Search results for ‘Subject term:"older people"’ Sort:
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Care coordination: translating policy into practice for older people
- Authors:
- SEDDON Diane, et al
- Journal article citation:
- Quality in Ageing and Older Adults, 14(2), 2013, pp.81-92.
- Publisher:
- Emerald
The findings from research on the implementation of Unified Assessment (UA) policy and the work of care coordinators who oversee the delivery of support to older people with complex needs are presented. The research used a mixed methods approach that included staff interviews (n=95) and focus groups (n=3) spanning eight local authority areas; one in North, Mid and South Wales. The care coordinator role is controversial and the lack of common terminology across health and social care obscures its importance. It is seen as a social care responsibility. Limited ownership amongst healthcare professionals leads to tensions in practice. The challenges of breaking down silo thinking embedded in established professional practices are highlighted as are infrastructural and capacity deficits. Disparities between policy intentions and practice means that UA is failing to meet core objectives relating to the delivery of seamless support. Practice implications identified are that practice development may be supported by: guidelines that are more prescriptive and include a formal role definition; joint training to promote shared understanding of key concepts; investment in administrative and IT infrastructures; and more coordinated direction at strategic level. (Edited publisher abstract)
The assessment of pain in older people
- Authors:
- ROYAL COLLEGE OF PHYSICIANS, BRITISH GERIATRICS SOCIETY, BRITISH PAIN SOCIETY
- Publisher:
- Royal College of Physicians
- Publication year:
- 2007
- Pagination:
- 13p.
- Place of publication:
- London
Pain is under-recognised and under-treated in older people, and the assessment of pain is particularly challenging in the presence of severe cognitive impairments, communication difficulties or language and cultural barriers. This guidance sets out the key components of assessing pain in older people, together with a range of practical scales that can be used with different groups, including those with cognitive or communication impairment. It aims to provide professionals with a set of practical skills to assess pain as the first step towards its effective management. It describes the background and methodology used, key components of an assessment of pain, and types of scale used to assess pain. It also provides a summary of recommendations in the full guidelines covering: pain awareness, pain enquiry, pain description, pain location and intensity, communication, assessment in people with impaired cognition/communication, cause of pain, and re-evaluation. It notes that the basic guidelines should be a routine part of the training and care provision of all healthcare professionals. The appendices include the guideline development process, an algorithm for the assessment of pain in older people, a pain map, and examples of pain scales.
Positive outcomes
- Author:
- MADDISON Jane
- Journal article citation:
- Community Care, 11.01.07, 2007, pp.32-33.
- Publisher:
- Reed Business Information
This article summarises research on the outcomes valued by older people and lessons learned from authorities developing outcomes-focused services for older people in England and Wales. The research was commissioned by the Social Care Institute for Excellence (SCIE) and carried out by the Social Policy Research Unit and Acton Shapiro.
The older prisoner health and social care assessment and plan (OHSCAP) versus treatment as usual: a randomised controlled trial
- Authors:
- FORSYTH Katrina, et al
- Journal article citation:
- BMC Public Health, 21(2061), 2021, Online only
- Publisher:
- BioMed Central Ltd
Background: Older people are the fastest-growing demographic group among prisoners in England and Wales and they have complex health and social care needs. Their care is frequently ad hoc and uncoordinated. No previous research has explored how to identify and appropriately address the needs of older adults in prison. This study hypothesised that the Older prisoner Health and Social Care Assessment and Plan (OHSCAP) would significantly increase the proportion of met health and social care needs 3 months after prison entry, compared to treatment as usual (TAU). Methods: The study was a parallel randomised controlled trial (RCT) recruiting male prisoners aged 50 and over from 10 prisons in northern England. Participants received the OHSCAP or TAU. A clinical trials unit used minimisation with a random element as the allocation procedure. Data analysis was conducted blind to allocation status. The intervention group had their needs assessed using the OHSCAP tool and care plans were devised; processes that lasted approximately 30 min in total per prisoner. TAU included the standard prison health assessment and care. The intention to treat principle was followed. The trial was registered with the UK Clinical Research Network Portfolio (ISRCTN ID: 11841493) and was closed on 30 November 2016. Results: Data were collected between 28 January 2014 and 06 April 2016. Two hundred and forty nine older prisoners were assigned TAU of which 32 transferred prison; 12 were released; 2 withdrew and 1 was deemed unsafe to interview. Two hundred and fifty three 3 prisoners were assigned the OHSCAP of which 33 transferred prison; 11 were released; 6 withdrew and 1 was deemed unsafe to interview. Consequently, data from 202 participants were analysed in each of the two groups. There were no significant differences in the number of unmet needs as measured by the Camberwell Assessment of Needs – Forensic Short Version (CANFOR-S). The mean number of unmet needs for the OHSCAP group at follow-up was 2.03 (SD = 2.07) and 2.06 (SD = 2.11) for the TAU group (mean difference = 0.088; 95% CI − 0.276 to 0.449, p = 0.621). No adverse events were reported. Conclusion: The OHSCAP was fundamentally not implemented as planned, partly due to the national prison staffing crisis that ensued during the study period. Therefore, those receiving the OHSCAP did not experience improved outcomes compared to those who received TAU. (Edited publisher abstract)
Falls: assessment and prevention of falls in older people: CG161
- Author:
- NATIONAL INSTITUTE FOR HEALTH AND CARE EXCELLENCE
- Publisher:
- National Institute for Health and Care Excellence
- Publication year:
- 2013
- Pagination:
- 315
- Place of publication:
- Manchester
