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Reducing emergency hospital admissions: what is the role of social care? Strategic briefing
- Author:
- MILLER Robin
- Publisher:
- Research in Practice for Adults
- Publication year:
- 2017
- Pagination:
- 20
- Place of publication:
- Dartington
This briefing looks at the factors that influence emergency admission rates and the role of adult social care in preventing emergency admissions to hospital. It explores how services can adopt strengths-based approaches when working with older people. It also builds an understanding of how preventable factors, such as loneliness, contribute to hospital admissions. Case studies demonstrate how these approaches have been used successfully in practice. It also discusses the concept of 'avoidable' and presents four comprehensive models of hospital avoidance. It concludes by outlining implications for social care commissioning and workforce. The briefing is intended for senior managers, service leads and commissioners. (Edited publisher abstract)
Can mindfulness-based interventions influence cognitive functioning in older adults? A review and considerations for future research
- Authors:
- BERK Lotte, BOXTEL Martin van, OS Jim van
- Journal article citation:
- Aging and Mental Health, 21(11), 2017, pp.1113-1120.
- Publisher:
- Taylor and Francis
Objectives: An increased need exists to examine factors that protect against age-related cognitive decline. There is preliminary evidence that meditation can improve cognitive function. However, most studies are cross-sectional and examine a wide variety of meditation techniques. This review focuses on the standard eight-week mindfulness-based interventions (MBIs) such as mindfulness-based stress reduction (MBSR) and mindfulness-based cognitive therapy (MBCT). Method: The authors searched the PsychINFO, CINAHL, Web of Science, COCHRANE, and PubMed databases to identify original studies investigating the effects of MBI on cognition in older adults. Results: Six reports were included in the review of which three were randomised controlled trials. Studies reported preliminary positive effects on memory, executive function and processing speed. However, most reports had a high risk of bias and sample sizes were small. The only study with low risk of bias, large sample size and active control group reported no significant findings. Conclusion: The authors conclude that eight-week MBI for older adults are feasible, but results on cognitive improvement are inconclusive due a limited number of studies, small sample sizes, and a high risk of bias. Rather than a narrow focus on cognitive training per se, future research may productively shift to investigate MBI as a tool to alleviate suffering in older adults, and to prevent cognitive problems in later life already in younger target populations. (Edited publisher abstract)
The DASH Pilot Project: developing community-based nutrition education for older adults
- Authors:
- IVERY Jan M., et al
- Journal article citation:
- Journal of Gerontological Social Work, 60(4), 2017, pp.286-299.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
Nutrition-related chronic health conditions among older adults are a growing concern. In this study, nutrition education materials were created for use in senior centres by graduate nutrition students. After the materials were presented, focus groups were conducted with participants (n = 62) to obtain feedback on the content and presentation. Findings related to the participant’s knowledge of nutrition-related information, strategies to improve future class sessions, and participant recruitment will be discussed. These findings will be useful to program administrators as they develop nutrition programs for older adults who are vulnerable to nutrition-related health problems. (Edited publisher abstract)
Towards defining restlessness in individuals with dementia
- Authors:
- REGIER Natalie G., GITLIN Laura N.
- Journal article citation:
- Aging and Mental Health, 21(5), 2017, pp.543-552.
