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Moving on? A handbook on modelling the whole system for delayed discharges in Tayside
- Author:
- AUDIT SCOTLAND
- Publisher:
- Audit Scotland
- Publication year:
- 2005
- Pagination:
- 24p.
- Place of publication:
- Edinburgh
During 2004 Audit Scotland led a project with the Tayside Partnership and ISD to develop a whole systems model for Tayside to help tackle its delayed discharges from hospital. This handbook aims to share this approach with Scotland’s NHS and council partnerships wishing to develop their own whole systems thinking. The Tayside model does not provide a solution to the problem of delayed discharges in Tayside. It is an interactive tool to inform and help planning and decision-making in relation to delayed discharges. The handbook describes how stakeholders were involved in building the whole systems model, how the model is used to plan services for older people.
Human rights and dementia
- Author:
- BUCHANAN Anna
- Publisher:
- Scottish Care
- Publication year:
- 2017
- Pagination:
- 20
- Place of publication:
- Ayr
This publication considers the potential of a human-rights based approach in the care and support of people living with dementia. The author shares some examples based on true life situations to show how human rights should be placed at the heart of the life experience of people with dementia and their families. The examples cover the human rights of: the right to hold a belief and the right to family life. The publication also highlights some examples of good practice in Scotland of supporting human rights care settings. It is one of a series of Care Cameos, designed to highlight issues which are important for the delivery of care and support for older people across Scotland. (Edited publisher abstract)
Findings: local urban environments and the wellbeing of older people
- Author:
- DAY Rosie
- Publisher:
- Scottish Centre for Research on Social Justice
- Publication year:
- 2008
- Pagination:
- 4p.
- Place of publication:
- Glasgow
This study investigated how local outdoor environments can influence older people’s health and wellbeing. It used qualitative techniques to engage in depth with older people in three different Scottish urban neighbourhoods. It also examined how much influence the older people felt they had in decision-making affecting their local environment. The findings indicate that certain key aspects of local environments can either promote or detract from older people’s mental and physical wellbeing especially by affecting the amount of exercise and social interaction older residents might attain. Planners and urban designers could usefully develop a greater awareness of older people’s perspectives. Key findings are presented.
Adults with Incapacity (Scotland) Act 2000: communication and assessing capacity: a guide for social work and health care staff
- Author:
- KILLEEN Jan
- Publisher:
- Scotland. Scottish Government
- Publication year:
- 2008
- Pagination:
- 40p.
- Place of publication:
- Edinburgh
This guide was produced to support professionals in assessing the capacity of individuals who may come under protection of the Adults with Incapacity (Scotland) Act 2000. This guide is primarily for social work and health care staff in Scotland, including care managers, clinical psychologists, and medical practitioners. The starting point for assessing someone’s capacity to make a particular decision is always the assumption that the individual has capacity.
Capturing the concealed: Interprofessional practice and older patients' participation in decision-making about discharge after acute hospitalization
- Authors:
- HUBY Guro, et al
- Journal article citation:
- Journal of Interprofessional Care, 21(1), January 2007, pp.55-67.
- Publisher:
- Taylor and Francis
The aim of this paper is to investigate ways in which the dynamics of interprofessional work shaped older patients' “participation” in decision-making about discharge from acute hospital care in a medical directorate of a District General Hospital in Scotland. Twenty-two purposively selected older patients and their key professional hospital carers in three different ward environments participated in the study. An ethnographic approach was adopted, involving semi-structured interviews with patients and staff combined with rigorous observation of the practical context for staff and patient interactions during the discharge planning process over a 5-month period. Patients' and staff's understanding of “decision-making” and their priorities for discharge were different, but patients' perspectives fragmented and became invisible. Care routines, which centred around assessments and the decisions that flowed from these tended to exclude both staff and patients from active decision-making. Research and practice on patient involvement in discharge decision-making needs to focus on the organizational context, which shapes patients', unpaid carers' and staff's interactions and the dynamics by which some views are privileged and others excluded. Procedurally driven care routines and their impact on patients', carers' and staff's opportunity to actively engage in decision-making should be re-considered from an empowerment perspective.
