This document sets the scene for discussion on how the housing needs of an ageing population in Wales can be met. It begins by defining what it is meant by an ‘older’ person and how older people are an extremely heterogeneous group in terms of income, class, health and support needs. It provides a background to the current and projected demographic profile of the population in Wales (including limited information on housing tenure), thus providing an insight for planning ahead. In addition, it details the current policy and funding context for housing in Wales, as well as the building and planning regulations. The perspectives of older people and the accommodation options currently available for them in Wales are also discussed. Finally, this document considers the bigger picture, drawing on cross-sector perspectives on the importance of an integrated approach towards managing the opportunities and challenges of an ageing population in Wales.
(Edited publisher abstract)
This document sets the scene for discussion on how the housing needs of an ageing population in Wales can be met. It begins by defining what it is meant by an ‘older’ person and how older people are an extremely heterogeneous group in terms of income, class, health and support needs. It provides a background to the current and projected demographic profile of the population in Wales (including limited information on housing tenure), thus providing an insight for planning ahead. In addition, it details the current policy and funding context for housing in Wales, as well as the building and planning regulations. The perspectives of older people and the accommodation options currently available for them in Wales are also discussed. Finally, this document considers the bigger picture, drawing on cross-sector perspectives on the importance of an integrated approach towards managing the opportunities and challenges of an ageing population in Wales.
(Edited publisher abstract)
Subject terms:
housing, older people, literature reviews, policy, demographics, ageing, planning;
University of York. Centre for Reviews and Dissemination
Publication year:
2014
Pagination:
25
Place of publication:
York
A synthesis of evidence assessing the predictive ability of tools used to identify frail elderly and people living with multiple long-term chronic health conditions who are at risk of future unplanned hospital admissions. There are now a large number of models available that can be used to predict the risk of unplanned hospital admissions and this study aims to provide a summary of their comparative performance. Overall, the models identified in this review show reasonable concordance in terms of their predictive performance (based on c-statistics). Models reporting other performance indications showed that at different thresholds, as sensitivity increased, specificity would decrease. As the algorithms become more complex or incorporate longer term horizons specificity increased but the ability of the models to identify future high cost individuals reduced. It should also be noted that whilst the reported c-statistics are broadly similar, the underlying populations, data sources and coding may differ.
(Edited publisher abstract)
A synthesis of evidence assessing the predictive ability of tools used to identify frail elderly and people living with multiple long-term chronic health conditions who are at risk of future unplanned hospital admissions. There are now a large number of models available that can be used to predict the risk of unplanned hospital admissions and this study aims to provide a summary of their comparative performance. Overall, the models identified in this review show reasonable concordance in terms of their predictive performance (based on c-statistics). Models reporting other performance indications showed that at different thresholds, as sensitivity increased, specificity would decrease. As the algorithms become more complex or incorporate longer term horizons specificity increased but the ability of the models to identify future high cost individuals reduced. It should also be noted that whilst the reported c-statistics are broadly similar, the underlying populations, data sources and coding may differ.
(Edited publisher abstract)
Subject terms:
planning, prevention, hospital admission, health care, risk assessment, older people, long term conditions;
Based on the evidence of a systematic evidence review, this tool provides a strategic, future planning tool for the housing sector in the context of an ageing population, describing different elements of what constitutes inclusive living. The concept of inclusive living redefines the starting point in considering how to develop housing and the approach to adaptations, accessibility and independent living. It posits that the home of the future will be designed around individual needs and desires of the people living there. Specifically, the home of the future will reduce isolation and support connectivity and independence through a framework that focuses on: social inclusion and equality – structural barriers, representation of all groups, co-production, safety and well being; physical space and design – accessibility, adaptability of internal and external environments, technology, sustainability, green spaces, quality, universal design; relationships and connections – social connectedness, relationships, partnership, transitions through spaces and supporting independent living. Key findings from this study highlight approaches to planning for inclusive living: removing physical and social barriers to social inclusion by developing intergenerational communities which enable people to age-in-place; design and technology that enables people to remain independent within their communities (ageing in place); social connectedness is key to healthy ageing, both access to material resources and social networks; new areas such as social prescribing have been emerging as new pathways for partnership and connections.
