Search results for ‘Subject term:"older people"’ Sort:
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Outcomes for older telecare recipients: the importance of assessments
- Authors:
- WOOLHAM John, et al
- Journal article citation:
- Journal of Social Work, 21(2), 2021, p.162–187.
- Publisher:
- Sage
Summary: This article explores the role of telecare assessment, review and staff training in meeting the needs of older people living at home. Using original empirical data obtained from an online survey of English local authorities it reveals considerable variation in assessment and review practice and in training given to social work and other staff who assess and review, which may impact on outcomes for telecare users. The study findings are situated within an English policy context and earlier findings from a large, government funded randomised controlled trial. This trial concluded that telecare did not lead to better outcomes for users. Findings: Our survey findings suggest that it may be the way in which telecare is used, rather than telecare itself that shapes outcomes for people who use it, and that ‘sub-optimal’ outcomes from telecare may be linked to how telecare is adopted, adapted and used; and that this is influenced by staff training, telecare availability and a failure to regard telecare as a complex intervention. Application: The findings may help to reconcile evidence which suggests that telecare does not deliver better outcomes and local authority responses to this which either discount or contest its value. The article suggests that to use telecare to achieve optimal outcomes for older people, social workers, care managers and other professionals involved in assessing for telecare will need to be given enhanced training opportunities, and their employers will need to perceive telecare as a complex intervention rather than simply a ‘plug and play’ solution. (Edited publisher abstract)
The cognitive daisy in residential care
- Authors:
- POLLUX Petra, HUDSON John
- Journal article citation:
- Journal of Dementia Care, 25(5), 2017, pp.12-13.
- Publisher:
- Hawker
The authors explain how they have developed the "cognitive daisy" (COG-D) as a simple guide to the cognitive status of care home residents and they argue that care is better adapted to residents' needs as a result. (Edited publisher abstract)
'The meals look lovely but mum says the food is tasteless'
- Authors:
- WYLIE Kim, NEBAUER Monica
- Journal article citation:
- Journal of Dementia Care, 22(1), 2014, pp.19-22.
- Publisher:
- Hawker
A person's sense of taste and smell can contribute to under-nutrition in older people and those living with dementia. This article highlights the need for improved assessment skills and knowledge about chemosensory loss, under-nutrition and ways to enrich the flavour of food. Person-centred approaches to enhance the dining experience of people with dementia are also discussed. (Original abstract)
A good life in old age? Monitoring and improving quality in long-term care
- Authors:
- ORGANISATION FOR ECONOMIC CO-OPERATION AND DEVELOPMENT, EUROPEAN COMMISSION
- Publisher:
- Organisation for Economic Co-operation and Development
- Publication year:
- 2013
- Pagination:
- 270
- Place of publication:
- Paris
With the ageing populations and growing costs, ensuring and improving the quality of longterm care (LTC) services has become an important policy priority across OECD countries. The share of those aged 80 years and over is expected to increase from 4% in 2010 to nearly 10% in 2050, while in 2010 OECD countries allocated 1.6% of groos domestic product (GDP) to public spending on LTC, on average. The goal of good quality care is to maintain or, when feasible, to improve the functional and health outcomes of frail older people, the chronically ill and the physically disabled, whether they receive care in nursing homes, assisted living facilities, community-based or home care settings. This report is the outcome of a two-year collaboration between the OECD Health Division and the Directorate General for Employment, Social Affairs and Inclusion of the European Commission. The report discusses the importance of developing metrics for measuring safe, effective and responsive long-term care services, and looks at on-going country initiatives to improve the quality of life of frail older people, as well as the technical and broader challenges to measurement and improvement. The report focuses on three aspects generally accepted as critical to quality care: effectiveness and care safety; patient-centredness; and responsiveness and care co-ordination. The report is organised in three parts: measuring quality in long-term care; policies to drive the quality in long-term care; and case studies: Europe and the United States. (Edited publisher abstract)
Major depressive disorder in late life: a multifocus perspective on care needs
- Authors:
- HOUTJES W., et al
- Journal article citation:
- Aging and Mental Health, 14(7), September 2010, pp.874-880.
- Publisher:
- Taylor and Francis
To gain insight into the needs of outpatients with late-life depression this study interviewed 99 outpatients aged 58-92 who were receiving treatment for major depressive disorder from six specialised mental health care facilities in the Netherlands. They were interviewed using the Dutch version of the Camberwell Assessment of Needs for the Elderly (CANE-NL) to identify met and unmet needs and the Montgomery-Asberg Depression Rating Scale to measure depression severity. The results showed that depression severity levels varied from remission (23%), mild (31%), moderate (31%), to severe depression (15%). The average number of needs reported was 8.86, comprising 6.5 met needs and 2.3 unmet needs. Most of the unique variance in depression severity was explained by psychological unmet needs, more in particular by needs representing psychological distress. The environmental, social or physical unmet needs showed less or no meaningful predictive value for variance in depression severity. The article concludes that systematic needs assessment may be a necessary complement to medical examination and a prerequisite for the development of tailored treatment plans for older people with depression.
Development and initial testing of a measure of person-directed care
- Authors:
- WHITE Diana L., NEWTON-CURTIS Linda, LYONS Karen S.
- Journal article citation:
- Gerontologist, 48(S1), July 2008, pp.114-123.
