Search results for ‘Subject term:"older people"’ Sort:
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Models of integrated care for older people with frailty: a horizon scanning review
- Authors:
- KJELSNES Ashwanee A, FEIRING Eli
- Journal article citation:
- BMJ Open, 12(4), 2022, Online only
- Publisher:
- BMJ Publishing Group
Objectives: Frailty, a multifaceted geriatric condition, is an emerging global health problem. Integrated care models designed to meet the complex needs of the older people with frailty are required. Early identification of innovative models may inform policymakers and other stakeholders of service delivery alternatives they can introduce and locally adapt so as to tackle system fragmentation and lack of coordination. This study used horizon scanning methodologies to systematically search for, prioritise and assess new integrated care models for older people with frailty and investigated experts' views on barriers and facilitators to the adoption of horizon scanning in health services research. Methods: A four-step horizon scanning review was performed. Frailty-specific integrated care models and interventions were identified through a review of published literature supplemented with grey literature searches. Results were filtered and prioritised according to preset criteria. An expert panel focus group session assessed the prioritised models and interventions on innovativeness, impact and potential for implementation. The experts further evaluated horizon scanning for its perceived fruitfulness in aiding decision-making. Results: Nine integrated care models and interventions at system level (n=5) and community level (n=4) were summarised and assessed by the expert panel (n=7). Test scores were highest for the Walcheren integrated care model (system-based model) and EuFrailSafe (community-based intervention). The participants stated that horizon scanning as a decision-making tool could aid in assessing knowledge gaps, criticising the status quo and developing new insights. Barriers to adoption of horizon scanning on individual, organisational and wider institutional level were also identified. Conclusion: Study findings demonstrated that horizon scanning is a potentially valuable tool in the search for innovative service delivery models. Further studies should evaluate how horizon scanning can be institutionalised and effectively used for serving this purpose. (Edited publisher abstract)
Developing a model of short-term integrated palliative and supportive care for frail older people in community settings: perspectives of older people, carers and other key stakeholders
- Authors:
- BONE Anna E., et al
- Journal article citation:
- Age and Ageing, 45(6), 2016, pp.863-873.
- Publisher:
- Oxford University Press
Background: Understanding how best to provide palliative care for frail older people with non-malignant conditions is an international priority. The authors aimed to develop a community-based episodic model of short-term integrated palliative and supportive care (SIPS) based on the views of service users and other key stakeholders in the United Kingdom. Method: Transparent expert consultations with health professionals, voluntary sector and carer representatives including a consensus survey; and focus groups with older people and carers were used to generate recommendations for the SIPS model. Discussions focused on three key components of the model: potential benefit of SIPS, timing of delivery and processes of integrated working between specialist palliative care and generalist practitioners. Content and descriptive analysis was employed and findings were integrated across the data sources. Findings: The authors conducted two expert consultations (n = 63), a consensus survey (n = 42) and three focus groups (n = 17). Potential benefits of SIPS included holistic assessment, opportunity for end of life discussion, symptom management and carer reassurance. Older people and carers advocated early access to SIPS, while other stakeholders proposed delivery based on complex symptom burden. A priority for integrated working was the assignment of a key worker to co-ordinate care, but the assignment criteria remain uncertain. Interpretation: Key stakeholders agree that a model of SIPS for frail older people with non-malignant conditions has potential benefits within community settings, but differ in opinion on the optimal timing and indications for this service. The findings highlight the importance of consulting all key stakeholders in model development prior to feasibility evaluation. (Edited publisher abstract)
A systematic review of different models of home and community care services for older persons
- Authors:
- LOW Lee-Fay, YAP Melvyn, BRODATY Henry
- Journal article citation:
- BMC Health Services Research, 11(93), 2011, pp.1-15. Online only
- Publisher:
- BioMed Central Ltd
Background: Costs and consumer preference have led to a shift from the long-term institutional care of aged older people to home and community based care. The aim of this review is to evaluate the outcomes of case managed, integrated or consumer directed home and community care services for older persons, including those with dementia. Methods: A systematic review was conducted of non-medical home and community care services for frail older persons. MEDLINE, PsycINFO, CINAHL, AgeLine, Scopus and PubMed were searched from 1994 to May 2009. Two researchers independently reviewed search results. Results: Thirty five papers were included in this review. Evidence from randomised controlled trials showed that case management improves function and appropriate use of medications, increases use of community services and reduces nursing home admission. Evidence, mostly from non-randomised trials, showed that integrated care increases service use; randomised trials reported that integrated care does not improve clinical outcomes. The lowest quality evidence was for consumer directed care which appears to increase satisfaction with care and community service use but has little effect on clinical outcomes. Studies were heterogeneous in methodology and results were not consistent. Conclusions: The outcomes of each model of care differ and correspond to the model’s focus. Combining key elements of all three models may maximise outcomes. (Edited publisher abstract)
Changing the paradigm:strengths-based and empowerment-oriented social work with frail elders
- Authors:
- CHAPIN Rosemary, COX Enid Opal
- Journal article citation:
- Journal of Gerontological Social Work, 36(3/4), 2001, pp.165-179.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
Empowerment-oriented and strengths based practice with older adults who face physical, mental and resources related challenges in late life have gained recognition in recent decades. This article explores the basic tenets of these approaches to practice and suggests their similarities, differences and potential contributions. The article stresses work across various levels of practice (personal, interpersonal and political) and the potential of older adults to be active participants in decisions and actions that affect their quality of life.
