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Managing adult malnutrition in the community: a spotlight on information, help and support available for patients and carers in England
- Author:
- PATIENTS ASSOCIATION
- Publisher:
- Patients Association
- Publication year:
- 2015
- Pagination:
- 57
- Place of publication:
- Harrow
This report sets out our recommendations to improve the quality of nutrition and hydration support, drawing on information from patient sources, from a review of recent work into malnutrition by government and concerned charitable organisations, from two specific dedicated surveys and from a Freedom of Information request to NHS Trusts. There are currently more than three million people in the UK who are either malnourished or at risk of malnutrition. The report looks at malnutrition prevalence, policy and practice; prevention and treatment of malnutrition; nutritional care in hospitals and the view from patients and professionals; and nutritional support in the community. The report makes a set of recommendations, including: developing a nutrition measurement and audit tool for nutritional care in all care settings; raising awareness; ensuring that nutrition and hydration care is integral to any training provided to care professionals in all care settings; and ensuring GPs and other community healthcare professionals take an active role in monitoring and addressing malnutrition. (Edited publisher abstract)
Case management for long-term conditions: implementation and processes
- Authors:
- REILLY Siobhan, HUGHES Jane, CHALLIS David
- Journal article citation:
- Ageing and Society, 30(1), January 2010, pp.125-155.
- Publisher:
- Cambridge University Press
This literature review focused on comprehensive case management by nurses for adults with long-term conditions living in the community. Twenty-nine studies were included; the majority were concerned with case management for frail older people, and others focused on people with multiple chronic diseases, high-cost patients, or those at high risk of hospital admissions. All the studies reported that case managers undertook the core tasks of assessment, care planning and the implementation of the care plan, but there was more variation in who carried out case finding, monitoring, review and case closure. Few studies provided adequate implementation information. Three issues were identified as key to the coherent and sustainable implementation of case management for people with long-term conditions: fidelity to the core elements of case management; size of caseload; and case-management practice. It is recommended that future evaluations of case-management interventions include a comprehensive process component or, at the very least, that interventions should be more fully described.
Evidence-based interventions for community dwelling older adults
- Editor:
- ENGUIDANOS Susan M.
- Publisher:
- Haworth
- Publication year:
- 2006
- Pagination:
- 176p.
- Place of publication:
- Binghamton
Evidence-Based Interventions for Community Dwelling Older Adults presents an overview of significant evidence-based programs that can improve the health of seniors living in community-based settings. The book examines research conducted on a variety of health-related issues, including depression, care management, falls prevention, physical activity, and medications management. It also looks at research models that were translated into real-life practice settings, explores the benefits of implementing evidence-based models into care settings, and provides examples of how to adapt tested programs to meet local agency and population needs. The health care delivery system in the United States has embraced evidence-based medicine, largely based on its potential to reduce unwanted variations and keep a lid on escalating health care costs. But there are few resources available on how to gather information about model programs and even fewer on how to adapt them for practice. Evidence-Based Interventions for Community Dwelling Older Adults discusses how to effectively manage care beyond the hospital or clinic, as researchers, practitioners, policymakers, and academics provide an overview of evidence-based practice that works toward the best possible care for patients. The book also highlights the efforts of social workers, pharmacists, and case managers, and illustrates the importance of the leadership efforts of the Administration on Aging, National Council on Aging, and the Centers for Disease Control.
High prevalence of central nervous system medications in community-dwelling older adults with dementia over a three-year period
- Authors:
- FICK D., KOLANOWSKI A., WALLER J.
- Journal article citation:
- Aging and Mental Health, 11(5), September 2007, pp.588-595.
- Publisher:
- Taylor and Francis
Few recent studies have investigated the prevalence and outcomes for central nervous system (CNS)-active medication use in older persons with dementia (PWD) who live in the community. Thus, the purpose of this study was to describe the health outcomes and patterns of use of CNS-active drugs in PWD living in the community. Using a retrospective study design from a southeastern managed care organization (MCO), claims data were collected for three years on all identified cases with dementia and included age, gender, medical diagnoses for each claim (International Classification of Disease [ICD-9 code]) and prescription drugs (National Drug Code [NDC]). Individuals (N = 960) were selected who were continuously enrolled and had prescription drug coverage. Over 79% of PWD in this sample were on a CNS-active medication during the three-year period and 35% were on a benzodiazepine. The highest number of drug-related problems (DRPs) within 45 days after receiving a CNS drug prescription were for syncope, fatigue, altered level of consciousness, delirium, constipation, falls and fractures. This study illustrates the need to further examine inappropriate CNS-active medication use in PWD and to test non-pharmacologic therapies for the clinical problems that initiate their use in PWD.
Improvement in depressive symptoms and changes in self-rated health among community-dwelling disabled older adults
- Authors:
- HAN B., JYLHA M.