- Publisher:
- Oxford University Press
In this study a new measure designed to assess person-directed care (PDC) practices in long-term care was empirically tested. After reviewing the literature, five areas related to PDC were identified: personhood, comfort care, autonomy, knowing the person, and support for relationships. An additional component of environmental support was also identified. Items were then developed to reflect the constructs, and a series of lay and professional experts in the field reviewed the items for face validity. The resulting 64-item PDC and Environmental Support for PDC measure was distributed to direct care workers and nursing, administrative, and other staff from a range of long-term settings across Oregon, culminating in a sample size of 430 participants from eight sites. Exploratory factor analyses was employed to reveal the underlying structure of the measure. After 14 items were dropped from the measure, it attained good simple structure, revealing five PDC constructs as previously theorized and three Environmental Support constructs: Support for Work With Residents; Person-Directed Environment for Residents, and Management/Structural Support. All constructs were conceptually distinct and internally consistent, and, as expected, all were positively correlated.
Assessing older people with complex care needs using EASY-Care, a pre-defined assessment tool
- Authors:
- LAMBERT Susan, et al
- Journal article citation:
- Research Policy and Planning, 25(1), 2007, pp.43-56.
- Publisher:
- Social Services Research Group
Nurse assessors undertook assessments of 119 older people living in a care home setting or awaiting discharge from hospital. Older people who had been assessed also completed questionnaires to evaluate use of the tool. Assessors took part in semi-structured focus groups or interviews. The results suggest that EASY-Care was considered in general to be useful in exploring needs and acceptable to both assessors and older people. Assessors thought it was person-centred in that open-ended questions allowed people to describe their circumstances in their own words. Some assessors were less comfortable with the open-ended questioning approach and felt it made collection information difficult and was likely to cause confusion. One the whole, use of the tool was considered to facilitate rapport. However, some questions provoked anxiety and assessors needed to use their professional judgement to identify non-verbal cues of anxiety in order to achieve a person-centred assessment. Professional training and skills were essential to identify non-verbal cues of distress and to moderate potentially difficult situations where older people became upset during assessment.
Comprehensive geriatric assessments in integrated care programs for older people living at home: a scoping review
- Authors:
- STOOP Annerieke, et al
- Journal article citation:
- Health and Social Care in the Community, 27(5), 2019, pp.e549-e566.
- Publisher:
- Wiley
In many integrated care programs, a comprehensive geriatric assessment (CGA) is conducted to identify older people's problems and care needs. Different ways for conducting a CGA are in place. However, it is still unclear which CGA instruments and procedures for conducting them are used in integrated care programs, and what distinguishes them from each other. Furthermore, it is yet unknown how and to what extent CGAs, as a component of integrated care programs, actually reflect the main principles of integrated care, being comprehensiveness, multidisciplinarity and person‐centredness. Therefore, the objectives of this study were to: (a) describe and compare different CGA instruments and procedures conducted within integrated care programs for older people living at home, and (b) describe how the principles of integrated care were applied in these CGAs. A scoping review of the scientific literature on CGAs in the context of integrated care was conducted for the period 2006–2018. Data were extracted on main characteristics of the identified CGA instruments and procedures, and on how principles of integrated care were applied in these CGAs. Twenty‐seven integrated care programs were included in this study, of which most were implemented in the Netherlands and the United States. Twenty‐one different CGAs were identified, of which the EASYcare instrument, RAI‐HC/RAI‐CHA and GRACE tool were used in multiple programs. The majority of CGAs seemed to reflect comprehensiveness, multidisciplinarity and person‐centredness, although the way and extent to which principles of integrated care were incorporated differed between the CGAs. This study highlights the high variability of CGA instruments and procedures used in integrated care programs. This overview of available CGAs and their characteristics may promote (inter‐)national exchange of CGAs, which could enable researchers and professionals in choosing from the wide range of existing CGAs, thereby preventing them from unnecessarily reinventing the wheel. (Publisher abstract)
The Cognitive Daisy – a novel method for recognising the cognitive status of older adults in residential care: innovative practice
- Authors:
- HUDSON John M., POLLUX Petra
- Journal article citation:
- Dementia: the International Journal of Social Research and Practice, 18(5), 2019, pp.1948-1958.
- Publisher:
- Sage
The Cognitive Daisy is an innovative assessment system created to provide healthcare staff with an instant snapshot of the cognitive status of older adults in residential care. The Cognitive Daisy comprises a flower head consisting of 15 colour coded petals depicting information about: visual-spatial perception, comprehension, communication, memory and attention. This study confirmed the practicality of the Cognitive Daisy protocol for assessing cognition in a sample of 33 older adults living in residential care and endorsed the use of the Cognitive Daisy as a tool for recognising the cognitive status of care home residents. (Edited publisher abstract)
Comprehensive care: older people living with frailty in hospitals
- Author:
- NIHR DISSEMINATION CENTRE
- Publisher:
- NIHR Dissemination Centre
- Publication year:
- 2017
- Pagination:
- 48
- Place of publication:
- London
This review looks at the concept of 'frailty' in older people and what can be done to raise awareness amongst hospital staff, so that they can better identify and manage the needs of this ‘frail’ older people. It features 53 completed and ongoing studies funded by the National Institute of Health Research. The review covers four key aspects of caring for older people living with frailty in hospital: assessment; identifying and managing symptoms associated with frailty in hospital; discharge planning; and caring environments which consider the context in which inpatient diagnosis and treatment is delivered. The review highlights promising evaluations of workplace training and interventions. It also identifies a number of tools, such as the Frailty Index, that can help hospital staff to identify the severity of needs and help to provide targeted support. It also finds good evidence that the Comprehensive Geriatric Assessment (CGA) is a reliable way of diagnosing and meeting the needs of older people with input from multi-disciplinary teams. It also identifies areas where more research is needed, which include: maintaining activities of daily living for people admitted to hospital; and the effectiveness and cost-effectiveness of different models of delivering care. The review also includes a series of questions that hospital boards, staff and families can ask about the care of older people with frailty in hospitals. Summaries of the 53 studies are also included. (Edited publisher abstract)