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Understanding and improving transitions of older people: a user and carer centred approach: executive summary
- Authors:
- ELLINS Jo, et al
- Publisher:
- National Institute for Health Research
- Publication year:
- 2012
- Pagination:
- 7p.
- Place of publication:
- London
Research studies and reports from inspectors have shown that older people experience many problems before, during and after transitions. This study focuses on older people and their transition between different services and agencies in health and social care. It aims to explores older people’s experiences of moving across service boundaries, identify how the needs of a particular group may differ from each other, investigated these issues over times, and draw out policy implications for the way in which services prepare and support older people and their carers for care transitions. Data were drawn from four sites in England. Findings revealed that experiences of transition were accompanied by a sense of disorientation and uncertainty. Good communication by service providers assisted in making sense of the transitions, however the experience of stumbling across services or having to seek them out was common. Overall, the way older people were treated by professionals and staff had considerable impact on their experiences.
Growing old my way: a review of the impact of the National Service Framework for Older People in Wales
- Author:
- CARE AND SOCIAL SERVICES INSPECTORATE WALES
- Publisher:
- Care and Social Services Inspectorate Wales
- Publication year:
- 2012
- Pagination:
- 81p.
- Place of publication:
- Cardiff
Focusing on older people’s services seen through the ‘lens of someone with dementia’, the review concluded that the National Service Framework has had an impact in Wales. Together with related strategies and the role of the Older People’s Commissioner, it has raised the profile of services received by older people in Wales and highlighted the need for them to be treated as individuals and without discrimination. The review also highlighted that across Wales a number of innovative and valuable services and support mechanisms for older people have been put in place. For example: exercise and activity classes; lunch clubs; shop and drop internet services such as the food solutions project in Flintshire; and television adverts such as the FAST advert for stroke. However, the review also found that: greater focus is needed at a local level in health promotion, prevention and community services if we are to help and support people to live healthy and longer lives; older people with complex needs often end up in hospital when in reality for many it is the last place they should be; and when older people do get admitted to hospital they are frequently there for too long and as a result their independence and confidence is impacted upon. The report also refers to ongoing concerns around the fundamental aspects of care, dignity and respect that are essential for anyone accessing health and social care services.
Active ageing: an Anchor Housing report in association with Demos
- Authors:
- ANCHOR HANOVER, DEMOS
- Publishers:
- DEMOS, Anchor Hanover
- Publication year:
- 2019
- Pagination:
- 25
- Place of publication:
- London
This report highlights the human cost of inactivity in later life, illustrating how inactivity contributes to poorer physical health, cognitive decline, reduced emotional wellbeing and loneliness. It also highlights the costs of physical inactivity in older people to the NHS, which it estimates could be as much as £1.3bn by 2030. The report draws on the findings of over 80 studies concerning physical activity and a new survey of experiences and attitudes to physical activity among more than 1,000 people aged 55 and over. It also explains the benefits of increased activity, highlights lessons in overcoming the barriers to older people's improved activity rates. It summaries 'what works' into four key lessons: the importance of providing support; offer both community and home-based activity; get the messaging right - focusing on the fun and enjoyment of activities; and that one size will not fit all. (Edited publisher abstract)
‘They just throw you out’: release planning for older prisoners
- Authors:
- FORSYTH Katrina, et al
- Journal article citation:
- Ageing and Society, 35(9), 2015, pp.2011-2025.
