Search results for ‘Subject term:"older people"’ Sort:
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Come together, right now
- Authors:
- GLADDEN Roz, CUTHEL Bernie
- Journal article citation:
- Health Service Journal, 123(6359), 19 July 2013, pp.24-25.
- Publisher:
- Emap Healthcare
Increasingly complex health needs in cities such as Liverpool demand a seamless and integrated service to improve life expectancy and wellbeing outcomes. The approach has led to the creation of new hubs to better support vulnerable adults in the community. The initiative has produced 85 reablement beds supported by multidisciplinary teams of staff from the council and from Liverpool Community Health, providing personalised care and support. (Edited publisher abstract)
Integrating housing with care for older people
- Author:
- BLOOD Imogen
- Journal article citation:
- Journal of Integrated Care, 21(4), 2013, pp.178-187.
- Publisher:
- Emerald
Purpose – The research explored the way in which different services, providers and other key players work together in housing with care (HWC) schemes and the impact of this on the quality of life of the older people living in them, especially those with high support needs. Methods – This qualitative study included interviews with 47 residents and five relatives at 19 private and not-for-profit schemes across the UK and 52 professionals from provider, statutory and other relevant organisations. Findings – Most participants were very satisfied with the services in HWC but a third described problems linked to “boundary” issues, where gaps, delays or confusion had arisen at the interface between teams, organisations or professional groups. Gaps often occurred where tasks were relatively small: they affected the quality of life of older people with high support needs but did not necessarily outweigh the benefits of living in HWC. Practical implications – We identify ways of improving integrated working in HWC and beyond. The paper is relevant to those commissioning and providing services to older people and to all those with an interest in integrating care and housing. Originality/value – This is the first UK-wide, cross-sector study to focus specifically on the boundaries between roles and responsibilities and their impact on residents in HWC. (Publisher abstract)
Care coordination: translating policy into practice for older people
- Authors:
- SEDDON Diane, et al
- Journal article citation:
- Quality in Ageing and Older Adults, 14(2), 2013, pp.81-92.
- Publisher:
- Emerald
The findings from research on the implementation of Unified Assessment (UA) policy and the work of care coordinators who oversee the delivery of support to older people with complex needs are presented. The research used a mixed methods approach that included staff interviews (n=95) and focus groups (n=3) spanning eight local authority areas; one in North, Mid and South Wales. The care coordinator role is controversial and the lack of common terminology across health and social care obscures its importance. It is seen as a social care responsibility. Limited ownership amongst healthcare professionals leads to tensions in practice. The challenges of breaking down silo thinking embedded in established professional practices are highlighted as are infrastructural and capacity deficits. Disparities between policy intentions and practice means that UA is failing to meet core objectives relating to the delivery of seamless support. Practice implications identified are that practice development may be supported by: guidelines that are more prescriptive and include a formal role definition; joint training to promote shared understanding of key concepts; investment in administrative and IT infrastructures; and more coordinated direction at strategic level. (Edited publisher abstract)
Integration of health and social care - what can Wales learn ... and contribute?
- Author:
- MORGAN Gareth
- Journal article citation:
- Quality in Ageing and Older Adults, 14(1), 2013, pp.47-55.
- Publisher:
- Emerald
Drawing on the findings of a literature review, and on experience from the United Kingdom, Europe and Canada in particular, this paper looks at health and social care service integration and considers the situation in Wales. It summarises developments in health and social care integration in European countries and Canada, commenting on learning opportunities and challenges. It then considers health and social care integration policy and practice in Wales, with particular reference to experience of integration, person centred care, and the United Nations Principles for Older People. It concludes that integration challenges remain, but that Wales is well placed to advance the integration agenda.
