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The relevance of Marjory Warren’s writings today
- Authors:
- ST. JOHN Philip D., HOGAN David B.
- Journal article citation:
- Gerontologist, 54(1), 2014, pp.21-29.
- Publisher:
- Oxford University Press
Marjory Warren was one of the initial geriatricians in the United Kingdom. She established specialised geriatric units, held important administrative positions, and wrote influential papers where she argued for the need of the specialty of geriatric medicine and outlined principles for inpatient care of older adults with chronic illness. The authors compare and contrast Warren’s early papers describing these principles with contemporary models for improving inpatient care of older adults and the need for the specialty of geriatrics. Warren’s writings on the inpatient care of older adults presage the principles of both Hospital Elder Life Programs and Acute Care of the Elderly units. The importance of multidisciplinary teams, the physical environment, attention to diverse issues (medical, social, functional), early ambulation, and the active involvement of the older person in their daily routine are present in Warren’s writings and in contemporary approaches. Warren’s arguments for both the specialty of geriatric medicine and increased training of nonspecialist physicians and other health professionals are remarkably similar to those made in a recent Institute of Medicine report. Across time and place, there has been consistency in the general principles perceived as required for the effective cares of older persons, but challenges persist in implementing and sustaining them. (Publisher abstract)
Analysing equity in the use of long-term care in Europe
- Authors:
- RODRIGUES Ricardo, ILINCA Stefania, SCHMIDT Andrea
- Publisher:
- European Commission
- Publication year:
- 2014
- Pagination:
- 39
- Place of publication:
- Brussels
There are significant differences across social protection systems in Europe in the scope, breadth and depth of coverage of the risk to need long-term care in old-age. Together with other factors, such as education, household structure or societal values regarding care for frail older people, these differences can have a significant impact on the use of long-term care. Using SHARE data, this Research Note compares differences between European countries in the use of long-term care across income groups, for older people living at home. It analyses not only inequalities in the use of long-term care, but also differences in use that persist after differences in need have been taken into consideration, i.e. horizontal inequity. For this purpose, concentration indices, concentration curves and horizontal inequity indices are estimated for home care services and informal care. The countries analysed here are Austria, Germany, Sweden, the Netherlands, Spain, Italy, France, Denmark, Greece, Belgium and Czech Republic. The findings suggest that differences in use of home care services across income groups mostly reflect differences in need between those same groups. For informal care, the differences in use persist even after accounting for needs, and less affluent individuals are much more likely to use informal care. Some possible causes for these differences and policy implications are considered.
Negative feelings and help seeking among older adults with chronic conditions
- Authors:
- SHTOMPE Natalia, WHITEMAN Karen, RUGGIANO Nicole
- Journal article citation:
- Journal of Gerontological Social Work, 57(8), 2014, pp.810-824.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
Older adults with chronic conditions are at greater risk of negative affect, though few studies have focused on older adults’ perspectives on how chronic conditions affect their mental well-being. This study involved in-depth interviews that explored how older adults describe their feelings about chronic conditions, the context within which they experience these feelings, and their experiences with help-seeking for negative feelings. Participants reported that older adults experience a range of negative feelings related to their conditions and are only comfortable talking to people who understand their everyday experiences with managing chronic conditions. The findings have implications for health self-management. (Publisher abstract)
Predictive validity of tools used to assess the risk of unplanned admissions: a rapid review of the evidence
- Authors:
- PATON Fiona, WILSON Paul, WRIGHT Kath
- Publisher:
- University of York. Centre for Reviews and Dissemination
- Publication year:
- 2014
- Pagination:
- 25
- Place of publication:
- York
A synthesis of evidence assessing the predictive ability of tools used to identify frail elderly and people living with multiple long-term chronic health conditions who are at risk of future unplanned hospital admissions. There are now a large number of models available that can be used to predict the risk of unplanned hospital admissions and this study aims to provide a summary of their comparative performance. Overall, the models identified in this review show reasonable concordance in terms of their predictive performance (based on c-statistics). Models reporting other performance indications showed that at different thresholds, as sensitivity increased, specificity would decrease. As the algorithms become more complex or incorporate longer term horizons specificity increased but the ability of the models to identify future high cost individuals reduced. It should also be noted that whilst the reported c-statistics are broadly similar, the underlying populations, data sources and coding may differ. (Edited publisher abstract)
Heatwave plan for England: supporting vulnerable people before and during a heatwave: advice for health and social care professionals
- Author:
- PUBLIC HEALTH ENGLAND
- Publisher:
- Public Health England
- Publication year:
- 2014
- Pagination:
- 16
- Place of publication:
- London
This factsheet is part of a national programme to reduce the health risks by alerting people to the dangers of severe heat and encouraging them to plan in advance what to do in the event of a heatwave. Heatwaves can happen with little warning and illness and death can occur within the first couple of days. This leaflet offers advice both on caring for people most at risk during a heatwave, and on organising others who provide care. Example advice cards for commissioners of health and social care, Directors of Public Health and health and social care staff are also included. (Edited publisher abstract)
Heatwave plan for England: supporting vulnerable people before and during a heatwave: advice for care home managers and staff
- Author:
- PUBLIC HEALTH ENGLAND
- Publisher:
- Public Health England
- Publication year:
- 2014
- Pagination:
- 12
- Place of publication:
- London
This factsheet is part of a national programme to reduce the health risks by alerting people to the dangers of severe heat and encouraging them to plan in advance what to do in the event of a heatwave. Heatwaves can happen with little warning and illness and death can occur within the first couple of days. This fact sheet contains action cards outlining the roles and responsibilities required of care home managers and staff at each level. (Edited publisher abstract)
The highs and lows of caregiving for chronically ill lesbian, gay, and bisexual elders
- Authors:
- MURACO Anna, FREDRIKSEN-GOLDSEN Karen I.
