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Late-life depression, social support, instrumental activities of daily living, and utilization of in-home and community-based services in older adults
- Authors:
- LAM Brian Trung, CERVANTES Anna R., LEE Wilfred K.
- Journal article citation:
- Journal of Human Behavior in the Social Environment, 24(4), 2014, pp.499-512.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
This study examined the relationship between social support, depression, instrumental activities of daily living (IADLs), and utilisation of in-home and community-based services. The sample included 39 adults age 65 years old and older. The data were collected by distributing a self-administered questionnaire. Depression levels significantly decreased as levels of social support increased. IADLs functioning significantly decreased as depression levels increased. The number of in-home services used significantly increased as IADLs functioning decreased. The number of community-based services used significantly increased as depression levels decreased. The number of in-home and community-based services used significantly increased as levels of support decreased. (Edited publisher abstract)
We do everything
- Author:
- JACKSON Catherine
- Journal article citation:
- Mental Health Today, April 2008, pp.16-17.
- Publisher:
- Pavilion
- Place of publication:
- Hove
Home treatment provides brief, intensive care at home as an alternative to hospital admission. This article describes the work of the older people's home treatment team based at Penn Hospital at Wolverhampton, winners of the NIMHE Positive Practice Award for innovative commissioning. Their model reduces the risk of dependency and also helps older people re-engage with their families and communities.
Development and preliminary validation of an Observation List for detecting mental disorders and social Problems in the elderly in primary and home care (OLP)
- Authors:
- TAK Erwin C.P.M., et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 31(7), 2016, pp.755-764.
- Publisher:
- Wiley
Objective: Even though the prevalence of mental disorders and social problems is high among elderly patients, it is difficult to detect these in a primary (home) care setting. Goal was the development and preliminary validation of a short observation list to detect six problem areas: anxiety, depression, cognition, suspicion, loneliness, and somatisation. Methods: A draft list of indicators identified from a short review of the literature and the opinions of 22 experts was evaluated by general practitioners (GPs) and home care organisations for feasibility. It was then used by GPs and home care personnel to observe patients, who also completed validated tests for psychological disorders (General Health Questionnaire 12 item version (GHQ-12)), depression (Geriatric Depression Scale 15-item version (GDS-15)), anxiety and suspicion (Symptom Checklist-90 (SCL-90)), loneliness (University of California, Los Angeles (UCLA)), somatisation (Illness Attitude Scale (IAS)), and cognition (Mini-Mental State Examination (MMSE)). Results: GPs and home care personnel observed 180 patients (mean age 78.4 years; 66% female) and evaluated the draft list during a regular visit. Cronbach's α was 0.87 for the draft list and ≥0.80 for the draft problem areas (loneliness and suspicion excepted). Principal component analysis identified six components (cognition, depression + loneliness, somatisation, anxiety + suspicion, depression (other signs), and an ambiguous component). Convergent validity was shown for the indicators list as a whole (using the GHQ-12), and the subscales of depression, anxiety, loneliness, cognition, and somatisation. Using pre-set agreed criteria, the list was reduced to 14 final indicators divided over five problem areas. Conclusion: The Observation List for mental disorders and social Problems (OLP) proved to be preliminarily valid, reliable, and feasible for use in primary and home care settings. (Publisher abstract)
The effectiveness of crisis resolution/home treatment teams for older people with mental health problems: a systematic review and scoping exercise
- Authors:
- TOOT Sandeep, DEVINE Mike, ORRELL Martin
- Journal article citation:
- International Journal of Geriatric Psychiatry, 26(12), December 2011, pp.1221-1230.
- Publisher:
- Wiley
This systematic review assessed the effectiveness of crisis resolution/home treatment teams (CRHTTs) for older people with mental health problems. A scoping exercise was also carried out to assess the typologies of older people's CRHTTs in practice, and to review these in the context of policy and research findings. CRHTTs were effective in reducing numbers of admissions to hospitals, but outcomes such as length of hospital stay and maintenance of community residence was inconclusive. The scoping exercise defined three types of home treatment service model: generic home treatment teams; specialist older adults’ home treatment teams; and intermediate care services. These home treatment teams seemed to be effectively managing crises and reducing admissions. The review highlighted a lack of evidence for the effectiveness of crisis resolution/home treatment teams in supporting older people with mental health problems to remain at home. The authors suggest the need for a randomised controlled trial to establish the efficacy of crisis resolution/home treatment services for older people with mental health problems, as well as an assessment of the home treatment service models available in the UK.
