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Evaluating a project to improve care of older people in Scotland
- Authors:
- McDONACH Eileen, KYDD Angela
- Journal article citation:
- Nursing Times, 21.9.04, 2004, pp.34-36.
- Publisher:
- Nursing Times
The second of two articles describing an innovative pilot study in Scotland attempting to promote evidence-based practice in the nursing care of older people in a variety of residential care settings. Documents findings from a qualitative process evaluation of the experiences of 8 nurse clinicians who participated in the pilot. The evaluation provided valuable insights into how future schemes might be enhanced.
We are the champions
- Author:
- MANTHORPE Jill
- Journal article citation:
- Community Care, 6.5.04, 2004, p.36.
- Publisher:
- Reed Business Information
Reports on the results of a recent survey undertaken for Better Government of Older People. The study looked at the role of older people's champions, who have the responsibility for implementing the National Service Framework's in local authorities, how they feel about their role and how effective they are.
Diversity in intermediate care
- Authors:
- MARTIN Graham Paul, et al
- Journal article citation:
- Health and Social Care in the Community, 12(2), March 2004, pp.150-154.
- Publisher:
- Wiley
Discusses the evolution of intermediate care (IC) and presents interim observations from a survey of providers in England being conducted as part of a national evaluation. Telephone interviews covering various issues concerning level of provision and style of delivery have been conducted with 70 services. Data are used to discuss the progress, range and nature of IC in relation to clinician viewpoints and academic and official literature on the subject. IC 'on the ground' is a multiplicitous entity, with provision apparently evolving in accordance with the particularities of local need. While protocols for medical involvement in IC generally appear to be well established, there are some tensions concerning integration of services in a locality, care management processes and questions of flexibility and inclusiveness in relation to eligibility criteria.
Evaluating an education project in mental health of older people
- Author:
- BUTLER Rose
- Journal article citation:
- Nursing Times, 31.8.04, 2004, pp.38-40.
- Publisher:
- Nursing Times
Describes the development and evaluation of an education and training pathway for older people's mental health aiming to increase the knowledge and skills of non-specialist NHS-registered and support staff working on acute wards for older people. Concludes the workshops were successful because learning outcomes appear to have been achieved. Summarises factors affecting success and makes recommendations to improve training.
Evaluating mental health services for older people
- Author:
- FINCH Jenny
- Publisher:
- Radcliffe
- Publication year:
- 2004
- Pagination:
- 212p.,bibliog.
- Place of publication:
- Oxford
This book provides an account of the current developments in mental health services for older people and describes a robust model for evaluating health and social care to improve these services. Drawing on international experience, it provides accounts of the development of mental health services for older people in the UK, Europe, the USA, Canada and Australia. The approaches to evaluating health and social care in these countries are all outlined, and a comparative analysis is given. The services currently offered are patchy, so there is a pressing need for effective mechanisms to be introduced in order to monitor quality.
Agreement between dementia patient report and proxy reports using the Nottingham Health Profile
- Authors:
- BOYER F., et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 19(11), November 2004, pp.1026-1034.
- Publisher:
- Wiley
The aim of the study was to examine the agreement between patient reports and their proxy reports (family and care provider proxies) on Health Status in a sample of patients with dementia. Completion rates for the different NHP dimensions ranged from 78 to 90% for the dementia subjects. Inter-rater agreement between different proxies and subject was from moderate to good for physical assessment (ICCs from 0.54 to 0.78 for physical mobility scales). Patient/family proxy concordance was moderate to good for five out of six dimensions (physical mobility, social isolation, pain, energy, sleep) and poor for emotional reaction. Family proxies systematically reported lower functioning than did patients in the four subscales assessing: physical mobility (p < 0.0001), energy (p < 0.005), social isolation (p < 0.01) and sleep (p < 0.03). Care provider proxies only estimated physical mobility as lower (p < 0.0001). Age and physical status of the patient significantly affected agreement in patient-care provider proxy ratings. Thus, caution is appropriate when resorting to proxies to estimate the Health Status of a dementia patient.
