Aged Care / Geriatrics
Hospital admissions from care homes – Nuffield Trust Quality Watch – 29 January 2015
“Our analysis explores how care home residents use hospital services, and how this information could prompt improvement in the way care is provided.”Read Full Post | Make a Comment ( Comments Off on Hospital admissions from care homes – Nuffield Trust Quality Watch – 29 January 2015 )
Key to care: report of the Burstow Commission on the future of the home care workforce – LGiU – Local Government Democracy Think Tank – 2 December 2015Read Full Post | Make a Comment ( Comments Off on Key to care: report of the Burstow Commission on the future of the home care workforce – LGiU – Local Government Democracy Think Tank – 2 December 2015 )
Going home alone: counting the cost to older people and the NHS – Royal Voluntary Service – 16 November 2015
“Lack of support after hospital doubles readmissions for older people”Read Full Post | Make a Comment ( Comments Off on Going home alone: counting the cost to older people and the NHS – Royal Voluntary Service – 16 November 2015 )
New perspectives and approaches to understanding dementia and stigma – Medical Research Council [UK] – 24 October 2014
“The social stigma which surrounds dementia is impeding early diagnosis, care and research into the disease, according to a new report championed by the Medical Research Council (MRC).
The report, New perspectives and approaches to understanding dementia and stigma, published by the think tank International Longevity Centre UK (ILC-UK) in collaboration with the MRC, Alzheimer’s Research UK, Alzheimer’s Society and supported by the drug company Pfizer, shines a light on the impact the fear around dementia has on those living with the condition, their families and carers, which prevents the research community capturing a full picture of the disease.
According to data in the report, people over the age of 55 fear being diagnosed with dementia more than any other condition and at least 1 in 4 people hide their diagnosis, citing stigma as the reason.”
… continues on the site
How not to solve the dementia crisis – £55 lollipops for GPs – Guardian – 29 October 2014Read Full Post | Make a Comment ( Comments Off on New perspectives and approaches to understanding dementia and stigma – Medical Research Council [UK] – 24 October 2014 )
Cracks in the pathway: People’s experiences of dementia care as they move between care homes and hospitals – Care Quality Commission [UK] – 13 October 2014
“A major review into the care provided to people living with dementia by the Care Quality Commission found an unacceptable gap in the quality of care that means people are at risk of experiencing poor care as they move between care homes and hospitals.
The CQC carried out a themed review of dementia services in 129 care homes and 20 hospitals across England, looking specifically at four areas: how people’s care needs were assessed; how care was planned and delivered; how providers worked together and how the quality of care was monitored.”
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2014 Alzheimer’s Disease: facts and figures – includes a special report on women and Alzheimer’s Disease – Alzheimer’s Association [US]Read Full Post | Make a Comment ( Comments Off on 2014 Alzheimer’s Disease: facts and figures – includes a special report on women and Alzheimer’s Disease – Alzheimer’s Association [US] )
How can we do more to prevent dementia, save lives and reduce avoidable costs?
“This report highlights how we can do more to prevent dementia, save lives and reduce avoidable costs.
A new Provocation launched today from the ILC-UK and Improving Care explores potential savings to the state if we were able to intervene successfully on the risk factors that cause dementia- these include physical activity, smoking, obesity and depression.
The authors of the report have modelled the impact of matching best practice interventions from global case studies on reducing six risk factors for dementia.
We estimate that over a 27 year period (2013-2040) this could prevent nearly 3 million people developing dementia in the UK – and would reduce the costs to the state in the UK by £42.9 billion between now and 2040 (minus any associated costs of intervention).
For example, if we managed to successfully reduce depression by 22.5% by 2040 (best practice intervention) this could prevent 22,000 dementia cases and save the state £308million. Similarly, if we managed to reduce type 2 diabetes by 58% through intensive lifestyle interventions, through weight reduction and exercise, we could potentially prevent 40,000 people developing dementia by 2040 and save the state £560million.
This Provocation links to the key messages of a study published in the Lancet Neurology today that argues one in three cases of dementia could be avoided by changes in lifestyle.”Read Full Post | Make a Comment ( Comments Off on Preventing dementia: a provocation – International Longevity Centre – UK (ILC-UK) – 14 July 2014 )
Better care for older people – General Medical Council [UK] – 9 July 2014
It has worked closely with partner organisations, including the British Geriatrics Society and Age UK, to create Better care for older people. The resource gives practical advice, including from leading clinicians, on how to put older patients first and use GMC guidance to handle their clinical, emotional and psychological needs.
At the core of the resource is a series of videos featuring interviews with older patients. Their experiences of dealing with doctors, from feeling that they have been pushed aside because of their age to the importance of seeing the same doctor, helps put the GMC’s guidance into context and is a strong reminder of the importance of placing the patient at the centre of care.
The resource also contains a mixture of guidance, case studies, scenarios, articles and tips to prepare doctors for caring for the growing number of older patients.”
… continues on the site
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Focus on the Health and Care of Older People – Health & Social Care Information Centre [UK] – June 2014
” This publication provides a compilation of information on older people living in England to give a broad picture of their health, care and wellbeing.
It will be of use to readers wanting a better understanding of older people’s use of health and social care and an introduction to the data sources that are available for further analysis.”
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“Millions of Americans already struggle with dementia, a degenerative cognitive condition that costs the United States billions of dollars annually, more than cancer or heart disease. As the nation’s population grows grayer, these numbers will only soar. RAND researchers have developed a national blueprint to help decisionmakers improve long-term services and supports that are crucial for those with dementia and those who care for them.”Read Full Post | Make a Comment ( Comments Off on What to Do About Dementia? Policy Options for Crucial Long-Term Care – RAND – 2014 )
Dementia care in the acute hospital setting: issues and strategies – Alzheimer’s Australia – 16 June 2014
Extract from the executive summary
“Australia is facing a huge healthcare challenge with an ever increasing demand for appropriate acute care services for people with dementia. Yet, people with dementia still struggle to get the care they need in the acute care setting. People with dementia experience unacceptably worse clinical outcomes, longer lengths of stay as well as a higher likelihood for readmission compared to people without dementia at a high cost to the health care system.1
With good care, the costs of dementia care in hospital may be the same but the outcomes for people with dementia would be improved leading to a more efficient use of health care spending.
Alzheimer’s Australia held a Dementia Care in Hospitals Symposium in Sydney on the 29th of April 2014, where the most recent Australian research in dementia care in hospitals was presented and discussed by leading researchers and experts. This included latest findings on current dementia care as well as interventions and strategies to improve the quality of care. This report provides a summary of the issues and strategies that were discussed at this Symposium.”
