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Supporting vulnerable people before and during a heatwave: advice for health and social care professionals
- Author:
- NORTHERN IRELAND. Department of Health, Social Services and Public Safety
- Publisher:
- Northern Ireland. Department of Health, Social Services and Public Safety
- Publication year:
- 2014
- Pagination:
- 110
- Place of publication:
- Belfast
This factsheet informs health and social care staff about the risks and dangers of a severe heatwave and helps them to plan what to do in advance. It offers advice both on caring for people most at risk during a heatwave, and on organising others who provide care. It outlines who is at risk, the effects of heat on health, reducing the risk before a heatwave and action to take during a heatwave. (Edited publisher abstract)
Defining a fall and reasons for falling: comparisons among the views of seniors, health care providers, and the research literature
- Authors:
- ZECEVIC Aleksandra A., et al
- Journal article citation:
- Gerontologist, 46(3), June 2006, pp.367-376.
- Publisher:
- Oxford University Press
The purpose of this Canadian study was (a) to obtain information about the perceptions held by seniors and health care providers concerning what constitutes a fall and potential reasons for falling, and (b) to compare these perceptions to the research literature. As part of a larger telephone survey, interviewers asked 477 community-dwelling seniors to define a fall and to provide reasons for falling. In addition, 31 health care providers from the community were interviewed on the same topics. In order to capture patterns in conceptualized thinking, content analysis was used to develop codes and categories for a fall definition and reasons for falling. Selected articles were reviewed in order to obtain a comprehensive overview of fall definitions currently used in the research and prevention literature. The results found that a fall had different meanings for different groups. Seniors and health care providers focused mainly on antecedents and consequences of falling, whereas researchers described the fall event itself. There were substantial differences between the reasons for falling as reported by seniors and the risk factors as identified in the research literature. The authors conclude that if not provided with an appropriate definition, seniors can interpret the meaning of a fall in many different ways. This has the potential to reduce the validity in studies comparing fallers to nonfallers. Research reports and prevention programs should always provide an operational definition of a fall. In communication between health care providers and seniors, an appropriate definition increases the possibility for early detection of seniors in greater need of care and services.
Caring for older people living alone with dementia: healthcare professionals’ experiences
- Authors:
- DE WITT Lorna, PLOEG Jenny
- Journal article citation:
- Dementia: the International Journal of Social Research and Practice, 15(2), 2016, pp.221-238.
- Publisher:
- Sage
Older adults living alone with dementia are at greater risk of placement in long-term care homes compared with those living with others. Healthcare professionals have vital roles in supporting them to continue living in the community. Yet, little is known about how healthcare professionals fulfill these roles and what their experiences are like. The study purpose was to describe health care professionals’ experiences of caring for older people with dementia living alone. Using a qualitative descriptive approach and qualitative content analysis method, 15 healthcare professionals were interviewed in Ontario, Canada. The overall theme of the findings, doing the best that they could for them, involved discussing sensitive care issues with what professionals viewed as gentle realism. Walking the tightrope expressed tensions in meeting professional responsibilities. Constraints (my hands are tied) and boundaries (it’s not my job, it’s not my decision) described perceived limitations on professional roles. Effects of the emotional struggle involved in working with these older people were lessened by believing that they did the right thing. The findings have implications for what could be done better for older people with dementia living alone, through integration of person-centred/relationship-centred principles in education programmes, community agency policies, a national dementia care strategy, and culture change in community care. (Edited 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)
Sexual activity and risk-taking in later life
- Author:
- GOTT Merryn C.
- Journal article citation:
- Health and Social Care in the Community, 9(2), March 2001, pp.72-78.