Falls and fall-related injuries are a common and serious problem for older people. People aged 65 and older have the highest risk of falling, with 30% of people older than 65 and 50% of people older than 80 falling at least once a year. This clinical guideline is for healthcare and other professionals and staff who care for older people who are at risk of falling. It provides evidence and recommendations on the assessment and prevention of falls in older people. It extends and replaces ‘Falls: assessment and prevention of falls in older people’ (NICE clinical guideline 21; 2004), by including additional recommendations about preventing falls in people admitted to hospital (inpatients). This document includes all the recommendations, details of how they were developed, and summaries of the evidence they were based on. (Edited publisher abstract)
Falls in older people: assessing risk and prevention: CG161
- Author:
- NATIONAL INSTITUTE FOR HEALTH AND CARE EXCELLENCE
- Publisher:
- National Institute for Health and Care Excellence
- Publication year:
- 2013
- Pagination:
- 33
- Place of publication:
- Manchester
This clinical guideline is for healthcare and other professionals and staff who care for older people who are at risk of falling. It extends and replaces NICE clinical guideline 21 (published November 2004). It offers evidence-based advice on preventing falls in older people; and also offers best practice advice on the care of older people who are at risk of falling. New recommendations have been added about assessing and preventing falls in older people during a hospital stay. All people aged 65+r are covered by all guideline recommendations. People aged 50 to 64 who are admitted to hospital and are judged by a clinician to be at higher risk of falling because of an underlying condition are also covered by the guideline recommendations about assessing and preventing falls in older people during a hospital stay. The full guideline, 'Falls: assessment and prevention of falls in older people' contains details of the methods and evidence used to develop the guideline; it was developed by the Internal Clinical Guidelines Programme at NICE. (Edited publisher abstract)
National review of access and eligibility in adults' social care: overview report
- Author:
- CARE AND SOCIAL SERVICES INSPECTORATE WALES
- Publisher:
- Care and Social Services Inspectorate Wales
- Publication year:
- 2010
- Pagination:
- 19p.
- Place of publication:
- Cardiff
In order to manage their resources, local authorities have to apply eligibility criteria in order to identify the people whose needs they will meet and those they will not. The aim of this review was to investigate the issues that impact on access to social services, including the application of eligibility criteria. The review primarily focuses on services for older people. The research involved a survey completed by all 22 local authorities. This was followed by fieldwork in 8 local authorities involving small group, semi-structured discussions with a number of identified officers. The report discusses: the thresholds for accessing social services; whether officers understand and monitor how eligibility criteria are applied; where eligibility criteria fit with the broader issues on access to services; and whether the application of eligibility criteria is fair and consistent. The findings showed that most local authorities (15 out of 22) set their eligibility criteria at critical and substantial. The barrier to getting support is at the stage of first contact where decisions are made regarding who gets through to assessment. The overall picture is of tightening resources, with increasing demand, people presenting with increasingly complex or severe levels of need, and changes to eligibility criteria due to financial pressures.
Clinical practice guideline for the assessment and prevention of falls in older people
- Author:
- NATIONAL COLLABORATING CENTRE FOR NURSING AND SUPPORTIVE CARE
- Publisher:
- Royal College of Nursing
- Publication year:
- 2004
- Pagination:
- 283p.
- Place of publication:
- London
This guideline for health professionals covers older people living in the community, either at home, in a retirement complex, or in a residential or nursing home. An older person is defined as someone who is aged 65 or over. The guideline does not cover people who are bed bound or who are in hospital for reasons other than treatment after a fall. The main areas examined by the guideline were: the evidence for factors that increase the risk of falling; the most effective methods of assessment and identification of older people at risk of falling; the most clinically and cost effective interventions and preventative strategies for the prevention of falls; the clinical effectiveness of hip protectors for the prevention of hip fracture; the most clinically and cost effective interventions and rehabilitation programmes for the prevention of further falls; and older peoples’ views and experiences of falls prevention strategies and programmes. Recommendations for good practice and cost effectiveness are presented. The guidance was commissioned by the National Institute for Clinical Excellence (NICE).
Assessing older people with complex care needs using EASY-Care, a pre-defined assessment tool
- Authors:
- LAMBERT Susan, et al
- Journal article citation:
- Research Policy and Planning, 25(1), 2007, pp.43-56.
- Publisher:
- Social Services Research Group
Nurse assessors undertook assessments of 119 older people living in a care home setting or awaiting discharge from hospital. Older people who had been assessed also completed questionnaires to evaluate use of the tool. Assessors took part in semi-structured focus groups or interviews. The results suggest that EASY-Care was considered in general to be useful in exploring needs and acceptable to both assessors and older people. Assessors thought it was person-centred in that open-ended questions allowed people to describe their circumstances in their own words. Some assessors were less comfortable with the open-ended questioning approach and felt it made collection information difficult and was likely to cause confusion. One the whole, use of the tool was considered to facilitate rapport. However, some questions provoked anxiety and assessors needed to use their professional judgement to identify non-verbal cues of anxiety in order to achieve a person-centred assessment. Professional training and skills were essential to identify non-verbal cues of distress and to moderate potentially difficult situations where older people became upset during assessment.
Charges for residential accommodation: CRAG amendment no. 22: National Assistance (Assessment of Resources and Sums for Personal Requirements) (Amendment) (Wales) Regulations 2006
- Author:
- WALES. Welsh Assembly Government
- Publisher:
- Wales. Welsh Assembly Government
- Publication year:
- 2006
- Pagination:
- 7p.
- Place of publication:
- Cardiff
Advises of changes to the Charging for Residential Accommodation Guide (CRAG) to take account of the coming into effect of the Civil Partnerships Act 2004 and other requirements.