(Edited publisher abstract)
Based on the evidence of a systematic evidence review, this tool provides a strategic, future planning tool for the housing sector in the context of an ageing population, describing different elements of what constitutes inclusive living. The concept of inclusive living redefines the starting point in considering how to develop housing and the approach to adaptations, accessibility and independent living. It posits that the home of the future will be designed around individual needs and desires of the people living there. Specifically, the home of the future will reduce isolation and support connectivity and independence through a framework that focuses on: social inclusion and equality – structural barriers, representation of all groups, co-production, safety and well being; physical space and design – accessibility, adaptability of internal and external environments, technology, sustainability, green spaces, quality, universal design; relationships and connections – social connectedness, relationships, partnership, transitions through spaces and supporting independent living. Key findings from this study highlight approaches to planning for inclusive living: removing physical and social barriers to social inclusion by developing intergenerational communities which enable people to age-in-place; design and technology that enables people to remain independent within their communities (ageing in place); social connectedness is key to healthy ageing, both access to material resources and social networks; new areas such as social prescribing have been emerging as new pathways for partnership and connections.
(Edited publisher abstract)
Subject terms:
social inclusion, older people, planning, ageing, housing, supported housing, intergenerational relationships, building design, social networks, relationships;
A synthesis of research evidence on how people experiences the move from paid employment to retirement. The review considered people’s attitudes towards their upcoming retirement, the factors that determine any variation in attitude, and people’s experiences of the period post-retirement. It adopts a narrative synthesis approach, to combine the findings of qualitative and quantitative studies. Based on the review the literature, the report discusses the factors that impact on the experience of retirement across themes: gender; socioeconomic position; ethnic and cultural factors; family situation; health; attitudes to ageing; work and occupation; and preparedness and control. Key conclusions identified include, that: control over the retirement process leads to more positive adjustment to retirement; those in less advantaged social positions tend to have more negative experiences of retirement; positive attitudes toward the future predict high levels of planning among men; and negative expectations about the consequences of retirement predict difficulties in adjusting both for the person retiring and for their partner. The review concludes that organisations can have an important impact on expectations around retirement by supporting their older workers’ career development. It also argues that policy makers and practitioners must improve the resources that can help people increase their levels of control to enable them to make the decisions around work and retirement in later life.
(Edited publisher abstract)
A synthesis of research evidence on how people experiences the move from paid employment to retirement. The review considered people’s attitudes towards their upcoming retirement, the factors that determine any variation in attitude, and people’s experiences of the period post-retirement. It adopts a narrative synthesis approach, to combine the findings of qualitative and quantitative studies. Based on the review the literature, the report discusses the factors that impact on the experience of retirement across themes: gender; socioeconomic position; ethnic and cultural factors; family situation; health; attitudes to ageing; work and occupation; and preparedness and control. Key conclusions identified include, that: control over the retirement process leads to more positive adjustment to retirement; those in less advantaged social positions tend to have more negative experiences of retirement; positive attitudes toward the future predict high levels of planning among men; and negative expectations about the consequences of retirement predict difficulties in adjusting both for the person retiring and for their partner. The review concludes that organisations can have an important impact on expectations around retirement by supporting their older workers’ career development. It also argues that policy makers and practitioners must improve the resources that can help people increase their levels of control to enable them to make the decisions around work and retirement in later life.
(Edited publisher abstract)
Subject terms:
older people, ageing, retirement, attitudes, socioeconomic groups, planning, income, literature reviews, quality of life;
Based on a synthesis of evidence from 116 papers, this scoping review summarises the available evidence on what enables people to plan for their later lives from mid-life onwards, and the factors can present barriers to planning. The research found that while barriers exist, planning and preparing for later life is both possible and likely to be beneficial. The evidence shows that those who are living in challenging circumstances, such as those on low income or juggling multiple caring responsibilities, tend to focus on the immediate concerns and are less likely to plan for later life. Factors that could encourage or discourage planning in later life were found to revolve around five themes: Awareness/salience; Choice and control; Knowledge and skills; Instrumental and informational support; and Social influence. The final section of the review considers evaluations of programmes and courses designed to promote retirement and later life planning and general lessons for anyone wanting to enable people to overcome the barriers to planning. The review found that evidence on specific interventions aimed at increasing planning behaviours is limited. Interventions often focus on formal retirement rather than general later-life planning. Evaluations also often suffer methodological shortcomings. However the review highlights some general lessons for anyone wanting to enable people to overcome the barriers to planning.
