GREAT BRITAIN. Department for Digital, Culture, Media and Sport
Publication year:
2022
Pagination:
31
Place of publication:
London
This report aims to establish the evidence gaps in the field of loneliness, including those related to interventions; examine what existing evidence can be built on and what needs to be developed from first principles; determine which evidence gaps should be prioritised; and establish which pre-existing quantitative datasets could be used to address the prioritised evidence gaps, and identify which prospective cohort studies would be enhanced by inclusion of a measure of loneliness. As well as continuing to improve measurement, the review has identified eight priority areas: life course approach – looking at how loneliness changes over people’s lives; social stigma; societal culture – the impact of a collectivist vs individualistic society; mental health; place and context; workplace; economic evaluation; effectiveness of loneliness interventions. The number of studies examining interventions for loneliness has increased significantly in recent years and is diverse in terms of participant groups and intervention types, although most are for older people and western countries for groups or individuals. There are some school and community-based interventions with broad target groups. Social support and social network intervention strategies are most used because they are group face to face interventions, although digital is increasing.
(Edited publisher abstract)
This report aims to establish the evidence gaps in the field of loneliness, including those related to interventions; examine what existing evidence can be built on and what needs to be developed from first principles; determine which evidence gaps should be prioritised; and establish which pre-existing quantitative datasets could be used to address the prioritised evidence gaps, and identify which prospective cohort studies would be enhanced by inclusion of a measure of loneliness. As well as continuing to improve measurement, the review has identified eight priority areas: life course approach – looking at how loneliness changes over people’s lives; social stigma; societal culture – the impact of a collectivist vs individualistic society; mental health; place and context; workplace; economic evaluation; effectiveness of loneliness interventions. The number of studies examining interventions for loneliness has increased significantly in recent years and is diverse in terms of participant groups and intervention types, although most are for older people and western countries for groups or individuals. There are some school and community-based interventions with broad target groups. Social support and social network intervention strategies are most used because they are group face to face interventions, although digital is increasing.
(Edited publisher abstract)
Subject terms:
older people, social isolation, loneliness, intervention;
This evidence review summarises what is known about the design of mainstream, community-based housing and neighbourhoods for older people, and to identify what will support the adaptation and development of homes and neighbourhoods for older people over the next 25 years. It draws on literature from various sources: peer-reviewed research papers, government reports, reports from research organisations and design guidance. The review first considers the current provision of housing and neighbourhoods in the UK and predictions of how these are expected to develop over the next 25 years. Secondly, it summarises what older people need and want from their housing in terms of personal satisfaction and well-being, physical support and accessibility, sensory support, support for dementia, and health and safety. Finally, it summarises existing design guidance. The review finds that older people are disproportionately represented in houses in poor repair. Neighbourhood-based hubs that are actively managed to provide support for older people have been shown to have benefits greater than simply amenity. The report concludes that the key challenge is to bring an understanding of the research and knowledge about older people and their needs to the agencies of the mainstream; the house builders, developers, service engineers, planners, estate agents, local politicians, parish councils and so on who mediate the physical environment.
(Edited publisher abstract)
This evidence review summarises what is known about the design of mainstream, community-based housing and neighbourhoods for older people, and to identify what will support the adaptation and development of homes and neighbourhoods for older people over the next 25 years. It draws on literature from various sources: peer-reviewed research papers, government reports, reports from research organisations and design guidance. The review first considers the current provision of housing and neighbourhoods in the UK and predictions of how these are expected to develop over the next 25 years. Secondly, it summarises what older people need and want from their housing in terms of personal satisfaction and well-being, physical support and accessibility, sensory support, support for dementia, and health and safety. Finally, it summarises existing design guidance. The review finds that older people are disproportionately represented in houses in poor repair. Neighbourhood-based hubs that are actively managed to provide support for older people have been shown to have benefits greater than simply amenity. The report concludes that the key challenge is to bring an understanding of the research and knowledge about older people and their needs to the agencies of the mainstream; the house builders, developers, service engineers, planners, estate agents, local politicians, parish councils and so on who mediate the physical environment.
