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Deprivation, demography, and the distribution of general practice: challenging the conventional wisdom of inverse care
- Authors:
- ASTHANA Sheena, GIBSON Alex
- Journal article citation:
- British Journal of General Practice, 58(555), October 2008, pp.720-728.
- Publisher:
- Royal College of General Practitioners
It is generally believed that the most deprived populations have the worst access to primary care. Lord Darzi's review of the NHS responds to this conventional wisdom and makes a number of proposals for improving the supply of GP services in deprived communities. This paper argues that these proposals are based on an incomplete understanding of inverse care which underestimates the degree to which, relative to their healthcare needs, older populations experience low availability of primary care. Many deprived practices appear to have a better match between need and supply than practices serving affluent but ageing populations. However, practices serving the oldest and most deprived populations have the worst availability of all.
Older carers in the UK
- Authors:
- SHEFFIELD HALLAM UNIVERSITY, CARERS UK
- Publisher:
- Carers UK
- Publication year:
- 2007
- Pagination:
- 25p.
- Place of publication:
- London
This publication details demographic, employment, and health and well-being data for older carers, as well as estimates of the number of carers claiming public support benefits. The report highlights the need for older carers to have supportive jobs and an adequate income to help meet the costs and time of caregiving.
HIV/AIDS and older adults in North America
- Authors:
- EMLET Charles A., ZABLOTSKY Diane
- Journal article citation:
- Global Ageing, 4(2), August 2006, pp.72-85.
This article discusses how the profile of how HIV/AIDS impacts older adults who are infected or at-risk for HIV across the United States and Canada. The article first provides epidemiological trends for both countries, including patterns related to gender, ethnicity and transmission routes. It then goes on to discuss psychosocial issues faced by older adults living with HIV/AIDS, including issues of stigma and social support. The article concludes with an examination of service delivery and access to services in the US and Canada.
Unmet needs for supportive services: a comparison of rural and urban older adults
- Author:
- LI Hong
- Journal article citation:
- Journal of Social Service Research, 32(3), 2006, pp.19-39.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
This study examined residence differences in unmet needs for seven commonly used supportive services including respite/adult day care, personal care, homemaker, home-delivered/congregate meals, transportation, home modification, and assistive devices services. Data were extracted from the 1999 National Long-Term Care Survey and included 848 caregivers of an adult who was over 65 years old, was community dwelling, and used one or more supportive services. Over one-third of caregivers reported that supportive services provided did not meet the needs of old adults. The prevalence rate of unmet needs differs across the seven supportive services. Using multivariate logistic regression tests, rural versus urban differences in unmet needs were found for personal care, homemaker, and assistive devices services. Rural older adults were less likely to experience unmet needs for these services than their urban counterparts. (Copies of this article are available from: Haworth Document Delivery Centre, Haworth Press Inc., 10 Alice Street, Binghamton, NY 13904-1580)
Demographic changes among ethnic minority elders in England and Wales: implications for development and delivery of old age psychiatry services
- Author:
- SHAH Ajit
- Journal article citation:
- International Journal of Migration Health and Social Care, 3(2), October 2007, pp.22-32.
- Publisher:
- Emerald
Demographic data pertaining to the elderly from black and minority ethnic groups in the 2001 population census were analysed to evaluate the implications for development and delivery of old age psychiatry services for black and minority ethnic elders. The demographic changes identified have important implications for the future development and delivery of services. Unless they are addressed it is argued that black and minority elders will continue to harbour untreated, hidden psychiatric morbidity.
Caring for our elders: a contemporary conundrum for working people
- Authors:
- SWANBERG Jennifer E., et al
- Journal article citation:
- Families in Society, 87(3), July 2006, pp.417-426.
- Publisher:
- The Alliance for Children and Families
As the U.S. population of individuals older than age 65 increases, so does the number of employees providing informal care to aging family members and friends. Using quantitative data, the authors describe the types of elder care situations experienced by individuals employed at one large organization in the United States. The authors present demographic information about employee caregivers and the people for whom they are seeking services, the reasons employees seek elder care consultation and services, and the types of services offered by the elder care program. Employees’ perceived benefits of utilizing elder care resources programs are also examined. Implications for practice, policy, and further research are discussed.
Longitudinal changes in the amount of informal care among publicly paid home care recipients
- Author:
- LI Lydia W.
- Journal article citation:
- Gerontologist, 45(4), August 2005, pp.465-473.
- Publisher:
- Oxford University Press
This study examined how the amount of informal care received by disabled elders changes when they are receiving publicly paid home care, and whether formal service use, disability, caregiving arrangements, and demographic characteristics of older adults predict changes in the amount of informal care. Hierarchical linear models were estimated, using 3-year data (12 repeated observations) collected from 888 elderly participants in Michigan's Home- and Community-Based Medicaid Waiver Program. The amount of informal care declined in the beginning period when publicly paid home care was received, and then it stabilized. Changes in activities and instrumental activities of daily living and caregiver residence predicted changes in the amount. The living arrangement and age of elders predicted different patterns of change over time. Neither formal service amount nor its change significantly predicted the amount of informal care. The study concludes informal caregivers do not relinquish caregiving when publicly paid home care is available. Expanding community-based long-term care is a means of fostering partnerships between formal and informal caregivers.
Promoting modern technology and internet access for under-represented older populations
- Authors:
- IRIZARRY Carol, DOWNING Andrew, WEST Deborah
- Journal article citation:
- Journal of Technology in Human Services, 19(4), November 2002, pp.13-30.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
Reports on an Australian research based programme which was designed to introduce the concepts of modern technology and some Internet skills to people over 55. Target populations included people in rural areas, those with a first language other than English and people who were frail or had a disability. Informal, interactive, hands-on sessions were developed which demonstrated the concepts underpinning modern computer-based devices and their applications in society. Major findings indicated that most participants identified feeling less anxious and more confident about using a new range of computer-based skills.
The helping networks of rural elders: demographic and social psychological influences on service use
- Authors:
- BLIESZNER Rosemary, ROBERTO Karen A., SINGH Kusum
- Journal article citation:
- Ageing International, 27(1), Winter 2002, pp.89-119.
- Publisher:
- Springer
- Place of publication:
- New York
The aim of this American study was to extend theory and research use or avoidance among rural older adults. Results indicated that variables indexing more education, less family contact, and a preference for formal services over informal assistance predicted use of formal services. Conclusions address the need to plan and market services differently for subgroups of rural elders, potential applications of the results by community leaders and gerontology practitioners, and suggestions for future research on service use.
Access to a community aged psychiatry service by elderly from non-English-speaking backgrounds
- Authors:
- HASSETT Anne, GEORGE Kuruvilla
- Journal article citation:
- International Journal of Geriatric Psychiatry, 17(7), July 2002, pp.623-628.
- Publisher:
- Wiley
With the ageing of Australia's ethnic communities, aged mental health services need to examine issues pertaining to accessibility and appropriateness in the context of this sociodemographic change. The aim of this review of referrals to a community aged-psychiatry service was to compare for differences between patients from non-English-speaking backgrounds and English-speaking backgrounds. The 12-month review of referrals to an aged psychiatry community service found that nearly half were of elderly patients from Non English Speaking Backgrounds. The lower utilisation of the service by certain ethnic groups may reflect obstacles in their pathway to care. Alternatively, strong family networks, or a lower prevalence of mental illness in these elderly, may explain the findings in this report.