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COVID 19 and dementia: experience from six European countries
- Authors:
- BURNS Alistair, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, early cite 18 January 2021,
- Publisher:
- Wiley
The effects of Covid‐19 have been well documented across the world with an appreciation that older people and in particular those with dementia have been disproportionately and negatively affected by the pandemic. This is both in terms of their health outcomes (mortality and morbidity), care decisions made by health systems and the longer‐term effects such as neurological damage. The International Dementia Alliance (IDEAL) is a group of dementia specialists from six European countries and this paper is a summary of our experience of the effects of COVID‐19 on our populations. Experience from England, France, Germany, the Netherlands, Spain and Switzerland highlight the differential response from health and social care systems and the measures taken to maximise support for older people and those with dementia. The common themes include recognition of the atypical presentation of COVID‐19 in older people (and those with dementia) the need to pay particular attention to the care of people with dementia in care homes; the recognition of the toll that isolation can bring on older people and the complexity of the response by health and social services to minimise the negative impact of the pandemic. Potential new ways of working identified during the pandemic could serve as a positive legacy from the crisis. (Edited publisher abstract)
Prominent physical inactivity in acute dementia care: psychopathology seems to be more important than the dose of sedative medication
- Authors:
- FLEINER Tim, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 34(2), 2019, pp.308-314.
- Publisher:
- Wiley
Introduction: To objectively quantify patients' physical activity and analyze the relationships between physical activity levels, psychopathology, and sedative medication in acute hospital dementia care. Materials and Methods: In this cross‐sectional study, the authors assessed the patients' physical activity based on data collection by hybrid motion sensors attached on their lower back. Daily doses of antipsychotics have been converted to olanzapine‐equivalents and daily benzodiazepine medication is reported as diazepam‐equivalents. The authors assessed patients' neuropsychiatric symptoms with the Neuropsychiatric Inventory and the Cohen‐Mansfield Agitation Inventory. Results: The authors analyzed motion sensor data from 64 patients (MMSE M = 18.6). On average, patients were lying for 11.5 hours, sitting/standing sedentary for 10.3 hours, sitting/standing active for 1.0 hours, and walking for 1.2 hours per day. The analysis revealed no correlations between patients' physical activity and antipsychotic or benzodiazepine medication. More severe neuropsychiatric symptoms were associated with a decrease in the patients' physical activity (r = .32, P = .01). In particular, patients with apathy symptoms were less physically active than patients without apathy symptoms. Discussion: The results reveal that most of the patients in acute dementia care had very low levels of physical activity. Their physical inactivity may be due to the severity of their neuropsychiatric symptoms, especially apathy. Antipsychotic and benzodiazepine medication appeared to have less impact on patients' physical activity. Dementia care should pay more attention to prevent physical inactivity in patients. (Edited publisher abstract)
Care regimes on the move: comparing home care for dependent older people in Belgium, England, Germany and Italy
- Authors:
- DEGAVRE Florence, et al
- Publisher:
- Universite Catholique de Louvan. Centre Interdisciplinaire de Recherche Travail, Etat et Societe
- Publication year:
- 2012
- Pagination:
- 290p.
- Place of publication:
- Charleroi
Taking the reforms of the 1990s as its starting point, this report examines the dynamics of change experienced by Belgium, England, Germany and Italy in their home care sectors. Central to our analysis is the process of “marketisation”. This constitutes one of the major trends in all these four countries, yet its nature and impact show important national variations. The data referred to in this report relate to developments in and around various home care sectors, and cover both societal and organisational dynamics. Country-based research teams gathered the information, each team following identical methodological guidelines. This report uses official documents and grey literature from the care sector to analyse the discourses underpinning reforms in the field. The conclusions of this research will be of relevance for any country or region struggling to design a home care system for an ageing population. The coordinators of this research project have submitted a proposal for a special issue of Ageing and Society based on the main chapters of this report.
Quality assurance indicators of long-term care in European countries
- Authors:
- DANDI Roberto, CASANOVA Georgia
- Publisher:
- European Network of Economic Policy Research Institutes
- Publication year:
- 2012
- Pagination:
- 128p.