- Publisher:
- Taylor and Francis
Objectives: Most individuals with dementia develop significant behavioural problems. Restlessness is a behavioural symptom frequently endorsed by caregivers as distressing, yet is variably defined and measured. Lack of conceptual and operational clarity hinders an understanding of this common behavioural type, its prevalence, and development of effective interventions. The authors advance a systematic definition and understanding of restlessness from which to enhance reporting and intervention development. Method: The literature for existing definitions and measures of restlessness, is reviewed and common elements across existing definitions are identified. Fit with relevant theoretical frameworks are assessed, and the relationship between restlessness and other behavioural symptoms in a data set of 272 community-dwelling persons with dementia are explored. Results: Twenty-five scales assessing restlessness were identified. Shared components included motor/neurological, psychiatric, and needs-based features. Exploratory analyses suggest that restlessness may co-occur primarily with argumentation, anxiety, waking the caregiver, delusions/hallucinations, and wandering. The authors propose that restlessness consists of three key attributes: diffuse motor activity or motion subject to limited control, non-productive or disorganised behavior, and subjective distress. Restlessness should be differentiated from and not confused with wandering or elopement, pharmacological side effects, a (non-dementia) mental or movement disorder, or behaviours occurring in the context of a delirium or at end-of-life. Conclusion: Restlessness appears to denote a distinct set of behaviours that have overlapping but non-equivalent features with other behavioural symptoms. The authors propose that it reflects a complex behaviour involving three key characteristics. Understanding its specific manifestations and which components are present can enhance tailoring interventions to specific contexts of this multicomponent behavioural type. (Edited publisher abstract)
Effects of multisensory and motor stimulation on the behavior of people with dementia
- Authors:
- SPOSITO Giovana, et al
- Journal article citation:
- Dementia: the International Journal of Social Research and Practice, 16(3), 2017, pp.344-359.
- Publisher:
- Sage
A quasi-experimental study using a pre–posttest design was conducted in four aged care facilities to assess the effects of a person-centred care (PCC) multisensory stimulation (MSS) and motor stimulation (MS) programme, implemented by direct care workers, on the behaviours of residents with dementia. Data were collected at baseline and after the intervention through video recordings of morning care routines. Forty-five residents with moderate and severe dementia participated in the study. A total of 266 morning care routines were recorded. The frequency and duration of a list of behaviours were analysed. The frequency of engagement in task decreased significantly (p = .002) however, its duration increased (p = .039). The duration of gaze directed at direct care workers improved significantly (p = .014) and the frequency of closed eyes decreased (p = .046). There was a significant decrease in the frequency of the expression of sadness. These results support the implementation of PCC–MSS and MS programmes as they may stimulate residents' behaviours. (Edited publisher abstract)
Recognising and preventing delirium
- Authors:
- NATIONAL INSTITUTE FOR HEALTH AND CARE EXCELLENCE, SOCIAL CARE INSTITUTE FOR EXCELLENCE
- Publishers:
- National Institute for Health and Care Excellence, Social Care Institute for Excellence
- Publication year:
- 2017
- Pagination:
- 4
- Place of publication:
- London
A quick guide to help care home managers and their staff to recognise the symptoms of delirium and to understand what they can do to prevent it. The guide covers: risk factors for delirium, recognising delirium, preventing delirium, and sharing information with the person and their family. The guide will be useful for staff training. (Edited publisher abstract)
Loneliness and the aging population: how businesses and governments can address a looming crisis
- Authors:
- PALMARINI Nicola, et al
- Publisher:
- IBM
- Publication year:
- 2017
- Pagination:
- 28
- Place of publication:
- Armonk, NY
This report explores the growing problem of loneliness in older people, current interventions, and ideas for future solutions. It draws on insights from interviews with a range of experts from six countries, including insight from medical professionals, social workers, academic researchers, technologists. The report focuses on why it is important for organisations understand loneliness and ageing, the triggers for loneliness, and why loneliness is so difficult to alleviate. It also looks at what is being done to alleviate loneliness in the ageing population today and potential future solutions. The report shows that for older people, loneliness is an emerging risk factor that has implications for personal, economic, and societal well-being. It identifies three areas for developing future solutions to address loneliness: detecting loneliness earlier and intervening earlier; helping people feel more engaged with others, and helping people rebuild social capital. It also outlines suggested actions for providers, business and employers. Short case studies of initiatives are included. (Edited publisher abstract)