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Good practice in the design of homes and living spaces for people living with dementia and sight loss – Thomas Pocklington Trust – June 2014Read Full Post | Make a Comment ( Comments Off on Good practice in the design of homes and living spaces for people living with dementia and sight loss – Thomas Pocklington Trust – June 2014 )
RCN development programme: transforming dementia care in hospitals – evaluation report – 21 May 2014
“The RCN has today published a report into a major year-long programme which has highlighted the importance of investing in nurse leaders and dementia nurse specialists to improving dementia care.
The results of the programme, which was funded by the RCN Foundation, have been published at the Transforming Dementia Care in Hospitals conference.
The programme involved nine NHS trusts developing innovative ways to improve dementia care in hospitals – ranging from trust-wide education programmes, improving individualized care and supporting family carers.”
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Looking Forward to Later Life Taking an early action approach to our ageing society – Community Links [UK] – 15 May 2014
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Who Cares? The Role that Technology and Entrepreneurs Can Play in Improving Informal Care in the UK – Nesta [UK] – 1 May 2014
“This report examines the need to increase the supply and improve efficiency of informal care for older people, with a focus on the role that entrepreneurs and technology can play.”Read Full Post | Make a Comment ( Comments Off on Who Cares? The Role that Technology and Entrepreneurs Can Play in Improving Informal Care in the UK – Nesta [UK] – 1 May 2014 )
Aged Care in Australia: Parts 1 & 2 – ARC Centre of Excellence in Population Ageing Research (CEPAR) – 10 April 2014
“For a proportion of people, a long life comes with chronic illnesses, disability, or physical or cognitive decline. Population ageing means more people will require care and support. Much of it will be provided informally by family, but increasingly it will take the shape of formal aged care. This is the first of two research briefs on aged care in Australia. This research brief introduces the policy setting and looks at the demand and funding of formal and informal care.”
“Population ageing is likely to result in more people requiring care. Australia’s aged care system is the set of public, private and community institutions that offer care interventions to older people suffering chronic illnesses, disability, or physical and cognitive decline. It is also the subject of an evolving reform agenda, so a wide understanding of how it operates is critical.
This brief looks at aged care by describing care recipients, providers, the workforce and access and quality issues.”Read Full Post | Make a Comment ( Comments Off on Aged Care in Australia: Parts 1 & 2 – ARC Centre of Excellence in Population Ageing Research (CEPAR) – 10 April 2014 )
Drug Use Among Seniors on Public Drug Programs in Canada, 2012 – Canadian Institute for Health Information – 1 May 2014
“Most seniors in Canada are taking at least 5 drugs—and that number increases dramatically for older seniors and those living in long-term care facilities, according to a new report from the Canadian Institute for Health Information (CIHI).
Drug Use Among Seniors on Public Drug Programs in Canada, 2012 found that nearly two-thirds of seniors (those age 65 and older) are taking 5 or more prescription drugs. Drug use increases with age, with more than 40% of Canadians age 85 and older taking more than 10 drugs. Additionally, seniors living in long-term care facilities take more medications than those who are living in the community; nearly two-thirds are taking at least 10 drugs.”
“Although seniors those age 65 and older account for only 15% of the Canadian population, they are estimated to account for 40% of all spending on prescribed drugs and 60% of public drug program spending. Seniors take more drugs than younger Canadians because, on average, they have a higher number of chronic conditions. Although taking multiple medications may be necessary to manage these conditions it is important to consider the benefits and risks of each medication and the therapeutic goals of the patient. Drug use is also important to monitor from a spending perspective, as increased drug utilization has been found to be the biggest driver of drug spending in Canada.”Read Full Post | Make a Comment ( Comments Off on Drug Use Among Seniors on Public Drug Programs in Canada, 2012 – Canadian Institute for Health Information – 1 May 2014 )
“Loneliness causes misery and poor quality of life for too many people, but it is the oldest old – the over 85s – who are most badly affected. Nearly half of this age group experience loneliness some or most of the time. Understanding loneliness in this age group is becoming increasingly important as what was once a small group of exceptional individuals rapidly grows into a whole new generation.
This new CentreForum report by James Kempton and Sam Tomlin argues that loneliness should be a public health priority and explores practical steps that can be taken to reduce levels of loneliness among the oldest old.
Addressed to politicians and policy makers in both central and local government, leaders and innovators in the voluntary and community sector, and wider society as a whole, the report urges them to give more priority to the services and support that we know can help older people avoid ageing in loneliness and isolation.”Read Full Post | Make a Comment ( Comments Off on Ageing alone: loneliness and the oldest old – CentreForum – April 2014 )
Care and management of younger and older Australians living with dementia and behavioural and psychiatric symptoms of dementia (BPSD) – Australian Senate Community Affairs References Committee – March 2014
Care and management of younger and older Australians living with dementia and behavioural and psychiatric symptoms of dementia (BPSD) – Australian Senate Community Affairs References Committee – March 2014
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“Budget allocations from central Government to English local authorities were reduced by 14% in real terms between 2011/12 and 2014/15. This report asks how local authorities have responded to this decline in income and explores the possible impact on older adults’ health and wellbeing.”Read Full Post | Make a Comment ( Comments Off on Social care for older people – The Health Foundation and Nuffield Trust – 26 March 2014 )
The Use of Restraint and Psychotropic Medication in People with Dementia – Alzheimer’s Australia – 26 March 2014
“Up to 80% of people with dementia and nearly half of people in residential aged care facilities are receiving psychotropic medications that in some cases are inappropriately prescribed, a report released today by Alzheimer”s Australia has revealed.
The report, The Use of Restraint and Psychotropic Medication in People with Dementia, provides an evidence-based review of the prevalence of the use of restraint, and the potential negative consequences and legal issues surrounding the use of psychotropic medication and physical restraints in people with dementia.”
“A new study produced by Alzheimer’s Australia suggests up to 80 per cent of dementia patients in aged care facilities are being treated with psychotropic drugs.
The report, to be released today, suggests only one in five dementia patients receive any benefit from taking such medication.
Alzheimer’s Australia says the use of drugs in nursing homes is excessive and it has called for reform of the sector.”
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2030 vision: The best – and worst – futures for older people in the UK – International Longevity Centre [UK] – 13 March 2014
” A futures perspective on how we make the UK the best country to grow old in.
The speed at which the world is changing is both inspiring and alarming. We know more; we do more; there’s simply more in the world as we accumulate more ‘stuff’. We’ve even invented a whole other world we can retreat to, just in case the business of life gets too boring: the digital world – literally a new dimension to modern life.
So how do we even begin to contemplate the future? This is the task that Independent Age, together with the International Longevity Centre-UK (ILC-UK), has set itself in putting together this report. Futurology conjures up madcap ideas; visions of unimaginable technological creativity and mind-warping innovation. Yet if we really want to look to the future and take the necessary steps as a society to create better conditions for future generations of older people, we should look at the trends we can predict, the “known knowns”, as former US Defence Secretary, Donald Rumsfeld, would have it.
