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Who knows best? Older people's contribution to understanding and preventing avoidable hospital admissions
- Author:
- SOCIAL CARE INSTITUTE FOR EXCELLENCE
- Publisher:
- Social Care Institute for Excellence
- Publication year:
- 2016
- Pagination:
- 18 mins 50 secs
- Place of publication:
- London
This video summarises the key findings of a research project conducted by the University of Birmingham’s Health Services Management Centre and the Department of Social Policy and Social Work which interviewed 104 older people about their emergency admissions to hospital. The research looked at how the older people were admitted to hospital, whether they felt this was the best place for them and what alternatives might have been explored. Similar questions were also asked of a GP and / or hospital doctor representing as many of these older people as possible. Overall, the study found that most older people were admitted to hospital appropriately. Only nine of 104 older people (almost 9%) felt that hospital was not the right place for them. Key findings covered in the video include: delays in seeking help; prevention and early intervention; poor communication; proactive initial approaches; working with GPs and paramedics; and the underfunding of social care. (Edited publisher abstract)
Who knows best? Top tips for managing the crisis: older people's emergency admissions to hospital
- Authors:
- GLASBY Jon, et al
- Publisher:
- University of Birmingham. School of Social Policy
- Publication year:
- 2016
- Pagination:
- 12
- Place of publication:
- Birmingham
This resource identifies ten key themes, or ‘top tips’, which could help health and social care services to reduce inappropriate hospital admissions. It has been developed from a national research project which involved interviews and focus groups with older people and their families, and front-line health and social care professionals. It is argued that these ‘perceptions’ from older people and front-line staff are important as they can have a significant impact on how people live their life and access services. The themes cover: not making older people feel they are a burden; making community alternatives to hospital easier to access; to distinguish between ‘inappropriate’ and ‘preventable’ admissions; the need for early action; the importance role of adult social care; and the importance of engaging with older people to understand and respond to the increasing number of emergency admissions. Quotations from older people, their families and professionals are included throughout to illustrate key points. (Edited publisher abstract)
Who knows best? Older people's contribution to understanding and preventing avoidable hospital admissions
- Authors:
- GLASBY Jon, et al
- Publisher:
- University of Birmingham. School of Social Policy
- Publication year:
- 2016
- Pagination:
- 64
- Place of publication:
- Birmingham
This study sets out to understand the appropriateness of hospital admission for older people, looking at the issue from different perspectives. It estimates the rate of so-called ‘inappropriate admissions’ whilst also engaging older people in a meaningful way to gather their longer-term perspective on their health and what underlay their hospital admission, together with their views about what might have been done to prevent it. Working with 104 older people and some 40 local professionals, the research looked in detail at how the older people were admitted to hospital, whether they felt this was the best place for them and what alternatives might have been explored. Similar questions were also asked of a GP and / or hospital doctor representing as many of these older people as possible. Overall, the study found that most older people were admitted to hospital appropriately. Only nine of 104 older people (almost 9%) felt that hospital was not the right place for them – and even these nine people sounded very unwell at the time of admission. None of the GPs or hospital doctors who took part felt that these (or any other) admissions in the study were ‘inappropriate’ (making a rate of ‘inappropriate’ admissions of 0% from a medical perspective). Despite the majority of older people feeling their emergency admission was appropriate, about a quarter of the older people interviewed could identify earlier action which might have prevented their admission, mainly to do with earlier intervention following previous health assessments or earlier access to their GP. The report however cautions that reducing the number of emergency admission to hospital requires complex and multi-faceted interventions, with no evidence of simple solutions. It argues that potential solutions to reducing the number of emergency admissions to hospital of older people can only be addressed by health and social care services working together in collaboration, and that further exploration of the potential role of appropriately funded adult social care services is needed. (Edited publisher abstract)
Men's perspectives on fall risk and fall prevention following participation in a group-based programme conducted at Men's Sheds, Australia
- Authors:
- LIDDLE Jeannine L.M., et al
- Journal article citation:
- Health and Social Care in the Community, 25(3), 2017, pp.1118-1126.
- Publisher:
- Wiley
Research on older men's views regarding fall prevention is limited. The purpose of this qualitative study was to explore the experiences and perspectives of older men regarding fall risk and prevention so that fall prevention programmes can better engage older men. Eleven men who had taken part in a group-based fall prevention programme called Stepping On conducted at Men's Sheds in Sydney, Australia, participated in semi-structured interviews during June and July 2015 which were audio-recorded and transcribed. Data were coded and analysed using constant comparative methods. Over-arching theoretical categories were developed into a conceptual framework linking programme context and content with effects of programme participation on men. Men's Sheds facilitated participation in the programme by being inclusive, male-friendly places, where Stepping On was programmed into regular activities and was conducted in an enjoyable, supportive atmosphere. Programme content challenged participants to think differently about themselves and their personal fall risk, and provided practical options to address fall risk. Two major themes were identified: adjusting the mindset where men adopted a more cautious mindset paying greater attention to potential fall risks, being careful, concentrating and slowing down; and changing the ways where men acted purposefully on environmental hazards at home and incorporated fall prevention exercises into their routine schedules. Practitioners can engage and support older men to address falls by better understanding men's perspectives on personal fall risk and motivations for action. (Publisher abstract)
Draft national occupational standards: falls
- Author:
- SKILLS FOR HEALTH
- Publisher:
- Skills for Health
- Publication year:
- 2006
- Pagination:
- 58p.
