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Reminiscence in dementia: a concept analysis
- Authors:
- DEMPSEY Laura, et al
- Journal article citation:
- Dementia: the International Journal of Social Research and Practice, 13(2), 2014, pp.176-192.
- Publisher:
- Sage
This paper is a report of an analysis of the concept of reminiscence in dementia and highlights its uses as a therapeutic intervention used on individuals with dementia. No single definition of reminiscence exists in healthcare literature; however, definitions offered have similar components. The term life review is commonly used when discussing reminiscence; however, both terms are quite different in their goals, theory base and content. This concept analysis identified reminiscence as a process which occurs in stages, involving the recalling of early life events and interaction between individuals. The antecedents of reminiscence are age, life transitions, attention span, ability to recall, ability to vocalise and stressful situations. Reminiscence can lead to positive mental health, enhanced self esteem and improved communication skills. It also facilitates preparation for death, increases interaction between people, prepares for the future and evaluates a past life. Reminiscence therapy is used extensively in dementia care and evidence shows when used effectively it helps individuals retain a sense of self worth, identity and individuality. (Publisher abstract)
Configuring joint preventive services: a structured approach to service transformation and delivering better outcomes for older people
- Author:
- CARE SERVICES IMPROVEMENT PARTNERSHIP. Care Services Efficiency Delivery Programme
- Publisher:
- Care Services Improvement Partnership. Care Services Efficiency Delivery Programme
- Publication year:
- 2008
- Pagination:
- 40p.
- Place of publication:
- London
CSED published a Configuring Future Services Toolkit in October 2007. The approach, developed with the Institute of Public Care (IPC), at Oxford Brookes University, identified opportunities at the health and social care interface to build on Joint Strategic Needs Assessment [JSNA] with joint projects. IPC research literature on conditions affecting older people have provided evidence for interventions aimed at maintaining independence and avoiding costly residential care and hospital admissions. Two pilot authorities tested the approach and their experience, including problems they encountered in organisation, resourcing and information access, which has influenced the revised recommendations for implementation of such change projects. This paper sets out the new approach and summarises conclusions on the process of service transformation to deliver better outcomes for older people.
Evaluation of continuing care accommodation for elderly people: vol. 3; a multiple case study of NHS hospital wards and nursing homes; some aspects of structure and outcome
- Authors:
- BOND Senga, BOND John
- Publisher:
- University of Newcastle upon Tyne. School of Health Care Sciences
- Publication year:
- 1989
- Pagination:
- 204p.,tables,bibliog.
- Place of publication:
- Newcastle upon Tyne
Report of an evaluation of 3 experimental National Health Service nursing homes set up by the Department of Health and Social Security in 1983 and 1984.
Adherence and acceptance of a home-based telemonitoring application used by multi-morbid patients aged 65 years and older
- Authors:
- LANG Caroline, et al
- Journal article citation:
- Journal of Telemedicine and Telecare, 28(1), 2022, pp.37-51.
- Publisher:
- Sage
- Place of publication:
- London
Introduction: Currently, there are only a small number of comprehensive study results on adherence and acceptance of telemonitoring applications (TMAs) regarding multi-morbid older patients. The ATMoSPHAERE study aimed to develop an information and communication platform for an intersectoral networking of, for example, general practitioners, therapists, social services and the multi-morbid older patient. Methods: The study presented was designed as a longitudinal bicentric intervention study which focused on multi-morbid patients aged ≥65 years using home-based telemedical measurement and input devices. The development and testing of this TMA aimed to optimise patients’ health care through intersectoral networking of all treating actors. Quantitative methods of data collection and analysis were used. Results: Patients who completed the study were significantly younger than drop-outs and non-participants. The mental health of study patients significantly improved between the beginning and end of TMA use. The main reason for non-participation in the study was the high time expenditure when participating in the study. No perceived (information) benefits for health and insufficient content variety were the main reasons for drop-out. Appropriateness and handling of TMAs must be aligned with the needs of the heterogeneous user group of multi-morbid patients in order to increase acceptance and the added value of TMAs. Telemonitoring hardware should be oriented on functional capabilities of the older target group. Telemonitoring software content requires an individual, disease-specific approach for patients. The TMA should be unobtrusively integrated into usual daily life and be used to an appropriate extent according to the underlying disease in order to avoid stressing patients. With regard to adherence concerning TMAs, it is crucial to provide a contact person who is always available for patients having problems handling TMAs. Health concerns and questions can thus be addressed early, providing a feeling of safety in the care process. Discussion: User acceptance of TMAs is an essential indicator and driver for use and for future implementation efforts in health care. In order to achieve maximum user centricity in development processes, patients must be involved as experts, co-designers and future users, considering their needs and perceptions. (Edited publisher abstract)
Poorer outcomes and greater healthcare costs for hospitalised older people with dementia and delirium: a retrospective cohort study
- Authors:
- TROPEA Joanne, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 32(5), 2017, p.539–547.