We know, for example, that we are living longer: one piece of evidence presented to Parliament suggests that 50% of people born in 2007 will live to 103. And the number of people aged 60 or over is expected to pass the 20 million mark by 2031- from nearly 20% of the total population at present to 28% in 2030.
So will the UK become a better or worse country for older people?
This report was launched at a breakfast debate in the House of Lords: ‘One year on: Are we ready to make the UK the best country to grow old in?’.”
Is excessive paperwork in care homes undermining care for older people? JFR Joseph Rowntree Foundation – 28 February 2014
“Are older people in care homes missing out on quality time with staff because workers are preoccupied with paperwork?
Care homes have to regularly complete more than 100 separate items of paperwork, often duplicating the same information, this study found. Researchers visited care homes and spoke to staff who felt they were judged more on their ability to produce paperwork than deliver care.
The research recommends that the sector rethinks its priorities and makes changes to the way it deals with administration so older people can be given more compassionate, personalised care.”
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Digital care services: harnessing ICT to create sustainable aged care services – Aged Care Industry IT Council (ACIITC) – March 2014
ACIITC is a collaboration of the two aged services industry peak bodies: Aged and Community Services Australia (ACSA) and Leading Age Services Australia (LASA).Read Full Post | Make a Comment ( Comments Off on Digital care services: harnessing ICT to create sustainable aged care services – Aged Care Industry IT Council (ACIITC) – March 2014 )
“Our fragmented health and care system is not meeting the needs of older people, who are most likely to suffer problems with co-ordination of care and delays in transitions between services. This report sets out a framework and tools to help local service leaders improve the care they provide for older people across nine key components.”
John Oldham to lead Labour ‘commission’ on integration – 23 April 2013
“Labour will set up an independent commission to examine how health and social care can be integrated to meet what Ed Miliband claims is the biggest challenge in the history of the NHS.
The Labour leader will highlight the gap between NHS and care demand which is expected in coming years, and current funding.
HSJ revealed in January that shadow health secretary Andy Burnham was developing plans for the vast majority of NHS funding to councils.
Mr Miliband will today claim integration is being damaged by the government’s “free market ideology”.
An Independent Commission on Whole-Person Care will be set up and led by former Department of Health clinical lead for efficiency and productivity Sir John Oldham, who is a GP.
Launching the commission on a visit to Lancashire today, Mr Miliband was expected to say: “The NHS is facing the biggest challenge in its history. The toughest financial pressures for 50 years are colliding with our rising need for care as society gets older and we see more people with chronic illnesses like cancer, diabetes and dementia.”
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Safe, compassionate care for frail older people using an integrated care pathway: Practical guidance for commissioners, providers and nursing, medical and allied health professional leaders – NHS England – February 2014
Safe, compassionate care for frail older people using an integrated care pathway: Practical guidance for commissioners, providers and nursing, medical and allied health professional leaders – NHS England – February 2014
“If frail older people are supported in living independently and understanding their long-term conditions, and educated to manage them effectively, they are less likely to reach crisis, require urgent care support and experience harm.
The practical guidance document summarises the evidence of the effects of an integrated pathway of care for older people and suggests how a pathway can be commissioned effectively using levers and incentives across providers.
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It’s about time: tackling substance misuse in older people revealing the extent to which problems among older people remain hidden – DrugScope – 27 February 2014
Drawing on the results of recent studies and government figures, together with DrugScope’s own consultations with academics and health professionals and site visits to specialist services, the report highlights some disturbing trends:
It has been estimated that 1.4 million people aged over 65 currently exceed recommended drinking limits (1);
Between 2002-2010 – alcohol-related hospital admissions for men aged 65 and over have risen by 136% (2);
For women, the percentage rise over the same period has been 132% (2);
Alcohol-related death rates among those aged 55 and over have risen in the past year (3);
For the 75 plus group alcohol-related deaths are at the highest level since 1991, when records began (3);
These trends partly reflect the health consequences of long-term drug or alcohol use, but significant numbers of older people are also ‘late starters’ using substances to self-medicate physical and psychological problems associated with getting older;
Older people constitute the highest group of those using prescription medicines and over the counter drugs (4);
The population of people in treatment for heroin problems is also aging, and their health is increasingly impaired as problems related to heroin use are compounded by the aging process (5).
The report highlights some welcome and effective specialist service provision for older people with drug and alcohol problems, while calling for improved services and interventions for a group that has not been a focus at national drug and alcohol policy level or for health and social care agencies. It concludes that greater awareness of this issue is the critical first step to providing more effective support, with a need for specialist services that are age-appropriate and improved awareness and support in other care settings, including primary and social care.”
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Healthy Ageing in the 21st Century: the best is yet to come – University of Birmingham Policy Commission – January 2014
“The third Birmingham Policy Commission is exploring how good ageing in a multi-cultural society is defined. It is looking in particular at how good health in later life can be promoted.”
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by Nick Goodwin, Anna Dixon, Geoff Anderson, Walter Wodchis
“Lessons from seven international case studies
Around the world, rapidly ageing populations are resulting in increased demand for health and social care services, which presents significant challenges for national health and care systems. Many have adopted an integrated care approach to meet the needs of older people with chronic or multiple conditions. This approach often involves a single point of entry – designating a care manager to help with assessing needs, sharing information, and co-ordinating care delivery by multiple caregivers (formal and informal).
This report synthesises evidence from seven case studies covering Australia, Canada, the Netherlands, New Zealand, Sweden, the United Kingdom and the United States. It considers similarities and differences of programmes that are successfully delivering integrated care, and identifies lessons for policy-makers and service providers to help them address the challenges ahead.”Read Full Post | Make a Comment ( Comments Off on Providing integrated care for older people with complex needs – King’s Fund – 30 January 2014 )
Identifying best practices for care-dependent elderly by benchmarking costs and outcomes of community care – iBenC – 10 January 2014
“Report D6.1: Review on the structure of community care of the six participating countries and their benchmarking practices Van Eenoo, L.; Declercq, A.; Van der Roest, H.; Van Hout, H. – on behalf of the IBenC consortium
The overall aim of IBenC project is to identify best practices in community care delivery for care dependent community dwelling elderly people by benchmarking the cost-effectiveness of community care delivery systems across Europe. To understand why some organisations and health care systems provide better quality of care than others, studying the micro (client), meso (organisation) and macro (policy) levels is equally important. This report focuses on the macro level of care delivery and reviews and compares the context, regulations and conditions for community care system delivery to care dependent elderly in countries that participate in IBenC (Belgium, Finland, Germany, Iceland, Italy and the Netherlands).”Read Full Post | Make a Comment ( Comments Off on Identifying best practices for care-dependent elderly by benchmarking costs and outcomes of community care – iBenC – 10 January 2014 )
Examining the effectiveness and cost-effectiveness of rehabilitation-care models for frail seniors – McMaster University Health Forum Issue Brief – 30 September 2013
Wilson MG. Rapid Synthesis: Examining the Effectiveness and Cost-Effectiveness of Rehabilitationcare Models for Frail Seniors. Hamilton, Canada: McMaster Health Forum, 30 September 2013.