- Publisher:
- Wiley
Article aims to identify the prevalence of sexual activity and sexual risk-taking behaviour among a sample of older community-based adults. Of three hundred and nineteen individuals aged over 50 years, 80 percent of respondents were currently sexually active and 7 percent engaged in behaviours that may place them at risk of contracting a sexually transmitted infection (STI). Risks takers were typically male, aged between 50 and 60 years and married. Being male was also related to reporting current or past sexual health concerns. Of 75 respondents reporting such concerns, two thirds had discussed these concerns with their GP or attended a GUM clinic. Levels of satisfaction with such consultations were generally high, but declined with increasing age. Overall, most participants felt they had not received very much information about STIs and HIV, and about one quarter reported that they would like to receive more information on these topics. Indicates a potential need for education to help professionals meet the sexual health needs of their older patients/clients.
Understanding which people with dementia are at risk of inappropriate care and avoidable transitions to hospital near the end-of-life: a retrospective cohort study
- Authors:
- LENIZ Javiera, et al
- Journal article citation:
- Age and Ageing, 48(5), 2019, pp.672-679.
- Publisher:
- Oxford University Press
Background: transitions between care settings near the end-of-life for people with dementia can be distressing, lead to physical and cognitive deterioration, and may be avoidable. Objective: to investigate determinants of end-of-life hospital transitions, and association with healthcare use, among people with dementia. Design: retrospective cohort study. Setting: electronic records from a mental health provider in London, linked to national mortality and hospital data. Subjects: people with dementia who died in 2007–2016. Methods: end-of-life hospital transitions were defined as: multiple admissions in the last 90 days (early), or any admission in the last three days of life (late). Determinants were assessed using logistic regression. Results: of 8,880 people, 1,421 (16.0%) had at least one end-of-life transition: 505 (5.7%) had early, 788 (8.9%) late, and 128 (1.5%) both types. Early transitions were associated with male gender (OR 1.33, 95% CI 1.11–1.59), age (>90 vs <75 years OR 0.69, 95% CI 0.49–0.97), physical illness (OR 1.52, 95% CI 1.20–1.94), depressed mood (OR 1.49, 95% CI 1.17–1.90), and deprivation (most vs least affluent quintile OR 0.58, 95% CI 0.37–0.90). Care home residence was associated with fewer early (OR 0.63, 95% CI 0.53 to 0.76) and late (OR 0.80, 95% CI 0.65 to 0.97) transitions. Early transitions were associated with more hospital admissions throughout the last year of life compared to those with late and no transitions (mean 4.56, 1.89, 1.60; P < 0.001). Conclusions: in contrast to late transitions, early transitions are associated with higher healthcare use and characteristics that are predictable, indicating potential for prevention. (Edited publisher abstract)
Some limits and political implications of participation within health and social care for older adults
- Author:
- CAREY Malcolm
- Journal article citation:
- Ageing and Society, 39(8), 2019, pp.1691-1708.
- Publisher:
- Cambridge University Press
This paper critically examines service user participation and involvement for older adults. It concentrates on research and community-led engagement for older people, and maintains that despite extensive support and expansion, participation offers a complex form of governance and ideological control, as well as a means by which local governments and some welfare professions seek to legitimise or extend their activities. Some of the paradoxes of participation are discussed, including tensions that persist between rhetorical claims of empowerment, active citizenship and democratic engagement, on one hand, despite tendencies towards risk-aversion, welfare retrenchment and participant ambivalence, on the other. The paper also highlights practical problems in relation to participative research and community involvement, and questions arguments that participation may challenge the authority of welfare professionals. Critical theory is drawn upon to contextualise the role of participative narratives within wider welfare, including its role in moving debate away from ownership or redistribution while masking and validating policy-related goals which can counter many older people's needs. Tension is also noted between participation projects represented as resources to support ageing identities as opposed to those representing technologies for social regulation and conformity. (Edited publisher abstract)
Assessment of metabolic syndrome risk factors among rural-dwelling older adults requires innovation: partnerships and a mobile unit can help
- Authors:
- CROWTHER Martha R., et al
- Journal article citation:
- Quality in Ageing and Older Adults, 19(4), 2018, pp.251-260.
