Search results for ‘Subject term:"older people"’ Sort:
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Preventing loneliness and social isolation for older people: prompt cards for those who provide support
- Authors:
- MOFFAT Vivien, MUNRO Fiona
- Publisher:
- IRISS
- Publication year:
- 2014
- Pagination:
- 23
- Place of publication:
- Glasgow
A set prompt cards, designed for people who work with or support older people, and aim to help prevent loneliness and social isolation. The cards prompt those who provide such support to think about whether older people may be at risk of social isolation or loneliness and to think about ways to help them keep connected. (Edited publisher abstract)
Interventions to reduce the number of falls among older adults with/without cognitive impairment: an exploratory meta-analysis
- Authors:
- GUO Jong-Long, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 29(7), 2014, pp.661-669.
- Publisher:
- Wiley
Objective: This exploratory meta-analysis aimed to examine and compare the effective interventions to prevent falls among institutionalized/non-institutionalised older adults without cognitive impairment with interventions to prevent falls for older adults with cognitive impairment. Design: A database search identified 111 trials published between January 1992 and August 2012 that evaluated fall-prevention interventions among institutionalised/non-institutionalised older adults with and without cognitive impairment as measured by valid cognition scales. Results: Exercise alone intervention was similar effective on reducing the numbers of falls among older adults without cognitive impairment regardless of setting (non-institutionalized: OR = 0.783, 95% confidence interval (CI) = 0.656–0.936; p = 0.007 institutionalized: OR = 0.799, 95% CI = 0.646–0.988, p = 0.038). Vitamin D/calcium supplementation had a positive effect on the reduction of numbers of falls among non-institutionalized older adults without cognitive impairment (OR = 0.789, 95% CI = 0.631–0.985, p = 0.036), as did home visits and environment modification (OR = 0.751, 95% CI = 0.565–0.998, p = 0.048). Exercise alone, exercise-related multiple interventions, and multifactorial interventions were associated with positive outcomes among both institutionalised and non-institutionalized older adults with cognitive impairment, but studies are limited. Conclusions: Single exercise interventions can significantly reduce numbers of falls among older adults with and without cognitive impairment in institutional or non-institutional settings. Vitamin D and calcium supplementation, home visits, and environment modification can reduce the risk of falls among older adults in non-institutional settings. Exercise-related multiple interventions and multifactorial interventions may only be effective for preventing falls in older adults with cognitive impairment. (Edited publisher abstract)
Rosalie Wolf Memorial Lecture: reconsidering assumptions regarding men as elder abuse perpetrators and as elder abuse victims
- Author:
- KOSBERG Jordan I.
- Journal article citation:
- Journal of Elder Abuse and Neglect, 26(3), 2014, pp.207-222.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
From research findings and practice experiences, it is concluded that abuse of older men is especially invisible and underreported, compared to abuse of older women. It is proposed that attention should be directed not to gender, but to those conditions in different countries and cultures leading to abuse of both older men and women, including (but not limited to) economic problems, few alternatives to family care of the elderly, violence, changing characteristics of the family, ageism, and sexism. Advocates for the prevention of elder abuse should work together in combating, reducing, and eliminating the problem of elder abuse of both older men and older women. (Publisher abstract)
Preventing depression in homes for older adults: are effects sustained over 2 years?
- Authors:
- SCHAIK Dinga J.F. van, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 29(2), 2014, pp.191-197.