Extract from the key messages
How effective and cost-effective are different models of physical and occupational rehabilitation for frail seniors?
Why the issue is important
Functional difficulties significantly compromise quality of life and are associated with depression, increased frailty, long-term care home (LTCH) placement, and mortality.
Rehabilitation services to improve functional abilities are generally understood to be essential components of the bundle of services that should be made available to seniors to help them live in their own homes for as long as possible.
It has been recommended that Ontario adopt an ‘assess and restore’ approach to the care of all seniors that emphasizes timely access to rehabilitation and other ‘restorative care’ services as a means of avoiding or delaying LTCH placement, emergency department visits, and admissions to hospital.
What we found”
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New Zealand Framework for Dementia Care – NZ Ministry of Health – 21 November 2013Read Full Post | Make a Comment ( Comments Off on New Zealand Framework for Dementia Care – NZ Ministry of Health – 21 November 2013 )
“This report sets out what is known about dementia care, support and research. It highlights where improvements are being made and where progress can be seen – it also shows where improvements are needed, including where better data is necessary.
It assesses the scale of the challenge of dementia and also looks at:
living with dementia
dementia education and training
dementia friendly communities
The report supports an interactive map where people can see data about dementia care in their area and across the country.”Read Full Post | Make a Comment ( Comments Off on Dementia: A state of the nation report on dementia care and support in England – 29 November 2013 )
G8 Dementia Summit Declaration – 11 December 2013
We, the G8 Health Ministers, met at the G8 Dementia Summit in London on 11 December 2013 to discuss how to shape an effective international response to dementia.
We acknowledge the on-going work occurring in our countries and globally to identify dementia as a major disease burden and to address issues related to ageing and mental health, including the World Health Organisation’s 2012 report, Dementia – A Public Health Priority. Building upon the significant research collaborations that exist between our countries and our multilateral partners will strengthen our efforts and allow us to better meet the challenges that dementia presents society.
We recognise that dementia is not a normal part of ageing. It is a condition that impairs the cognitive brain functions of memory, language, perception and thought and which interferes significantly with the ability to maintain the activities of daily living. We also acknowledge that dementia affects more than 35 million people worldwide, a number that is expected to almost double every 20 years.
We note the socio-economic impact of dementia globally. Seventy per cent of the estimated annual world-wide cost of US$604 billion is spent on informal, social and direct medical care. Yet nearly 60 per cent of people with dementia live in low and middle income countries so the economic challenge will intensify as life expectancy increases across the globe. These costs are expected to increase significantly if therapies to prevent dementia and improve care and treatment are not developed and implemented. We recognise the need to strengthen efforts to stimulate and harness innovation and to catalyse investment at the global level.
Therefore, and in accordance with national, sub-national and local responsibilities, we commit ourselves to:”
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Polypharmacy and medicines optimisation: Making it safe and sound – The King’s Fund – 28 November 2013
“Polypharmacy – the concurrent use of multiple medications by one individual – is an increasingly common phenomenon that demands attention at clinical policy and practice level. Driven by the growth of an ageing population and the rising prevalence of multi-morbidity, polypharmacy has previously been considered something to avoid. It is now recognised as having both positive and negative potential, depending on how medicines and care are managed.
This report proposes a pragmatic approach, offering the terms ‘appropriate’ and ‘problematic’ polypharmacy to help define when polypharmacy can be beneficial. Drawing on literature from predominantly Western countries, the report traces the occurrence of polypharmacy in primary and secondary care, and in care homes. It explores systems for managing polypharmacy and considers it in the context of multi-morbidity and older people, offering recommendations for improving care in both cases.”
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Caring for an ageing population: points to consider from reform in Japan – Nuffield Trust – 27 November 2013
Changing demography and the rising prevalence of long-term conditions has meant that finding a sustainable and fair model of funding social care for our growing older population is a matter of significant policy attention in England.
Japan has the oldest population in the world with 23 per cent of its population aged over 65; this is set to rise to 40 per cent by 2050. In order to address the shortage of social care, to ease burdens on informal carers and to relieve pressure on health services, a new insurance system for long-term care was introduced in Japan in 2000.”
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An Ageing Australia: Preparing for the Future – Productivity Commission – 22 November 2013
“The report focuses on the effects of ageing on economic output (underpinned by changes in population, participation and productivity) and the resulting implications for government budgets were current policy settings to be maintained. In that context, it will help inform the forthcoming Intergenerational Report (IGR).”Read Full Post | Make a Comment ( Comments Off on An Ageing Australia: Preparing for the Future – Productivity Commission – 22 November 2013 )
Elder Abuse and Its Prevention is the summary of a workshop convened in April 2013 by the Institute of Medicine’s Forum on Global Violence Prevention. Using an ecological framework, this workshop explored the burden of elder abuse around the world, focusing on its impacts on individuals, families, communities, and societies. Additionally, the workshop addressed occurrences and co-occurrences of different types of abuse, including physical, sexual, emotional, and financial, as well as neglect. The ultimate objective was to illuminate promising global and multisectoral evidence-based approaches to the prevention of elder maltreatment. While the workshop covered scope and prevalence and unique characteristics of abuse, the intention was to move beyond what is known about elder abuse to foster discussions about how to improve prevention, intervention, and mitigation of the victims’ needs, particularly through collaborative efforts. The workshop discussions included innovative intervention models and opportunities for prevention across sectors and settings.
Violence and related forms of abuse against elders is a global public health and human rights problem with far-reaching consequences, resulting in increased death, disability, and exploitation with collateral effects on well-being. Data suggest that at least 10 percent of elders in the United States are victims of elder maltreatment every year. In low- and middle-income countries, where the burden of violence is the greatest, the figure is likely even higher. In addition, elders experiencing risk factors such as diminishing cognitive function, caregiver dependence, and social isolation are more vulnerable to maltreatment and underreporting. As the world population of adults aged 65 and older continues to grow, the implications of elder maltreatment for health care, social welfare, justice, and financial systems are great. However, despite the magnitude of global elder maltreatment, it has been an underappreciated public health problem. Elder Abuse and Its Prevention discusses the prevalence and characteristics of elder abuse around the world, risk factors for abuse and potential adverse health outcomes, and contextually specific factors, such as culture and the role of the community.”Read Full Post | Make a Comment ( Comments Off on Elder Abuse and Its Prevention: Workshop Summary – Institute of Medicine – 2013 )
Dementia self-assessment framework – Department of Health [England] – 16 October 2013
“The self-assessment framework was created by nurses and care staff to compare current dementia care with the best practice criteria.”
