Search results for ‘Subject term:"older people"’ Sort:
Results 1 - 10 of 18
Equity in health and social care
- Authors:
- EVANDROU Maria, et al
- Publisher:
- London School of Economics. Suntory-Toyota International Centre for Economics an
- Publication year:
- 1990
- Pagination:
- 70p.,tables,bibliogs.
- Place of publication:
- London
Studies equity in the distribution of primary health care and domiciliary care for elders.
It ‘makes you feel more like a person than a patient’: patients’ experiences receiving home-based primary care (HBPC) in Ontario, Canada
- Authors:
- SMITH-CARRIER Tracy, et al
- Journal article citation:
- Health and Social Care in the Community, 25(2), 2017, pp.723-733.
- Publisher:
- Wiley
The lack of effective systems to appropriately manage the health and social care of frail older adults, especially among those who become homebound, is becoming all the more apparent. Home-based primary care (HBPC) is increasingly being promoted as a promising model that takes into account the accessibility needs of frail older adults, ensuring that they receive more appropriate primary and community care. There remains a paucity of literature exploring patients' experiences with HBPC programmes. The purpose of this study was to explore the experiences of patients accessing HBPC delivered by interprofessional teams, and their perspectives on the facilitators and barriers to this model of care in Ontario, Canada. Using certain grounded theory principles, we conducted an inductive qualitative content analysis of in-depth patient interviews (n = 26) undertaken in the winter of 2013 across seven programme sites exploring the lived experiences and perspectives of participants receiving HBPC. Themes emerged in relation to patients' perceptions regarding the preference for and necessity of HBPC, the promotion of better patient care afforded by the model in comparison to office-based care, and the benefits of and barriers to HBPC service provision. Underlying patterns also surfaced related to patients' feelings and emotions about their quality of life and satisfaction with HBPC services. The authors argue that HBPC is well positioned to serve frail homebound older adults, ensuring that patients receive appropriate primary and community care – which the office-based alternative provides little guarantee – and that they will be cared for, pointing to a model that may not only lead to greater patient satisfaction but also likely contributes to bettering the quality of life of a highly vulnerable population. (Edited publisher abstract)
Development and preliminary validation of an Observation List for detecting mental disorders and social Problems in the elderly in primary and home care (OLP)
- Authors:
- TAK Erwin C.P.M., et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 31(7), 2016, pp.755-764.
- Publisher:
- Wiley
Objective: Even though the prevalence of mental disorders and social problems is high among elderly patients, it is difficult to detect these in a primary (home) care setting. Goal was the development and preliminary validation of a short observation list to detect six problem areas: anxiety, depression, cognition, suspicion, loneliness, and somatisation. Methods: A draft list of indicators identified from a short review of the literature and the opinions of 22 experts was evaluated by general practitioners (GPs) and home care organisations for feasibility. It was then used by GPs and home care personnel to observe patients, who also completed validated tests for psychological disorders (General Health Questionnaire 12 item version (GHQ-12)), depression (Geriatric Depression Scale 15-item version (GDS-15)), anxiety and suspicion (Symptom Checklist-90 (SCL-90)), loneliness (University of California, Los Angeles (UCLA)), somatisation (Illness Attitude Scale (IAS)), and cognition (Mini-Mental State Examination (MMSE)). Results: GPs and home care personnel observed 180 patients (mean age 78.4 years; 66% female) and evaluated the draft list during a regular visit. Cronbach's α was 0.87 for the draft list and ≥0.80 for the draft problem areas (loneliness and suspicion excepted). Principal component analysis identified six components (cognition, depression + loneliness, somatisation, anxiety + suspicion, depression (other signs), and an ambiguous component). Convergent validity was shown for the indicators list as a whole (using the GHQ-12), and the subscales of depression, anxiety, loneliness, cognition, and somatisation. Using pre-set agreed criteria, the list was reduced to 14 final indicators divided over five problem areas. Conclusion: The Observation List for mental disorders and social Problems (OLP) proved to be preliminarily valid, reliable, and feasible for use in primary and home care settings. (Publisher abstract)
The distribution of domiciliary and primary health care in Britain: preliminary results on modelling resource allocation in the welfare state
- Authors:
- EVANDROU Maria, WINTER David
- Publisher:
- London School of Economics. Suntory Toyota International Centre Economics and Re
- Publication year:
- 1988
- Pagination:
- 45p., tables, bibliog.
- Place of publication:
- London
Overview of the level and range of care services received by the elderly.
'It's not just the word care, it’s the meaning of the word...(they) actually care': caregivers' perceptions of home-based primary care in Toronto, Ontario
- Authors:
- SMITH-CARRIER Tracy, et al
- Journal article citation:
- Ageing and Society, 38(10), 2018, pp.2019-2040.
