Search results for ‘Subject term:"older people"’ Sort:
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A framework to discharge frail older people
- Author:
- LEES-DEUTSCH Liz
- Journal article citation:
- Nursing Times, 112(37/38), 2016, pp.13-15.
- Publisher:
- Nursing Times
A framework to discharge frail older patients who have had an unplanned admission to hospital and are subsequently discharged (or transferred)to another setting. It discusses current issues in discharge practice, briefly reviews the background policy to guide the discharge assessment of older people and examines challenges in discharging them from the acute setting. Finally, it uses an assessment framework to integrate current principles form national discharge guidance into practice. (Publisher abstract)
Implementing change in older people's acute care.
- Author:
- CHARALAMBOUS Liz
- Journal article citation:
- Nursing Times, 112(27/28), 2016, pp.15-17.
- Publisher:
- Nursing Times
Visiting times on wards providing care for older poeple (HCOP) wards were explored as part of a master's in advanced nursing. Restricted visiting was not found to be evidence-based so strategies were used to explore alternative options. This small-scale project, which set out to benefit the care of older people on acute wards, used a systematic, inclusive approach to involve staff at all levels and demonstrate how evidence and theory can be translated into practice. (Publisher abstract)
The utility of the clock drawing test in detection of delirium in elderly hospitalised patients
- Authors:
- ADAMIS Dimitrios, et al
- Journal article citation:
- Aging and Mental Health, 20(9), 2016, pp.981-986.
- Publisher:
- Taylor and Francis
Objectives: Delirium is common neuropsychiatric condition among elderly inpatients. The clock drawing test (CDT) has been used widely as bedside screening tool in assessing cognitive impairment in elderly people. Previous studies which evaluate its usefulness in delirium reported conflicting results. The objective of this study was to evaluate the utility of CDT to detect delirium in elderly medical patients. Method: Prospective, observational, longitudinal study. All acute medical admissions 70 years of age and above were approached within 72 hours of admission for recruitment. Patients eligible for inclusion were assessed four times, twice weekly during admission. Assessment included Confusion Assessment Method (CAM), Delirium Rating Scale (DRS-98R), Montreal Cognitive Assessment (MoCA), Acute Physiology and Chronic Health Evaluation II (APACHE) II, and CDT. Data was analysed using a linear mixed effect model. Results: Three hundred and twenty-three assessments with the CDT were performed on 200 subjects (50% male, mean age 81.13; standard deviation: 6.45). The overall rate of delirium (CAM+) during hospitalisation was 23%. There was a significant negative correlation between the CDT and DRS-R98 scores (Pearson correlation r = −0.618, p < 0.001), CDT and CAM (Spearman's rho = −0.402, p < 0.001) and CDT and total MoCA score (Pearson's r = 0.767, p < 0.001). However, when the data were analysed longitudinally controlling for all the factors, we found that cognitive function and age were significant factors associated with CDT scores (p < .0001): neither the presence nor the severity of delirium had an additional significant effect on the CDT. Conclusion: CDT score reflects cognitive impairment, independently of the presence or severity of delirium. The CDT is not a suitable test for delirium in hospitalised elderly patients. (Publisher abstract)
Older adult recovery: “What are we working towards?”
- Authors:
- RANKIN Samantha, PETTY Stephanie
- Journal article citation:
- Mental Health Review Journal, 21(1), 2016, pp.1-10.
- Publisher:
- Emerald
Purpose: The perspectives of frontline clinical staff working with individuals in later life within an inpatient mental health setting, of their role in recovery, have not yet been explored. The purpose of this paper is to understand what recovery means within an inpatient mental health setting for older adults. The authors address clear implications for clinical practice. Design/methodology/approach: Semi-structured interviews were conducted with 11 multidisciplinary participants across two specialist older adult recovery units at an independent hospital in the UK. Thematic analysis was applied to the transcripts. Findings: Three main themes were identified: participants identified their normative task as the promotion of 'moving on' (clinical recovery) and their existential task as personal recovery. The context in which recovery happens was highlighted as the third theme. These represented competing workplace goals of clinical and personal recovery. This highlights the need to give permission to personal recovery as the process that enables mental health recovery in older adults. Originality/value: Staff working in an inpatient mental health service for older adults discussed the meaning of recovery and their role in enabling recovery. This has implications for sustainable clinical practice in this setting. Recovery-orientated practice in this setting is required but the detail is not yet understood. (Publisher abstract)
What is the current state of care for older people with dementia in general hospitals? a literature review
- Authors:
- DEWING Jan, DIJK Saskia
- Journal article citation:
- Dementia: the International Journal of Social Research and Practice, 15(1), 2016, pp.106-124.