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“To provide for the future care needs of today’s and tomorrow’s seniors, Canada must invest its increasingly scarce health dollars in the right type and mix of services. This Conference Board of Canada primer provides an overview of the landscape of care and services outside of hospitals that support aging Canadians, along with a discussion of why it is important to look toward the future of care for Canadian seniors. Future Care for Canadian Seniors provides information on the numbers and life expectancy of the over-55 population between 2013 and 2030, as well as their health conditions and medical requirements, living arrangements, and out-of-institution support systems, including hospice or home-based palliative care. This briefing is part of the Conference Board’s Future Care for Canadian Seniors research series.”Read Full Post | Make a Comment ( Comments Off on Future Care for Canadian Seniors: Why it Matters – The Conference Board of Canada – October 2013 )
Movement between hospital and residential aged care 2008-09 – AIHW – 20 September 2013
“This report examines movements between hospital and residential aged care by people aged 65 and over in 2008-09. Overall, almost 10% of 1.1 million hospitalisations for older people were for people already living in residential aged care. A further 3% of hospitalisations for older people ended with the patient being newly admitted into residential care. This report also describes the characteristics of people moving between the two sectors, and short-term outcomes for people going into residential care.”
ISSN 1833-1238; ISBN 978-1-74249-490-6; Cat. no. CSI 16; 232ppRead Full Post | Make a Comment ( Comments Off on Movement between hospital and residential aged care 2008-09 – AIHW – 20 September 2013 )
Assisted Living Innovation Platform – The Long Term Care Revolution [UK] – September 2013
“The Long Term Care Revolution (pdf – 877Kb)
This impressive report by Anthea Tinker, Leonie Kellaher, Jay Ginn and Eloi Ribe at the Institute of Gerontology, King’s College London, comprehensively outlines the case for a revolution in long term care and captures some of the supporting material that has aided the development of the TSB’s Assisted Living Innovation Platform’s, ‘Long Term Care Revolution’ programme. It sets out a vision for an alternative to institutional care, drawing on substantial evidence about the views of older people and their carers in the UK, lessons from abroad, the implications for industry/providers and makes recommendations to government and industry leaders on key factors for revolutionizing long term care for older people, including mainstream and specialist living environments.
This accompanying study for the TSB’s Assisted Living Innovation Platform was also carried out by researchers at the Institute of Gerontology King’s College London, to see what can be learned from the experience of the Netherlands about long term care in order to inform policy, research and opportunities for business in the UK. The comprehensive analysis of the two countries showcases examples of innovation and best practice in adult social care provision in a country similar to the UK in many ways. Of particular interest is that while the two countries are very similar in demographic profile and the experiences of the older generation, it is notable that according to official statistics older individuals remain disability-free for nearly half a decade longer in the Netherlands than in the UK.”Read Full Post | Make a Comment ( Comments Off on Assisted Living Innovation Platform – The Long Term Care Revolution [UK] – September 2013 )
Staff, patients and families experiences of giving and receiving care during an episode of delirium in an acute hospital care setting – Healthcare Improvement Scotland – September 2013
A Report by Professor Belinda Dewar, University of West of Scotland, Penny Bond, Michelle Miller and Karen Goudie, Healthcare Improvement Scotland
“This report provides details of a project undertaken to explore staff, patients’ and families’ experience of episodes of delirium in an acute hospital setting. The Improving Care for Older People in Acute Care workstream has been working with colleagues from the Scottish Delirium Association and others to design, develop and test a delirium bundle to support staff with the early identification and management of delirium in caring for older people in the acute care setting. As part of this development, the project team was keen to explore what it felt like to both give and receive care during an episode of delirium to:
enhance our learning about caring for patients and family during an episode of delirium
help us to improve communication, and
contribute to the development of a guidance document for the delirium bundle.”
“In order for dementia-friendly communities to succeed, the views and opinions of people with dementia and their carers must be at the heart of any considerations or decisions. Building dementia-friendly communities: A priority for everyone provides evidence of dementia-friendly communities from the perspective of people affected by dementia. It explores the barriers that people face in their community, how they would like to be engaged in their local area and the support they need to empower them to do so. Overall, the report aims to provide guidance to areas that are looking to become dementia-friendly and to provide extra evidence for those already committed to becoming dementia-friendly. New and existing evidence from people with dementia and their carers is collated alongside examples of projects that are making a difference for people with dementia.”Read Full Post | Make a Comment ( Comments Off on Building dementia-friendly communities: A priority for everyone – Alzheimer’s Society [UK] – 2013 )
Older people with high support needs in housing with care – JRF Joseph Rowntree Foundation [UK] – 21 May 2013
“Housing with care (HWC) offers a promising model for improving the quality of life of older people with high support needs, but also poses challenges. This Round-up covers key messages and practice examples from JRF studies into three aspects of HWC: promoting supportive and positive relationships; boundaries of roles and responsibilities; and affordability, choices and quality of life. It found that:”
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Evaluation of the first year of the Inner North West London Integrated Care Pilot – Nuffield Trust – 17 May 2013
“This report outlines the findings of our evaluation of the Inner North West London Integrated Care Pilot, which aimed to develop new forms of care for older people and those with diabetes.”Read Full Post | Make a Comment ( Comments Off on Evaluation of the first year of the Inner North West London Integrated Care Pilot – Nuffield Trust – 17 May 2013 )
There are around 800,000 people with dementia in the UK, and the disease costs the economy £23 billion a year. By 2040, the number of people affected is expected to double – and the costs are likely to treble.”
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The desire to age in place among older Australians volume 1 – reasons for staying or moving – AIHW – 17 April 2013
“Many older Australians report a desire to age in place. This bulletin explores the relationship between this desire and the housing circumstances of older Australians of different tenure types; that is, those who own their home outright, those paying a mortgage and those who rent their home either privately or through social housing.”
ISSN 1446-9820; ISBN 978-1-74249-417-3; Cat. no. AUS 169; 20pp.Read Full Post | Make a Comment ( Comments Off on The desire to age in place among older Australians volume 1 – reasons for staying or moving – AIHW – 17 April 2013 )
Dementia 2013: The hidden voice of loneliness – Alzheimer’s Society [UK] – 9 April 2013
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“his report is the sixth in a series on hospitalisations due to falls by Australians aged 65 and over, and focuses on 2009-10. The estimated number of hospitalised injury cases due to falls in older people was 83,800 – more than 5,100 extra cases than in 2008-09 – and about 70% of these falls happened in either the home or an aged care facility. One in every 10 days spent in hospital by a person aged 65 and older in 2009-10 was directly attributable to an injurious fall (1.3 million patient days over the year), and the average total length of stay per fall injury case was estimated to be 15.5 days.”