- Publisher:
- Cambridge University Press
The frail and homebound older adult populations currently experience difficulties accessing primary care in the medical office. Given this fundamental access to care problem, and the questionable care quality that arises when navigating a labyrinthine health-care system, these populations have typically been subject to inadequate primary care. To meet their needs better, growing research stresses the importance of providing comprehensive home-based primary care (HBPC), delivered by an inter-professional team of health-care providers. Family care-givers typically provide the majority of care within the home, yet their perceptions of HBPC remain under-researched. The purpose of this study was to explore unpaid care-givers' perceptions of and experiences with HBPC programmes in Toronto, Canada. The research conducted qualitative inductive content analysis, using analytic procedures informed by grounded theory, to discover a number of themes regarding unpaid care-givers' understandings of HBPC. Findings suggest that, compared to the standard office-based care model, HBPC may better support unpaid care-givers, providing them assistance with system navigation and offering them the peace of mind that they are not alone, but have someone to call should the need arise. The implications of this research suggest that HBPC could be a model to help mitigate the discontinuities in care that patients with comorbid chronic conditions and their attendant unpaid care-givers experience when accessing fragmented health, home and social care systems. (Edited publisher abstract)
Care transition types across acute, sub-acute and primary care: case studies of older people with complex conditions and their carers
- Authors:
- HARVEY Desley, et al
- Journal article citation:
- Journal of Integrated Care, 26(3), 2018, pp.189 -198.
- Publisher:
- Emerald
Purpose: The purpose of the paper is to examine the care transitions of older people who transfer between home, acute and sub-acute care to determine if there were common transition types and areas for improvements. Design/methodology/approach: A longitudinal case study design was used to examine care transitions of 19 older people and their carers as a series of transitions and a whole-of-system experience. Case study accounts synthesising semi-structured interviews with function and service use data from medical records were compared. Findings: Three types of care transitions were derived from the analysis: manageable, unstable and disrupted. Each type had distinguishing characteristics and older people could experience elements of all types across the system. Transition types varied according to personal and systemic factors. Originality/value: This study identifies types of care transition experiences across acute, sub-acute and primary care from the perspective of older people and their carers. Understanding transition types and their features can assist health professionals to better target strategies within and across the system and improve patient experiences as a whole. (Edited publisher abstract)
Perceived value of support for older adults coping with multi-morbidity: patient, informal care-giver and family physician perspectives
- Authors:
- NAGANATHAN Gayathri, et al
- Journal article citation:
- Ageing and Society, 36(9), 2016, pp.1891-1914.
- Publisher:
- Cambridge University Press
This study investigated the perceived value of informal and formal supports for older adults with multi-morbidity from the perspectives of patients, care-givers and family physicians. Semi-structured interviews were conducted with 27 patients, their informal care-givers and their family physicians in an urban academic family health team in Ontario. Analysis was conducted using a General Inductive Approach to facilitate identification of main themes and build a framework of perceived value of supports. Participant views converged on supports that facilitate patient independence and ease care-giver burden. However, important differences in participant perceptions arose regarding these priorities. Physicians and care-givers valued supports that facilitate health and safety while patients prioritised supports that enable self-efficacy and independence. While formal supports which eased care-giver burden were viewed positively by all members of the triad, many patients also rejected formal supports, citing that informal support from their care-giver was available. Such conflicts between patient, care-giver and physician-perceived value of supports may have important implications for consumer and care-giver willingness to accept formal supports when supports are available. These findings contribute to the broader literature on community-based care by incorporating the perspectives of patients, informal care-givers and family physicians to understand better the barriers and facilitators of uptake of supportive services that contribute to successful ageing at home. (Publisher abstract)
Intermediate care: what do we know about older people's experiences?
- Author:
- PETCH Alison
- Publisher:
- Joseph Rowntree Foundation
- Publication year:
- 2003
- Pagination:
- 37p.,bibliog.
- Place of publication:
- York
Traditionally ‘intermediate care’ has often been used to refer to a range of services at the boundary of primary and secondary care, although there have been differing assumptions as to the goal of intermediate care, the intensity of support provision and the appropriate target groups. Confusingly, intermediate care has also been used within the hospital as a term for units located between the intensive care unit and the general ward. The current form of intermediate care provision started to shape up with the NHS Plan. This proposed a range of intermediate care services designed to bridge between hospital and home and to: help people recover and regain independence more quickly; bring about swifter hospital discharge when people are ready to leave; and avoid unnecessary long-term care.
Domiciliary clinics: a cost minimisation analysis
- Authors:
- ANDERSON David, AQUILINA Carmelo
- Journal article citation:
- International Journal of Geriatric Psychiatry, 17(10), October 2002, pp.945-949.
- Publisher:
- Wiley
This article compares the cost of assessing new referrals to an old age psychiatry service at the patient's home or a hospital-based clinic. An old age psychiatry service in Liverpool where routine referrals were assessed at home (domiciliary clinic) was compared to an adjacent service which assessed people in an outpatient clinic. Activity levels for four years of the service were collected and analysed. The domiciliary clinic was marginally cheaper than outpatient assessment (£48 compared to £50 per successful assessment). The most important variables in determining the cost effectiveness of the service were non-attendance rates, the grade of doctor seeing the patient and the time spent traveling for the home assessment.
Designing services for older people: lessons for practitioners
- Author:
- -
- Journal article citation:
- Community Practitioner, 73(8), August 2000, pp.716-718.
- Publisher:
- Community Practitioners' and Health Visitors' Association
This third article in the assessment of older people in the community series looks at community oriented primary care (COPC) methodology and introduces phase I of the primary care for older people programme, which applies the COPC model to innovative primary care for the elderly.