RMH Aged Care Research (RACER)

• 
  Associate Professor
  Dina LoGiudice

  dclogi@unimelb.edu.au

  View researcher's webpage

Research Overview

The RMH Aged Care Research (RACER) team comprises a group of multidisciplinary health professionals and researchers dedicated to optimising the holistic well-being of older people. One in 6 Australians are over 65 years, and come from diverse backgrounds, with 1 in 3 older people born overseas.  The Aboriginal and Torres Strait Islander population is also ageing, with many survivors of the Stolen Generation now requiring aged care services. The majority of the older population continue to lead healthy, meaningful and independent lives, but for many conditions such as dementia, frailty, chronic wounds, urinary incontinence and social isolation can affect their well-being. This in turn affects their families, carers, and communities. The research principles undertaken by our multidisciplinary team, include a collaborative and co design approach with consumers, communities, and stakeholders to facilitate translation into everyday practice within the settings of home, hospital, and residential care.

Highlighted research

Let’s CHAT Dementia The population of older Aboriginal and Torres Strait Islander people is increasing and although many people are living well to older ages, dementia is recognised as being  a common condition in communities.   There is a range of activities throughout the life course to promote brain health and to prevent dementia. The Let’s CHAT (Community Health Approaches To) dementia project funded by NHMRC is a co-design project based in 12 Aboriginal Community Controlled Health services across Australia and aims to optimise detection and management of cognitive impairment in primary care. The project team developed a Best Practice Guide and clinical resources to address the aspects of health care provision combined with key cultural and other elements that support effective health care for Aboriginal and Torres Strait Islander peoples.

OnTRACK(Teaching, Research and Community Knowledges): promoting brain health with older Aboriginal and Torres Strait Islander peoples Centre for Research Excellence (CRE) , works collaboratively with older Aboriginal and Torres Strait Islander peoples, their families, carers and communities to better understand their needs and to find ways to optimise health and well being. With a particular focus on promoting brain health, the OnTRACK CRE takes up the priorities identified in the Aboriginal and Torres Strait Islander Dementia Research and Translation Roadmap (NHMRC, 2020).  Supported by Indigenous leaders and community networks, the OnTRACK CRE offers a comprehensive program of dementia research and translation leading to community informed, culturally safe care and improved health and well-being outcomes. A focus of the program is to encourage capacity building of First Nations students and researchers in ageing well.

IMMERSE IMpleMenting Effective infection prevention and control in ReSidential aged care. Older people living in aged care homes are susceptible to infections such as influenza and COVID-19. We will assess organisational readiness and use common infection prevention and control scenarios to identify the staff behaviour/s that need to be targeted for change. We will then comprehensively investigate barriers to practice change using the Theoretical Domains Framework of behaviour change (TDF). The TDF provides a theoretical basis and method for assessing implementation problems and staff behaviours to inform development of interventions. As well as knowledge and skills, it includes domains such as environmental context, beliefs about consequences, and professional role. We will then determine feasible and locally relevant actions to address these barriers.

Geriatric Oncology The aim of the CGA-Oncology study is to prospectively assess the utility of the Comprehensive Geriatric Assessment in older patients with lung cancer in terms of their quality of life, functional abilities, survival, rates of admission to hospital and health care related costs. These findings are informing development of a Geriatric Oncology clinic at RMH led by Dr Claire Maddison

TANGO is an initiative aligned with the Continence Service at RMH. Since its inception in 2014 the TANGO group have built an international reputation and collaborated with leading research centres in Belgium and Canada.

In addition, there are a number of projects addressing ways to facilitate best practice in diverse settings including Clinical outpatients (Wound, Memory, Falls and Balance and Continence): hospital settings (Trauma geriatrics, Peri operative Older persons) and residential care (transition to care, palliative care)

Staff

Head

• Associate Professor Dina LoGiudice, Professor of Aged Care, Medicine – Royal Melbourne Hospital

Senior Researchers

• Professor Wen Kwang Lim
• A/Prof Wendy Bower
• A/Prof Rosie Watson

Research Fellows

• Dr Jo Tropea
• Dr Jo Hughson
• Dr Jesse Zanker

PhD students

• Dr Huong Nguyen
• Dr Claire Maddison
• Robyn Smith
• Kate Bradley
• Harry Douglas
• Penny O’Brien
• Jo Luke
• Roslyn Malay

Research staff

Honorary / Clinical Affiliates and RMH Collaborators

• Dr Rebecca Iseli
• Dr Rachael Atkin
• Dr Kate Gregorevic
• Dr Zoe Hyde
• Celia Marston
• Aruska D’Souza
• Jacqui Kay
• Adelle Brown
• Alana Jacob
• Erin Bicknell
• Dr Jacqui Gilbert
• Dr Ross Bicknell
• A/Prof Peter Lange