- Publisher:
- Cambridge University Press
Older prisoners are the fastest growing incarcerated sub-group. They have more complex health and social care needs than both younger prisoners and their age-matched peers living in the community. Prisoners who have been recently released are at enhanced risk in terms of their physical and mental health. Consequently, there is a need for timely, multi-disciplinary release planning. The aim of this study was to explore the health and social care needs of older male adults discharged from prison into the community. Qualitative interviews were carried out with prisoners with four weeks left to serve (N=62), with follow-up interviews conducted four weeks after release (N=45). Participants were selected from nine prisons in the North of England. The constant comparison method was used to analyse the data. Older prisoners perceived release planning to be non-existent. There was a reported lack of formal communication and continuity of care, causing high levels of anxiety. Older prisoners experienced high levels of anxiety about the prospect of living in probation-approved premises; however, those who did go on to live in probation-approved premises had their immediate health and social care needs better met than those who did not move into such accommodation. Release planning for older prisoners is generally inadequate and there is currently a missed opportunity to address the needs of this vulnerable group (Publisher abstract)
Priorities for the next government
- Author:
- KING'S FUND
- Publisher:
- King's Fund
- Publication year:
- 2014
- Pagination:
- 12
- Place of publication:
- London
Sets out the key health and social care challenges and priorities for the next government. These include: meeting the financial needs, with a renewed drive to improve productivity, the establishment of a health and social care transformation fund and a new settlement for health and social care; transforming services for patients, through integrated care delivered at scale and pace, a new deal for general practice and political backing for service changes; improving the quality of care, by engendering a new culture of care, parity of esteem for mental health and a revolution in the care of older people; and a new approach to NHS reform, with a new political settlement to demarcate the role of politicians, a focus on reform from within and investment in the right kind of leadership. (Edited publisher abstract)
Suitability of the 6CIT as a screening test for dementia in primary care patients
- Authors:
- HESSLER Johannes, et al
- Journal article citation:
- Aging and Mental Health, 18,(4) 2014, pp.515-520.
- Publisher:
- Taylor and Francis
Objectives: To map the suitability of the Six Item Cognitive Impairment Test's (6CIT) as a screening instrument for dementia in primary care and to assess its feasibility, reliability, and validity in a real-world setting.Method: The present study was part of a population-based prospective trial aimed at reducing the incidence of stroke and dementia. The 6CIT was administered by general practitioners (GPs) at routine examinations every two years. Incidence of dementia was obtained from health insurance records. Psychometric qualities of the 6CIT were evaluated for two different cut-offs.Results: At baseline, 72 GPs examined 3908 patients. In total, 528 patients were diagnosed with new dementia. Less than 1% of the tests were not completed. Internal consistency (Cronbach's alpha), stability over time (Pearson's r), and the agreement between successive tests (Cohen's kappa) reached values of 0.58, 0.62, and 0.45, respectively. Sensitivity and specificity reached values of 0.49 and 0.92 at the 7/8 cut-off and of 0.32 and 0.98 at the 10/11 cut-off, respectively. Patients with dementia had significantly higher mean error scores than patients without dementia. High scores at baseline posed a more than fourfold risk of being diagnosed with dementia.Conclusion: The 6CIT's psychometric properties in a real-world setting suggest that the test is not suited as a routine screening instrument. Factors inherent to screening in primary care likely contributed to its low reliability and validity. This highlights the need for training GPs in the conduct of cognitive screening before such procedures can be implemented on a routine basis. (Publisher abstract)
North West Joint Improvement Partnership: commissioning and joint strategic needs assessments
- Author:
- OXFORD BROOKES UNIVERSITY. Institute of Public Care
- Publisher:
- Oxford Brookes University. Institute of Public Care
- Publication year:
- 2010
- Pagination:
- 24p.
- Place of publication:
- Oxford
The production of a Joint Strategic Needs Assessment (JSNA) is meant to be a key enabler of effective commissioning to improve health and well-being outcomes. This study explores whether the desired relationship between commissioning and the JSNA has occurred and what could be done to improve that relationship. The project was structured around key questions, centred on commissioners' requirements and how they can be reconciled with the practice and requirements of people working in public health, as well as how the JSNA processes can best be constructed to promote outcomes-based commissioning. It involved the review of, and discussions with, eight local authorities. JSNAs were assessed against the project questions, and interviews were conducted with Directors of Public Health, Directors of Adult Social Services and Directors of Childrens’ Services at each of the localities using a semi-structured interview. The report analyses JSNA content and identifies overarching themes, presenting and discussing findings from the interviews against each of the identified questions. There are summary analyses of these findings, including recommendations for steps that could be taken to improve the relationship between commissioning and the JSNA.