- Journal article citation:
- Journal of Gerontological Social Work, 57(2-4), 2014, pp.251-272.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
This study examines informal caregivers’ and LGB care recipients’ best and worst experiences of care within their relationship. Communal relationship theory guides the research. The work uses qualitative interview data from a sample of 36 care pairs (N = 72), divided between committed partners and friends, to understand the similarities and differences in the care norms employed in varied relationship contexts. Findings from the study show that relationship context influences the experiences that caregivers and care recipients identify as best and worst, but often focus on the relationship and needs met at bests, and conflict and fear of worsening health as worsts.
An evaluation of the effectiveness of engaging Canadian clients as partners in in-home care
- Authors:
- McWILLIAM C.L., et al
- Journal article citation:
- Health and Social Care in the Community, 22(2), 2014, pp.210-224.
- Publisher:
- Wiley
This exploratory quasi-experimental evaluation assessed the effectiveness of the use of a concrete discussion guide to promote organisation-wide application of an approach to engage older home-care clients with chronic disease/disabilities as care partners. The discussion guide was provided to all providers for use with all clients in one home-care programme in Ontario, Canada and this organisation was compared with a similar but geographically distanced organisation, also in Ontario. Seven hundred and ninety-one randomly selected clients (mean age = 72.5 years) receiving 3+ months of in-home care for chronic conditions/disabilities from the two home-care programmes between September 2007 and May 2010 completed a researcher-administered questionnaire at either baseline, 1 year or 2 years. Instruments included the Client's Partnering Experience, Health-Promoting Partnering Effort, a modified version of Locus of Authority in Decision-Making, the Medical Outcomes Survey Self-Rated Health Scale, Health and Social Services Utilization and a modified Functional Independence Measure. Analysis revealed that the use of the concrete discussion guide achieved significantly greater client partnering experience and health-promoting partnering effort over time than did the usual approach to in-home-care interactions. (Edited publisher abstract)
Relationship between pain and chronic illness among seriously ill older adults: expanding role for palliative social work
- Authors:
- MORRISSEY Mary Beth, VIOLA Deborah, SHI Qiuhu
- Journal article citation:
- Journal of Social Work in End-of-Life and Palliative Care, 10(1), 2014, pp.8-33.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia
Confronting the issue of pain among chronically ill older adults merits serious attention in light of mounting evidence that pain in this population is often undertreated or not treated at all (Institute of Medicine, 201126. Institute of Medicine . ( 2011 ). Relieving pain in America: A blueprint for transforming prevention, care, education and research . Washington, DC : National Academies Press . The relationship between pain and chronic illness among adults age 50 and over was examined in this study through the use of longitudinal data from the University of Michigan Health and Retirement Study, sponsored by the National Institute on Aging and the Social Security Administration. Findings suggested positive associations between pain and chronic disease, pain and multimorbidity, as well as an inverse association between pain and education. Policy implications for workforce development and public health are many, and amplification of palliative social work roles to relieve pain and suffering among seriously ill older adults at all stages of the chronic illness trajectory is needed. (Edited publisher abstract)
Increasing employment opportunities and improving workplace health. Local action on health inequalities: health equity evidence review 5
- Author:
- INSTITUTE OF HEALTH EQUITY
- Publishers:
- Public Health England, University College London. Institute of Health Equity
- Publication year:
- 2014
- Pagination:
- 86
- Place of publication:
- London
A summary of evidence on the effects of unemployment and poor working conditions on health and the unequal distribution of these effects. The review outlines the potential actions that can be taken in local areas around four specific topics: workplace interventions to improve health and wellbeing; work with local employers to encourage, incentivise and enforce good quality work; interventions to increase employment opportunities and retention for people with a long-term health condition or disability; interventions to increase employment opportunities and retention for older people. Each section explains how and why such interventions will contribute to reducing unemployment, improving working conditions and reducing health inequalities. Examples of effective interventions are provided and briefly assessed in each area. The paper takes a ‘social determinants’ approach and views people’s health and social position as shaped by, and related to, inequities in power, money and resources, and the conditions in which they are born, grow, live, work and age. The review highlights that those in more disadvantaged socioeconomic positions are more likely to be unemployed and as a result at greater risk of poor health. Lower paid workers with fewer skills or qualifications are more likely to experience poor psychosocial working conditions and worse health. The review argues that local authorities have a role to play in promoting personalised, tailored support for people with disabilities and long term conditions into work or training. This review and the accompanying briefings are part of a series commissioned by Public Health England to describe and demonstrate effective, practical local action on a range of social determinants of health. (Edited publisher abstract)