Search results for ‘Subject term:"very old people"’ Sort:
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A framework to discharge frail older people
- Author:
- LEES-DEUTSCH Liz
- Journal article citation:
- Nursing Times, 112(37/38), 2016, pp.13-15.
- Publisher:
- Nursing Times
A framework to discharge frail older patients who have had an unplanned admission to hospital and are subsequently discharged (or transferred)to another setting. It discusses current issues in discharge practice, briefly reviews the background policy to guide the discharge assessment of older people and examines challenges in discharging them from the acute setting. Finally, it uses an assessment framework to integrate current principles form national discharge guidance into practice. (Publisher abstract)
Handbook of care planning
- Authors:
- ATHERTON Kate, BRANDON Althea, BRANDON David
- Publisher:
- Positive Publications
- Publication year:
- 1996
- Pagination:
- 52p.
- Place of publication:
- London
Booklet based on lessons learned through the involvement of the authors in care planning over the last 5 years. Suggests how the process of care planning can become more sensitive to individual need by focusing on the four 'magnets' of control, skills, pain and contacts. Explores in detail how the magnets were used to discover the needs of 2 people - a young man who suffered severe head injury when a child and a frail older women.
Moving upstream in health promoting policies for older people with early frailty in England? A policy analysis
- Authors:
- DRENNAN Vari, et al
- Journal article citation:
- Journal of Health Services Research and Policy, 23(3), 2018, pp.168-175.
- Publisher:
- Sage
- Place of publication:
- London
Objectives: Globally, populations are rapidly ageing and countries have developed health promotion and wellbeing strategies to address increasing demand for health care and old-age support. The older population is not homogeneous however, and includes a large group in transition between being active and healthy to being frail, i.e. with early frailty. This review explores the extent to which policy in England has addressed this group with a view to supporting independence and preventing further progression towards frailty. Methods: A narrative review was conducted of 157 health and social care policy documents current in 2014–2017 at three levels of the health and social care system in England. Findings: the policy problem analysis, the shifts over time in language from health promotion to illness prevention, the shift in target populations to mid-life and those most at risk of adverse outcomes through frailty, and changes to delivery mechanisms to incentivize attention to the frailest rather than those with early frailty. Findings: that older people in general were not identified as a specific population in many of these policies. While this may reflect a welcome lack of age discrimination, it could equally represent omission through ageism. Only at local level did we identify some limited attention to preventative actions with people with early frailty. Conclusion: The lack of policy attention to older people with early frailty is a missed opportunity to address some of the demands on health and social care services. Addressing the individual and societal consequences of adverse experiences of those with the greatest frailty should not distract from a more distinct public health perspective which argues for a refocusing upstream to health promotion and illness prevention for those with early frailty. (Edited publisher abstract)
A standardized menu for Goal Attainment Scaling in the care of frail elders
- Author:
- MORROW-HOWELL Nancy
- Journal article citation:
- Gerontologist, 38(6), December 1998, pp.735-742.
- Publisher:
- Oxford University Press
Goal Attainment Scaling (GAS), an individualised measurement approach, is particularly attractive for the evaluation and care planning of frail elders, who often experience multiple, complex problems. Some service providers find GAS too unwieldy for routine use. A modified version of GAS that uses a standardized menu of goals and attainment levels has been developed by a regional referral hospital in Nova Scotia, Canada. This article reviews the development, implementation, benefits and challenges of the standardised menu, as well as the results of a retrospective descriptive study of its measurement properties.
Elderly care planning model: Wessex Regional Health Authority
- Author:
- OPIT L.J
- Publisher:
- University of Kent. Centre for Health Services Studies
- Publication year:
- 1990
- Pagination:
- 36p.,tables.
- Place of publication:
- Canterbury
Document developing a 'synthetic' model for estimating disability amongst the population over 70 years of age who reside at home. Based on data contained in the 1985 OPCS household disability survey.
Understanding variation in unplanned admissions of people aged 85 and over: a systems-based approach
- Authors:
- WILSON Andrew, et al
- Journal article citation:
- BMJ Open, 9(7), 2019, p.e026405. Online only
- Publisher:
- BMJ Publishing Group
Aim: To examine system characteristics associated with variations in unplanned admission rates in those aged 85+. Design: Mixed methods. Setting: Primary care trusts in England were ranked according to changes in admission rates for people aged 85+ between 2007 and 2009, and study sites selected from each end of the distribution: three ‘improving’ sites where rates had declined by more than 4% and three ‘deteriorating’ sites where rates had increased by more than 20%. Each site comprised an acute hospital trust, its linked primary care trust/clinical commissioning group, the provider of community health services and adult social care. Participants: A total of 142 representatives from these organisations were interviewed to understand how policies had been developed and implemented. McKinsey’s 7S framework was used as a structure for investigation and analysis. Results: In general, improving sites provided more evidence of comprehensive system focused strategies backed by strong leadership, enabling the development and implementation of policies and procedures to avoid unnecessary admissions of older people. In these sites, primary and intermediate care services appeared more comprehensive and better integrated with other parts of the system, and policies in emergency departments were more focused on providing alternatives to admission. Conclusions: Health and social care communities which have attenuated admissions of people aged 85+ prioritised developing a shared vision and strategy, with sustained implementation of a suite of interventions. (Edited publisher abstract)
Comprehensive geriatric assessment: needs assessment tool
- Authors:
- FISHER Elizabeth, KEEBLE Eilis, KRAINDLER Joshua
- Publisher:
- Nuffield Trust
- Publication year:
- 2018
- Place of publication:
- London
- Edition:
- Version 2
Toolkit to help local providers (NHS acute trusts) and local authority commissioners of care in England assess the needs of frail older people being cared for in hospital. It aims to make information more accessible in order to help providers and commissioners describe hospital activity and frailty in people aged 75 years and older. It includes indicators for each local authority and NHS acute trust to describe populations, hospital costs and hospital usage for people aged 75 years and over using Hospital Episode Statistics (HES) and Office for National Statistics datasets. These are presented alongside HES-based measures of frailty by different types of hospital activity. Additional indicators on patient outcomes (mortality and emergency readmissions) for NHS acute trusts are also included. The tool may prove useful for local planning and making a business case for wider use of CGA locally. It has been developed as part of an National Institute for Health Research (NIHR)-funded project to inform NHS managers, clinicians, patients and the public about how best to organise hospital services for frail older people. (Edited publisher abstract)
Support at home: views of older people about their needs and access to support
- Author:
- MACDONALD Charlotte
- Publisher:
- Stationery Office
- Publication year:
- 1999
- Pagination:
- 100p.,tables,bibliog.
- Place of publication:
- Edinburgh
Report of a survey of older people's perceptions of their needs and the availability of support at home. The survey was carried out in central Scotland in 1997 and 1998 and aims to: identify levels and types of felt need for help and support among over 75's; explore the perceptions and experience of older people in relation to seeking help and support; ascertain the level and type of service provision in urban areas in central Scotland; investigate and compare the fit between what is said by local authorities and other service providers and what services are actually known to be available and accessible; to identify factors that might contribute to unmet need; and on the basis of the study's findings to suggest ways in which agencies can bridge the gap between needs and services.