- Publisher:
- Wiley
Objective: To compare healthcare utilisation outcomes among older hospitalised patients with and without cognitive impairment, and to compare the costs associated with these outcomes. Methods: Retrospective cohort study of administrative data from a large teaching hospital in Melbourne, Australia from 1 July 2006 to 30 June 2012. People with cognitive impairment were defined as having dementia or delirium coded during the admission. Outcome measures included length of stay, unplanned readmissions within 28 days and costs associated with these outcomes. Regression analysis was used to compare differences between those with and without cognitive impairment. Results: There were 93 300 hospital admissions included in the analysis. 6459 (6.9%) involved cognitively impaired patients. The adjusted median length of stay was significantly higher for the cognitively impaired group compared with the non-cognitively impaired group (7.4 days 6.7–10.0 vs 6.6 days, interquartile range 5.7–8.3; p < 0.001). There were no differences in odds of 28-day readmission. When only those discharged back to their usual residence were included in the analysis, the risk of 28-day readmission was significantly higher for those with cognitive impairment compared with those without. The cost of admissions involving patients with cognitive impairment was 51% higher than the cost of those without cognitive impairment. Conclusions: Hospitalised people with cognitive impairment experience significantly greater length of stay and when discharged to their usual residence are more likely to be readmitted to hospital within 28 days compared with those without cognitive impairment. The costs associated with hospital episodes and 28-day readmissions are significantly higher for those with cognitive impairment. (Publisher abstract)
Admission avoidance hospital at home (review)
- Authors:
- SHEPPERD Sasha, et al
- Publishers:
- John Wiley and Sons, Cochrane Collaboration
- Publication year:
- 2016
- Pagination:
- 67
Aims: There continues to be more demand for acute hospital beds than there are beds. One way to reduce reliance on hospital beds is to provide people with acute health care at home, sometimes called ’hospital at home’. This systematic review of the literature examines the effect of providing hospital at home services to avoid hospital admission for adults. This is the third update of the original review. Results: A total of 16 studies were retrieved, of which six were identified for this update. Three studies recruited participants with chronic obstructive (lung) disease, two recruited participants recovering from a stroke, six recruited participants with a (sudden or short-term) medical condition who were mainly elderly, and the remaining studies recruited participants with a mix of conditions. The studies showed that when compared to in-hospital care, admission avoidance hospital at home services probably make little or no difference to patient health outcomes or to the likelihood of being taken to hospital, and may increase the chances of living at home at six months’ follow-up. Patients who receive care at home may be more satisfied than those who are in hospital, but it is not known how this type of health care affects the caregivers who support them. With respect to costs, it is uncertain if hospital at home services reduce or increase length of stay or cost to the health service; when the costs for caregivers are taken into account any difference in cost may disappear. Conclusion: Admission avoidance hospital at home, with the option of transfer to hospital, may provide an effective alternative to inpatient care for a select group of elderly patients requiring hospital admission. However, the evidence is limited by the small randomised controlled trials included in the review, which adds a degree of imprecision to the results for the main outcomes. (Edited publisher abstract)
International migrations and care provisions for elderly people left behind. The cases of the Republic of Moldova and Romania
- Author:
- VIANELLO Francesca Alice
- Journal article citation:
- European Journal of Social Work, 19(5), 2016, pp.779-794.
