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The development of a short instrument to identify common unmet needs in older people in general practice
- Authors:
- ILIFFE Steve, et al
- Journal article citation:
- British Journal of General Practice, 54(509), December 2004, pp.914-918.
- Publisher:
- Royal College of General Practitioners
No structured needs assessment tool appropriate for older people and also suitable for use in routine general practice consultations exists. This study aimed to engage older people in the development of a brief, valid, practical and acceptable instrument to help identify common unmet needs suitable for use in routine clinical practice in primary care by user involvement in a multi-stages approach to heuristic development in general practices, voluntary groups and community organisations in north and central London. Subjects included patients 65 and over in purposively selected practices, voluntary organisations for older people, community organisations involving older people, GPs and community nurses. Data were collected through mixed methodology interviews using a structured assessment tool, a postal questionnaire, and focus groups. Synthesis and interpretation was done through a consensus conference followed by a Delphi process involving primary care professionals. Five domains of unmet need were identified as priority areas by all 3 methods, the consensus conference, and the Delphi process: senses (vision and hearing), physical ability (mobility and falls), incontinence, cognition, and emotional distress (depression and anxiety). Concludes that public involvement in the design of clinical tools allowed the development of a brief assessment instrument that could potentially identify common, important and tractable unmet needs in older people.
A 'shared care' model for people with dementia
- Authors:
- ILIFFE Steve, WILCOCK Jane, HAWORTH Deborah
- Journal article citation:
- Journal of Dementia Care, 12(3), May 2004, pp.16-17.
- Publisher:
- Hawker
Recent legislation obliges Primary Care Trusts to implement 'shared care' protocols - collaboration between GPs and hospital specialists - for people with dementia. Explains 'shared care' and suggests how PCTs should proceed.
The recognition of and response to dementia in the community: lessons for professional development
- Authors:
- ILIFFE Steve, MANTHORPE Jill
- Journal article citation:
- Learning in Health and Social Care, 3(1), March 2004, pp.5-16.
- Publisher:
- Blackwell
Adult learning approaches require professionals to identify their learning needs. Learning about dementia syndromes is a complex task because of the insidious onset and variable course of the disease processes, the inexorability of cognitive and functional loss, and the emotional impact of neurodegenerative disorders on those experiencing them and on their family and professional carers. This report describes the ways in which learning tasks were understood and articulated by 774 community-based professionals from different disciplines, working in nominal groups in 24 settings across the United Kingdom, and explores how these groups set about identifying their learning needs. These groups focused on being insufficiently skilled to carry out educational functions, on solving problems of limited resources and inflexible systems, and on carers rather than on people with dementia. The groups' solution hinged on multidisciplinary learning being the best route to achieving system change, but such an approach to learning was dealt with uncritically. Three themes received scant attention: the impact of practitioners' own emotional responses to dementia on their clinical or practical skills; the educational potential of voluntary organizations; and the value of learning from the person with dementia, as much as from their carers. Professional development should therefore widen the debate about recognition of dementia to improvement of timely responses. It should concentrate on developing capacities not only around diagnosis, but also around communication and support.