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Under reconstruction: the impact of COVID-19 policies on the lives and support networks of older people living alone
- Authors:
- PFABIGAN Johanna, et al
- Journal article citation:
- International Journal of Care and Caring, 6(1-2), 2022, pp.211-228.
- Publisher:
- Policy Press
In the spring of 2020, the Austrian government introduced COVID-19 containment policies that had various impacts on older people living alone and their care arrangements. Seven qualitative telephone interviews with older people living alone were conducted to explore how they were affected by these policies. The findings show that the management of everyday life and support was challenging for older people living alone, even though they did not perceive the pandemic as a threat. To better address the needs of older people living alone, it would be important to actively negotiate single measures in the area of conflict between protection, safety and assurance of autonomy. (Edited publisher abstract)
Changes in commissioning home care: an English survey
- Authors:
- DAVIES Sue, et al
- Journal article citation:
- Quality in Ageing and Older Adults, 21(1), 2020, pp.3-14.
- Publisher:
- Emerald
The purpose of this study is to examine changes in the nature, form and range of commissioning arrangements for home care.Design/methodology/approach: Data from two discrete national surveys of English local authorities with social service responsibilities were used. In the first, undertaken in 2007, responses from 111 of the 151 local authorities (74%) were received; in the second, undertaken in 2017, responses from 109 local authorities (72%) were received. A combined data set of 79 complete cases, 52% of local authorities, was created. Percentage point differences across the two time periods were calculated and tested to identify significant changes and a systematic analysis of the free-text responses regarding intended changes to the commissioning process in each data set was undertaken.Findings: Findings identified substantial changes in some aspects of the commissioning of home care in the 2007-2017 decade. Collaboration between stakeholders had increased, particularly regarding the identification of future needs. Improved conditions of service and remuneration for home care workers were evident within the commissioning process. Standardised charges for home care (regardless of time and day) had also become more widespread. Initiatives to prompt providers to deliver more personalised care were more evident. Originality/value: This paper describes the evolution of commissioning arrangements for home care in localities in response to national policy initiatives. It provides guidance to commissioners in meeting the needs of current service users and emphasises the importance of collaboration with stakeholders, particularly providers, in securing future capacity. (Edited publisher abstract)
House calls: the impact of home-based care for older adults with Alzheimer’s and dementia
- Authors:
- WILSON Kasey, BACHMAN Sara S.
- Journal article citation:
- Social Work in Health Care, 54(6), 2015, pp.547-558.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
Older adults with Alzheimer’s/dementia have high health care costs; they may benefit from home-based care, but few have home visits. This article describes a home-based care programme for frail elders, including those with Alzheimer’s/dementia. Descriptive statistics are provided for Medicare-enrolled programme participants and matched controls with Alzheimer’s/dementia on expenditures along six services: skilled nursing facility, inpatient acute, physician, home health, hospice, and social services. Cases with dementia were significantly more likely to have home health and hospice expenditures than controls, suggesting potential for the program to improve end-of-life care. Very few cases or controls had any social service expenditures. Social workers should advocate for the expanded role of home-based care for older adults with dementia and for increased Medicare reimbursement of social work services. (Edited publisher abstract)
The bigger picture: policy insights and recommendations
- Author:
- LLOYD James
- Publishers:
- Independent Age, Strategic Society Centre
- Publication year:
- 2014
- Pagination:
- 50
- Place of publication:
- London
This report evaluates the performance of government policy on care and support of older people who struggle with day-to-day activities in England during the period 2011 to 2013, using the data and insights from ‘The bigger picture: understanding disability and care in England’s older population’. Part 1 of this report examines the reach of publicly funded support; the unmet need in the older population; and variation and consistency of care and support. Part 2 considers the implications of the Care Act implementation and looks at policy development beyond 2016, focusing on eligible needs after the Act, financial eligibility and the means test after 2016 and mapping, identifying and engaging older population groups. The report concludes that given the feasibility and budget challenges implied by the sheer numbers of older people experiencing difficulties with activities of daily living, a rethink and revolution is required among national and local policymakers around how individuals and families are engaged and supported. This will mean revisiting the balance between consistency and variation in services organised by local authorities, as well as fully integrating and exploiting the different ‘touch points’ and ‘gateways’ available for engaging the older population. It will also mean evaluating which aspects of the vision of the Care Act need to be fulfilled by local authorities directly, or can be devolved to empowered, third-party charities and organisations at a local level. (Edited publisher abstract)
The effect of telecare on the quality of life and psychological well-being of elderly recipients of social care over a 12-month period: the Whole Systems Demonstrator cluster randomised trial
- Authors:
- HIRANI Shashivadan Parbati, et al
- Journal article citation:
- Age and Ageing, 43(3), 2014, pp.334-341.