- Publisher:
- Wiley
Methods: A 2-year follow-up study of a pragmatic randomised controlled trial was conducted in 14 residential homes in the Netherlands to evaluate the 2-year effects of a stepped-care programme to prevent the onset of a major depressive disorder (MDD). A total of 185 residents (Center for Epidemiologic Studies Depression Scale score >7), who did not meet the diagnostic criteria for MDD, were randomised to a stepped-care programme (n = 93) or to usual care (n = 92). Stepped-care participants sequentially underwent watchful waiting, a self-help intervention, life review and a consultation with the general practitioner. The primary outcome measure was the incidence of MDD during a period of 2 years, according to the Mini International Neuropsychiatric Interview. Results: After 2 years, the incidence of MDD was not significantly reduced in the intervention group compared with the control group. However, in the completer analysis, on the basis of 79 residents who completed the 2-year measurements, there was a significant difference in favour of the intervention group. Dropout percentages were high (44%), mostly accounted for by illness and death (68%). Conclusion: A minority of residents had benefit from the intervention that sustained after 2 years in the completer group. Yet, these findings cannot be generalised as the majority of the residents did not opt for participation in the project and many dropped out. Ways should be sought to motivate residents with depressive symptoms to engage in preventive interventions. (Edited publisher abstract)
Interventions to reduce unplanned admissions from care home settings
- Author:
- UNIVERSITY OF YORK. Centre for Reviews and Dissemination
- Publisher:
- University of York. Centre for Reviews and Dissemination
- Publication year:
- 2014
- Pagination:
- 5
- Place of publication:
- York
This briefing summarises evidence related to community geriatrician services, case management, discharge planning, integrated working between primary care and care homes, medicines management, the prevention of delirium and end-of-life care. Key points are: there is little good quality comparative evidence to inform strategies for reducing unplanned admissions from care homes; much of the evidence for integration and community geriatric services comes from case studies which are not always well reported and any positive findings may not be easily replicated elsewhere; closer working between healthcare and care home staff (through dedicated GP or community geriatric services), protected training for care home staff, and implementing processes for stated end-of-life care preferences all appear promising; NICE recommends that multifaceted interventions to prevent delirium should be implemented in long-term care settings; the lack of good quality evidence in this area highlights the need to monitor the impact of changes made to the delivery of services especially in relation to resource use and patient experience. (Edited publisher abstract)
Older people's experiences of therapeutic exercise as part of a falls prevention service: survey findings from England, Wales and Northern Ireland
- Authors:
- BUTTERY Amanda K., et al
- Journal article citation:
- Age and Ageing, 43(3), 2014, pp.369-374.
- Publisher:
- Oxford University Press
Introduction: Falling, and fear of falling, significantly affect older people and their lifestyle resulting in loss of confidence, restriction of activity and deteriorating quality of life. Multi-factorial assessment and active participation in an evidence-based exercise programme are key interventions to prevent and manage falls. Objective: To examine older people's experiences of therapeutic exercise as part of a falls prevention service in NHS Trusts in England, Wales and Northern Ireland. Methods: Across-sectional survey targeted patients and staff members delivering exercise interventions for reducing falls. A multi-disciplinary group including patient and staff representatives developed a 20-item patient questionnaire and a 12-item staff questionnaire that were distributed to 94 NHS Trusts (113 participating sites within the NHS Trusts) in October 2011. Results: Response was 57% for the patient sample and 88% for the staff sample. The median (IQR) age of patients was 82 (77–86) years. 72% were women. Two-thirds reported attending group-based therapeutic exercise classes generally of short duration (80% <12 weeks) and low intensity (85% one class per week) at hospitals and community venues. Balance and strength exercises were prescribed; 68% reported using resistance equipment such as ankle weights and/or exercise band. Only 52% reported exercises were made more difficult as they improved. However, patient satisfaction levels were high (95% satisfied or very satisfied). Patients and staff reported limited availability of strength and balance follow-up classes. Conclusion: Despite high levels of patient satisfaction therapeutic exercise provision was limited and implementation of evidence-based exercise interventions by healthcare providers is incomplete and varies widely. Patients and staff wanted greater availability of long-term exercise services for falls prevention. (Publisher abstract)
Which factors are associated with fear of falling in community-dwelling older people?
- Authors:
- KUMAR Arun, et al
- Journal article citation:
- Age and Ageing, 43(1), 2014, pp.76-84.
