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Understanding service context: development of a service pro forma to describe and measure elderly peoples' community and intermediate care services
- Author:
- NANCARROW Susan A.
- Journal article citation:
- Health and Social Care in the Community, 17(5), September 2009, pp.434-446.
- Publisher:
- Wiley
The purpose of this paper was to develop a pro forma which classifies the components of service delivery and organization which may impact on the outcomes of elderly peoples' community and intermediate care services. The resulting analytic template provides a basis for comparison between services and may help guide service commissioning and development. A qualitative approach was used in which key evaluations and reports were selected on the basis that they described elderly peoples' community and intermediate care services. These were analysed systematically using a qualitative (template) approach to draw out the key themes used to describe services. Themes were then structured hierarchically into an analytic template. Seventeen key documents were analysed. The initial coding framework classified 334 themes describing intermediate care services. These items were then clustered into 78 categories, which were reduced to 17 subcategories, then six overall groupings to describe the services, namely; (1) context; (2) reason for the service; (3) service-users; (4) access to the service; (5) service structure; and (6) the organization of care. The resulting analytic template has been developed into a 'service pro forma' which can be used as a basis to describe and compare a range of services. It is proposed that all service evaluations should describe, in detail, their context in a comparable way, so that other services can learn from and/or apply the findings from these studies.
Adapting services for a changing society: a reintegrative model for old age psychiatry (based on a model proposed by Knight and Emanuel, 2007)
- Authors:
- BLANCHARD Martin, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 24(2), February 2009, pp.202-206.
- Publisher:
- Wiley
The authors discuss models of care for older people with mental health problems. The weaknesses of the Recovery model for this group are discussed, and an alternative, the reintegration model is put forward.
Paying for care in Wales: report of the stakeholder advisory group
- Authors:
- MILSON Steve, (chair)
- Publisher:
- Wales. Welsh Assembly Government. Health and Social Care Department. Paying for Care in Wales Stakeholder Advisory Group
- Publication year:
- 2009
- Pagination:
- 58p., bibliog.
- Place of publication:
- Cardiff
The report of a Stakeholder Advisory Group, set up by the Deputy Minister for Social Services, to consider reform of the system of paying for long-term care in Wales. Membership of the Advisory Group was made up of organisations and individuals representing a range of stakeholder interests, including disabled people, service users and carers, local government and health, care home owners, and older people. This report sets out the conclusions and 28 recommendations for reform. The recommendations are aimed primarily at the Welsh Assembly and UK Governments.
A Slovenia model of integrated care for older people can offer solutions for NHS services
- Author:
- JONES Helen
- Journal article citation:
- Nursing Times, 15.12.09, 2009, pp.10-12.
- Publisher:
- Nursing Times
A visit to an integrated model of care for older people in Slovenia is described. The care home visited, 'Sunny Dale' enabled residents with health and social care needs to remain in the same place throughout their lives.
Adherence to antiretroviral medication in older adults living with HIV/AIDS: a comparison of alternative models
- Authors:
- JOHNSON Christopher J., et al
- Journal article citation:
- AIDS Care, 21(5), May 2009, pp.541-551.
- Publisher:
- Taylor and Francis
The CDC estimates that by 2015, half of all persons living with HIV/AIDS in the USA will be over the age of 50. Despite increasing HIV seroprevalence rates in older adults, most research examining adherence to antiretroviral therapy (ART) has focused on young HIV-infected persons and, in general, has been atheoretical in nature. This study examined two ART adherence conceptual frameworks to determine whether these models generalize to HIV-seropositive older adults. Two hundred and forty-four HIV-positive adults 50-plus years of age were recruited through AIDS service organizations in Ohio and New York. Participants completed a neuropsychological battery and an audio computer-assisted self-interview. FIML SEM analyses revealed that neuropsychological functioning was not associated with adherence. Fit indices supported a stress and coping model, with negative affect mediating the effects of social support and maladaptive coping on ART adherence. Results were consistent with stress and coping models and suggest that interventions intending to increase adherence to ART in HIV-infected older adults may be more effective if they address negative affect and enhance adaptive coping and social support.
