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Obstacles to improving visual health in older people
- Authors:
- ILIFFE Steve, KHARICHA Kalpa, MYERSON Sybil
- Publisher:
- Thomas Pocklington Trust
- Publication year:
- 2009
- Pagination:
- 7p.
- Place of publication:
- London
This publication summarises findings from research which aimed to explore the obstacles to improving visual health in an ageing population, and why screening does not lead to greater improvement. A mixed methodological approach was taken. Data from earlier health promotion studies was used and qualitative data were collected from older people. The conclusions include a proposal for an educational intervention. The research was funded by Thomas Pocklington Trust and carried out at the Research Department of Primary Care and Population Health, University College London.
Applying community-oriented primary care methods in British general practice: a case study
- Authors:
- ILIFFE Steve, et al
- Journal article citation:
- British Journal of General Practice, 52(481), August 2002, pp.646-651.
- Publisher:
- Royal College of General Practitioners
Health assessments for older people have become an increasing priority with the NSF for Older People. In response to low level of activity in primary care around health assessment for older people, Camden and Islington Health Authority initiated a project in 1996-97 to develop innovative primary care for older people. This article reports on the study which was conducted in four general practices. Results found all four practices identified problems needing attention in the older population, developed different projects focused on particular needs among older people, and tested them in practice. Patient and public involvement were central to the design and implementation process in only one practice. Innovations were sustained in only one practice, but some were adopted by primary care group and others extended to a wider group of practices by the health authority.
Recognition and response: approaches to late-life depression and mental health problems in primary care
- Author:
- ILIFFE Steve
- Journal article citation:
- Quality in Ageing, 10(1), March 2009, pp.9-15.
- Publisher:
- Pier Professional
- Place of publication:
- Brighton
The boundaries between what is a healthy response to stress and anxiety and what is abnormal are often difficult to determine, especially in primary care. This paper considers depression in later life as an example of this tension. Depressive symptoms may be viewed as an understandable response to bereavement of physical illness, or it can be a disabling and life-threatening condition if left untreated. The article discusses the key role primary care has to play in supporting depressed older people, though improved pattern recognition and diagnosis, by tailoring effective treatments to fit the individual, and providing or signposting the older person to information and advice.
The development of a short instrument to identify common unmet needs in older people in general practice
- Authors:
- ILIFFE Steve, et al
- Journal article citation:
- British Journal of General Practice, 54(509), December 2004, pp.914-918.
- Publisher:
- Royal College of General Practitioners
No structured needs assessment tool appropriate for older people and also suitable for use in routine general practice consultations exists. This study aimed to engage older people in the development of a brief, valid, practical and acceptable instrument to help identify common unmet needs suitable for use in routine clinical practice in primary care by user involvement in a multi-stages approach to heuristic development in general practices, voluntary groups and community organisations in north and central London. Subjects included patients 65 and over in purposively selected practices, voluntary organisations for older people, community organisations involving older people, GPs and community nurses. Data were collected through mixed methodology interviews using a structured assessment tool, a postal questionnaire, and focus groups. Synthesis and interpretation was done through a consensus conference followed by a Delphi process involving primary care professionals. Five domains of unmet need were identified as priority areas by all 3 methods, the consensus conference, and the Delphi process: senses (vision and hearing), physical ability (mobility and falls), incontinence, cognition, and emotional distress (depression and anxiety). Concludes that public involvement in the design of clinical tools allowed the development of a brief assessment instrument that could potentially identify common, important and tractable unmet needs in older people.
Health risk appraisal in older people 2: the implications for clinicians and commissioners of social isolation risk in older people
- Authors:
- ILIFFE Steve, et al
- Journal article citation:
- British Journal of General Practice, 57(537), April 2007, pp.277-282.
- Publisher:
- Royal College of General Practitioners
This study aimed to explore the significance of social isolation in the older population for GPs and for service commissioners. Secondary analysis of baseline data from a randomised controlled trial of health risk appraisal. The study used secondary analysis of baseline data from a randomised controlled trial of health risk appraisal. Participants were a total of 2641 community-dwelling, non-disabled people aged 65 years and over in suburban London. Analysis included demographic details, social network and risk for social isolation based on the 6-item Lubben Social Network Scale, measures of depressed mood, memory problems, numbers of chronic conditions, medication use, functional ability, self-reported use of medical services. The results found more than 15% of the older age group were at risk of social isolation, and this risk increased with advancing age. In bivariate analyses risk of social isolation was associated with older age, education up to 16 years only, depressed mood and impaired memory, perceived fair or poor health, perceived difficulty with both basic and instrumental activities of daily living, diminishing functional ability, and fear of falling. Despite poorer health status, those at risk of social isolation did not appear to make greater use of medical services, nor were they at greater risk of hospital admission. Half of those who scored as at risk of social isolation lived with others. Multivariate analysis showed significant independent associations between risk of social isolation and depressed mood and living alone, and weak associations with male sex, impaired memory and perceived poor health. The risk of social isolation is elevated in older men, older persons who live alone, persons with mood or cognitive problems, but is not associated with greater use of services. These findings would not support population screening for individuals at risk of social isolation with a view to averting service use by timely intervention. Awareness of social isolation should trigger further assessment, and consideration of interventions to alleviate social isolation, treat depression or ameliorate cognitive impairment.
The NSF for Older People: a market town experience
- Authors:
- HAMMOND Judith, ILIFFE Steve, ELLIOT Debra
- Journal article citation:
- Community Practitioner, 75(6), June 2002, pp.211-213.
- Publisher:
- Community Practitioners' and Health Visitors' Association
The National Service Framework for Older People highlights the need for comprehensive assessment of the health and social needs of the community. Reports on a one year project in West Wiltshire Primary Care Group to investigate: the numbers of people of 75 years and over who had not been seen by a health or social care professional in the last tow years; to determine the numbers of people 75 and over at risk of falling or failing health; to raise the profile of carers at each GP practice; and to determine the views of older people in relation to the annual 75 and over health checks.
Primary care and dementia
- Authors:
- ILIFFE Steve, DRENNAN Vari
- Publisher:
- Jessica Kingsley
- Publication year:
- 2001
- Pagination:
- 155p.,bibliog.
- Place of publication:
- London
Part of a series of good practice guides produced by the Bradford Dementia Group at the University of Bradford, this practice and training guide is written with the needs of health and social care professionals working with people with dementia in mind. Drawing together theoretical considerations and examples of good practice, the guide explains how to: make the initial diagnosis (including guidelines for distinguishing dementia from depression); convey the diagnosis to the person with dementia and their family (outlining the use of cognitive tests and the role of anti dementia drugs); support the user through lifestyle adjustments; care for people with dementia as it progresses, both in their own homes and in care home settings. The guide is illustrated with case studies and includes a chapter on understanding and responding to the needs of the carer and the effect on their own health as well as outlining the shared knowledge base required by health and social care practitioners.