Report on incapable adults: report submitted under section 3(2) of the Law Commissions Act 1965; presented to Parliament by the Lord Advocate by command of Her Majesty, September 1995
- Author:
- SCOTTISH LAW COMMISSION
- Publisher:
- HMSO
- Publication year:
- 1995
- Pagination:
- 240p.
- Place of publication:
- Edinburgh
Examines the law in Scotland relating to decision making for people who are unable to decide for themselves, looks at what is wrong with the current system. Goes on to make suggestions and recommendations for improvements.
Should I move?: a guide to sheltered housing and retirement housing in Scotland
- Author:
- ANDERSON Christine
- Publisher:
- Age Concern
- Publication year:
- 1992
- Pagination:
- 68p.,list of orgs.,bibliog.
- Place of publication:
- Edinburgh
Practical text aimed at older people considering a move to sheltered housing, to help them come to the best decision. Includes a questionnaire to aid the decision making process.
Cost-effectiveness of donepezil and memantine in moderate to severe Alzheimer's disease (the DOMINO-AD trial)
- Authors:
- KNAPP Martin, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 32(12), 2017, pp.1205-1216.
- Publisher:
- Wiley
Objective: Most investigations of pharmacotherapy for treating Alzheimer's disease focus on patients with mild-to-moderate symptoms, with little evidence to guide clinical decisions when symptoms become severe. The authors examined whether continuing donepezil, or commencing memantine, is cost-effective for community-dwelling, moderate-to-severe Alzheimer's disease patients. Methods: Cost-effectiveness analysis was based on a 52-week, multicentre, double-blind, placebo-controlled, factorial clinical trial. A total of 295 community-dwelling patients with moderate/severe Alzheimer's disease, already treated with donepezil, were randomised to: (i) continue donepezil; (ii) discontinue donepezil; (iii) discontinue donepezil and start memantine; or (iv) continue donepezil and start memantine. Results: Continuing donepezil for 52 weeks was more cost-effective than discontinuation, considering cognition, activities of daily living and health-related quality of life. Starting memantine was more cost-effective than donepezil discontinuation. Donepezil–memantine combined is not more cost-effective than donepezil alone. Conclusions: Robust evidence is now available to inform clinical decisions and commissioning strategies so as to improve patients' lives whilst making efficient use of available resources. Clinical guidelines for treating moderate/severe Alzheimer's disease, such as those issued by NICE in England and Wales, should be revisited. (Edited publisher abstract)
Talking mats: a model of communication training
- Authors:
- MURPHY Joan, ALEXANDER Jean, McLINTON Ann
- Journal article citation:
- Journal of Dementia Care, 24(5), 2016, pp.22-25.
- Publisher:
- Hawker
Talking Mats is an interactive communication resource which was devised by NHS speech and language therapists in a series of research projects at Stirling University. The authors explain how it works and why it is a valuable tool. They use an example of training they were commissioned to do in a long stay hospital in Glasgow, where patients were mainly older people with dementia who often found it difficult to communicate their needs and wishes. (Edited publisher abstract)
Empowerment and decision-making for people with dementia: the use of legal interventions in Scotland
- Author:
- WILKINSON H.
- Journal article citation:
- Aging and Mental Health, 5(4), November 2001, pp.322-328.
- Publisher:
- Taylor and Francis
Dementia is associated with a decline in the ability to reason and make judgements thereby affecting a person's ability to make sound decisions. The growing emphasis on early diagnosis for people with dementia provides an opportunity for people to plan and control decisions about financial management and welfare. This paper coincides with a move to reform outdated Scottish Law with the Adults with Incapacity (Scotland) Act 2000. This legislation proposes a more integrated and flexible approach to the legal management of the affairs of people with reduced decision-making capability. This article reviews of the recent literature on the use of legal interventions for people with dementia and their families, and discusses the empowering or disempowering nature of the interventions.