- Publisher:
- Taylor and Francis
International migrations are posing numerous challenges to care systems in both sending and receiving countries. Based on a multi-method research conducted between 2011 and 2013, this article looks at how the care provisions for elderly people are rearranged in two Eastern European countries affected by the care drain phenomenon (the Republic of Moldova and Romania). The author charts and compares how transnational families, but also the other facets of the care diamond, such as the public sector, the market and the not-for-profit sector, provide care to elderly people left to cope at home alone because their close relatives have migrated. The main findings of the article are that transnational families are the principal welfare provider for elderly people left behind, while there is a serious delay in the adoption of specific policies for the elderly. (Publisher abstract)
Medical day hospital care for older people versus alternative forms of care (review)
- Authors:
- BROWN Leslie, et al
- Publisher:
- John Wiley and Sons
- Publication year:
- 2015
- Pagination:
- 98
Geriatric day hospitals are out-patient facilities which older patients attend for a full or near full day and receive multidisciplinary health care in one place. They can provide a range of specialist services, including assessment, rehabilitation, and medical, nursing, maintenance, social and respite care. This systematic review aimed to examine the effectiveness of medical day hospitals for older people in preventing death, disability, institutionalisation and improving subjective health status. The searches included the Cochrane Effective Practice and Organisation of Care (EPOC) Group Register of Studies, CENTRAL (2013,Issue 7), MEDLINE via Ovid (1950-2013 ), EMBASE via Ovid (1947-2013) and CINAHL via EbscoHost (1980-2013). Sixteen trials involving 3,689 participants were included in the review. They compared day hospitals with other comprehensive services (including inpatient and outpatient services), home based care and no comprehensive services. Results found that attendance at a day hospital offers benefits compared to providing no treatment which include reducing the risk of needing more help with daily activities such as washing or dressing. Patients are also less likely to suffer one of the following: dying, being institutionalised or becoming more dependent on others. There is no apparent benefit when day hospitals are compared with other comprehensive services or home care. The economic value of day hospitals when compared with other health care services remains unclear. (Edited publisher abstract)
The Integrated Care Evaluation Framework ((ICE-F): a realistic evaluation of integrated health and social care services in Wales
- Authors:
- CARNES-CHICHLOWSKA Susan, BURHOLT Vanessa, REA David
- Publisher:
- Welsh Government Social Research
- Publication year:
- 2015
- Pagination:
- 81
- Place of publication:
- Cardiff
Building on the interim report from researchers at the Centre for Innovative Ageing, Swansea University, this report sets out the Integrated Care Evaluation Framework (ICE-F) developed to help service providers to design and undertake evaluations of integrated services. Specifically the ICE-F assesses the impact of delivering integrated care to older people with the aim of improving wellbeing and independence. The model provides guidance on core elements that need to be considered in the evaluation, namely cost efficiency, effectiveness and the personal benefit of independence and wellbeing. It describes the stages necessary, the data requirements and the tools providers can use to assess the outcomes of their services.The framework is structured in four stages: describing what the service hopes to achieve and how; making a decision about what is going to be used to know whether the service will achieve it overall aims; the construction of a template for service evaluation; and the health economic evaluation of cost effectiveness, followed by a cost benefit analysis on the social return of investment. The final section provides a refined theory of integrated care, explaining why and how some aspects of the different contexts, mechanisms and outcomes work together in Wales. A series of recommendations for the Welsh Government and providers of integrated health and social care are also provided. (Edited publisher abstract)
Making the case for integrated, impartial information and advice about housing and care for older people
- Authors:
- ADAMS Sue, GREEN Gill
- Publisher:
- Foundations
- Publication year:
- 2015
- Pagination:
- 39
- Place of publication:
- London
This joint report sets out the case for the provision of integrated information and advice for older people which covers housing, care and finance. It looks at how this will enable local councils to meet their new duties under the Care Act; identifies current integrated information and advice provision; and demonstrates there wider cost benefits and their value to older people themselves. It also shows how these services meet specific NHS, Public Health and Social Care Outcomes Framework measures. Case studies are used throughout to illustrate the financial and social benefits of integrated provision and the added value that the voluntary sector can bring. The report has been jointly produced was Care and Repair England, EAC First Stop, Foundations, Independent Age and Age UK. It is of particular relevance to commissioners and providers of care, health or housing services. (Edited publisher abstract)