- Journal article citation:
- Aging and Mental Health, 10(6), November 2006, pp.599-605.
- Publisher:
- Taylor and Francis
This study investigated the association between improvement in depressive symptoms and changes in self-rated health among community-dwelling disabled older adults over time. Multivariate logistic regression models were applied using the 1993 and 1995 Assets and Health Dynamics among the Oldest-Old Survey data. Changes in depressive symptoms and changes in self-rated health clearly coincide. Among participants with functional disability in 1993 and 1995, a decrease in depressive symptoms was associated with decreased odds of having decline in self-rated health (odds ratio [OR], 0.85; 95% confidence interval [CI], 0.78–0.93) and was associated with increased odds of having improvement in self-rated health (OR, 1.15; 95% CI, 1.04–1.27). Similar results were also found among participants with no functional disability in 1993 and with functional disability in 1995. Among community-dwelling older adults who remained disabled at follow-up or who experienced disability only at follow-up, even just a small decrease in depressive symptoms was associated with increased odds of having improvement in self-rated health and with decreased risks of having decline in self-rated health. Reducing the number of symptoms of depression among these disabled older adults would be beneficial in improving their self-rated health as well as maintaining and promoting their quality of life.
Residential community care: Scotland 1998
- Author:
- GREAT BRITAIN. Scottish Office
- Publisher:
- Great Britain. Scottish Office
- Publication year:
- 1999
- Pagination:
- 6p.,tables.
- Place of publication:
- Edinburgh
A fresh start
- Author:
- HIRST Judy
- Journal article citation:
- Community Care, 4.7.96, 1996, pp.18-19.
- Publisher:
- Reed Business Information
The author explains about adult placement schemes, that they are not new, but they have been recently 'rediscovered', and are responding to the demands of community care legislation.
Care in the community: home care use among adults with intellectual and developmental disabilities over time
- Authors:
- MARTIN Lynn, OUELLET-KUNTZ Helene, McKENZIE Katherine
- Journal article citation:
- Journal of Policy and Practice in Intellectual Disabilities, 14(3), 2017, pp.251-254.
- Publisher:
- Wiley
Community-based healthcare services have quickly evolved over the last few decades to respond to the growing population of older adults, and their desire to remain independent in the community. In Ontario, Canada, deinstitutionalization has resulted in all persons with intellectual and developmental disabilities living and ageing, in the community. This paper compares use of home care services in Ontario among adults (age 18–99 years) with and without intellectual and developmental disabilities over time. Home care use over a 5-year period was compared between a cohort of 46,008 adults with intellectual and developmental disabilities and a random sample of 3,272,080 adults without intellectual and developmental disabilities. Persons with and without intellectual and developmental disabilities received similar types of home care services. Adults with intellectual and developmental disabilities had much higher rates of admission to home care, and at much earlier ages. While this remained true over time, slight differences by age were noted between groups. Higher use at earlier ages suggests that home care services are responding to the needs of adults with intellectual and developmental disabilities. Future research should identify (or develop) best practices for promoting independence in the community for adults with intellectual and developmental disabilities with healthcare needs. (Edited publisher abstract)
Residential care and care to community-dwelling parents: out-selection, in-selection and diffusion of responsibility
- Author:
- BROEK Thijs van den
- Journal article citation:
- Ageing and Society, 37(8), 2017, pp.1609-1631.
- Publisher:
- Cambridge University Press
Research suggests that adult children are less likely to provide care to community-dwelling parents when beds in residential care settings are more widely available. The underlying mechanisms are not well understood. Drawing on data from the Survey of Health, Ageing and Retirement in Europe (SHARE) on 1,214 impaired parent–child dyads from 12 countries, we find that adult children are less likely to provide care in countries where beds in residential care settings are more widely available because (a) parents’ care needs are less severe in such countries (out-selection hypothesis) and (b) adult children and impaired parents are less likely to share a household in such countries (in-selection hypothesis). Finally (c), after taking these two factors into account, adult children remain less likely to provide care in countries where beds in residential care settings are more widely available (diffusion of responsibility hypothesis). Plausibly, being able to rely on residential care undermines adult children's sense of urgency to step in and provide care to their parents. (Publisher abstract)
Statistics on community care for adults in Northern Ireland 2014 - 2015
- Authors:
- O'HAGAN Joanne, et al
- Publisher:
- Northern Ireland. Department of Health, Social Services and Public Safety. Community Information Branch
- Publication year:
- 2015
- Pagination:
- 92
- Place of publication:
- Belfast
Summarises information on a range of community care services collected from Health and Social Care Trusts in Northern Ireland. Data includes: contacts with Trusts (including care for older people, people with learning disabilities, people with physical and sensory disabilities); care packages in effect (residential and nursing home care); meals on wheels services; residential and nursing accommodation; and day care registrations. The report includes trend analysis over the past five years. (Edited publisher abstract)