Commissioning care closer to home: final report
- Authors:
- WISTOW Gerald, WADDINGTON Eileen, KITT Iain
- Publisher:
- Association of Directors of Adult Social Services
- Publication year:
- 2009
- Pagination:
- 60p.
- Place of publication:
- London
A project to promote better commissioning by social care and partner agencies of care closer to home for older people was commissioned in 2007. Seven local sites agreed to participate in the fieldwork: three focusing on the commissioning implications for adult social care, local authority and community sector partners of the shift from care in acute hospital settings (Blackpool, Islington and Sandwell), and four focusing on more effective commissioning arrangements for older people with mental health needs (Hampshire, Knowsley, Leeds and Oxfordshire). The key findings were that care closer to home is being interpreted and implemented in a variety of ways, that it is not clear whether it is seen as a specific objective of central government policy or a dimension of other policies, and that there is a corresponding lack of clarity about where ownership and accountability lie locally and nationally for its implementation and how its success will be measured. This report describes the overall findings from the project, including the commissioning framework designed for commissioning care closer to home, analyses the implications for the further development of care closer to home, and describes the work undertaken at the fieldwork sites.
Crisis resolution and home treatment teams for older people with mental illness
- Authors:
- DIBBEN Claire, et al
- Journal article citation:
- Psychiatric Bulletin, 32(7), July 2008, pp.268-270.
- Publisher:
- Royal College of Psychiatrists
Examined the impact of a crisis resolution and home treatment teams (CRHTT) on hospital admission rates, bed days and treatment satisfaction among older people with mental illness and their carers. The authors compared these factors in the 6 months before the service started and 6 months after its introduction. The CRHTT significantly reduced admissions, but there was no significant difference in the length of hospital stay as compared before and after the introduction of this service. There was a trend towards carers, but not patients, being more satisfied with treatment after the introduction of the CRHTT. Admissions for older people were up by 31% and carers preferred the service. Further research on crisis teams in older people with mental illness is needed using randomised controlled methodology.
The unmet needs of the elderly with diabetes in home health care
- Author:
- LEE Ji S.
- Journal article citation:
- Social Work in Health Care, 45(3), 2007, pp.1-17.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
The implementation of the Prospective Payment System in Medicare home health care (HHC) is intended to reduce spending and has raised concerns about the health outcomes for older people. This study examines the unmet health needs of 129 older diabetic patients while receiving HHC, and after discharge from the programme. The findings show that a quarter reported experienced unmet needs post-discharge though not reporting such needs while receiving HHC, while 15.5% reported unmet needs while receiving HHC. Unmet needs included social work services, home health aides, homemaker services and medical equipment. The higher than average levels of depression and emotional problems in the sample (relatively more common among people with diabetes) may be significant. The findings highlight the importance of social work services for people with diabetes who receive HHC, and the need for social workers to be involved in discharge planning. (Copies of this article are available from: Haworth Document Delivery Centre, Haworth Press Inc., 10 Alice Street, Binghamton, NY 13904-1580).
Support for family carers for an elderly person at home: a systematic literature review
- Authors:
- STOLTZ Peter, UDDEN Giggi, WILLMAN Ania
- Journal article citation:
- Scandinavian Journal of Caring Sciences, 18(2), June 2004, pp.111-119.
- Publisher:
- Blackwell Publishing
Sweden, like other countries, has an ageing population, and support for the carers of older people in their own homes is an important policy issue. Support may take a variety of forms, both formal and informal, and this review aims to identify and synthesise high quality evidence on family carers’ perspectives of their situations and needs. Twenty-six papers (primarily American and of carers of people with Alzheimer’s disease) are included in the review, showing that carers fear social isolation and want to network with their peers, either for social or learning purposes. They also want respite care. However, the evidence is not clear on whether they actually benefit from these forms of support, or how service provision should be attempted.
Intermediate care and mental health
- Authors:
- SULLIVAN Julia, TRINDER Sally
- Journal article citation:
- Working with Older People, 8(1), March 2004, pp.21-24.
- Publisher:
- Emerald
Describes the 24-hour Elderly Mental Health intermediate care service set up in Portsmouth to provide intermediate care services for older people with mental health problems. The service gives people the choice to remain at home.
Care of the elderly with psychiatric disorders
- Author:
- SPOOR Chris
- Publisher:
- University of Aberdeen. Health Economics Research Unit
- Publication year:
- 1988
- Pagination:
- 40p., tables, bibliog.
- Place of publication:
- Aberdeen
Reports on a study which set out to specify and measure the benefits generated by various service options for care of the elderly with psychiatric disorders.