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Multidisciplinary team perspectives on older adult hoarding and mental illness
- Authors:
- KOENIG Terry L., et al
- Journal article citation:
- Journal of Elder Abuse and Neglect, 25(1), 2013, pp.56-75.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
Hoarding, characterised as animal or inanimate object hoarding, can have debilitating consequences for older adults who hoard, as well as for their families and communities. Because of the complex nature of hoarding, many believe that a multidisciplinary approach is needed to respond to hoarding. The purpose of this qualitative study was to examine multidisciplinary team perspectives on their involvement in older adult hoarding cases. Fifteen informants, as members of 4 hoarding teams and representing multiple agencies (e.g. adult protective services, mental health services, and animal control), were specifically asked to describe cases in which their team did or did not work well together to resolve a case. In doing so, the informants described: their team’s characteristics (e.g. team composition, and processes for working together); the need for team members’ increased awareness of hoarding as a mental illness; barriers to providing mental health services for older adults who hoard; and components of successful teamwork within the team and with the older adult as hoarder. Implications include research to better guide interventions, team training to develop common perspectives, and policy development that supports mental health representation on teams and in-home mental health treatment.
A framework for understanding outcomes of integrated care programs for the hospitalised elderly
- Authors:
- HARTGERINK Jacqueline M., et al
- Journal article citation:
- International Journal of Integrated Care, 13(4), 2013, Online only
- Publisher:
- International Foundation for Integrated Care
Integrated care is a new strategy to enhance the quality of care for hospitalised elderly. Current models do not provide insight into the mechanisms underlying integrated care delivery. This article provides a framework to identify the underlying mechanisms of integrated care delivery in order to increase understanding between the relation between structure and outcomes. The overall aim is to improve the quality of care delivery and eventually patient outcomes. First, the cognitive components of the framework are outlined. These components consist of mechanisms that alter the way of thinking by professionals delivering care to older patients. Next the behavioural components are explained, which consist of mechanisms that explain how professionals actively share and combine patient information from various sources. An example of an application of the evaluation model for an integrated care programme for hospitalised and vulnerable older people is then provided. The following aspects are discussed: organisational context; care delivery by interdisciplinary teams; team context; health service delivery; quality of life for elderly patients. Interprofessional collaboration among professionals is considered to be critical in integrated care delivery due to many interdependent work requirements. Effective integrated care programmes combine the interacting components of care delivery. These components affect professionals’ cognitions and behaviour, which in turn affect quality of care. Insight is gained into how these components alter the way care is delivered through mechanisms such as combining individual knowledge and actively seeking new information. (Edited publisher abstract)
Developing community resource teams in Pembrokeshire, Wales: integration of health and social care in progress
- Authors:
- THIEL Veronika, et al
- Publisher:
- King's Fund
- Publication year:
- 2013
- Pagination:
- 31
- Place of publication:
- London
For older people who need both health and social care support, the divisions in the organisation, funding and delivery of care in the United Kingdom (UK) can result in poor user experiences and outcomes. There is also a lack of knowledge about how best to apply care co-ordination tools in practice. This case study looks at integrated teams of health and social care professionals, known as community resource teams (CRTs), who work to co-ordinate care for people living at home in the largely rural county of Pembrokeshire. This model of care is one aspect of a wider strategic programme of integrated care, called Care Closer to Home. This case study is one ofi five successful UK-based models of care co-ordination, and is part of a research project undertaken by The King’s Fund and funded by Aetna and the Aetna Foundation in the United States, The report briefly explains the health and social care system in Wales. It examines barriers and facilitators in care co-ordination; and how care co-ordination can best be supported in terms of planning, organisation and leadership. Case studies about individual recipients of care illustrate the effectiveness of solutions offered by the CRTs. (Edited publisher abstract)
Shake-ups that don't shake up the patient
- Author:
- TAYLOR Jennifer
- Journal article citation:
- Health Service Journal, 21.3.13, 2013, pp.21-23.
- Publisher:
- Emap Healthcare
Southwark and Lambeth Integrated care has redesigned models of care to offer better care, while reducing bed occupancy and achieving sustainability. Six community multidisciplinary teams coordinate the care of higher risk patients with complex needs. The service began with older patients over 65 years old, and will expand to all adults with long-term conditions. The article summarises the five elements of the systems redesign. The planned four part external evaluation will investigate user experience; reductions in hospital bed days and admissions to residential care homes; economic costs and savings of the new model and the process of change.