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SCIE research briefing 28: assistive technology and older people
- Authors:
- SOCIAL CARE INSTITUTE FOR EXCELLENCE, BEECH Roger, ROBERTS Diane
- Publisher:
- Social Care Institute for Excellence
- Publication year:
- 2008
- Pagination:
- 11p.
- Place of publication:
- London
The term ‘assistive technology’ incorporates a wide variety of devices. Assistive technology can be supportive, preventive or responsive. The increasing proportion of older people in the population makes the use of assistive technology an attractive option in social services. Perceptions vary as to whether or not assistive technology has sufficient benefits. Existing research supports the greater use of assistive technology but further evaluation and ‘local learning’ is needed. The views and needs of people using assistive technology need to be taken into account.
An evaluation of Wigan Council’s Partnership for Older People Project
- Authors:
- BEECH Roger, et al
- Journal article citation:
- Research Policy and Planning, 29(2), 2012, pp.69-81.
- Publisher:
- Social Services Research Group
Wigan Council participated in the Department of Health for England’s Partnership for Older People Project (POPP) and piloted eleven community based schemes for promoting older people’s health and well-being and reducing their need for higher intensity forms of care. This paper describes evaluation activity that guided decisions about the development and ongoing sustainability of these schemes. A mixed method, observational study design generated information about the number and characteristics of POPP service users and the ‘value’ and ‘effectiveness’ of POPP schemes from the perspectives of older people and other POPP stakeholders. From May 2006 through January 2008 there were 7,572 referrals to POPP schemes. A survey covering 1,362 service users and interviews with whole system stakeholders revealed high levels of support for POPP schemes in terms of their relevance, value and ability to promote partnership working between agencies. Results also offered ‘plausible’ evidence that some schemes were helping to reduce older people’s use of more intensive and higher cost services. Implications: evaluation results supported a decision that all POPP schemes should be sustained when pilot funding from the Department of Health ended. The study also demonstrated the importance of local evaluation activity when developing new services. (Edited publisher abstract)
An evaluation of a multidisciplinary team for intermediate care at home
- Authors:
- BEECH Roger, et al
- Journal article citation:
- International Journal of Integrated Care, 4(4), 2004, Online only
- Publisher:
- International Foundation for Integrated Care
This paper describes an evaluation of a multidisciplinary Rapid Response Team (RRT). This service aimed to provide a home based alternative to care previously provided in an acute hospital bed which was acceptable to patients and carers and which maintained clinical care standards. The service was provided for the population of Hereford, a rural town in the middle of England. A mixed-method descriptive design using quantitative and qualitative techniques was used to monitor: the characteristics of service users, the types and amounts of care received, any ‘adverse’ events arising from that care, and the acceptability of the service to patients and carers. A collaborative approach involving key stakeholders allowed appropriate data to be gathered from patient case notes, RRT staff, local health and social care providers, and patients and their carers. A suite of self-completed questionnaires was, therefore, designed to capture study data on patients and activities of care, and workshops and semi-structured interview schedules used to obtain feedback from users and stakeholders. Service users (231) were elderly (mean age 75.9), from three main diagnostic categories (respiratory conditions 19.0%, heart/stroke 16.2%, falls 13.4%), with the majority (57.0%) having both medical and social care needs. All patients received care at home (mean duration 5.6 days) with only 5.7% of patients having to be re-admitted to acute care. Overall, patients and carers had positive attitudes to the new service but some expressed concerns about their ability to influence the choice of care option (24.1% and 25.0% of patients and carers, respectively), whilst 22.7% of carers were concerned about the quality of information about care. The findings of this evaluation suggest that the Rapid Response Team provided an ‘acceptable’ alternative to an extended period of care in an acute setting. Such schemes may have relevance beyond the NHS of the UK as a means of providing a more appropriate and cost efficient match between patients' needs for care, the types of care provided, and the place in which care is provided.
Does integrated governance lead to integrated patient care? Findings from the innovation forum
- Authors:
- BEECH Roger, et al
- Journal article citation:
- Health and Social Care in the Community, 21(6), 2013, pp.598-605.