Evaluation of the H4All Wellbeing Service pilot: April 1st 2016 - January 31st 2017
- Authors:
- JAMMU Dalvinder, BOND Andy
- Publisher:
- NHS Hillingdon Clinical Commissioning Group
- Publication year:
- 2017
- Pagination:
- 41
- Place of publication:
- London
An evaluation of the first 10 months of the Hillingdon H4All Wellbeing Service pilot, commissioned by Hillingdon CCG in April 2016. The service is a collaboration between 5 local third sector charities and provides older patients in Hillingdon with a range of services, including: information and advice, practical support, goal setting and ongoing support to manage LTCs, befriending and mentoring, and signposting and referral to voluntary and statutory services. During the evaluation period the H4All service supported 1,099 patients with 2,729 enquiries resulting in 11,675 contacts with/for patients. Analysis of completed Patient Activation Measure (PAM) outcome questionnaires found that most people accessing the service increased their PAM score, with an average movement of 8 points per patient in their individual scores. A total of 44 of the Hillingdon GP practices referred to the Wellbeing Service during the evaluation period in the first ten months and gave very positive feedback. The appendices include individual patient case studies highlight how they have benefitted from the service. (Edited publisher abstract)
Specifying the content of home-based health behaviour change interventions for older people with frailty or at risk of frailty: an exploratory systematic review
- Authors:
- GARDNER Benjamin, et al
- Journal article citation:
- BMJ Open, 7(2), 2017, Online only
- Publisher:
- BMJ Publishing Group
Objectives: To identify trials of home-based health behaviour change interventions for frail older people, describe intervention content and explore its potential contribution to intervention effects. Design: 15 bibliographic databases, and reference lists and citations of key papers, were searched for randomised controlled trials of home-based behavioural interventions reporting behavioural or health outcomes. Setting Participants' homes. Participants: Community-dwelling adults aged ≥65 years with frailty or at risk of frailty. Primary and secondary outcome measures: Trials were coded for effects on thematically clustered behavioural, health and well-being outcomes. Intervention content was described using 96 behaviour change techniques, and 9 functions (eg, education, environmental restructuring). Results: 19 eligible trials reported 22 interventions. Physical functioning was most commonly assessed (19 interventions). Behavioural outcomes were assessed for only 4 interventions. Effectiveness on most outcomes was limited, with at most 50% of interventions showing potential positive effects on behaviour, and 42% on physical functioning. 3 techniques (instruction on how to perform behaviour, adding objects to environment, restructuring physical environment) and 2 functions (education and enablement) were more commonly found in interventions showing potential than those showing no potential to improve physical function. Intervention content was not linked to effectiveness on other outcomes. Conclusions: Interventions appeared to have greatest impact on physical function where they included behavioural instructions, environmental modification and practical social support. Yet, mechanisms of effects are unclear, because impact on behavioural outcomes has rarely been considered. Moreover, the robustness of our findings is also unclear, because interventions have been poorly reported. Greater engagement with behavioural science is needed when developing and evaluating home-based health interventions. (Edited publisher abstract)
Loneliness: the public health challenge of our time. A policy briefing by the Mental Health Foundation and Age Scotland
- Authors:
- MENTAL HEALTH FOUNDATION, AGE SCOTLAND
- Publisher:
- Mental Health Foundation Scotland
- Publication year:
- 2017
- Pagination:
- 11
- Place of publication:
- London
This policy briefing, which focuses on loneliness among older people, explores the connection between loneliness and mental health. It reports new data commissioned by the Mental Health Foundation and Age Scotland which shows that a quarter of Scottish adults aged 65 and older experience depression when they are lonely. The paper provides 12 key recommendations to government and society to prevent and tackle loneliness and social isolation in older adults. These recommendations include: investment in community services to reduce and prevent hospital admissions; “Welcome Home Boxes” which contain information about activities and local support groups for older people discharged from hospital; investment in community transport to keep marginalised older people connected; and developing initiatives to encourage social inclusion for ethnic minority older people, including asylum seekers and refugees. (Edited publisher abstract)