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Home improvement agencies' response to an ageing society
- Author:
- RAMSAY Malcolm
- Journal article citation:
- Housing Care and Support, 11(4), December 2008, pp.17-19.
- Publisher:
- Emerald
Since the Government published its lifetime homes strategy, the focus has shifted to home improvement agencies (HIAs) to find some of the answers to housing an ageing populations. This article describes what the future might look like for the HIA sector.
Building to last: the importance of designing life-ling communities
- Author:
- CANN Paul
- Journal article citation:
- Housing Care and Support, 11(4), December 2008, pp.10-13.
- Publisher:
- Emerald
This article discusses how policy-makers and local government need to listen to the voice of older people when designing the communities we live in. It highlights how simple, joined-up thinking can make a difference to older people's lives.
Valuing the ICECAP capability index for older people
- Authors:
- COAST Joanna, et al
- Journal article citation:
- Social Science and Medicine, 67(5), September 2008, pp.874-882.
- Publisher:
- Elsevier
This paper reports the first application of the capabilities approach to the development and valuation of an instrument for use in the economic evaluation of health and social care interventions. The ICECAP index of capability for older people focuses on quality of life rather than health or other influences on quality of life, and is intended to be used in decision making across health and social care in the UK. The measure draws on previous qualitative work in which five conceptual attributes were developed: attachment, security, role, enjoyment and control. This paper details the innovative use within health economics of further iterative qualitative work in the UK among 19 informants to refine lay terminology for each of the attributes and levels of attributes used in the eventual index. For the first time within quality of life measurement for economic evaluation, a best-worst scaling exercise has been used to estimate general population values (albeit for the population of those aged 65+ years) for the levels of attributes, with values anchored at one for full capability and zero for no capability. Death was assumed to be a state in which there is no capability. The values obtained indicate that attachment is the attribute with greatest impact but all attributes contribute to the total estimation of capability. Values that were estimated are feasible for use in practical applications of the index to measure the impact of health and social care interventions.
Validation of a screening instrument for post-traumatic stress disorder in a clinical sample of older adults
- Authors:
- HUDSON Sheila A., et al
- Journal article citation:
- Aging and Mental Health, 12(5), September 2008, pp.670-673.
- Publisher:
- Taylor and Francis
To determine the diagnostic validity of the Post Traumatic Disorder Checklist (PCL) against the 'gold standard' of the Clinician Administered PTSD Scale (CAPS) in a clinical sample of older adults. A cross-sectional validation study: participants were patients (65 years and over) being treated for medical and/or psychiatric conditions in a hospital setting. Participants completed the PCL, measures of mood, cognition, physical health, alcohol use and the CAPS. A receiver operating characteristics curve was constructed to determine the optimal cut-point of the PCL. Analysis of variance was used to examine clinical differences between PTSD cases, sub-threshold cases and the remainder of the sample. Using the recommended cut-point of 50, the PCL had a sensitivity of 0.40, specificity of 0.97 and positive predictive value of 0.57. However, these values changed to 0.90, 0.87 and 0.45, respectively, when the optimal cut-point of 36 was used. With an adjusted cut-point the PCL is an acceptable and brief screening instrument for PTSD in older adults.
A controlled evaluation of monthly maintenance interpersonal psychotherapy in late-life depression with varying levels of cognitive function
- Authors:
- CARREIRA Kristen, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 23(11), November 2008, pp.1110-1113.
- Publisher:
- Wiley
This study evaluated the effect of maintenance Interpersonal Psychotherapy (IPT) on recurrence rates and time to recurrence of major depression in elderly patients with varying levels of cognitive function. Two-year maintenance study of monthly maintenance IPT vs supportive clinical management (CM) in remitted depressed elderly who were participants in a previously reported placebo-controlled study of maintenance paroxetine and IPT (Reynolds et al., [2006]). Cox regression analysis was used to test interactions between cognitive status (Dementia Rating Scale score) and treatment (IPT, CM) with respect to recurrence of major depression. A significant interaction between cognitive status and treatment was observed: lower cognitive performance was associated with longer time to recurrence in IPT than in CM. Subjects with average cognitive performance showed no effect of maintenance IPT vs CM on time to recurrence. Monthly maintenance IPT confers protection against recurrence of major depression in elders with lower cognitive functioning.
Purchasing power: getting the best for older people
- Authors:
- MANTHORPE Jill, ILIFFE Steve
- Journal article citation:
- Mental Health Today, November 2008, pp.26-29.
- Publisher:
- Pavilion
- Place of publication:
- Hove
The authors discuss some of the challenges facing commissioners who are purchasing mental health services for older people. They briefly highlight some of the main complexities which include: the complexity of older people's identities; the make up of workforces; the difficult nature of work with older people; and the multiple agencies involved in working with older people. It is argued that consistent application of a long-term strategy, which allows the accumulation of small changes across agencies and disciplines, is likely to be the key to success. It sets out the issues that need to be addressed, the pitfalls to avoid, and examines a series of objectives for commissioners.
Costs and health outcomes of intermediate care: results from five UK case study sites
- Authors:
- KAAMBWA Billingsley, et al
- Journal article citation:
- Health and Social Care in the Community, 16(6), December 2008, pp.573-581.
- Publisher:
- Wiley
The objectives of this study were to explore the costs and outcomes associated with different types of intermediate care (IC) services, and also to examine the characteristics of patients receiving such services. Five UK case studies of 'whole systems' of IC were used, with data collected on a sample of consecutive IC episodes between January 2003 and January 2004. Statistical differences in costs and outcomes associated with different IC services and patient groups were explored. Factors associated with variation in IC episode outcomes were explored using an econometric framework. Data were available for 2253 episodes of IC. In terms of Department of Health criteria, a large proportion of patients (up to 47% of those for whom data were available) in this study were inappropriately admitted to IC services. As regards service function, compared to supported discharge, admission avoidance services were associated with both lower costs and greater health and functional gains. These gains appear to be driven, in part, by illness severity (more dependent patients tended to gain most benefit). In addition, these gains appear to be larger where the admission was appropriate. This study suggests a need for the development and application of robust and reliable clinical criteria for admission to IC, and close co-operation between hospital and community service providers over selection of patients and targeting of IC and acute care services to meet defined clinical need.
Help to reduce depression
- Authors:
- LYNE Jake, MOXON Sallie, SOCIAL CARE INSTITUTE FOR EXCELLENCE
- Journal article citation:
- Community Care, 13.11.08, 2008, p.34, 36.
- Publisher:
- Reed Business Information
The results of a recent research project have found that care workers can help control depression among older people. The authors summarise some of the key messages from the study. In the second part of the article, the Social Care Institute for Excellence (SCIE) provides details of selected resources on reducing depression in older people.
No country for old lags
- Author:
- VALIOS Natalie
- Journal article citation:
- Community Care, 13.11.08, 2008, pp.28-29.
- Publisher:
- Reed Business Information
The number of older people in prison is rising, and many have chronic health and social care needs. This article describes three initiatives set up to address the problems facing older prisoners. Offender Health, a policy branch in the Department of health, has set up the Older Prisoners Action Group. The Older Prisoners Project on the Isle of Wight is developing an outcome-based assessment framework to identify the health and social care needs of older prisoners. Buddy schemes are also developing to provide a support network
Old and inside: older people in prison
- Author:
- ATKINSON Lorraine
- Journal article citation:
- Working with Older People, 12(3), September 2008, pp.34-37.
- Publisher:
- Emerald
The number of older people in prison is growing. This article draws on past research to discusses how the prison service is failing to meet their complex needs.