- Place of publication:
- Bristol
This workforce competence is about working directly with individuals, and where appropriate their carers, to assess their risk of falls. The assessment may be aimed at primary or secondary prevention of falls and may take place on an ad hoc basis or as part of a structured programme for identifying individuals at risk of falls. The process should involve a holistic assessment of each individual and his or her specific needs.
Older people's views of falls-prevention interventions in six European countries
- Authors:
- YARDLEY Lucy, et al
- Journal article citation:
- Gerontologist, 46(5), October 2006, pp.650-660.
- Publisher:
- Oxford University Press
This study conducted semi-structured interviews to assess perceived advantages and barriers to taking part in falls-related interventions were carried out in six European countries (Denmark, the Netherlands, Germany, Greece, Switzerland and United Kingdom) with 69 people aged 68 to 97 years. The sample was selected to include people with very different experiences of participation or nonparticipation in falls-related interventions, but all individuals were asked about interventions that included strength and balance training. The results found attitudes were similar in all countries and contexts. People were motivated to participate in strength and balance training by a wide range of perceived benefits (interest and enjoyment, improved health, mood, and independence) and not just reduction of falling risk. Participation also was encouraged by a personal invitation from a health practitioner and social approval from family and friends. Barriers to participation included denial of falling risk, the belief that no additional falls-prevention measures were necessary, practical barriers to attendance at groups (e.g., transport, effort, and cost), and a dislike of group activities. Implications: Because many older people reject the idea that they are at risk of falling, the uptake of strength and balance training programs may be promoted more effectively by maximizing and emphasizing their multiple positive benefits for health and well-being. A personal invitation from a health professional to participate is important, and it also may be helpful to provide home-based programs for those who dislike or find it difficult to attend groups.
Older people's views about community falls prevention: an Australian perspective
- Authors:
- BALLINGER Claire, CLEMSON Lindy
- Journal article citation:
- British Journal of Occupational Therapy, 69(6), June 2006, pp.263-270.
- Publisher:
- Sage
Although targets have been set for the establishment of falls prevention services, little is known about the views of older people in respect of such initiatives. The purpose of this study was to investigate the perspectives of the older participants in a community group falls prevention programme in Australia and to explore their views about the most and least useful aspects of the programme, using methods deriving from a grounded theory approach. Semi-structured interviews were carried out with nine women and two men who had attended a falls prevention programme. The multifaceted intervention comprised seven weekly meetings of 2 hours each. The key principle underpinning the programme was enhancement of self-efficacy. Four themes were identified through qualitative analysis: identity (focusing on participants as active elders); the salience of interventions (or the meaning attributed to different programme components); the social experience (the views about group interaction); and the consequences of participation. The participants were very positive about their experience of the programme and described a range of psychological and physical outcomes. A decrease in the likelihood of a fall did not feature prominently in these interviews. It may be more meaningful to older people to embed falls prevention within a wider context of wellbeing and independence.
The importance of 'low level' preventive services to older people
- Author:
- CLARK Heather
- Journal article citation:
- Integrate News, 71, October 1998, pp.21-23.
Reports the findings of a recently published study which was funded by the Joseph Rowntree Foundation. The research focused on the value of 'low level' service in enhancing the quality of life of older people and helping them to maintain their independence.
That bit of help: the high value of low level preventative services for older people
- Authors:
- CLARK Heather, DYER Sue, HORWOOD Jo
- Publisher:
- Policy Press
- Publication year:
- 1998
- Pagination:
- 72p.,bibliog.
- Place of publication:
- Bristol
Report focusing on the value older people give to low level services such as help with housework, gardening, home maintenance, and safety and security. Highlights the extent to which these services promote older people's ability to look after themselves and maintain their independence and shows that older people give a higher value to help than they do to care, which they often view as a threat to their independence. The older people saw these low level services as preventing the need for care.
Harm's way: abuse experienced by residents in homes and steps to take to reduce it
- Author:
- BRIGHT Les
- Publisher:
- Counsel and Care
- Publication year:
- 1997
- Pagination:
- 42p.
- Place of publication:
- London
Report looking at abuse of older people in residential and nursing home care and highlighting the importance of organisational power and the culture that exists in determining whether a home is safe for its residents. Based on accounts by relatives, the report also presents ways of preventing and dealing with abuse and makes recommendations for guidelines.