- Publisher:
- Sage
This paper summarises a literature review focusing on the literature directly pertaining to the acute care of older people with dementia in general hospitals from 2007 onwards. Following thematic analysis, one overarching theme emerged: the consequences of being in hospital with seven related subthemes. Significantly, this review highlights that overall there remains mostly negative consequences and outcomes for people with dementia when they go into general hospitals. Although not admitted to hospital directly due to dementia, there are usually negative effects on the dementia condition from hospitalisation. The review suggests this is primarily because there is a tension between prioritisation of acute care for existing co-morbidities and person-centred dementia care. This is complicated by insufficient understanding of what constitutes person-centred care in an acute care context and a lack of the requisite knowledge and skills set in health care practitioners. The review also reveals a worrying lack of evidence for the effectiveness of mental health liaison posts and dementia care specialist posts in nursing. Finally, although specialist posts such as liaison and clinical nurse specialists and specialist units/shared care wards can enhance quality of care and reduce adverse consequences of hospitalisation (they do not significantly) impact on reducing length of stay or the cost of care. (Publisher abstract)
Review of delayed transfers of care: Cardiff and Vale Health and Social Care Community
- Author:
- AUDITOR GENERAL FOR WALES
- Publisher:
- Wales Audit Office
- Publication year:
- 2016
- Pagination:
- 34
- Place of publication:
- Cardiff
A review of Cardiff and Vale Integrated Health and Social Care (IHSC) partnership (the Partnership), carried out between March and June 2016, to assess ambitious whether their plans to integrate health and social care services have led to improvements in levels of delayed transfers of care from hospital. The review found that the independence of older people is being prioritised through joint working and the implementation of an integrated service model. It also found good use of the intermediate care fund, but highlights that there are no contingency plans in place if the fund was to stop. It also found that partners had develop a strong governance, performance monitoring and evaluation arrangements. Although delayed transfers of care remain the second highest in Wales, performance is steadily improving. The report concludes that partners are working well together to manage delayed transfers of care, whilst realising their plans for a whole systems model. The report makes two recommendations. The appendices includes four good practice case studies of initiatives that other health and social care services in England and Wales are using to reduce delayed transfers of care. (Edited publisher abstract)
People helping people: lessons learned from three years supporting social action innovations to scale
- Author:
- SELLICK Vicki
- Publisher:
- NESTA
- Publication year:
- 2016
- Pagination:
- 96
- Place of publication:
- London
Draws together lessons from the three year Centre for Social Action Innovation Fund, which supported 52 social action innovations with the aim of expanding the initiatives and increasing the evidence of their impact. The report shares case studies and impact metrics for innovations under each of the eight priority themes, drawing out four to five lessons from each. The themes cover using social action to transform the lives of young people; support people to manage long-term conditions; age well; build resilient communities through impact volunteering; support people back to work; meet city-wide needs, focusing on the Cities of Service programme; develop volunteering in hospitals – the Helping in Hospitals programme; and using digital technology to change lives. It also identifies learning for funders supporting social action projects in relation to planning for scale, demonstrating impact, using existing infrastructure, grant making with an investor mindset and learning from failure as well as success. During the programme the initiatives engaged with more than 70,000 volunteers across England, who supported a total of 175,000 people. The innovations show how social action can transforms lives and can also have a transformative effect on institutions. Findings reported include that the social action initiatives were successful in helping students who have fallen behind at school to catch up, job seekers to find work, and isolated older people to feel connected and less lonely. Despite the evidence, the report concludes that many still view social action as a ‘nice to have’ rather than an integrated component of good public services. (Edited publisher abstract)
Effect of orthostatic hypotension on falls risk
- Authors:
- WINDSOR Julie, et al
- Journal article citation:
- Nursing Times, 112(43/44), 2016, pp.11-13.
- Publisher:
- Nursing Times
Orthostatic hypertension (OH) occurs frequently in older patients, particularly when they are in hospital. It can caus lightheadedness, unsteadiness and falls, This article looks at the role of nurses in understanding, assessing, monitoring and treating OH. (Edited publisher abstract)
Talking mats: a model of communication training
- Authors:
- MURPHY Joan, ALEXANDER Jean, McLINTON Ann
- Journal article citation:
- Journal of Dementia Care, 24(5), 2016, pp.22-25.
- Publisher:
- Hawker
Talking Mats is an interactive communication resource which was devised by NHS speech and language therapists in a series of research projects at Stirling University. The authors explain how it works and why it is a valuable tool. They use an example of training they were commissioned to do in a long stay hospital in Glasgow, where patients were mainly older people with dementia who often found it difficult to communicate their needs and wishes. (Edited publisher abstract)
Measuring the impact of Helping in Hospitals: final evaluation report
- Authors:
- BABUDU Peter, TREVITHICK Elliot, SPATH Rahel
- Publishers:
- NESTA, The Social Innovation Partnership
- Publication year:
- 2016
- Pagination:
- 56
- Place of publication:
- London
An evaluation of the Helping in Hospitals project to examine the effectiveness of hospital volunteering in improving patient experience and well-being. The project included a variety of hospital impact volunteering roles such as mealtime assistants or dementia buddies aimed at directly improving patient experience and well-being. Evaluation data were collected from nine hospitals, focusing on wards with a large proportion of older and frail patients, many with dementia. Outcomes measured included mood, anxiety, nutrition and hydration, reduced readmissions, length of stay, transfers of care and decreased number of falls. Not all of the sites collected all of the outcomes data. Key results from the nine hospital trusts’ evaluations found that volunteering shows promise as a way to improve patient experience, mood, anxiety levels, nutrition and hydration, while releasing nurse time to care. However, none of the hospitals found any effects on re-admissions, length of stay, delayed transfer of care and number of falls. (Edited publisher abstract)