(Edited publisher abstract)
Based on a synthesis of evidence from 116 papers, this scoping review summarises the available evidence on what enables people to plan for their later lives from mid-life onwards, and the factors can present barriers to planning. The research found that while barriers exist, planning and preparing for later life is both possible and likely to be beneficial. The evidence shows that those who are living in challenging circumstances, such as those on low income or juggling multiple caring responsibilities, tend to focus on the immediate concerns and are less likely to plan for later life. Factors that could encourage or discourage planning in later life were found to revolve around five themes: Awareness/salience; Choice and control; Knowledge and skills; Instrumental and informational support; and Social influence. The final section of the review considers evaluations of programmes and courses designed to promote retirement and later life planning and general lessons for anyone wanting to enable people to overcome the barriers to planning. The review found that evidence on specific interventions aimed at increasing planning behaviours is limited. Interventions often focus on formal retirement rather than general later-life planning. Evaluations also often suffer methodological shortcomings. However the review highlights some general lessons for anyone wanting to enable people to overcome the barriers to planning.
(Edited publisher abstract)
Subject terms:
literature reviews, ageing, retirement, older people, intervention, planning, personal finance, adults;
Journal of Policy and Practice in Intellectual Disabilities, 7(1), March 2010, pp.16-25.
Publisher:
Wiley
As a result of longer lifespan and the aging of their parents, siblings play an increasing role in the lives of people with intellectual and developmental disabilities. In this article, the authors reviewed the literature on siblings of adults with intellectual and developmental disabilities, concentrating on three main questions: what are the psychosocial outcomes of having a sibling with an intellectual and developmental disabilities on the sibling without a disability?; what factors relate to the nature of the sibling relationship?; and what factors relate to future planning, including expected and future relationships when parents can no longer provide care? The authors examined 23 relevant published studies for the period 1970–2008 on adult siblings over 21 years of age that addressed the relationships, psychosocial outcomes, and involvement in future planning. In conclusion, the authors suggest that these studies present a mixed, but positive picture of the psychosocial outcomes of having a sibling with a disability. They also indicate that siblings tend to have long-lasting close relationships with their siblings with a disability and anticipate taking on greater supportive roles as both grow older.
As a result of longer lifespan and the aging of their parents, siblings play an increasing role in the lives of people with intellectual and developmental disabilities. In this article, the authors reviewed the literature on siblings of adults with intellectual and developmental disabilities, concentrating on three main questions: what are the psychosocial outcomes of having a sibling with an intellectual and developmental disabilities on the sibling without a disability?; what factors relate to the nature of the sibling relationship?; and what factors relate to future planning, including expected and future relationships when parents can no longer provide care? The authors examined 23 relevant published studies for the period 1970–2008 on adult siblings over 21 years of age that addressed the relationships, psychosocial outcomes, and involvement in future planning. In conclusion, the authors suggest that these studies present a mixed, but positive picture of the psychosocial outcomes of having a sibling with a disability. They also indicate that siblings tend to have long-lasting close relationships with their siblings with a disability and anticipate taking on greater supportive roles as both grow older.
Subject terms:
informal care, learning disabilities, older people, outcomes, planning, psychosocial approach, siblings, adults, family relations;
International Journal of Geriatric Psychiatry, 25(4), April 2010, pp.329-337.