Analysis of recurrent events: a systematic review of randomised controlled trials of interventions to prevent falls
- Authors:
- DONALDSON Meghan G., et al
- Journal article citation:
- Age and Ageing, 38(2), March 2009, pp.151-155.
- Publisher:
- Oxford University Press
The use of appropriate methods for analysing recurrent events is important in randomised controlled trials of fall prevention interventions. This review identified 83 RCTs published between 1994 and November 2006, and determined the proportion using the following methods: negative binomial regression; the Andersen-Gill extension of the Cox proportional hazards model; and the WLW (Wei, Lin and Weissfield) marginal model. Fewer than a third of the papers used one of these methods, and fewer than 15% used the mean cumulative function to represent falls data graphically. The authors recommend that researchers and clinicians in the field should consult statisticians with expertise in recurrent event methodology, and that guidance should be developed by bodies such as CONSORT.
Ageing well in Dorset: how not to be invisible
- Author:
- COWEN Robin
- Journal article citation:
- Journal of Integrated Care, 17(6), December 2009, pp.31-36.
- Publisher:
- Emerald
This article describes a Dorset County Council commissioned project in 2008 to develop a plan for ageing well, that engaged and involved older people. The completed plan, supported by Cabinet and the Local Strategic Partnership, was carried out using outcome-based accountability, a methodology for focusing on outcomes, rather than process. Examining how the outcome-based plan worked to support this strategic development in adult services, at a time when it had been more widely used in children’s services, the author overviews outcome-based accountability, and how it starts with the end – or goals it should achieve. Working with the local older people to define the outcome, helped to retain a focus what mattered most to the older people of Dorset, which was at the heart of the commission.
All together now: a collaborative and relationship-centred approach to improving assessment and care management with older people in Swansea
- Authors:
- ANDREWS Nick, DRIFFIELD Deborah, POOLE Vicky
- Journal article citation:
- Quality in Ageing, 10(3), September 2009, pp.12-23.
- Publisher:
- Pier Professional
- Place of publication:
- Brighton
The need for more holistic and inclusive approaches to assessment and care management for older people is widely promoted but difficult to achieve. This paper describes the All Together Now initiative in Swansea, South Wales, which seeks to promote better practice in assessment and care management by actively involving all stakeholders, older people and family carers, and practitioners and service providers from across the statutory and third sectors. The project is underpinned by a relationship-centred approach based on the belief that an enriched environment of care will only be created when the needs of all stakeholders are acknowledged and given attention. How such a model was used to establish the goals for the project is described, together with the proposed model of evaluation.
Implementing the Mental Capacity Act 2005: challenges for commissioners
- Authors:
- MANTHORPE Jill, SAMSI Kritika
- Journal article citation:
- Journal of Integrated Care, 17(3), June 2009, pp.39-47.
- Publisher:
- Emerald
Local authorities and primary care trusts receive regular instructions to put new legislation into practice, and to ensure appropriate training. This article takes the implementation of the Mental Capacity Act as a case study of how commissioners are involved in such changes, and reports on two models. The MCA is an example of the gains that can be made if commissioners think about implementation across agencies, and between public and private sectors.
The ‘Quality in Care’ model of quality assurance and safeguarding for older people in institutional care
- Authors:
- ELVIDGE Felicity, MacPHAIL Geraldine
- Journal article citation:
- Journal of Adult Protection, 11(1), February 2009, pp.28-37.
- Publisher:
- Emerald
This paper profiles the Maidstone ‘Quality in Care’ project and makes suggestions for how it could be developed and implemented across residential and nursing care for older people and for social care more widely. ‘Quality in Care’ is a quality assurance model of support provided to residential care homes for older people where there are serious concerns about the risks of abuse and/or neglect and the quality of services and care provided. Quality in Care visits may be triggered by a safeguarding investigation or if the health and personal care of residents is identified a high risk. The aim of the intervention is to ensure that vulnerable adults are safeguarded and protected and that service standards are improved in key areas. The model has the potential to be transferred to all client groups and most service types although resource constraints currently limit the project to older people only.