- Place of publication:
- Brussels
This report present the findings and conclusions of research undertaken in the context of research projects carried out by a consortium of ENEPRI member institutes. This report is a contribution to Work Package 5 of the ANCIEN project, which focuses on the future of long-term care for the elderly in Europe. The report presents the quality indicators that were collected by the ANCIEN project partners in each country. The main contribution of this report is a classification of the quality assurance indicators in different European countries according to three dimensions: organisation type; quality dimensions; and system dimensions. The countries that provided quality indicators, which are used at a national level or are recommended to be used at a local level by a national authority, are: Estonia, Finland, France, Germany, Hungary, Italy, Latvia, the Netherlands, Spain, Sweden and the United Kingdom. In total, 390 quality indicators were collected. Each quality indicator has been assigned to one or more options in each dimension.
Long-term care quality assurance policies in European countries
- Authors:
- DANDI Roberto, et al
- Publisher:
- European Network of Economic Policy Research Institutes
- Publication year:
- 2012
- Pagination:
- 89p.
- Place of publication:
- Brussels
This report present the findings and conclusions of research undertaken in the context of research projects carried out by a consortium of ENEPRI member institutes. This report is a contribution to Work Package 5 of the ANCIEN project, which focuses on the future of long-term care for the elderly in Europe. This report analyses the quality assurance policies for long-term care (LTC) in the following countries: Austria, Estonia, Finland, France, Germany, Hungary, Italy, Latvia, Poland, Slovakia, Slovenia, Spain, Sweden, the Netherlands, and the United Kingdom. First, it discusses quality assurance in LTC by analysing: the dimensions of quality, the policy frameworks for quality in LTC, the different levels of development of LTC quality policies at the international, national, organisational, and individual levels. Second, it describes the methodology for collecting and analysing data on quality policies in the selected countries. Finally, it discusses the results, identifying four clusters of countries based on quality policies and indicators for LTC. These clusters are compared to the clusters identified in Work Package 1 of the ANCIEN project. Policy recommendations are proposed.
Housing our Ageing Population: Panel for Innovation
- Authors:
- HOMES AND COMMUNITIES AGENCY, GREAT BRITAIN. Department of Health, GREAT BRITAIN. Department for Communities and Local Government
- Publisher:
- Homes and Communities Agency
- Publication year:
- 2009
- Pagination:
- 59p.
- Place of publication:
- London
Following the Lifetime Homes, Lifetime Neighbourhoods national strategy report, the Housing our Ageing Population: Panel for Innovation was established in 2009 to examine what further reform is needed to ensure that new build specialised housing meets the needs and aspirations of the older people of the future. This report brings together the findings and recommendations of the panel, which focused on improving the quality of life of the ageing population by influencing the availability and choice of high-quality sustainable homes and neighbourhoods, challenging the perceptions of mainstream and specialised housing for older people, raising the aspirations of older people to demand higher quality more sustainable homes, and spreading awareness of the possibilities offered through innovative design of housing and neighbourhoods. It highlights key design recommendations, offers case studies from London, Bristol, York, Denmark, the Netherlands, Germany, Switzerland and Sweden, proposes further work, links to parallel studies that emphasise the role of place making in enhancing quality of life, and forms the basis of advice to government ministers.
Pushing the boundaries: a physical activity intervention extends sensor-assessed life-space in nursing home residents
- Authors:
- JANSEN Carl-Philipp, et al
- Journal article citation:
- Gerontologist, 58(5), 2018, pp.979-988.
