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Can person-centred care for people living with dementia be delivered in the acute care setting?
- Authors:
- ABBOTT Rebecca A., et al
- Journal article citation:
- Age and Ageing, 50(4), 2021, pp.1077-1080.
- Publisher:
- Oxford University Press
The need to improve care for people living with dementia in the hospital setting has long been recognised. Person-centred care has the potential to improve the experience of care for persons living with dementia and their carers, and has been shown to improve the experiences of hospital staff caring for the persons living with dementia, however it remains challenging to deliver in a time- and task-focussed acute care setting. This commentary suggests that to embed person-centred care across the hospital environment, cultural changes are needed at organisational and ward levels. In particular there needs to be: leadership that supports and advocates for workforce capacity to recognise and meet both psychological and physical needs of people living with dementia, promotion of physical environments that support familiarisation and social interactions, an inclusive approach to carers and the development of a culture of sharing knowledge and information across hierarchies and roles. An evidence-based set of pointers for service change are described which highlight institutional and environmental practices and processes that need to be addressed in order for person-centred care to become part of routine care. (Edited publisher abstract)
Older people's experience of emergency hospital readmission: research report
- Authors:
- LAWRIE Michael, BATTYE Fraser
- Publisher:
- Age UK
- Publication year:
- 2012
- Pagination:
- 41p.
- Place of publication:
- London
Reducing the occurrence of emergency hospital readmission (an unplanned readmission within 28 days of leaving) for older people is a key issue for the NHS. Over the past decade, rates of emergency hospital readmission have risen, particularly for those over the age of 75. The aim of this study was to investigate older people’s experience of emergency readmission to hospital. The study comprised: qualitative interviews with 18 older people who have experienced an emergency readmission (and in several cases their families); a brief review of key policy documents and research; and 4 semi-structured interviews with senior stakeholders. Interviewees were asked to share their experience, beginning from their first admission to hospital through to the discharge and return home, and then their experience of the readmission to hospital. The findings show that emergency hospital readmission is a complex issue with multiple potential causes which range across an individual’s care pathway. However there are particular challenges to be addressed in the transition between secondary and primary care, and ensuring that a personalised care package is put in place in the community. Implications for Age UK both at the local and national levels are discussed.
“Not just grapes and flowers”: older people's perspectives on the role and importance of hospital visiting
- Authors:
- GREEN Bert, et al
- Journal article citation:
- Quality in Ageing and Older Adults, 13(2), 2012, pp.82-88.
- Publisher:
- Emerald
This paper presents findings from a service user controlled research project which sought to provide commentary by older people on their experiences as visitors to hospital or as patients receiving visitors. Nine focus groups were held with a total of 43 older people at 8 different locations in North Lancashire and South Cumbria. The participants were asked about their recent experience of hospital visiting and its value to them, given their individual circumstances and those prevailing at the hospitals. Full transcripts of digital recordings from the focus groups were analysed to identify particular concerns or vivid experiences. These were classified into the following common themes: getting there and back; on the ward; and the value of visiting. The findings suggest that visitors’ needs are not always being met. Recommendations are made that could improve hospital visiting for older people, and consequently their wellbeing, including: times and rules for visitors; the response they get from staff; the potential of older visitors to help improve the welfare of the older patient; and locating older people's wards.
Hungry to be heard survey: older patients’ experience of hospital meals
- Author:
- AGE CONCERN SCOTLAND AND HELP THE AGED SCOTLAND
- Publisher:
- Age Concern Scotland
- Publication year:
- 2009
- Pagination:
- 7p.
- Place of publication:
- Edinburgh
Age Concern Scotland developed the Hungry to be Heard campaign to investigate the experience of older patients and offer recommendations for future action. As part of the campaign, research was carried out across Scotland with over 100 older people who had recently been in hospital. The survey was designed to gain an insight into whether the standards for nutritional care in acute hospitals are being met. A summary of the survey findings are presented.
Dazed and confused: making sense of delirium after hip fracture
- Authors:
- HARDING Rebecca, MARTIN Carol, HOLMES John
- Journal article citation:
- International Journal of Geriatric Psychiatry, 23(9), September 2008, pp.984-986.
- Publisher:
- Wiley
Delirium is a common complication in general hospitals associated with negative outcomes, including longer hospitalisation and fractures from falls while wandering. This small scale study interviewed nine older people about their delirious experiences. The interviews were analysed using Interpretative Phenomenological Analysis (IPA), enabling the researcher to develop a psychological understanding.
Polypharmacy: cure or curse?
- Authors:
- SALAM Abdul, et al
- Journal article citation:
- Quality in Ageing, 9(1), March 2008, pp.24-28.
- Publisher:
- Pier Professional
- Place of publication:
- Brighton
Polypharmacy literally means the use of multiple drugs by the same patient at any one point in time. More commonly it is used to indicate the use of multiple medications that are not clinically indicated or the use of more drugs that is clinically justified. This article discusses a recent audit on polypharmacy in older people conducted in a district general hospital.
Streamlining outpatient geriatric assessment: essential social, environmental and economic variables
- Authors:
- SALTZ Constance C., SCHAEFER Terry, WEINREICH Donna Meisel
- Journal article citation:
- Social Work in Health Care, 27(1), 1998, pp.1-14.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
There are no known standardised instruments that encompass all of the essential elements of a streamlined outpatient geriatric assessment. A process of arriving at a consensus on essential elements of streamlined geriatric assessment in three domains was initiated and described. Two rounds of the Delphi technique were conducted to identify social, environmental and economic variables essential for such an assessment. Consensus among an expert panel was achieved and a list of 27 variables was reduced to 16. This result is discussed in terms of assessment context and standardising assessment, using case examples.
Decline in quality of life for patients with severe dementia following a ward merger
- Authors:
- BREDIN Kathleen, KITWOOD Tom, WATTIS John
- Journal article citation:
- International Journal of Geriatric Psychiatry, 10(11), November 1995, pp.967-973.
- Publisher:
- Wiley
The effect of a ward merger on the quality of life of patients with severe dementia in a mental hospital was investigated by means of observational method of dementia care mapping (DCM). Key DCM indicators showed that the quality of life of patients had declined significantly. This may be explained, in part at least, in terms of a 'cycle of demoralization and depersonalisation' in the interaction of staff and patients. Further research is required into the dynamics of this cycle.
Dementia: a report by the Working Group on Acute Beds and the Elderly
- Author:
- GREAT BRITAIN. Scottish Office. National Health Service in Scotland Management Executive. Scottish Health Service Advisory Council
- Publisher:
- Great Britain. Scottish Office. Health Policy and Public Health Directorate
- Publication year:
- 1995
- Pagination:
- 16p.,bibliog.
- Place of publication:
- Edinburgh
Report from a working group looking at the effect of the increasing older population on the use of acute hospital inpatient facilities, focusing in particular on older people with dementia. The research excludes psychiatric beds.
Hospital discharge project
- Authors:
- NEILL June, WILLIAMS Jenny
- Journal article citation:
- Social Services Research, 1 1994, 1994, p.65.
- Publisher:
- Social Services Research Group
Briefly looks at elements of the work carried out by the Research Unit at the National Institute for Social Work (NISW), into the process of hospital discharge.