(Edited publisher abstract)
Subject terms:
older people, neighbourhoods, housing, supported housing, dementia, building design, independence;
Great Britain Scottish Office Central Research Unit;
Publication year:
1998
Pagination:
4p.
Place of publication:
Edinburgh
Outlines the findings of a study that identified and examined recent literatures relating to the discharge of frail older people and assessed the contribution of that literature to current practice. There are two main aspects to the study: an extensive review of the existing literature; and a review of case studies of discharge practice at four Scottish NHS Trusts, selected to represent a range of circumstances and catchment area populations.
Outlines the findings of a study that identified and examined recent literatures relating to the discharge of frail older people and assessed the contribution of that literature to current practice. There are two main aspects to the study: an extensive review of the existing literature; and a review of case studies of discharge practice at four Scottish NHS Trusts, selected to represent a range of circumstances and catchment area populations.
Subject terms:
literature reviews, older people, hospital discharge, very old people, community care, evaluation;
GREAT BRITAIN. Department of Health and Social Care
Publisher:
Great Britain. Department of Health and Social Care
Publication year:
2021
Place of publication:
London
Summarises the evidence review for adult social care reform. Its main purpose is to outline trends and challenges based on the current (as of 1 December 2021) adult social care system in England. It is a technical paper summarising the existing evidence that has informed the development of policy proposals. Data and evidence are presented on: changes in the numbers of people with care needs and the nature of those needs; current levels of formal care; the interface with wider systems, such as the NHS, housing and benefits; important factors influencing the resilience of the current system, including characteristics and availability of unpaid care, challenges in the providers’ market, workforce pressures. Evidence is strongest concerning demographic change and how this will substantially increase demand for care, though this will vary across the country and between socio-economic groups.
(Edited publisher abstract)
Summarises the evidence review for adult social care reform. Its main purpose is to outline trends and challenges based on the current (as of 1 December 2021) adult social care system in England. It is a technical paper summarising the existing evidence that has informed the development of policy proposals. Data and evidence are presented on: changes in the numbers of people with care needs and the nature of those needs; current levels of formal care; the interface with wider systems, such as the NHS, housing and benefits; important factors influencing the resilience of the current system, including characteristics and availability of unpaid care, challenges in the providers’ market, workforce pressures. Evidence is strongest concerning demographic change and how this will substantially increase demand for care, though this will vary across the country and between socio-economic groups.
(Edited publisher abstract)
Subject terms:
adult social care, care reform, ageing, comorbidity, complex needs, older people, public expenditure, social care staff;
GREAT BRITAIN. Department of Health and Social Care
Publisher:
Great Britain. Department of Health and Social Care
Publication year:
2021
Pagination:
125
Place of publication:
London
The report collates a wide range of evidence on challenges and changes facing social care in England and what is driving them. The evidence is clear that both the absolute numbers of over 65s, and the proportion of the population they represent, are growing. People are living longer (although the impact of COVID-19 on long-term life expectancy trend is still unclear). However, as people live longer, many are spending more years in ill health, with complex health needs or disabilities. Similarly, there is an increasing number of adults under 65 with disabilities. This is driven in particular by more people with learning disabilities being diagnosed and supported, and many are now living longer than they did in previous generations. Overall, the total number of users of long-term adult social care in England is projected to increase by 50% between 2018/19 and 2038/39. This would mean total expenditure on adult social care services under the current, unreformed, system would more than double in real terms, from £28bn to £56bn (2018 prices), over the same period. The evidence shows significant variations both in care need and system capacity across the country. There is also significant variation in health and disability between socio-economic groups. The increasing prevalence of long-term conditions and complex comorbidities, driven in part by factors such as rising obesity rates, may require different models of care. Other drivers of ill health such as poor or inappropriate housing, and changes in living arrangements that affect people’s ability to care for themselves, may also increase future demand for care. At the same time, issues such as workforce turnover and a fragmented provider market are potential barriers to the system responding, for example through new technology that could help manage that demand.
