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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.
Longitudinal assessment of psychotherapeutic day hospital treatment for neuropsychiatric symptoms in dementia
- Authors:
- WEBER Kerstin, et al
- Journal article citation:
- Aging and Mental Health, 13(1), January 2009, pp.92-98.
- Publisher:
- Taylor and Francis
Behavioural and psychological symptoms (BPSD) of dementia are associated with more rapid cognitive deterioration as well as increased caregiver stress. The effectiveness of psychiatric day hospital care for this condition remains disputed. This study reports on the assessment of a psychotherapeutic day hospital program in a series of elderly people with dementia and concomitant BPSD. The day hospital program combined music, movement, psychodynamic group therapies, sociotherapy as well as individual interviews and family interventions. Participants were 76 individuals with mild to moderate dementia. Outcome measures were the Neuropsychiatric Inventory (NPI), Therapeutic Community Assessment scale including staff (SAS) and client assessments (CAS) and a Group Evaluation Scale (GES) were administrated at admission, 3, 6 and 12 months and discharge. Linear regression analysis showed that SAS (but not CAS) and GES scores significantly increased while the NPI total scores decreased across the different time points. NPI item score modifications were significant for anxiety and apathy. These changes remained significant when demographic variables, drug treatment changes and occurrence of life events were also considered. It is concluded that a psychotherapeutic day hospital program designed for older people with dementia and neuropsychiatric symptoms allows for a significant reduction of anxiety and apathy, better adhesion to therapeutic community treatment and clinical progress in group therapy. Controlled interventional studies are needed to further confirm these data.
Does dementia predict adverse hospitalization outcomes? A prospective study in aged inpatients
- Author:
- ZEKRY Dina
- Journal article citation:
- International Journal of Geriatric Psychiatry, 24(3), March 2009, pp.283-291.
- Publisher:
- Wiley
This study assesses the relative value of dementia for predicting hospitalization outcomes, taking into account comorbidity, functional and nutritional status in 435 inpatients (age 85.3 ± 6.7; 207 cognitively normal, 48 with mild cognitive impairment and 180 demented) from the acute and rehabilitation geriatric hospital of Geneva. Hospitalization outcomes (death in hospital, length of stay, institutionalisation and formal home care needs) were predicted using logistic regression models with sociodemographic characteristics, cognitive status, comorbid Charlson index-CCI, functional and nutritional status as independent variables. Moderate and severe dementia and poor physical function strongly predicted longer hospital stay, institutionalization and greater home care needs in univariate analyses. CCI was the best single predictor, with a four-fold difference in mortality rates between the highest and lowest scores. In multivariate analysis, the best predictor of institutionalisation was dementia, whereas the best predictor of death in hospital or longer hospital stay was higher comorbidity score, regardless of cognitive status. Functional status was the best predictor of greater home care needs. Dementia in very old medically ill inpatients was predictive only of discharge to a nursing home. Higher levels of comorbidity and poor functional status were more predictive than dementia for the other three hospitalization outcomes. Thus, comorbid medical conditions, functional and nutritional status should be considered, together with cognitive assessment, when predicting hospitalization outcome.