- Publisher:
- Oxford University Press
Background: Home-based telecare (TC) is utilised to manage risks of independent living and provide prompt emergency responses. This study examined the effect of TC on health-related quality of life (HRQoL), anxiety and depressive symptoms over 12 months in patients receiving social care. Design: A study of participant-reported outcomes [the Whole Systems Demonstrator (WSD) Telecare Questionnaire Study; baseline n = 1,189] was nested in a pragmatic cluster-randomised trial of TC (the WSD Telecare trial), held across three English Local Authorities. General practice (GP) was the unit of randomisation and TC was compared with usual care (UC). Methods: Participant-reported outcome measures were collected at baseline, short-term (4 months) and long-term (12 months) follow-up, assessing generic HRQoL, anxiety and depressive symptoms. Primary intention-to-treat analyses tested treatment effectiveness and were conducted using multilevel models to control for GP clustering and covariates for participants who completed questionnaire measures at baseline assessment plus at least one other assessment (n = 873). Results: Analyses found significant differences between TC and UC on Short Form-12 mental component scores (P < 0.05), with parameter estimates indicating being a member of the TC trial-arm increases mental component scores (UC-adjusted mean = 40.52; TC-adjusted mean = 43.69). Additional significant analyses revealed, time effects on EQ5D (decreasing over time) and depressive symptoms (increasing over time). Conclusions: TC potentially contributes to the amelioration in the decline in users’ mental HRQoL over a 12-month period. TC may not transform the lives of its users, but it may afford small relative benefits on some psychological and HRQOL outcomes relative to users who only receive UC. (Publisher abstract)
Issues arising for older people at the 'interface' of intermediate care and social care issues
- Author:
- SCOURFIELD Peter
- Journal article citation:
- Research Policy and Planning, 25(1), 2007, pp.57-67.
- Publisher:
- Social Services Research Group
In recent years both the Health Act 1999 and the Health and Social Care Act 2001 have paved the way for the integrated care trusts with the aim of bringing about more flexible, person-centred services for older people. Concern to avoid both unnecessary hospital admissions and so called 'bed-blocking' has led to the expansion of intermediate care services. The National Service Framework for Older People, published in 2001, further articulated these ambitions. Evaluations to date have indicated that, whilst further research is still needed to see whether all the goals have been effectively realised, intermediate care is associated with a range of perceived benefits. However, this paper highlights the fact that, on the ground there remain certain unresolved difficulties at the point where intermediate care ends and where social care begins that needed further consideration before it can be said that services are properly 'joined-up and 'person-centred'. Implications for both practice and policy are considered.
Cost-benefit analysis in social care for elderly people
- Author:
- DUTRENIT Jean-Marc
- Journal article citation:
- Evaluation Review, 29(5), October 2005, pp.389-406.
- Publisher:
- Sage
Social care at home for elderly people is now growing rapidly in France. The research presented here, and made for the Comity of Lille Employment Area with cooperation of the Caisse Primaire d’Assurance Maladiede Lille (the local board of the national social security system), attempts to discover 'What kind of social activities could stimulate good health for elderly people measured by lower cost of pharmacy expenditures?'. The results found that ceteris paribus, cultural activities - in a group or at home - versus others appear to produce more interest for elderly, professional caregivers, and the rest of society.