- Publisher:
- Oxford University Press
Background: Fear of falling (FOF) is common in older people and associated with serious physical and psychosocial consequences. Identifying those at risk of FOF can help target interventions to both prevent falls and reduce FOF. Objective: To identify factors associated with FOF. Study design: Cross-sectional study in 1,088 community-dwelling older people aged ≥65 years. Methods: Data were collected on socio-demographic characteristics, self-perceived health, exercise, risk factors for falls, FOF (Short FES-I), and functional measures. Logistic regression models of increasing complexity identified factors associated with FOF. Results: High FOF (Short FES-I ≥11) was reported by 19%. A simpler model (socio-demographic + falls risk factors) correctly classified as many observations (82%) as a more complex model (socio-demographic + falls risk factors + functional measures) with similar sensitivity and specificity values in both models. There were significantly raised odds of FOF in the simpler model with the following factors: unable to rise from a chair of knee height (OR: 7.39), lower household income (OR: 4.58), using a walking aid (OR: 4.32), difficulty in using public transport (OR: 4.02), poorer physical health (OR: 2.85), black/minority ethnic group (OR: 2.42), self-reported balance problems (OR: 2.17), lower educational level (OR: 2.01) and a higher BMI (OR: 1.06). Conclusions: A range of factors identify those with FOF. A simpler model performs as well as a more complex model containing functional assessments and could be used in primary care to identify those at risk of FOF, who could benefit from falls prevention interventions. (Publisher abstract)
Predictive validity of tools used to assess the risk of unplanned admissions: a rapid review of the evidence
- Authors:
- PATON Fiona, WILSON Paul, WRIGHT Kath
- Publisher:
- 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)
Drug cessation in complex older adults: time for action
- Authors:
- van der CAMMEN Tischa J.M., et al
- Journal article citation:
- Age and Ageing, 43(1), 2014, pp.20-25.
- Publisher:
- Oxford University Press
Background: general opinion is growing that drug cessation in complex older patients is warranted in certain situations. From a clinical viewpoint, drug cessation seems most warranted in four situations, i.e., falls, delirium, cognitive impairment and end-of-life situations. To date, little information about the effects of drug cessation in these four situations is available. Objectives: To identify the effects and effectiveness of drug cessation on falls, delirium and cognitive impairment. For end-of-life situations, we reviewed cessation of inappropriate drug use. Methods: Electronic databases were searched using MeSH terms and relevant keywords. Studies published in English were included if they evaluated the effects of drug cessation in older persons, aged ≥65 years, with falls, delirium or cognitive impairment; or cessation of inappropriate drug use in end-of-life situations. Results: The authors selected seven articles for falls, none for delirium, two for cognition and two for end-of-life situations. Withdrawal of psychotropics reduced fall rate; a prescribing modification programme for primary care physicians reduced fall risk. Withdrawal of psychotropics and a systematic reduction of polypharmacy resulted in an improvement of cognition. Very little rigorous research has been conducted on reducing inappropriate medications in patients approaching end of life. Conclusion: Little research has focussed on drug cessation. Available studies showed a beneficial impact of cessation of psychotropic drugs on falls and cognitive status. More research in this field is needed. The issue of systematic drug withdrawal in end-of-life cases is controversial, but is increasingly relevant in the face of rising numbers of older people of this clinical status. (Publisher abstract)
Heatwave plan for England: supporting vulnerable people before and during a heatwave: advice for health and social care professionals
- Author:
- PUBLIC HEALTH ENGLAND
- Publisher:
- Public Health England
- Publication year:
- 2014
- Pagination:
- 16
- Place of publication:
- London
This factsheet is part of a national programme to reduce the health risks by alerting people to the dangers of severe heat and encouraging them to plan in advance what to do in the event of a heatwave. Heatwaves can happen with little warning and illness and death can occur within the first couple of days. This leaflet offers advice both on caring for people most at risk during a heatwave, and on organising others who provide care. Example advice cards for commissioners of health and social care, Directors of Public Health and health and social care staff are also included. (Edited publisher abstract)