ISSN 1444-3791; ISBN 978-1-74249-414-2; Cat. no. INJCAT 146; 73ppRead Full Post | Make a Comment ( Comments Off on Hospitalisations due to falls by older people, Australia 2009-10 – AIHW – 4 April 2013 )
Adverse Drug Reaction-Related Hospitalizations Among Seniors, 2006 to 2011- Canadian Institute for Health Information (CIHI) – 26 March 2013
This analysis examines hospital discharge data for seniors in all Canadian provinces and territories from 2006-2007 to 2010-2011 to provide an overview of the prevalence of hospitalizations related to adverse drug reactions ADRs. The relationship between various potential risk factors and the likelihood of being hospitalized for an ADR were examined for Alberta, Manitoba and P.E.I.Read Full Post | Make a Comment ( Comments Off on Adverse Drug Reaction-Related Hospitalizations Among Seniors, 2006 to 2011- Canadian Institute for Health Information (CIHI) – 26 March 2013 )
Dementia: scoping the role of the dementia nurse specialist in acute care – Royal College of Nursing – 25 March 2013
“The Royal College of Nursing and the University of Southampton have published a new report that calls for greater support, funding and training for specialist dementia nurses.
The report Scoping the Role of Dementia Nurse Specialists in Acute Care highlights the significant contribution dementia nurse specialists could make in hospital settings.
Research has found that if dementia specialist nurses were properly funded and trained, they could reduce hospital stays for older people by one day on average, saving almost £11,000,000 a year.
The report recommends that there should be at least one whole-time dementia specialist nurse for every 300 hospital admissions for people with dementia.”
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Making integrated care happen at scale and pace: Lessons from experience – King’s Fund – 21 March 2013
“The current fragmented services in health and social care fail to meet the needs of the population. A shift to an approach that develops integrated models of care for patients, especially older people and those with long-term conditions, can improve the patient experience and the outcomes and efficiency of care.
Making integrated care happen at scale and pace: Lessons from experience is intended to support the process of converting policy intentions into meaningful and widespread change on the ground. The authors summarise 16 steps that need to be taken to make integrated care a reality and draw on work by The King’s Fund and others to provide examples of good practice.
There are no universal solutions or approaches to integrated care that will work everywhere and there is also no ‘best way’ of integrating care, and the authors emphasise the importance of discovery rather than design and of sharing examples of good practice when developing policy and practice.
Finally, the paper acknowledges that changes are needed to national policy and to the regulatory and financial frameworks for local leaders to fully realise a vision of integration.”Read Full Post | Make a Comment ( Comments Off on Making integrated care happen at scale and pace: Lessons from experience – King’s Fund – 21 March 2013 )
Ready for ageing? – [UK] report from the House of Lords Select Committee on Public Service and Demographic Change – March 2013
“The report from the House of Lords Committee on Public Service and Demographic Change warns that the Government and our society are woefully underprepared for ageing. The Committee says that longer lives can be a great benefit, but there has been a collective failure to address the implications and without urgent action this great boon could turn into a series of miserable crises.
The report covers a broad range of policy areas, providing a comprehensive analysis of the potential impact of an ageing population on public services.”
… continues on the site
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Dementia care in hospitals: costs and strategies – AIHW – 14 March 2013
“This report estimates the cost of caring for people with dementia in New South Wales hospitals, and presents strategies and practices being implemented in Australia and internationally that might improve outcomes for people with dementia and reduce care costs. The average cost of hospital care for people with dementia was generally higher than for people without dementia ($7,720 compared with $5,010 per episode). The total cost of hospital care for these patients was estimated to be $462.9 million, of which around $162.5 million may be associated with dementia.”
ISBN 978-1-74249-406-7; Cat. no. AGE 72; 109pp.Read Full Post | Make a Comment ( Comments Off on Dementia care in hospitals: costs and strategies – AIHW – 14 March 2013 )
Improving Later Life: Understanding the oldest old – Age UK – 11 March 2013
“People aged over 85 are the fastest growing age-group in our population. What was formerly a small group of exceptional individuals is rapidly becoming a whole new generation. Our longevity is to be celebrated, but we are concerned that people making key decisions concerning the welfare needs of those aged over 85 know relatively little about what is unique, or indeed not unique, about this group.”Read Full Post | Make a Comment ( Comments Off on Improving Later Life: Understanding the oldest old – Age UK – 11 March 2013 )
“With life expectancies increasing by five hours a day and Baby Boomers entering their later years, our assumptions about ageing and who is ‘old’ are fundamentally challenged. Moving beyond chronology as a way of understanding age will be a key shift as we move to an older society. And we need to innovate to enable us to adapt to an ageing population, including recreating our social institutions and creating ways for people to help one another to harness the opportunities of an ageing society and enable all of us to age better.”Read Full Post | Make a Comment ( Comments Off on 5 Hours a day: systemic innovation for an ageing population – Nesta – February 2013 )
2012 National Aged Care Workforce Census and Survey – The Aged Care Workforce, 2012 – Final Report – February 2013
“The Aged Care Workforce Census and Survey informs workforce planning on issues surrounding the recruitment and retention, training and education, carer development and employment conditions of the aged care workforce. It provides a comprehensive profile of the aged care workforce which spans almost a decade.
The 2012 report incorporates data from Departmental funded census and surveys conducted in 2003 (residential aged care) and 2007 (residential and community aged care).
The results of the 2012 Census and Survey are outlined in the 2012 National Aged Care Workforce Census and Survey – The Aged Care Workforce, 2012 – Final Report.”
Print ISBN: 978-1-74241-873-5
Online ISBN: 978-1-74241-874-2
Publications approval number: D1010
Home care across Europe. Current structure and future challenges – European Observatory on Health Systems and Policies – 2012
Edited by Nadine Genet, Wienke Boerma, Madelon Kroneman, Allen Hutchinson and Richard Saltman
Observatory Studies Series 27
2012, xiii + 145 pages
ISBN 978 92 890 0288 2
“For every person over the age of 65 in today’s European Union, there are four people of working age but, by 2050, there will only be two. Demand for long-term care, of which home care forms a significant part, will inevitably increase in the decades to come.
Despite the importance of the issue, however, up-to-date and comparative information on home care in Europe is lacking. This book attempts to fill some of that gap by examining current European policy on home care services and strategies.