Analysis of the future need and demand for appropriate models of accommodation and associated services for older people
- Author:
- PARIS Chris
- Publisher:
- Northern Ireland Housing Executive
- Publication year:
- 2010
- Pagination:
- 99p.
- Place of publication:
- Belfast
This reports analysed demographic and policy trends to support informed decision making regarding future housing need assessment for older people; collation of information on the existing supply of accommodation for elderly people in relation to the distribution of the elderly population for Northern Ireland. The review examined issues relating to older persons’ housing and care needs: housing arrangements and preferences, independence and control; income, poverty and wealth; health and well-being; and neighbourhood and location. It identified strong evidence that older people wish to maintain independence in their own homes for as long as possible. In many instances, this would require at most small levels of assistive input. Some older people, however, prefer other options: moving to more suitable mainstream accommodation or accommodation combined with care. Research indicated that access to suitable housing is not perceived as a major problem by older people, but they are more concerned about the fear of crime, keeping warm in winter, loneliness, making ends meet (especially ‘asset rich, income poor’ households) and isolation.
The impact of depression and anxiety on well being, disability and use of health care services in nursing home patients
- Authors:
- SMALBRUGGE Martin, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 21(4), April 2006, pp.325-332.
- Publisher:
- Wiley
The study-population consisted of 350 elderly nursing home patients from 14 nursing homes in the Netherlands. Well being, disability, use of health care services (i.e. assistance in ADL, paramedical care, number of medications) and depression and anxiety and other relevant characteristics (gender, age, education, marital status, urbanization, cognition, morbidity, social support) were measured cross-sectionally. Associations of well being, disability and use of health care services with independent baseline characteristics were assessed with bivariate and with multivariate analyses. Results found that the presence of depression and/or anxiety was associated with significantly less well being, but not with more disability. Presence of depression and/or anxiety was also significantly associated with four of the seven indicators of health care service use measured in this study: less assistance in ADL, more consultation of medical specialists, a higher mean number of medications and more use of antidepressants. It is concluded that presence of depression and/or anxiety has a statistically and clinically significant negative impact on well being, but not on disability. Future studies should focus on interventions for improving the detection, diagnosis and treatment of depression and/or anxiety in the nursing home.
Use of the minimum data set-home care: a cluster randomized controlled trial among the Chinese older adults
- Authors:
- CHI I., et al
- Journal article citation:
- Aging and Mental Health, 10(1), January 2006, pp.33-39.
- Publisher:
- Taylor and Francis
The objective of this study was to test whether the utilization of Minimum Data Set—Home Care (MDS-HC) as a case finding instrument for Chinese attenders of elderly health centres in Hong Kong had a beneficial impact on the physical and mental health status of those older clients. The dependent variables were 13 outcome variables measuring different dimensions of participants’ physical and mental health status. Using a cluster randomized controlled trial design, we assigned three of six participating elderly health centres to the experimental group and the other three to the control group. The respondents were 925 (472 in the experimental group and 453 in the control group) elderly health centre attenders aged 65 years or above. They were assessed by MDS-HC and 734 (382 in the experimental group and 352 in the control group) of them were re-assessed one year later. In the experimental group, the medical doctors had been given their patients’ profile of potential problem areas identified by MDS-HC before they treated their patients whereas in the control, the medical doctors treated their patients with their usual practice. We found that older attenders in the experimental group improved more than the ones in the control group in only two out of 13 areas. Surprisingly, the patients in the experimental group deteriorated even more than the ones in the control group in terms of bowel incontinence. Our results indicated that the function of the MDS-HC in case finding or screening is limited in the Hong Kong primary medical care setting.