Senior citizens centers: what they offer, who participates, and what they gain
- Author:
- TURNER A. Whisnant
- Journal article citation:
- Journal of Gerontological Social Work, 43(1), 2004, pp.37-49.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
This study extends exploration of what senior centers offer, who participates, and what they gain. Center staff surveyed 856 participants in 27 senior centers regarding personal characteristics, program participation, and acquisition of vital information. Although senior centers are considered conduits for group activities and enrichment for older citizens, this investigation indicates that personal characteristics of participants exert a notable influence on the experience and perceived benefits of activities engaged in at senior centers. These findings should interest providers of aging services and advocates who view the senior center as an important vehicle for enhancing independent living for older adults. (Copies of this article are available from: Haworth Document Delivery Centre, Haworth Press Inc., 10 Alice Street, Binghamton, NY 13904-1580)
Congruence between disabled elders and their primary caregivers
- Authors:
- HOROWITZ Amy, GOODMAN Caryn R., REINHARDT Joann P.
- Journal article citation:
- Gerontologist, 44(4), August 2004, pp.532-542.
- Publisher:
- Oxford University Press
This study examines the extent and independent correlates of congruence between disabled elders and their caregivers on several aspects of the caregiving experience. Participants were 117 visually impaired elders and their caregivers. Correlational analyses, kappa statistics, and paired t tests were used to examine the extent of congruence. Hierarchical multiple regression analyses identified significant correlates of congruence on four target issues: elder's functional disability, elder's adaptation to vision impairment, caregiver's overprotectiveness, and caregiver's understanding of the vision problem. Caregivers assessed elders as more disabled and rated themselves as more overprotective than did the elders. Although independent correlates varied by target issue, two domains most consistently influenced congruence across measures: the caregiver's assessment of the elder's status and quality of the relationship. Findings underscore the importance of addressing congruence by target issue, rather than as a global characteristic of the caregiving relationship.
A survey of assistive equipment use by older people following hospital discharge
- Authors:
- HOFFMANN Tammy, McKENNA Kryss
- Journal article citation:
- British Journal of Occupational Therapy, 67(2), February 2004, pp.75-82.
- Publisher:
- Sage
Occupational therapists prescribe assistive equipment to increase clients' independence in self-care activities. This study examined clients' use of assistive equipment post-discharge and explored the factors that might have influenced use. The participants were 127 clients who were issued one or more items of assistive equipment while inpatients at a metropolitan hospital. At approximately 10 weeks post-discharge, the participants completed a postal questionnaire. Of the 407 items of equipment prescribed, 363 were used, with three types of equipment (bathboards, hand-held shower hoses and stair rails) having 100% use. The participants who lived alone were more likely to use toileting equipment and shower chairs than the participants who did not live alone. The long-handled equipment had the lowest usage rates. For unused equipment, 16.5% was not used because it was no longer needed and 9.3% because the participants reported that they had never really needed it. Overall, 91.3% of the participants reported that they had received adequate training in the use of the equipment. Although most of the participants used prescribed assistive equipment, makes recommendations based on a client-centred approach to the prescription process to increase clients' use of equipment further.
An evaluation of a multidisciplinary team for intermediate care at home
- Authors:
- BEECH Roger, et al
- Journal article citation:
- International Journal of Integrated Care, 4(4), 2004, Online only
- Publisher:
- International Foundation for Integrated Care
This paper describes an evaluation of a multidisciplinary Rapid Response Team (RRT). This service aimed to provide a home based alternative to care previously provided in an acute hospital bed which was acceptable to patients and carers and which maintained clinical care standards. The service was provided for the population of Hereford, a rural town in the middle of England. A mixed-method descriptive design using quantitative and qualitative techniques was used to monitor: the characteristics of service users, the types and amounts of care received, any ‘adverse’ events arising from that care, and the acceptability of the service to patients and carers. A collaborative approach involving key stakeholders allowed appropriate data to be gathered from patient case notes, RRT staff, local health and social care providers, and patients and their carers. A suite of self-completed questionnaires was, therefore, designed to capture study data on patients and activities of care, and workshops and semi-structured interview schedules used to obtain feedback from users and stakeholders. Service users (231) were elderly (mean age 75.9), from three main diagnostic categories (respiratory conditions 19.0%, heart/stroke 16.2%, falls 13.4%), with the majority (57.0%) having both medical and social care needs. All patients received care at home (mean duration 5.6 days) with only 5.7% of patients having to be re-admitted to acute care. Overall, patients and carers had positive attitudes to the new service but some expressed concerns about their ability to influence the choice of care option (24.1% and 25.0% of patients and carers, respectively), whilst 22.7% of carers were concerned about the quality of information about care. The findings of this evaluation suggest that the Rapid Response Team provided an ‘acceptable’ alternative to an extended period of care in an acute setting. Such schemes may have relevance beyond the NHS of the UK as a means of providing a more appropriate and cost efficient match between patients' needs for care, the types of care provided, and the place in which care is provided.