- Publisher:
- Wiley
Good integration of services that aim to reduce avoidable acute hospital bed use by older people requires frontline staff to be aware of service options and access them in a timely manner. In three localities where closer inter-organisational integration was taking place, this research sought patients’ perceptions of the care received across and within organisational boundaries. Between February and July 2008, qualitative methods were used to map the care journeys of 18 patients (six from each site). Patient interviews (46) covered care received before, at the time of and following a health crisis. Additional interviews (66) were undertaken with carers and frontline staff. Grounded theory-based approaches showed examples of well-integrated care against a background of underuse of services for preventing health crises and a reliance on ‘traditional’ referral patterns and services at the time of a health crisis. There was scope to raise both practitioner and patient awareness of alternative care options and to expand the availability and visibility of care ‘closer to home’ services such as rapid response teams. Concerns voiced by patients centred on the adequacy of arrangements for organising ongoing care, while family members reported being excluded from discussions about care arrangements and the roles they were expected to play. The coordination of care was also affected by communication difficulties between practitioners (particularly across organisational boundaries) and a lack of compatible technologies to facilitate information sharing. Finally, closer organisational integration seemed to have limited impact on care at the patient/practitioner interface. To improve care experienced by patients, organisational integration needs to be coupled with vertical integration within organisations to ensure that strategic goals influence the actions of frontline staff. As they experience the complete care journey, feedback from patients can play an important role in the service redesign agenda. (Publisher abstract)
Delivering person-centred holistic care for older people
- Authors:
- BEECH Roger, et al
- Journal article citation:
- Quality in Ageing and Older Adults, 18(2), 2017, pp.157-167.
- Publisher:
- Emerald
Purpose: This paper is an evaluated case study of the Wellbeing Coordinator (WBC) service in Cheshire, UK. WBCs are non-clinical members of the GP surgery or hospital team who offer advice and support to help people with long-term conditions and unmet social needs remain independent at home. Design/methodology/approach: A mixed method design assessed the outcomes of care for recipients and carers using interviews, diaries and validated wellbeing measures. Service utilization data, interviews and observations of WBC consultations enabled investigation of changes in processes of care. Data were analysed using simple descriptive statistics, established instrument scoring systems and accepted social science conventions. Findings: The WBC complements medical approaches to supporting people with complex health and social care problems, with support for carers often a key service component. Users reported improvements in their wellbeing, access to social networks, and maintenance of social identity and valued activities. Health and social care professionals recognized the value of the service. Practical implications: The WBC concept relieves the burden on health and social care professionals as the social elements of ill-health are addressed. A shift in thinking from ill-health to wellbeing means older people feel more able to regain control over their own lives, being less dependent on consulting professionals. Originality/value: The WBC is a new service focussing on the individual in their health, social and economic context. Process and outcomes evaluations are rare in this field. (Edited publisher abstract)
Social engagement and healthy ageing in disadvantaged communities
- Authors:
- BEECH Roger, MURRAY Michael
- Journal article citation:
- Quality in Ageing and Older Adults, 14(1), 2013, pp.12-14.
- Publisher:
- Emerald
Social engagement is important for healthy ageing but may be challenging for residents of disadvantaged urban communities. This article describes a study which examined levels of social engagement and its link with well-being and community attachment among older residents in 4 disadvantaged urban communities in Manchester. The research was part of the Community Action in Later Life Manchester East (Call-Me) project, which aimed to promote greater social engagement among older people. The project introduced community-based activities to encourage older people to become more socially active, and used a questionnaire survey to assess participants' wider involvement in local activities and their feelings of well-being and community attachment. The article describes the study and presents the results of data analysis. Of the 65 people who completed the survey, most lived alone (over 69%) but had contact at least monthly with family, friends and neighbours (over 70%) and made regular use of local amenities (over 79%). Participants' mean health-related quality of life score was lower than the national average, but over 65% rated their generic quality of life as good or better and over 67% had a positive sense of community attachment. The authors discuss the findings and conclude that the results confirm the need for strategies to promote social engagement of older people together with a community-wide approach to ensure that local amenities (such as the corner shop and good public transport links) are maintained.
Evaluating Wigan's partnerships for older people project: end of project report
- Authors:
- BEECH Roger, et al
- Publisher:
- Keele University. Research Institute for Life Course Studies
- Publication year:
- 2008
- Pagination:
- 43p.
- Place of publication:
- Keele
Wigan’s Partnership for Older People Project (POPP) was led by the Adult Social Services Department of Wigan Council. Over a two year period, participants in the Wigan POPP aimed to: develop a range of needs led services requested by older people; encourage investment in preventative approaches for promoting older people’s health, well being and independence; and offer more low level care and community support with a view to preventing or delaying older people needing higher intensity and more costly care. The results of an evaluation of this programme of service development were originally incorporated in a report that Wigan Council submitted to the Department of Health. Key extracts from that report are presented in this one. It starts by providing an overview of the methods that were used to undertake the evaluation and a summary of the nature of the schemes that were introduced as part of the POPP. This section also includes evaluation results which indicate the impacts of the POPP on user access to services. The next section considers the resource and outcome implications of the POPP. Resource effects considered are the extent to which POPP schemes reduced or delayed an older person’s need for more intensive and costly services. Outcome effects considered are user satisfaction with POPP schemes and the extent to which POPP schemes affected user quality of life and wellbeing. The final section of the report then includes examples of the ways in which older people have been involved in both the evaluation and the delivery of POPP schemes.