Home care across Europe probes a wide range of topics including the links between social services and health-care systems, the prevailing funding mechanisms, how service providers are paid, the impact of governmental regulation, and the complex roles played by informal caregivers. Drawing on a set of Europe-wide case studies (available in a second, online volume), the study provides comparable descriptive information on many aspects of the organization, financing and provision of home care across the continent. It is a text that will help frame the coming debate about how best to serve elderly citizens as European populations age.”Read Full Post | Make a Comment ( Comments Off on Home care across Europe. Current structure and future challenges – European Observatory on Health Systems and Policies – 2012 )
Global Risks 2013 – Eighth Edition – World Economic Forum – January 2013
Includes a section on – The Dangers of Hubris on Human Health
“Health is a critical system that is constantly being challenged, be it by emerging pandemics or chronic illnesses. Scientific discoveries and emerging technologies allow us to face such challenges, but the medical successes of the past century may also be creating a false sense of security. Arguably, one of the most effective and common means to protect human life – the use of antibacterial and antimicrobial compounds (antibiotics) – may no longer be readily available in the near future. Every dose of antibiotics creates selective evolutionary pressures, as some bacteria survive to pass on the genetic mutations that enabled them to do so. Until now, new antibiotics have been developed to replace older, increasingly ineffective ones. However, human innovation may no longer be outpacing bacterial mutation. None of the new drugs currently in the development pipeline may be effective against certain new mutations of killer bacteria that could turn into a pandemic. Are there ways to stimulate the development of new antibiotics as well as align incentives to prevent their overuse, or are we in danger of returning to a pre-antibiotic era in which a scratch could be potentially fatal?”
and on the Costs of Living Longer
“We are getting better at keeping people alive for longer. Are we setting up a future society struggling to cope with a mass of arthritic, demented and, above all, expensive, elderly who are in need of long term care and palliative solutions?”
Widening choices for older people with high support needs – Joseph Rowntree Foundation – 15 January 2013
“Older people with high support needs want greater choice and control over their lives and a wider range of options.
This study identifies the benefits and potential of options based on mutuality (people supporting each other) and / or reciprocity (people contributing to individual and group well-being).
The study found that:
■Spending time identifying and understanding existing local models and arrangements will help commissioners widen their range of options;
■Adapting ways of working from other countries, e.g. Denmark, could stimulate further development in the UK;
■Planning, contracting and procurement rules need to be revised to stimulate the development of different models and ensure smaller-scale, relationship-based services are not damaged; and
■Communicating the range and benefits of different models to older people, their families, the wider public and frontline staff will raise awareness, increase take up, and drive local developments.”
Senior cohousing communities – an alternative approach for the UK? – Joseph Rowntree Foundation – 15 January 2013
“Is cohousing an option for older people?
This paper outlines the benefits of cohousing for older people. It draws on successful cohousing examples from Germany, Denmark and The Netherlands, and outlines the growing movement in the USA.
There aren’t yet any successful examples of cohousing in the UK, and this paper outlines its potential at a time when the typical housing ‘menu’ available to older people is still very limited. Support often amounts to domiciliary care (until needs become too intensive), followed by sheltered/extra care housing (if available locally) and/or a place in a care home.”
Preparing to grow old together – Joseph Rowntree Foundation – 15 January 2013
“How can housing co-operatives best support their older residents?
“This Viewpoint details Brixton Housing Co-op’s (BHC’s) experiences of working together to improve member’s chances of staying out of residential care, counteract loneliness in later life and improve support.
■The most significant action BHC members took was to begin talking with others about the issue of ageing and how they might help themselves.
■It is important to recognise that it is not being older that is a problem but being older in our current society; and that we can work together to make positive changes.
■We all have something to give, and we all need support of one sort or another.
This Viewpoint comes at a time when the typical housing ‘menu’ available to older people is still very limited. Support often amounts to domiciliary care (until needs become too intensive), followed by sheltered/extra care housing (if available locally) and/or a place in a care home.”
Developing supportive design for people with dementia – King’s Fund – 9 January 2013
The King’s Fund’s Enhancing the Healing Environment Programme 2009-2012
“Developing Supportive Design for People with Dementia is the latest publication from the EHE programme. It marks the completion of 26 schemes in 23 NHS acute, community and mental health hospitals in England to improve the environment of care for people with dementia.
The Environments of Care for People with Dementia programme was funded by the Department of Health as part of work to support the implementation of the National Dementia Strategy in England. There was tight competition for the available places, and projects were chosen for their ability to reflect the care pathway from diagnosis to end-of-life care.
This publication seeks to provide practical, value-for-money examples to encourage and inspire staff and their organisations to provide an environment of care that better supports people with dementia. As well as case studies with before and after photographs from participating sites, Developing Supportive Design for People with Dementia includes information about the development and evaluation of the EHE assessment tool; overarching design principles for creating a more supportive environment for people with dementia; and a project directory detailing the artists and designers involved in each scheme along with costs involved.”Read Full Post | Make a Comment ( Comments Off on Developing supportive design for people with dementia – King’s Fund – 9 January 2013 )
Delivering Dilnot: paying for elderly care – Centre Forum – 3 January 2013
Edited by Paul Burstow
“The recommendations of the Dilnot Commission on Funding of Care and Support have won widespread support from the sector and across the political spectrum. Demographic changes over the coming decades mean that reform can no longer be postponed. The question now is whether the government can find the resolve – and the funding – to deliver practical reform that works for Britain.
‘Delivering Dilnot: paying for elderly care includes pieces from a wide range of contributors, from Paul Burstow MP – former Care Services Minister under the Coalition – and Lord Sutherland – former chair of the Royal Commission on Long Term Care under Labour – to a carer and a pensioner who face our current broken system.
It emphasises that tough political deceisions must be made to deliver reform, and proposes how it can be funded a way that is fair and sustainable. The report also looks at what the private sector needs in order to deliver the necessary insurance products.
Together, these contributions make the case for Dilnot’s proposals, and show how they can be realised without further delay.”Read Full Post | Make a Comment ( Comments Off on Delivering Dilnot: paying for elderly care – Centre Forum – 3 January 2013 )
Improving decision-making in the care and support of older people – Joseph Rowntree Foundation – 5 December 2012Read Full Post | Make a Comment ( Comments Off on Improving decision-making in the care and support of older people – Joseph Rowntree Foundation – 5 December 2012 )
The cost of our ageing society – International Longevity Centre UK – 10 December 2012
“Governments must do more to reduce the long term cost of ageing to the public purse argues a new policy report from the International Longevity Centre – UK (ILC-UK).
“The cost of our ageing society”, sponsored by Milliman, highlights the projected financial impact of the cost of the world’s ageing population.
In the report, ILC-UK calls on governments across the world to consider linking eligibility ages of state pension to life expectancy and do more to ensure that the labour market is accessible to older people.
ILC-UK also argues that governments need to ensure pension systems are sustainable, allow for greater risk-sharing, and are less vulnerable to longevity risk. It also urges governments across the world to consider how to create better conditions for health care innovation and development.”
