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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)
Cognitive therapy for depression in the elderly
- Authors:
- KODER Deborah-Anne, BRODATY Henry, ANSTEY Kaarin J.
- Journal article citation:
- International Journal of Geriatric Psychiatry, 11(2), February 1996, pp.97-107.
- Publisher:
- Wiley
Reviews the applicability for older patients of cognitive (CT) and cognitive-behavioural (CBT) therapies for depression, now well established for clinical populations aged less than 65 years. The review looks at eighteen English language articles published to the end of 1994. Outcome data from seven studies indicate that CT is clearly more effective than no therapy or placebo, though prediction of success is uncertain. The review, though limited, concludes that CT is an effective intervention for depression in older people and recommends strategies for further research to enable more accurate targeting of therapy.