Publisher:
Wiley
This paper reviews the literature for end-of-life care for older people with dementia living in the community. Reviewing studies that focused on prognostic indicators for end-of-life care, assessment, support/relief, respite and educational interventions for community dwelling older people with dementia were included, a user representative group informed decisions on the breadth of literature used, with each study selected being screened independently by two reviewers using a standardised check list. Of the 68 papers included, only 12 were exclusively concerned living and dying with dementia at home, and 6 studies included evidence from people with dementia. The studies grouped into four broad categories: dementia care towards the end of life; palliative symptom management for people with dementia; predicting the approach of death for people with dementia; and decision-making. The few studies that developed dementia specific tools to guide end of life care and outcome measures demonstrated both what could be achieved, and how much more needs to be done. The authors concluded that research pertaining to end-of-life care for people with dementia has yet to develop interventions that address the particular challenges that dying with dementia poses, and that there is a need for further investigation of interventions and outcome measures for providing end-of-life care in the settings where the majority of this population live and die.
This paper reviews the literature for end-of-life care for older people with dementia living in the community. Reviewing studies that focused on prognostic indicators for end-of-life care, assessment, support/relief, respite and educational interventions for community dwelling older people with dementia were included, a user representative group informed decisions on the breadth of literature used, with each study selected being screened independently by two reviewers using a standardised check list. Of the 68 papers included, only 12 were exclusively concerned living and dying with dementia at home, and 6 studies included evidence from people with dementia. The studies grouped into four broad categories: dementia care towards the end of life; palliative symptom management for people with dementia; predicting the approach of death for people with dementia; and decision-making. The few studies that developed dementia specific tools to guide end of life care and outcome measures demonstrated both what could be achieved, and how much more needs to be done. The authors concluded that research pertaining to end-of-life care for people with dementia has yet to develop interventions that address the particular challenges that dying with dementia poses, and that there is a need for further investigation of interventions and outcome measures for providing end-of-life care in the settings where the majority of this population live and die.
Subject terms:
intervention, older people, outcomes, palliative care, planning, community care, decision making, dementia, dying, end of life care;
This review of the literature examines the effectiveness of continuing education programs in long-term care facilities. A comprehensive literature search was made for evaluation studies and included computerized bibliographic databases, manual searches of journals, the bibliographies of retrieved articles, and information from key informants. Results:Forty-eight studies met our selection criteria. Rigorous research in this area has been limited. Because of the lack of follow-up evaluation, there is minimal evidence that knowledge gained from training programs is sustained in the long term. Most studies do not consider organizational and system factors when planning and implementing training initiatives. This may account for difficulties encountered in the sustained transfer of knowledge to practice. There is a need for further rigorous research on the effectiveness of continuing education in long-term care, with systematic attention to the role of organisational and system factors.
This review of the literature examines the effectiveness of continuing education programs in long-term care facilities. A comprehensive literature search was made for evaluation studies and included computerized bibliographic databases, manual searches of journals, the bibliographies of retrieved articles, and information from key informants. Results:Forty-eight studies met our selection criteria. Rigorous research in this area has been limited. Because of the lack of follow-up evaluation, there is minimal evidence that knowledge gained from training programs is sustained in the long term. Most studies do not consider organizational and system factors when planning and implementing training initiatives. This may account for difficulties encountered in the sustained transfer of knowledge to practice. There is a need for further rigorous research on the effectiveness of continuing education in long-term care, with systematic attention to the role of organisational and system factors.
Subject terms:
information technology, literature reviews, long term care, older people, organisational structure, planning, training, training materials, education;
This research review looks at supply and demand factors relating to residential care. It makes recommendations for thorough assessments of older peoples needs, good care management, and respect for user and carer wishes throughout, in order to prevent unnecessary and unwilling admissions to residential care.
This research review looks at supply and demand factors relating to residential care. It makes recommendations for thorough assessments of older peoples needs, good care management, and respect for user and carer wishes throughout, in order to prevent unnecessary and unwilling admissions to residential care.
Extended abstract:
WARBURTON R. William. Implementing caring for people: home and away; a review of recent research evidence to explain why some elderly people enter residential care homes while others stay at home. Great Britain. Department of Health, 1994.