Collaborators

• CEPAR, Demography and Ageing Unit (UoM): A/Prof Jeromey Temple, Tom Wilson
• Indigenous Epidemiology and Health Unit, (UoM): Dr Bridgette McNamara
• Implementation Science, School of Health Sciences (UoM): Prof Jill Francis, Dr Sanne Peters
• UWA: Prof Leon Flicker, Dr Zoe Hyde, Prof Sandra Thomspon, Prof David Atkinson, Prof Dawn Bessarab, Dr Kate Smith
• John Richards Centre, La Trobe University: Prof Irene Blackberry
• NeuRA Dr Kylie Radford
• WEHI; A/Prof Nawaf Yassi and A/Prof Rosie Watson,
• NARI: Prof Briony Dow, A/Prof Bianca Brijnath, Paulene Mackell
• UQ: Prof Ruth Hubbard
• Dr Makarena Dudley, University of New Zealand
• A/Prof Jen Walker, McMaster University
• Prof Kristen Jacklin, University of Minnesota Medical School, Duluth
• Prof Andrea Maier ; National University of Singapore
• Prof Fary Khan: Department of Rehabilitation, RMH

Funding

• On TRACK (Teaching, Research and Community Knowledges): CRE promoting brain health with older Aboriginal and Torres Strait Islander peoples

LoGiudice D, Bessarab, Smith K, Burchill L, Radford K, Withall A, Malay R, Flicker L, Strivens E, Temple J.

CIA NHMRC 2021 Centres of Research Excellence APP2006797

2022-2026; $3M

• Good Spirit Good Life: Better health and wellbeing for older Aboriginal and Torres Strait Islander Australians.

Bessarab D, LoGiudice D, Flicker L, Smith K, Wright M, Radford K, Ratcliffe J, Malay R, Gibson C, Thompson S.

CIB NHMRC 2020 Centre for Excellence

2021-2025; $2.5M

• Let’s CHAT (Community Health Approaches to) Dementia in Indigenous Communities

LoGiudice D, Bessarab D, Flicker L, Wenitong M, Smith K, Radford K, Striven E, Atkinson D.

CIA NHMRC Targeted Call for Research into Dementia in Indigenous people APP1150337

2018- 2023; $2,661,502.00

• IMpleMenting Effective infection prevention and control in ReSidential aged care (IMMERSE)

Lim WK, Buising K, Francis J, Fetherstonhaugh D, Yates P, Johnson D, Tropea J, Aboltins C, Kwong J, Marshall C.

CIA and CIG MRFF 2020 Dementia, Ageing and Aged Care TCR APP2007632

2021-2024; $757,520

Associated grants

• IMPART - IMproving PAlliative care in Residential aged care using Telehealth.  NHMRC TCR into End of Life Care. CIA Wen K Lim (NARI).
• S-Adenosyl Methionine for Alzheimer's Disease:  A Phase 2 Clinical Trial.
  2019-2023. CIA Nawaf Yassi
• Frailty ADD: Improving Hospital Outcomes for Frail Patients Across Different Disciplines. CII Wen Kwang Lim CRE  2022-2027. APP2015821
• Improving interpreting for dementia assessments:  The MINDSET study.

CIB LoGiudice D NHMRC Partnership Grant. 2021-2024

• Defining and Prediction Healthy Ageing in Aboriginal and Torres Strait Islander populations. CID LoGiudice APP 1170422
• Targetted Call for Research into Healthy Ageing of Aboriginal and Torres Strait Islander peoples. CID LoGiudice 2019-2023
• A framework for healthy ageing in Torres Strait. CID LoGiudice Targeted Call for Research into Healthy Ageing of Aboriginal and Torres Strait Islander peoples. CID LoGiudice 2019- 2023
• Dementia prevention and risk Management Program for Aboriginal Australians (DAMPAA) CID LoGiudice NHMRC TCR for Dementia in Indigenous people APP1151782 2018-2023
• Multidisciplinary approach to identifying and addressing unmet continence needs in hospitalised older patients during sub acute care. CIA WF Bower, DM Whishaw. 2021 Strategic Innovation Grant from the Australian Association of Gerontology Research Trust. Topic: Amount awarded: $28,000 .
• Development of a nocturnal bladder symptom score. WF Bower, Ervin CF, Whishaw DM, Ong TJ, Baldrey C. Educational Grant Astellas Pharmaceuticals Amount awarded: $35,000
• Development of a cost description model for nocturnal bladder symptoms in older inpatients at risk of toilet-related falls. Bower WF, King S, Holm-Larsen T, Whishaw Melbourne Ageing Research Collaboration Amount awarded: $27,000