Reducing hospital bed use by frail older people: results from a systematic review of the literature
- Authors:
- PHILP Ian, et al
- Journal article citation:
- International Journal of Integrated Care, 13(4), 2013, Online only
- Publisher:
- International Foundation for Integrated Care
Introduction: Numerous studies have been conducted in developed countries to evaluate the impact of interventions designed to reduce hospital admissions or length of stay (LOS) amongst frail older people. A systematic review of the recent international literature (2007-present) was carried out to help improve understanding about the impact of these interventions. Methods: The following databases were systematically searched: PubMed/Medline, PsycINFO, CINAHL, BioMed Central and Kings Fund library. Studies were limited to publications from the period 2007-present and a total of 514 studies were identified. Results: A total of 48 studies were included for full review consisting of 11 meta-analyses, 9 systematic reviews, 5 structured literature reviews, 8 randomised controlled trials and 15 other studies. Interventions were classified into those which aimed to prevent admission, interventions in hospital, and those which aimed to support early discharge. Conclusions: Reducing unnecessary use of acute hospital beds by older people requires an integrated approach across hospital and community settings. A stronger evidence base has emerged in recent years about a broad range of interventions which may be effective. Local agencies need to work together to implement these interventions to create a sustainable health care system for older people. (Edited publisher abstract)
A realistic evaluation of integrated health and social care for older people in Wales, to promote independence and wellbeing: interim report
- Authors:
- CHICHLOWSKA S.Carnes, et al
- Publisher:
- Welsh Government Social Research
- Publication year:
- 2013
- Pagination:
- 123
- Place of publication:
- Cardiff
Researchers at the Centre for Innovative Ageing, Swansea University provide a critical overview of each of a range of integration projects or services across Wales, comparing them to an idealised ‘testable theory’ of how integration should work. The aim is that older people are able to maintain their wellbeing and independence whilst being able to live with a range of care needs extending to complex and chronic conditions, preferably in their own homes and their own communities. The first section of the report is a summary of the literature review related to policy strategy and provision of integrated health and social care services for older people, using literature sourced nationally across Britain and locally in Wales. The second section comprises information on the models of care of the projects and services selected, based on a small number of interviews with stakeholders. The information will be used to develop a conceptual model of integrated care that can be used to assess the impact of services to older people. The report observes the emergence of several unintended and undesirable outcomes of developing integrated care, including competition between services and alienation of GPs and other health and service professionals. Assessment, patient notes and data collection is still largely paper based, creating difficulties in sharing and disseminating information across services. Further work is required to evaluate integrated health and social care. (Original abstract)
A question of behaviours: why delivering care integration and managing acute demand depends as much on changing behaviour as new systems and structures
- Author:
- KHALDI Alex
- Publisher:
- IMPOWER
- Publication year:
- 2013
- Pagination:
- 40
- Place of publication:
- London
A behavioural insight specialist at iMPOWER highlights the importance of behaviours, attitudes and motivations alongside structures and systems as we integrate care. This report considers two connected challenges: the increasing dependency on acute settings and urgent care, particularly for older people; and the positive agenda to integrate care in home and community settings. It is based on a survey of 200 older people in Sandwell. West Midlands, a review of the relevant literature, a friends and family survey, a survey of more than 600 GPs, and interviews of leaders and managers in the care and health services. Evidence from the survey suggests that structural ‘big system’ change alone will not work, as 56% of the GPs think that their relationship with social care is poor or very poor, and less than half of the older people (46%) have the confidence to know how to access the health and social care system. Therefore, the priority must be to shift the focus of care to the most appropriate level, where the benefits of changing behaviour would be: being able to manage demand better; avoiding costs and saving money; improving outcomes and performance; and changing the patient and user experience. (Edited publisher abstract)
Caring for an ageing population: points to consider from reform in Japan
- Authors:
- CURRY Natasha, PATTERSON Linda, HOLDER Holly
- Publisher:
- Nuffield Foundation
- Publication year:
- 2013
- Pagination:
- 42
- Place of publication:
- London
Japan has the world’s oldest population, 23% being aged 65+. In order to relieve the pressure on its health and social care system, the country introduced Long Term Care Insurance (LTCI) in 2000, a compulsory scheme for those aged over 40, which offers access to social care for those aged over 65 on the basis of need alone. At the heart of the LTCI system is the care manager who is responsible for developing a package of care and advising individuals of their options. While quality of provision was not initially built into the system, it became a central focus in 2005. The authors describe two models of provision: integrated delivery systems; and dementia group homes. In many ways, the LTCI scheme has been a success, but it has not achieved all that was intended. It has also not been without controversy; and its greatest test is yet to come as it grapples with an older population that already accounts for nearly one quarter of its population. It will be useful for England to reflect on the Japanese experience, for its challenges and difficulties are as valuable as its successes in helping shed light on options for social care in England. This report is from a project part funded by the Great Britain Sasakawa Foundation, ‘Universal access and low costs? Health and social care the Japanese way’, which included a study visit to Japan in 2012, during which a variety of organisations, policy-makers, clinicians and academics were visited. (Edited publisher abstract)
Integrated care in action
- Author:
- O'HANLON Shaun
- Journal article citation:
- Health Service Journal, 123(6372), 25 October 2013, pp.20-21.
- Publisher:
- Emap Healthcare
The Caldicott review's 'duty to share' data is an imperative for the NHS, but the author asks whether the systems are in place, and identifies the rewards and pitfalls. (Edited publisher abstract)
Development of integrated care pathways: toward a care management system to meet the needs of frail and disabled community-dwelling older people
- Authors:
- DUBUC Nicole, et al
- Journal article citation:
- International Journal of Integrated Care, 13(2), 2013, Online only
- Publisher:
- International Foundation for Integrated Care
The home care and services provided to older adults with the same needs are often inadequate and highly varied. Integrated care pathways (ICPs) can resolve these issues. The aim of this study was to develop the content of electronic ICPs to ensure the follow up frail and disabled community-dwelling older people in Canada. A rigorous process was applied according to a series of steps: identification of desirable characteristics and a theoretical framework; review of evidence-based practices and current practices; and determination of ICPs by an interdisciplinary task team. In order to prevent specific problems, maximize independence, and promote successful aging, the ICPs followed five phases: (1) needs assessment and assessment of risk/protection factors; (2) data-collection summary and goals identification; (3) planning of interventions from a client-centered view; (4) coordination, delivery, and follow-up; and (5) identification of variances, as well as review and adjustment of plans. Once computerized, these ICPs will facilitate the exchange of information as well as the clinical decision-making process with a perspective to adequately matching the needs of an individual person with resources that delay or slow the progression of frailty and disability. Once aggregated, the data will also support managers in organizing teamwork and follow-up for clients. (Publisher abstract)