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Book

Intermediate care of older people

Editors:
WADE Sian, (ed.)
Publisher:
Whurr
Publication year:
2004
Pagination:
34p., bibliog.
Place of publication:
London

This book explores what is understood by the concept of intermediate care in four parts: the concept and context; understanding ageing and the older person in society and in health care; planning, developing, monitoring and evaluating new services; and delivering care and preparing staff for delivery.

Journal article

Making connections: effective development of the intermediate tier

Authors:
HERBERT Gill, LAKE Geoff
Journal article citation:
Journal of Integrated Care, 13(1), February 2005, pp.35-42.
Publisher:
Emerald

Distils messages from an extensive period of consultancy involving 25 primary care trusts and their local authority and acute and mental health services partners. Emphasis was on sharing experience of implementing national policies and learning together, which facilitated co-evolution within whole systems.

Journal article

Time to convalesce

Author:
ORELLANA Katharine
Journal article citation:
Working with Older People, 8(2), June 2004, pp.22-25.
Publisher:
Emerald

Discusses convalescence needs of older people and the importance of services. Argues that convalescence should b built into mandatory provision by making two streams of intermediate care available: one that is treatment focused and a second that is rest focused.

Book Full text available online for free

Intermediate care: developing capacity in step up and step down beds

Author:
JOINT IMPROVEMENT TEAM
Publisher:
Joint Improvement Team
Publication year:
2015
Pagination:
15
Place of publication:
Edinburgh

Reports the results of a short online survey designed to provide a 'snapshot' of step up and step down beds as part of intermediate care activity in Scotland at August 2014. Step up beds are defined as those were people are admitted from home as an alternative to acute hospital admission and as step down beds as a transfer from acute hospital for people who require additional time and rehabilitation to recover but are unable to have this provided at home. The survey aimed to: describe the range of step up and step down services provided; explore perceived barriers and solutions for scaling up this care; identify themes for improvement support; and signpost to examples of good practice. A total of 31 health and care partnerships responded to the survey, with 26 currently providing or commissioning step up or step down beds. Locations of bed provision include independent and council care homes, housing with care and community hospitals. Survey results also briefly report on how services are evaluated, multidisciplinary support provided and use of technology. Annexes include definitions of terms used and a list of key principles that underpin intermediate care. (Edited publisher abstract)

Digital Media Full text available online for free

Homecare re-ablement toolkit

Author:
GREAT BRITAIN. Department of Health. Care Services Efficiency Delivery
Publisher:
Great Britain. Department of Health
Place of publication:
London

Care Services Efficiency Delievery (CSED) has put together this online toolkit to help councils looking to introduce a new homecare re-ablement service or extend or improve an existing service. Organised into eight main sections, the toolkit tackles each of the critical aspects of designing and implementing a successful homecare re-ablement service. It covers both the rationale and benefits as well as project and service management, including tips, templates and case study examples to give practical help to council teams. The eight project steps that help lead to successful homecare re-ablement services are: 1. Setting the vision for a homecare re-ablement service, 2. Building a business case for homecare re-ablement, 3. The high level pathway - designing the optimum customer route through social care services, 4. Applying process design to homecare re-ablement services, 5. Developing the team and skills, 6. Establishing an effective performance management system to track and measure the service, 7. System and form design and 8. Implementing the new service - change and project management.

Journal article

The national standard for intermediate care

Author:
GREENWOOD Lynne
Journal article citation:
Health Service Journal, 3.12.09, 2009, pp.24-25.
Publisher:
Emap Healthcare

Some of the results from a pilot audit of standards in 116 intermediate care services are briefly presented. The audit was conducted by the British Geriatric Society. The possibility of a comprehensive national audit is also discussed.

Journal article

Understanding service context: development of a service pro forma to describe and measure elderly peoples' community and intermediate care services

Author:
NANCARROW Susan A.
Journal article citation:
Health and Social Care in the Community, 17(5), September 2009, pp.434-446.
Publisher:
Wiley-Blackwell

The purpose of this paper was to develop a pro forma which classifies the components of service delivery and organization which may impact on the outcomes of elderly peoples' community and intermediate care services. The resulting analytic template provides a basis for comparison between services and may help guide service commissioning and development. A qualitative approach was used in which key evaluations and reports were selected on the basis that they described elderly peoples' community and intermediate care services. These were analysed systematically using a qualitative (template) approach to draw out the key themes used to describe services. Themes were then structured hierarchically into an analytic template. Seventeen key documents were analysed. The initial coding framework classified 334 themes describing intermediate care services. These items were then clustered into 78 categories, which were reduced to 17 subcategories, then six overall groupings to describe the services, namely; (1) context; (2) reason for the service; (3) service-users; (4) access to the service; (5) service structure; and (6) the organization of care. The resulting analytic template has been developed into a 'service pro forma' which can be used as a basis to describe and compare a range of services. It is proposed that all service evaluations should describe, in detail, their context in a comparable way, so that other services can learn from and/or apply the findings from these studies.

Journal article

A rapid response intermediate care service for older people with mental health problems

Author:
GOMERSALL Caroline
Journal article citation:
Nursing Times, 5.5.09, 2009, pp.12-13.
Publisher:
Nursing Times

This article follows the development of an intermediate care service for older people with mental health needs in North Yorkshire and assesses the impact of the service on patients, carers and referrers, and the availability of dedicated elderly mentally ill (EMI) beds.

Journal article

Facilitating earlier transfer of care from acute stroke services into the community

Author:
ROBINSON Jennifer
Journal article citation:
Nursing Times, 31.3.09, 2009, pp.12-13.
Publisher:
Nursing Times

This article outlines an initiative to reduce length of stay for stroke patients within an acute hospital and to facilitate earlier transfer of care. Existing care provision was remodelled and expanded to deliver stroke care to patients within a community bed-based intermediate care facility or intermediate care at home. This new model of care has improved the delivery of rehabilitation through alternative and innovative ways of addressing service delivery that meet the needs of patients.

Journal article

Prevalence of depression and anxiety symptoms in elderly patients admitted in post-acute intermediate care

Authors:
YOHANNES A. M., BALDWIN R. C., CONNOLLY M. J.
Journal article citation:
International Journal of Geriatric Psychiatry, 23(11), November 2008, pp.1141-1147.
Publisher:
Wiley-Blackwell

Depression and anxiety symptoms are common in medically ill older patients. This study investigated the prevalence and predictors of depression and anxiety symptoms in older patients admitted for further rehabilitation in a post acute intermediate care unit, in the North West of England. One hundred and seventy-three older patients (60 male), aged mean (SD) 80 (8.1) years, referred for further rehabilitation to intermediate care. Depression and anxiety symptoms were assessed by the Hospital Anxiety and Depression Scale, and severity of depression examined by the Montgomery Asberg Depression Rating Scale. Physical disability was assessed by the Nottingham Extended ADL Scale and quality of life by the SF-36. Sixty-five patients (38%) were identified with depressive symptoms, 29 (17%) with clinical depression, 73 (43%) with anxiety symptoms, and 43 (25%) with clinical anxiety. 15 (35%) of the latter did not have elevated depression scores (9% of the sample). Of those with clinical depression, 14 (48%) were mildly depressed and 15 (52%) moderately depressed. Longer stay in the unit was predicted by severity of depression, physical disability, low cognition and living alone. Clinical depression and anxiety are common in older patients admitted in intermediate care. Anxiety is often but not invariably secondary to depression and both should be screened for. Depression is an important modifiable factor affecting length of stay. The benefits of structured management programmes for anxiety and depression in patients admitted in intermediate care are worthy of evaluation.

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