Summary
A review of recent research evidence to explain why some elderly people enter residential care homes while others stay at home: and how local authorities are enabling people to remain at home, supported by appropriate services of the users' choice.
Context
Review was commissioned by the Department of Health as a contribution to studies being carried out by the SSI and NHS Management Executive to gauge the progress made by local authorities in implementing the community care reforms set out in the NHSand Community Care Act 1990, and associated policy guidance.
Contents
The introduction addresses community care reforms and the role of residential care; special studies, research and reviews; international experience; terminology and the scope and limitations of the review. Chapter Two, Demand Factors, covers choice and involvement; fears and risks; age and gender of users; living arrangements; physical and mental impairment; dementia; loneliness and grief; carers; users' financial resources; and black elders. Chapter Three, Supply Factors, addresses the availability of help; crises; support for carers; needs of professionals; assessment; care management; community-based innovations; misplacement.
Findings
Many factors are at play when decisions are made about elderly people's future place of residence. Factors can be complex and difficult to discern.
In broad terms, the factors associated with admissions are
limited user choice and involvement
users' fears and doubts about living at home
living arrangement
increasing impairment and disability
lack of community services
carers' stress and lack of support to carers
inadequate preparations for leaving hospital
poor or ineffective assessment and care management
lack of service innovation and flexibility
professional and organisational concerns and interests
Conclusion
Community-based options could be more frequently tried with greater success, admissions to residential care homes would be an appropriate response for those people who could no longer live at home and the number of permanent admissions to residential care homes would probably decline appreciably if
assessments were thorough and addressed key social, functional and medical questions
people's care was genuinely managed and coordinated
users' and carers' concerns and wishes were heard and choice was respected
community-based options were readily available and flexible enough to be of lasting value to users
users staying at home were helped with personal care and other vital activities of daily living in
appropriate and timely ways, and were reassured about the safety and viability of staying at home
support were available to carers and assumptions about their ability to care were not casually made
Author calls for more research about black elders, users' attitudes' international comparisons, and the reasons for admissions to different types of 'shelter-with-care'.
149 ref
Subject terms:
older people, planning, referral, residential care, user participation, assessment, carers, care homes, care management, community care;
CALANZANI Natalia, HIGGINSON Irene J., GOMES Barbara
Publisher:
Help the Hospices
Publication year:
2013
Pagination:
48
Place of publication:
London
Commissioned by the Commission into the Future of Hospice Care, this report focuses on crucial factors for planning for the future level of need for hospice care towards the end of life for the adult population in the UK. It is based on analysis of mortality trends and population projections, together with identification and review of studies assessing preferences for place of care or place of death, and survey data about factors associated with choosing hospice/palliative care units as a preferred place to die. The report presents evidence-based findings, covering likely changes in the size and shape of the UK population (including data on actual and projected number of deaths in England, Wales, Scotland and Northern Ireland and on trends in hospice care services), and where people wish to be cared for and die and whether their preferences are being met. It considers evidence about whether hospice care makes a difference to patients and caregivers and the effectiveness and cost-effectiveness of hospice care. It makes recommendations in each of these areas, discusses the implications for future care planning for adequate hospice care, and includes suggestions for further research.
Commissioned by the Commission into the Future of Hospice Care, this report focuses on crucial factors for planning for the future level of need for hospice care towards the end of life for the adult population in the UK. It is based on analysis of mortality trends and population projections, together with identification and review of studies assessing preferences for place of care or place of death, and survey data about factors associated with choosing hospice/palliative care units as a preferred place to die. The report presents evidence-based findings, covering likely changes in the size and shape of the UK population (including data on actual and projected number of deaths in England, Wales, Scotland and Northern Ireland and on trends in hospice care services), and where people wish to be cared for and die and whether their preferences are being met. It considers evidence about whether hospice care makes a difference to patients and caregivers and the effectiveness and cost-effectiveness of hospice care. It makes recommendations in each of these areas, discusses the implications for future care planning for adequate hospice care, and includes suggestions for further research.
Subject terms:
hospices, needs, older people, palliative care, planning, population, service users, user views, adults, death, dying;