- Publisher:
- Emerald
Purpose: Older adults are at risk for developing metabolic syndrome (MSX). Given the growing rural older adult population and the unknown prevalence rate of MSX in rural communities, the purpose of this paper is to assess the risk factors for MSX among rural elders. Design/methodology/approach: Individuals aged 55+ from four West Alabama rural communities were assessed by an interdisciplinary healthcare team via a mobile unit (n=216). Descriptive analyses and analysis of variances (ANOVA) were conducted to assess the effect of gender, race and community on the number of risk factors of MSX among rural elders. Findings: Results of a three-way ANOVA revealed a significant interaction between gender, age and community on the number of MSX risk factors [F (16,193)= 2.41, p <0.01]. Rural communities with lower social economic status (SES) and predominantly African American residents were at higher risk for developing MSX compared to communities with higher SES [F(3, 68) = 7.42, p<0.05]. Practical implications: Findings suggest low SES rural communities are at risk of developing MSX. Innovative approaches such as mobile healthcare delivery are crucial to providing quality healthcare and preventive health screens to underserved rural older adult communities. Originality/value: Limited research is available on assessing rural midlife and older adults at risk for metabolic syndrome largely due to lack of communication or transportation infrastructure and their history of negative experiences with public institutions. This research demonstrates that how these barriers can be addressed. (Publisher abstract)
State of the nation: older people and malnutrition in the UK today
- Author:
- MALNUTRITION TASK FORCE
- Publisher:
- Malnutrition Task Force
- Publication year:
- 2017
- Pagination:
- 27
- Place of publication:
- London
Brings together information, statistics and evidence from across the health and social care system to provide a picture of what is happening to older people who are malnourished or at risk of malnutrition in England. It examines the causes and consequences of malnutrition in the UK. It discusses risk factors in three categories: medical and disease-related factors which are directly related to another on-going health condition, such as dementia; physical risk factors, which may be related to underlying health problems, such as mobility or sensory loss; and social factors, such as income and loneliness. The report shows that the prevalence of these risk factors is widespread and likely to increase as the population ages. It looks at older people at risk of malnutrition in hospitals and living in the community, and the support that could prevent malnutrition. The report also looks at economic costs and pressures, and whether the NHS and social care services are currently able to support older people at risk. The final section summarises existing good practice guidance and highlights the need for increasing public awareness, professional training, and an integrated system of health and social care in order to prevent and treat malnutrition. (Edited publisher abstract)
Aging with intellectual and developmental disabilities and dementia in Manitoba
- Authors:
- SHOOSHTARI Shahin, et al
- Journal article citation:
- Advances in Mental Health and Intellectual Disabilities, 11(4), 2017, pp.134-144.
- Publisher:
- Emerald
Purpose: Information on the risk of dementia in ageing persons with intellectual and/or developmental disability (IDD) in Manitoba, Canada is lacking. The purpose of this paper is to estimate dementia prevalence in adults with IDD. Design/methodology/approach: Anonymised population-level health and non-health administrative data (1979-2012) contained in the Population Health Research Data Repository of the Manitoba Centre for Health Policy (MCHP) were linked to identify adults with IDD, and estimate the prevalence of dementia based on the presence of ICD codes. Prevalence of dementia was estimated for persons aged 18-55 years and 55+ years, and was reported by sex, type of residence, region of residence, neighbourhood income quintiles, and IDD diagnostic category. Findings: Of the 8,655 adults with IDD identified, 8.1 per cent had an indication of dementia in their medical records; an estimate three times greater than that found for those without IDD (2.6 per cent). More than 17 per cent of Manitobans with IDD aged 55+ years had an indication of dementia, which was nearly twice the rate reported previously. Of those with IDD and dementia, 34.7 per cent lived in long-term care facilities. Originality/value: Health and social support services are typically available to individuals with dementia aged 65+ years; thus, younger adults with IDD and dementia may not be eligible for those supports. To promote equity in health and access to care, dementia screening and increased supports for ageing individuals with IDD are recommended. (Edited publisher abstract)