI 1.83-2.29) and lower likelihood of returning home within 30 days (aOR 0.27, 95%CI 0.24-0.30).

Delirium affects around 20% of patients presenting with hip fracture and is associated with important adverse outcomes. Integrating delirium assessment into the initial clinical assessment of hip fracture patients is feasible and should be considered as part of care for all hip fracture patients.