(Edited publisher abstract)
The report collates a wide range of evidence on challenges and changes facing social care in England and what is driving them. The evidence is clear that both the absolute numbers of over 65s, and the proportion of the population they represent, are growing. People are living longer (although the impact of COVID-19 on long-term life expectancy trend is still unclear). However, as people live longer, many are spending more years in ill health, with complex health needs or disabilities. Similarly, there is an increasing number of adults under 65 with disabilities. This is driven in particular by more people with learning disabilities being diagnosed and supported, and many are now living longer than they did in previous generations. Overall, the total number of users of long-term adult social care in England is projected to increase by 50% between 2018/19 and 2038/39. This would mean total expenditure on adult social care services under the current, unreformed, system would more than double in real terms, from £28bn to £56bn (2018 prices), over the same period. The evidence shows significant variations both in care need and system capacity across the country. There is also significant variation in health and disability between socio-economic groups. The increasing prevalence of long-term conditions and complex comorbidities, driven in part by factors such as rising obesity rates, may require different models of care. Other drivers of ill health such as poor or inappropriate housing, and changes in living arrangements that affect people’s ability to care for themselves, may also increase future demand for care. At the same time, issues such as workforce turnover and a fragmented provider market are potential barriers to the system responding, for example through new technology that could help manage that demand.
(Edited publisher abstract)
Subject terms:
adult social care, older people, ageing, service provision, care reform, complex needs, comorbidity, service uptake, public expenditure, social care staff;
This literature review identifies existing literature on the attitudes and aspirations of older people. The review informed new qualitative research on the attitudes and aspirations of older people through focus groups and individual in-depth interviews. The literature and qualitative research focused on the following themes identified by the Inter-Ministerial Group on older people: active ageing; health and social; consultation and involvement.
This literature review identifies existing literature on the attitudes and aspirations of older people. The review informed new qualitative research on the attitudes and aspirations of older people through focus groups and individual in-depth interviews. The literature and qualitative research focused on the following themes identified by the Inter-Ministerial Group on older people: active ageing; health and social; consultation and involvement.
Extended abstract:
BOAZ Annette, HAYDEN Carol, BERNARD Miriam. Attitudes and aspirations of older people: a review of the literature. Great Britain. Department of Social Security, 1999.
Context
This report presents a review of existing literature on the attitudes and aspirations of older people, focusing on UK literature produced during the last ten years. It forms the first stage of a programme of research, commissioned by the Department of Social Security, and carried out by The Local Government Centre, The University of Warwick, to inform the work of the Inter-Ministerial Group on Older People. The second stage of this research consisted of a qualitative study of the attitudes and aspirations of older people which is published in a companion volume (Research Report No. 102) titled 'Attitudes and Aspirations of Older People: a qualitative study'.
Method
This descriptive review focuses on literature from 1988 to 1998. The review identifies quantitative and qualitative research on the attitudes and aspirations of older people. For this research older people were identified as those aged 50 years and over, although the studies included often focus on specific age groups within this, such as those who have reached state pension age (currently 65 for men and 60 for women). The search was carried out in several complimentary ways. A computer and personal search of published material was used as a basis for the review. Databases of unpublished literature were also searched. The researchers also wrote to those researchers and practitioners who are known in the field and asked for copies of yet unpublished research and papers. The literature was reviewed paying particular attention to consensus and inconsistencies in outcomes between the different studies. The main reason for excluding papers were that the research was not UK based or the study was not concerned with the attitudes of older people themselves. This report does not attempt to review in detail the methodologies of the included studies. However, methodology has been taken into account when decisions were made as to whether or not, and to what extent, papers were included in the review. Sixty-eight papers were identified for inclusion in the review.
