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Better Health in Old Age: report from Professor Ian Philp, National Director for Older People's Health to Secretary of State for Health
- Author:
- GREAT BRITAIN. Department of Health
- Publisher:
- Great Britain. Department of Health
- Publication year:
- 2004
- Pagination:
- 34p.
- Place of publication:
- London
This report highlights progress since 2001 under the National Service Framework for Older People and sets out a vision for the future. The National Service Framework (NSF) for Older People promotes independence and well-being for older people and support for them to live at home or in community settings as far as possible. The emphasis in the NSF has been right across the whole health and social care system rather than being narrowly focused on just one or two conditions. This is an ambitious agenda but a crucial one.
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.
Beyond one hip fracture at a time: rethinking aging services
- Author:
- VLADECK Fredda W.
- Journal article citation:
- Journal of Gerontological Social Work, 43(3/4), 2004, pp.151-162.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
The argument in this article is that the basic conceptual model used in construction of services to older people served well in years past but is now inadequate, descriptively or analytically. An alternative approach to the construction of community-based services is proposed and then examples from the practice of the author and from other communities are described. (Copies of this article are available from: Haworth Document Delivery Centre, Haworth Press Inc., 10 Alice Street, Binghamton, NY 13904-1580)
Older patients - who cares?
- Author:
- O'KELL Stephen
- Journal article citation:
- Nursing Times, 12.3.97, 1997, p.37.
- Publisher:
- Nursing Times
The author explains why the government must spell out who does what in the assessment of community clients' health needs.
Factors influencing the use of community health and social services by those aged 65 and over
- Authors:
- BONIFACE David R., DENHAM Michael J.
- Journal article citation:
- Health and Social Care in the Community, 5(1), January 1997, pp.48-54.
- Publisher:
- Wiley
Interview data collected in a 1990/91 health and life-style survey is used to investigate in those aged 65 years and over the relationship to the use of community health and social services of age, health status and social and economic factors. Contacts with general practitioners (GPs), district nurses and home helps and the use of 'meals on wheels', day centres for elderly people and lunch clubs were related to age, chronic illnesses, gender, mental well-being, living alone, income and social class. Consideration is given to the implications for those who plan community health and social services.
Grey matters
- Authors:
- CARPENTER Iain, CALNAN Michael
- Journal article citation:
- Health Service Journal, 9.1.97, 1997, pp.22-23.
- Publisher:
- Emap Healthcare
Health and local authorities spend vast sums on community care for elderly people, yet there is no national standard for assessing their needs. The authors report on the potential benefits of a standardised assessment.
Assessing older people with dementia living in the community: practice issues for social and health services
- Author:
- GREAT BRITAIN. Department of Health. Social Services Inspectorate
- Publisher:
- Great Britain. Department of Health. Social Services Inspectorate
- Publication year:
- 1996
- Pagination:
- 1p.
- Place of publication:
- London
Letter accompanying the action checklist for the document 'Assessing older people with dementia living in the community.'
Assessing older people with dementia living in the community: practice issues for social and health services: report of the SSI workshop and visits May-June 1995
- Author:
- GREAT BRITAIN. Department of Health. Social Services Inspectorate
- Publisher:
- Great Britain. Department of Health. Social Services Inspectorate
- Publication year:
- 1996
- Pagination:
- 36p.,bibliog.
- Place of publication:
- London
Report of an exploratory project undertaken by the SSI to consider the assessment of older people with dementia who need support to live in the community. The study focused in particular on health needs and multidisciplinary work. Includes an action checklist.
Enabling older people with mental health needs to engage with community social care: a scoping review to inform a theory of change
- Authors:
- NEWBOULD Louise, TUCKER Susan, WILBERFORCE Mark
- Journal article citation:
- Health and Social Care in the Community, 30(4), 2022, pp.1286-1306.
- Publisher:
- Wiley
Despite apparent need, many older people with cognitive impairment and/or mental health needs do not fully engage with social care. This can manifest in different ways, including passive or aggressive attempts to avoid or repel care workers. However, little is known about how to support such individuals in their own homes and deliver effective care. Against this background, the researchers undertook a scoping review with a view to developing a preliminary theory of change suggesting how care might be modified to engage this client group. The most recent search was conducted on 21/04/21. Papers were included if they (i) focused on older people (65+) living at home with social care needs and (ii) described difficulties/problems with the provision/receipt of social care associated with individuals’ mental health needs. Twenty-six citations were identified through electronic database searches and reference screening, and the results were charted according to key theory of change concepts (long-term outcomes, preconditions, interventions, rationale and assumptions). All the included papers were related to people with dementia. Four subgroups of papers were identified. The first highlights those external conditions that make it more likely an intervention will be successful; the second describes specific interventions to engage older people who by virtue of their mental health needs have not engaged with social care; the third explores what services can be done to increase service uptake by older people with mental health needs and their caregivers more generally; and the fourth details theoretical approaches to explaining the behaviour of people with dementia. Each provides information that could be used to inform care delivery and the development of interventions to improve engagement with health and social care for these individuals. The study concludes that different framing of engagement difficulties, such as that offered through positioning theory, may assist in future service design. (Edited publisher abstract)