Heterogeneity in the effect of obesity on future long-term care use in England
- Authors:
- GOUSIA Katerina, et al
- Publisher:
- Quality and Outcomes of Person-centred Care Policy Research Unit
- Publication year:
- 2019
- Pagination:
- 28
- Place of publication:
- Canterbury
This study provides new evidence on the effect of obesity on future use of long-term care services in England. More specifically, it explores the effect of obesity on different types of care and tests for heterogeneous effects on different types of care by looking at different classifications of obesity. It also explores whether the findings are sensitive to the incorporation of information on long-term care use prior to death. The results found that in addition to the obesity at the level of BMI between 25 and 45 representing a risk for future use of informal care, (super) obesity at the level of BMI at 45 and greater represents a significant risk for all types of care use, including social care and nursing home/residential care. (Edited publisher abstract)
Linkage of social care and hospital admissions data to explore non-delivery of planned home care for older people in Scotland
- Authors:
- EVANS Josie, METHVEN Karen, CUNNINGHAM Nicola
- Journal article citation:
- Quality in Ageing and Older Adults, 20(2), 2019, pp.48-55.
- Publisher:
- Emerald
Purpose: As part of a pilot study assessing the feasibility of record-linking health and social care data, the purpose of this paper is to examine patterns of non-delivery of home care among older clients (>65 years) of a social home care provider in Glasgow, Scotland. The paper also assesses whether non-delivery is associated with subsequent emergency hospital admission. Design/methodology/approach: After obtaining appropriate permissions, the electronic records of all home care clients were linked to a hospital inpatient database and anonymised. Data on home care plans were collated for 4,815 older non-hospitalised clients, and non-delivered visits were examined. Using case-control methodology, those who had an emergency hospital admission in the next calendar month were identified (n=586), along with age and sex-matched controls, to determine whether non-delivery was a risk factor for hospital admission. Findings: There were 4,170 instances of “No Access” non-delivery among 1,411 people, and 960 instances of “Service Refusal” non-delivery among 427 people. The median number of undelivered visits was two among the one-third of clients who did not receive all their planned care. There were independent associations between being male and living alone, and non-delivery, while increasing age was associated with a decreased likelihood of non-delivery. Having any undelivered home care was associated with an increased risk of emergency hospital admission, but this could be due to uncontrolled confounding. Research limitations/implications: This study demonstrates untapped potential for innovative research into the quality of social care and effects on health outcomes. Originality/value: Non-delivery of planned home care, for whatever reason, is associated with emergency hospital admission; this could be a useful indicator of vulnerable clients needing increased surveillance. (Edited publisher abstract)
Met and unmet care needs of older people with dementia living at home: personal and informal carers’ perspectives
- Authors:
- MAZUREK Justyna, et al
- Journal article citation:
- Dementia: the International Journal of Social Research and Practice, 18(6), 2019, pp.1963-1975.
- Publisher:
- Sage
In Poland, there are few reports of the holistic approach to caring for older people with dementia. The aim of this study was to assess the needs of people with dementia living at home. This was done by evaluating the perspective of people with dementia themselves and that of their carers. The study included 47 people diagnosed with mild to moderate dementia and 41 informal carers, all living in Wroclaw in Poland, involved in the MeetingDem project. The needs were assessed using the CANE. Other scales used were: the MMSE, the GDS and the QOL-AD. The carers reported significantly more needs, both met and unmet, than the people with dementia themselves. The most frequent reported unmet needs both by the people with dementia and their carers included activities of daily living, psychological distress and the need for company. Based on this study’s findings, tailored multidisciplinary treatment, adjusted to their needs and wishes, can be offered thus creating integrated and individualised support. (Edited publisher abstract)