Search results for ‘Subject term:"older people"’ Sort:
Results 1 - 10 of 40
Hospital discharge and community care: early days
- Authors:
- HENWOOD Melanie, WISTOW Gerald
- Publisher:
- Great Britain. Department of Health. Social Services Inspectorate
- Publication year:
- 1993
- Pagination:
- 58p.
- Place of publication:
- London
Report based on a study of 6 English localities which were believed to have well advanced arrangements for the hospital discharge of older people. Provides a snapshot of the position around April 1993 when community care changes were starting to be implemented. Points up issues for continuing concern, as well as elements of good practice.
The evaluation of the South Glamorgan care for the elderly hospital discharge service: a position paper and workplan
- Author:
- REES Teresa
- Publisher:
- University College Cardiff. Social Research Unit
- Publication year:
- 1987
- Pagination:
- 17p.,bibliog.
- Place of publication:
- Cardiff
Can post-acute care programmes for older people reduce overall costs in the health system? A case study using the Australian Transition Care Programme
- Authors:
- HALL C. J., et al
- Journal article citation:
- Health and Social Care in the Community, 20(1), January 2012, pp.97-102.
- Publisher:
- Wiley
Community-based post-acute care discharge services for older people have been developed as a method of reducing length of stay in hospital and preventing readmissions in order to reduce pressure and costs in the hospital system. This article considers whether they reduce overall episode cost or expenditure in the health system at a more general level. It uses the Australian Transition Care Programme (TCP) as a case study. The TCP provides flexible care to older patients at the conclusion of a hospital episode including home help, personal care, and rehabilitation. An economic model was developed to identify the maximum potential benefits and the likely cost savings for participants of TCP from the reduced use of health services from earlier discharge from hospital, accelerated recovery, reduced likelihood of readmission to hospital and delayed entry into permanent institutional care. The findings show that, even assuming the best case scenario, the TCP is still unlikely to be cost saving to the healthcare system. Further research is needed to determine if the service can be demonstrated to offer additional health benefits such as quality of life which would make it cost-effective when compared with other community healthcare programmes.
The home-visiting process for older people in the in-patient intermediate care services
- Author:
- HIBBERD Jane
- Journal article citation:
- Quality in Ageing, 9(1), March 2008, pp.13-23.
- Publisher:
- Pier Professional
- Place of publication:
- Brighton
Within the current constraints on health and social care services, it is essential that interventions such as home visits for older people can be seen to be appropriately deployed resources for facilitating their safe and timely discharge home. This paper discusses the findings of an evaluation project undertaken in 2003/04 with two in-patient intermediate care services. The service provided a short-term intervention for older people, with an emphasis on rehabilitation to enable a safe return to their own home environment.
For the sake of their health: older service users' requirements for social care to facilitate access to social networks following hospital discharge
- Authors:
- McLEOD Eileen, et al
- Journal article citation:
- British Journal of Social Work, 38(1), January 2008, pp.73-90.
- Publisher:
- Oxford University Press
Facilitating older service users’ requirements for access to or re-engagement in social networks following hospital discharge is recognized in social care analysis and policy as critically important. This is because of the associated benefits for restoring physical health and psychological well-being. However, it tends to be a neglected dimension of current social care/intermediate care. This paper draws on a qualitative study of voluntary sector hospital aftercare social rehabilitation projects in five UK localities, which focused on addressing this issue. Through examining older service users’ feedback and experience, the study confirms the health benefits of social care facilitating access to social networks at this crucial juncture. By providing sensitive interpersonal interaction, advocacy and ‘educational’ assistance, social care workers supported older service users’ re-engagement in a variety of networks. These included friendship, recreational and family groups, health care treatment programmes and locality based contacts and organizations. As a result, material, interpersonal and health care resources were accessed, which contributed to restoring and sustaining physical health and psychological well-being. The process of such social care also emerged as critical. This included ensuring that objectives reflected service users’ priorities; integrating ‘low-level’ home care; offering befriending; and challenging the pre-set time frame of intermediate care.
Buying Time I: a prospective, controlled trial of a joint health/social care residential rehabilitation unit for older people on discharge from hospital
- Authors:
- TRAPPES-LOMAX Tessa, et al
- Journal article citation:
- Health and Social Care in the Community, 14(1), January 2006, pp.49-62.
- Publisher:
- Wiley
The study's objective was to determine the effectiveness of a joint NHS/Social Services rehabilitation unit (a form of intermediate care) for older people on discharge from community hospital, compared with 'usual' community services. This was a controlled clinical trial in a practice setting. The intervention was 6 weeks in a rehabilitation unit where individuals worked with care/rehabilitation assistants and occupational therapists to regain independence. Controls went home with the health/social care services they would ordinarily receive. Participants were from two matched geographical areas in Devon: one with a rehabilitation unit, one without. Recruitment was from January 1999 to October 2001 in 10 community hospitals. Study eligibility was assessed using the unit's inclusion/exclusion criteria: 55 years or older and 'likely to benefit from a short-term rehabilitation programme' ('potential to improve', 'realistic and achievable goals' and 'motivation to participate'). Ninety-four people were recruited to the intervention and 112 to the control. The mean (standard deviation) age was 81.8 (8.0) years. The main outcome measure was prevention of institutionalisation assessed by the number of days from baseline interview to admission to residential/nursing care or death ('survival-at-home time'). Secondary outcome measures were time to hospital re-admission over 12 months, quality of life and coping ability. There were no significant differences between the groups on any outcome measure. The findings suggest a stay in a rehabilitation unit is no more effective than 'usual' care at diverting older people from hospital/long-term care. Alternative service configurations may be as effective, having implications for tailoring services more specifically to individual need and/or user preferences. However, the unit did appear to facilitate earlier discharges from community hospital.
Partners in time
- Author:
- HENWOOD Melanie
- Journal article citation:
- Community Care, 6.1.05, 2005, pp.30-31.
- Publisher:
- Reed Business Information
Draws on findings from an independent evaluation of the Department of Health's change agent team (CAT) that helped reduce delayed discharge. Looks at the lessons for the proposed Care Services Improvement Partnership at the Social Care Institute for Excellence. It finds the partnership can contribute more than the sum of its parts, while also recognising the need for caution and clarity around the ends and means of service improvement.
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.
Informal caregiving to older adults hospitalized for depression
- Authors:
- MORROW-HOWELL N.L., PROCTOR E.K.
- Journal article citation:
- Aging and Mental Health, 2(3), August 1998, pp.222-231.
- Publisher:
- Taylor and Francis
This study addresses the following questions: what are the caregiving needs stemming from functional dependency of older adults hospitalised for depression and discharged at home; who are the informal caregivers, and what assistance do they provide; and how adequate is this informal care? On a sample of depressed older adults, in-hospital information was collected from medical records and discharge planners; and one-month post-discharge, a telephone interview was completed. Finds that despite high levels of involvement, concerns remain about the adequacy of the care informal caregivers are able to provide in the face of such need. Increased attention should be paid to the topic of informal caregiving to older adults with depression.