Research Publications

Selected publications from the last 5 years (2017-2022)

1. LoGiudice D, Josif CM, Malay R, Hyde Z, Haswell M, Lindeman MA, Etherton-Beer C, Atkinson D, Bessarab D, Flicker L, Smith K. The Well-Being of Carers of Older Aboriginal People Living in the Kimberley Region of Remote Western Australia: Empowerment, Depression, and Carer Burden. J Appl Gerontol. 2021 Jul;40(7):693-702. doi: 10.1177/0733464819898667.
2. LoGiudice D, Josif C, Malay R, Hyde Z, Haswell MR, Lindeman M, Etherton-Beer C, Atkinson D, Bessarab D, Flicker L, Smith K. Strong Carers, Strong Communities: a cluster randomised controlled trial to improve wellbeing of family carers of older people in remote Aboriginal communities. Rural Remote Health. 2021 Jul;21(3):6078. doi: 10.22605/RRH6078. Epub 2021 Jul 14. PMID: 34260859.
3. Smith K, Gilchrist L, Taylor K, Clinch C, LoGiudice D, Edgill P, Ratcliffe J, Flicker L, Douglas H, Bradley K, Bessarab D. Good Spirit, Good Life: A Quality of Life Tool and Framework for Older Aboriginal Peoples. Gerontologist. 2021 Jul 13;61(5):e163-e172
4. Tropea J, Nestel D, Johnson CE,… Lim WK. Evaluation of Improving Palliative care Education and Training Using Simulation in Dementia (IMPETUS-D) in nursing homes: a cluster randomised controlled trial. BMC Geriatrics 2022 22:127. https://doi.org/10.1186/s12877-022-02809-x
5. Tropea, J, Brand CA, Lim WK, Hepworth G, & Finch S. (2022). Exploratory and confirmatory factor analysis of the questionnaire on Palliative Care for Advanced Dementia (qPAD) using a large sample of staff from Australian residential aged care homes. International Journal of Older People Nursing, 00, e12505. https://doi.org/10.1111/opn.12505
6. Tropea J, Bicknell R, Nestel D, …Lim WK. Simulation training in non-cancer palliative care for healthcare workers: a systematic review of controlled studies. BMJ Simulation and Technology Enhanced Learning Published Online First: 14 August 2020. doi: 10.1136/bmjstel-2019-000570
7. Tropea J, Johnson CE, Nestel D, … Lim WK. A screen-based simulation training program to improve palliative care of people with advanced dementia living in residential aged care facilities and reduce hospital transfers: study protocol for the IMproving Palliative care Education and Training Using Simulation in Dementia (IMPETUS-D) cluster randomised controlled trial. BMC Palliat Care. 2019;18(1):86. doi:10.1186/s12904-019-0474-x
8. Tropea J, LoGiudice D, Kelly L. People with dementia in the emergency department: Behavioural symptoms and use of restraint. Emerg Med Australas. 2017 Oct;29(5):605-606.
9. Tropea J, LoGiudice D, Liew D, Roberts C, Brand C. Caring for people with dementia in hospital: findings from a survey to identify barriers and facilitators to implementing best practice dementia care. Int Psychogeriatr. 2017 Mar;29(3):467-474.
10. Gregorevic K, Hubbard RE, Peel NM, Lim WK. Validation of the health assets index in the Australian inpatient setting: a multicentre prospective cohort protocol study. BMJ Open. 2018 May 10;8(5):e021135. doi: 10.1136/bmjopen-2017-021135. PMID: 29748346; PMCID: PMC5950646
11. Bower WF, Ervin CF, Whishaw DM, Ong TJ, Baldrey C. Initial development of a patient-centred symptom score for bladder dysfunction at night in older hospitalised patients. Australian and New Zealand Continence Journal 2021; 27(3):71-76
12. Nguyen HXT, Penukonda S, Stephne S, Whishaw DM, Bower WF. Wake up call: 4 out of 5 hospitalised older patients have nocturnal lower urinary tract symptoms. Australasian J Ageing 2021 Oct 22. DOI: 10.1111/ajag.13002
13. Chin SK, Rose GE, Ervin CF, Ong TJ, Whishaw DM, Bower WF.  Does successful treatment of urinary urgency improve comorbidities in patients with nocturia? Australasian J Ageing. 2019 Mar 13. doi: 10.1111/ajag.12644. PMID: 30865375
14. Marston C, Koye DN, Goonan R, Lim WK, Juj G, Klaic M. Is there a relationship between intensity of occupational therapy and functional outcomes in hospitalised older patients? A prospective cohort study. Australian Occupational Therapy Journal. 2022 May 3.