Successful aging in the Australian longitudinal study of aging: applying the MacArthur model cross-nationally
- Authors:
- ANDREWS Gary, CLARK Michael, LUSZCZ Mary
- Journal article citation:
- Journal of Social Issues, 58(4), Winter 2002, pp.749-765.
- Publisher:
- Wiley
This study used the criteria developed in the MacArthur studies on successful aging to identify subgroups with higher, intermediate, or lower levels of function, and to compare them across a range of other domains. Data were drawn from the Australian Longitudinal Study of Aging (ALSA) in Adelaide, Australia, which is a population-based, bio-psycho-social study of a cohort of 1947 adults aged 70 years or more. Results showed risk and protective effects of successful aging for physical functioning and performance, lifestyle, cognition, affect, and personality. The findings confirm that people age with differing degrees of success and those aging most successfully not only live longer, but also experience a better quality of life.
Extra care villages: meeting the needs of a new century
- Author:
- PAYNE John
- Journal article citation:
- Housing Care and Support, 5(1), February 2002, pp.15-18.
- Publisher:
- Emerald
Extra care housing, which provides housing and 24-hour support, must be a more positive way to meet older people's needs than traditional residential care. The article explores a village model which provides substantial communal facilities and mixed-tenure possibilities. Consideration is given to current and future developments.
Elderly care planning model: Wessex Regional Health Authority
- Author:
- OPIT L.J
- Publisher:
- University of Kent. Centre for Health Services Studies
- Publication year:
- 1990
- Pagination:
- 36p.,tables.
- Place of publication:
- Canterbury
Document developing a 'synthetic' model for estimating disability amongst the population over 70 years of age who reside at home. Based on data contained in the 1985 OPCS household disability survey.
Long term care for the elderly: the community care scheme
- Authors:
- CHALLIS David, DAVIES Bleddyn
- Journal article citation:
- British Journal of Social Work, 15(6), December 1985, pp.563-579.
- Publisher:
- Oxford University Press
Describes the full evaluation of the community care scheme for older people in Kent. Compares the cost-effectiveness of the scheme for users and carers with the range of services which would otherwise have been received. Argues that effective case management by a key worker is an essential feature of more effective home care for the very frail elderly and that the case management role is an appropriate model of social work for other long term care groups.
Better care for frail older people: working differently to improve care
- Author:
- DELOITTE
- Publisher:
- Deloitte
- Publication year:
- 2014
- Pagination:
- 38
- Place of publication:
- London
This report draws on literature reviews, data analysis, interviews and Deloitte's experience of working to help redesign services to analyse the challenges that exist in caring more effectively for increasing numbers of frail older people. It focuses on people aged 75 in the UK, with an emphasis on England. The report identifies the need to improve the capacity and capability of care providers and reduce the current tendency for frail older people to move back and forth from home to hospital to care home. It covers four key themes: scale and extent of the challenge due to changing demographics; barriers to ensuring health and social care is fit for purpose, including funding, fragmented care delivery and workforce; new approaches, systems and models of care; and improving the place of care, such as improving housing conditions, better inspection of care home and the implementation of a hospital frailty care pathway. (Edited publisher abstract)
Gender differences in the self-rated health-mortality association: is it poor self-rated health that predicts mortality or excellent self-rated health that predicts survival?
- Authors:
- BENYAMINI Yael, et al
- Journal article citation:
- Gerontologist, 43(2), June 2003, pp.396-405.
- Publisher:
- Oxford University Press
This study investigates gender differences in the association between self-rated health (SRH) and mortality. This association has been well-documented, but findings regarding gender differences are inconsistent. The specific objectives were (a) to examine these differences in a short and a long time frame, (b) to examine these differences among old and old-old people, and (c) to address the question of whether this association is based on the accuracy of poor SRH as a predictor of future decline, and/or of better SRH as a predictor of longevity. The study is based on an Israeli nationally representative sample of 622 women and 730 men who were interviewed about their SRH, as well as sociodemographic information and other measures of health, physical functioning, cognitive status, and depression. For both genders, SRH was associated only with shorter term mortality (within the next 4 years) and not with longer-term mortality (9 years of follow-up). This association was strongest among the old (ages 75-84) women, compared with the old men and with the old-old (85-94) women and men. A possible explanation may be related to differences in the accuracy of excellent SRH at very old age. The SRH-mortality association may differ among age and gender groups. Identifying the conditions under which it is more accurate will enable researchers and practitioners to know when it can be utilized. It is important to assess differences in the accuracy of poor SRH as well as of excellent SRH as predictors of future health outcomes.