- Publisher:
- Oxford University Press
Background and Objectives: To determine whether a multicomponent, individually tailored intervention to promote physical activity (PA) enhances life-space (LS) utilization in nursing home (NH) residents and whether intervention effects can be sustained at follow-up after continuation of the program as part of institutional daily routines. Research Design and Methods: Pre-post-assessed controlled trial in two highly similar NHs with a 3month follow-up in 143 NH residents (intervention group: n = 78; control group: n = 65) and LS as primary outcome. The PA promoting intervention consisted of several components (group sessions; individual exercise; serious games training; competence training for staff) tailored to residents’ individual functional capacity. LS was innovatively assessed via an indoor wireless sensor network including three assessment-specific LS parameters: overall LS score (LSSc), time spent away from the private room (TAFR), and the maximally distal zone from private room visited (MaxZ). To exploit the available intervention-control comparative data in the best way possible, a generalized linear mixed model approach was applied. Results: At post-test, intervention participants had a significantly higher overall LSSc, spent more TAFR, and had extended their MaxZ as compared to controls. At follow-up, a significant group difference remained for MaxZ. Discussion and Implications: A PA intervention in the NH setting impacts on LS utilization as measured using sensor-based assessment. The program has proven its practical sustainability when being handed over to NH personnel for continuation in daily practice. Further research is needed to determine whether an increase in LS utilization also impacts on social participation and quality of life. (Edited publisher abstract)
An international comparison of long-term care funding and outcomes: insights for the social care green paper
- Author:
- INCISIVE HEALTH
- Publisher:
- Incisive Health
- Publication year:
- 2018
- Pagination:
- 49
- Place of publication:
- London
This report, commissioned by Age UK, highlights different approaches to long-term care taken by five countries in the developed world, and looks at how they compare to the system in England. These five countries have very different systems, but face similar demographic and financial challenges to those in England. The countries are France, Germany, Spain, Italy and Japan. The report compares the approaches in relation to: service structures, funding levels, funding models, and outcomes. The findings suggest that creating a sustainable social care system fit for a rapidly ageing population is a challenge in every one of these countries. However, it finds that the financial deal for citizens with care needs is often more generous in other countries in comparison to England, with other nations generally either providing some non-means tested basic level of support, and/or cap the amount of co-payment to be made, and/or use a more gradual means-test. Profiles for each of the five countries are also included. (Edited publisher abstract)
Analysing equity in the use of long-term care in Europe
- Authors:
- RODRIGUES Ricardo, ILINCA Stefania, SCHMIDT Andrea
- Publisher:
- European Commission
- Publication year:
- 2014
- Pagination:
- 39
- Place of publication:
- Brussels
There are significant differences across social protection systems in Europe in the scope, breadth and depth of coverage of the risk to need long-term care in old-age. Together with other factors, such as education, household structure or societal values regarding care for frail older people, these differences can have a significant impact on the use of long-term care. Using SHARE data, this Research Note compares differences between European countries in the use of long-term care across income groups, for older people living at home. It analyses not only inequalities in the use of long-term care, but also differences in use that persist after differences in need have been taken into consideration, i.e. horizontal inequity. For this purpose, concentration indices, concentration curves and horizontal inequity indices are estimated for home care services and informal care. The countries analysed here are Austria, Germany, Sweden, the Netherlands, Spain, Italy, France, Denmark, Greece, Belgium and Czech Republic. The findings suggest that differences in use of home care services across income groups mostly reflect differences in need between those same groups. For informal care, the differences in use persist even after accounting for needs, and less affluent individuals are much more likely to use informal care. Some possible causes for these differences and policy implications are considered.
Analysis of the UK long term care market
- Author:
- FROST AND SULLIVAN
- Publisher:
- Technology Strategy Board
- Publication year:
- 2013
- Pagination:
- 38
- Place of publication:
- Swindon
Examines the economic research in the current care market and makes some analyses and extrapolations of future market potential. The report looks at the public and private long term care provision in the UK and makes some comparisons with global markets. It argues that the residential sector will continue to see higher growth compared to the non-residential sector. The total residential market will see a compound annual growth rate of 4.3 per cent between 2030 and 2040, with the private sector growing faster than the public sector. The report also examines how demand factors impact on the market, focusing in particular on changing demographics, the source of funding and expenditure, the consumer trends and the role of technology, and provides a brief outline of the current political and regulatory context. (Edited publisher abstract)