Contents
The first chapter contains a brief introduction to the research sources, to the approach used in the review and to some of the key methodological issues. The report then addresses the attitudes and aspirations of older people related to the themes identified by the Inter-Ministerial Group, which are active ageing, health and social care, and consultation and involvement. Each chapter discusses the literature identified by the review in relation to a theme. They also signpost readers to a selection of relevant reviews, literature and to ongoing programmes of work, although these are not discussed in detail. The majority of the research included in the review and in the signposting sections is held in the Centre for Policy on Ageing (CPA) Library in London. Each chapter identifies gaps in the current literature and conclude with a summary of the results. The final chapter discusses three cross-cutting themes: participation, independence, and diversity. The chapter concludes with a brief discussion of the coverage of the research. Gaps identified were used to focus the qualitative phase of the research. There are 141 pages of data extraction sheets in the appendix. These give details of the publication, the research question, study design, research tools and results.
Conclusion
The current research should inform the content of national surveys to ensure that appropriate and relevant questions are asked of older people. There is also scope for further qualitative research which values the contribution of older people, adds meaning to quantitative results and allows for more in-depth exploration of areas of interest.
113 references
contains details of 100 other research reports available from the Department of Social Security.
Subject terms:
literature reviews, older people, social care provision, user participation, user views, ageing, attitudes, consultation, health care;
This research review looks at supply and demand factors relating to residential care. It makes recommendations for thorough assessments of older peoples needs, good care management, and respect for user and carer wishes throughout, in order to prevent unnecessary and unwilling admissions to residential care.
This research review looks at supply and demand factors relating to residential care. It makes recommendations for thorough assessments of older peoples needs, good care management, and respect for user and carer wishes throughout, in order to prevent unnecessary and unwilling admissions to residential care.
Extended abstract:
WARBURTON R. William. Implementing caring for people: home and away; a review of recent research evidence to explain why some elderly people enter residential care homes while others stay at home. Great Britain. Department of Health, 1994.
Summary
A review of recent research evidence to explain why some elderly people enter residential care homes while others stay at home: and how local authorities are enabling people to remain at home, supported by appropriate services of the users' choice.
Context
Review was commissioned by the Department of Health as a contribution to studies being carried out by the SSI and NHS Management Executive to gauge the progress made by local authorities in implementing the community care reforms set out in the NHSand Community Care Act 1990, and associated policy guidance.
Contents
The introduction addresses community care reforms and the role of residential care; special studies, research and reviews; international experience; terminology and the scope and limitations of the review. Chapter Two, Demand Factors, covers choice and involvement; fears and risks; age and gender of users; living arrangements; physical and mental impairment; dementia; loneliness and grief; carers; users' financial resources; and black elders. Chapter Three, Supply Factors, addresses the availability of help; crises; support for carers; needs of professionals; assessment; care management; community-based innovations; misplacement.
Findings
Many factors are at play when decisions are made about elderly people's future place of residence. Factors can be complex and difficult to discern.
In broad terms, the factors associated with admissions are
limited user choice and involvement
users' fears and doubts about living at home
living arrangement
increasing impairment and disability
lack of community services
carers' stress and lack of support to carers
inadequate preparations for leaving hospital
poor or ineffective assessment and care management
lack of service innovation and flexibility
professional and organisational concerns and interests
Conclusion
Community-based options could be more frequently tried with greater success, admissions to residential care homes would be an appropriate response for those people who could no longer live at home and the number of permanent admissions to residential care homes would probably decline appreciably if
assessments were thorough and addressed key social, functional and medical questions
people's care was genuinely managed and coordinated
users' and carers' concerns and wishes were heard and choice was respected
community-based options were readily available and flexible enough to be of lasting value to users
users staying at home were helped with personal care and other vital activities of daily living in
appropriate and timely ways, and were reassured about the safety and viability of staying at home
support were available to carers and assumptions about their ability to care were not casually made
Author calls for more research about black elders, users' attitudes' international comparisons, and the reasons for admissions to different types of 'shelter-with-care'.
149 ref
Subject terms:
older people, planning, referral, residential care, user participation, assessment, carers, care homes, care management, community care;