General practitioner and practice nurses perspectives on implementation of the 75+ health assessment: Implications for dementia care and well‐being

Author:

White Jennifer123ORCID,Norton Grace123,Pond Dimity2,Khaing Kay3,Dolja‐Gore Xenia123,Byles Julie123,Carey Mariko123

Affiliation:

1. Hunter Medical Research Institute New Lambton Heights New South Wales Australia

2. School of Medicine and Public Health, College of Health Medicine and Wellbeing, University of Newcastle Callaghan New South Wales Australia

3. Centre for Women's Health Research, College of Health Medicine and Wellbeing, University of Newcastle Callaghan New South Wales Australia

Abstract

AbstractBackgroundThe uptake of the health assessment for persons aged 75 years and older (75 + HA) remains low. Repeat assessments provide an opportunity to identify areas of change in cognitive function which may mark the onset of dementia. We aimed to explore general practitioner (GP) and practice nurse experiences of implementing the 75 + HA with a focus on clinical considerations for dementia care.MethodsAn interpretative qualitative study involving interviews with 15 GPs (female = 11, male = 4) and 5 practice nurses (all female). Data were analysed using an inductive thematic approach.ResultsThe majority of GPs (n = 11) worked in metropolitan settings and four GPs worked in regional settings across NSW. All participants worked in separate clinics, except for two GPs and one practice nurse who worked within the same metropolitan clinic. Distinct themes emerged regarding participants experiences of implementing the 75 + HA for patients with dementia: (1) negotiating aged care is complex and facilitated by a comprehensive assessment; (2) implementing work practices that support the 75 + HA in patients with cognitive decline; and (3) variations in follow up of findings and implications for care.DiscussionThe 75 + HA provides an opportunity for monitoring and acting on emergent physical and cognitive health changes. Increased engagement and support towards implementing the 75 + HA, particularly in the context of dementia, may facilitate the instigation of interventions. While some participants in this study were confident with identifying and managing cognitive decline, the majority relied on geriatricians to confirm dementia diagnosis and refer to community support services. We suggest the need for greater initiatives and clinical guidelines to assist GPs in the identification and management of cognitive decline.Implications for the ProfessionFrom a nursing perspective, this study highlights the valuable role of nurses towards assessment and management of issues raised in the health assessment for persons aged 75 years and older. However, more resources are needed to enable nurse time for adequate follow‐up care.

Publisher

Wiley

Reference55 articles.

1. A review of barriers and enablers to diagnosis and management of persons with dementia in primary care;Aminzadeh F.;Canadian Geriatrics Journal,2012

2. Australian Institute of Health and Welfare. (2019).Deaths in Australia. Canberra: Australian Governmenthttps://www.aihw.gov.au/reports/life‐expectancy‐death/deaths/contents/life‐expectancy

3. Australian Institute of Health and Welfare. (2023).Dementia in Australia ABS Website.

4. Evaluating general practitioners' views about the implementation of the enhanced primary care Medicare items;Blakeman T. M.;Medical Journal of Australia,2001

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