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A Future State of Mind: Facing up to the dementia challenge – Social Market Foundation – 13 December 2012
ISBN Number: 1-904899-80-3 Nida Broughton, Nigel Keohane and Ryan Shorthouse
“The number of people with dementia is set to rise over the coming years as the UK’s population ages, bringing considerable emotional and financial implications. The Prime Minister has described it as “a national crisis”. Increasing the number of people who are diagnosed early will reap significant benefits for individuals, families and government.
Currently however, the UK has a poor diagnosis rate, with only 41% of people with dementia estimated to be diagnosed. This report draws on in-depth interviews with people with Alzheimer’s and their carers and a wealth of research to identify the barriers to early diagnosis, from a patient and professional perspective. New policies are proposed to better incentivise the health system to diagnose dementia earlier.”Read Full Post | Make a Comment ( Comments Off on A Future State of Mind: Facing up to the dementia challenge – Social Market Foundation – 13 December 2012 )
Where Will I Live as I Age? Senior Australians’ Needs and Concerns about Future Housing and Living Arrangements – National Seniors Australia and Group Homes Australia – December 2012
“National Seniors Australia is pleased to announce the release of a new research report, conducted with Group Homes Australia, examining the needs and concerns of senior Australians regarding their future housing and living arrangements.
The report analyses respondents’ planning for future living arrangements as they age, their thoughts about higher care needs, and concerns about the affordability of any alterations they may need to make to their family home as well as residential care costs. This report sheds light on key issues that need to be considered in planning for the living arrangements of senior Australians in future decades.”
The Disconnect Between the Advance Care Planning Needs of the Healthcare System and the Needs of Patients – GeriPal – 11 December 2012
“In the spirit of patient empowerment, we have created a website called PREPARE that may address some gaps that currently available advance care planning materials do not fill. For instance, PREPARE is designed to empower people, through video demonstration, HOW to identify their values, how to communicate their values, how to asks physicians questions, and how to make informed medical decisions that are aligned with their values and beliefs. PREPARE is designed to be completed outside of the medical environment, is written at a 5th-grade reading level, includes videos that model behavior, helps people engage in a step-by-step process of advance care planning, and will be made available for free.
PREPARE will launch January 4th, 2013.”Read Full Post | Make a Comment ( Comments Off on The Disconnect Between the Advance Care Planning Needs of the Healthcare System and the Needs of Patients – GeriPal – 11 December 2012 )
Older people leaving hospital: a statistical overview of the Transition Care Program 2009-10 and 2010-11 – AIHW – 7 December 2012
“Older people leaving hospital: a statistical overview of the transition care program 2009-10 and 2010-11 presents key statistics about transition care services provided to older people directly after discharge from hospital. The Transition Care Program aims to improve recipients’ independence and functioning, and has assisted nearly 52,000 people since it started in 2005-06, including 18,000 individuals who received just under 20,300 episodes of transition care in 2010-11. The report includes for the first time an analysis of trends since the program’s establishment, and an examination of the final outcomes of people receiving consecutive episodes of care.”
ISSN 1329-5705; ISBN 978-1-74249-384-8; Cat. no. AGE 71; 72ppRead Full Post | Make a Comment ( Comments Off on Older people leaving hospital: a statistical overview of the Transition Care Program 2009-10 and 2010-11 – AIHW – 7 December 2012 )
Seniors and Alternate Level of Care: Building on our Knowledge Core – Canadian Institute for Health Information – 29 November 2012
This study provides an in-depth look at transitions from acute care to the community. It showcases three Canadian Institute for Health Information (CIHI) data holdings that inform health system planning about the care needs of elderly Canadians who wait in hospitals for placement in the community. These individuals no longer require acute care services but wait in acute care beds for placement in a more appropriate setting such as home or residential care. This population, referred to as “alternate level of care (ALC),” is expected to grow substantially as the Canadian population ages. Evidence suggests that seniors in acute care awaiting discharge may experience decline in their overall health and well-being.”
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Modelling the impact of interventions to delay the onset of dementia in Australia – prepared by the Dementia Collaborative Research Centre: Assessment and Better Care at UNSW – 20 November 2012
“A new report commissioned by Alzheimer’s Australia forecasts that three million Australians will develop dementia between 2012 and 2050.
The report, Modelling the impact of interventions to delay the onset of dementia in Australia, was prepared by the Dementia Collaborative Research Centre – Assessment and Better Care at the University of New South Wales. Centre Director, Scientia Professor Henry Brodaty, said that the new statistics provide even more evidence that Australia must invest in dementia research now.”
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AHRQ = US Agency for Healthcare Research and Quality
“The Long-Term Care version of TeamSTEPPS adapts the core concepts of the TeamSTEPPS program to reflect the environment of nursing homes and other other long-term care settings such as assisted living and continuing care retirement communities. The examples, discussions, and exercises below are tailored to the long-term care environment.”Read Full Post | Make a Comment ( Comments Off on TeamSTEPPS® Long-Term Care Version – AHRQ – 2012 )
Comparison of Characteristics of Nursing Homes and Other Residential Long-Term Care Settings for People With Dementia – AHRQ – October 2012
Agency for Healthcare Research and Quality [US]
Objectives. To compare characteristics and related outcomes of nursing homes (NHs) and other residential long-term care settings for people with dementia so as to reduce uncertainty when choosing a setting of care for someone with dementia.
Data Sources. We searched MEDLINE®, Embase®, the Cochrane Library, the Cumulative Index to Nursing and Allied Health Literature (CINAHL®), AgeLine®, and PsycINFO® from 1990 through March 23, 2012. We identified additional studies from reference lists and experts.
Review methods. Two people independently selected, abstracted data from, and rated the quality of relevant studies. Given that quantitative analyses were inappropriate because of clinical heterogeneity, insufficient numbers of similar studies, or insufficient or variation in outcome reporting, we synthesized the data qualitatively. Two reviewers graded the strength of evidence (SOE) using established criteria.
Results. We identified 14 studies meeting our inclusion criteria. Generally, studies examined characteristics, structures, and process of care for populations with mild to severe dementia. Ten studies addressed health outcomes (Key Question [KQ] 1), and 10 examined psychosocial outcomes (KQ 2) for people with dementia. No eligible studies examined health or psychosocial outcomes for informal caregivers (KQ 3 and KQ 4, respectively). The studies included four prospective cohort studies, nine randomized controlled trials (RCTs), and one non-RCT. Two studies showed that the use of pleasant sensory stimulation reduces agitation. We found limited evidence on a number of interventions, including protocols for individualized care to reduce pain/discomfort and agitation/aggression and functional skill training to improve function. We found largely no differences across outcomes including function, cognition, depressive symptoms, pain, morbidity, behavioral symptoms, engagement, and quality of life based on residence in an NH or residential care/assisted living (RC/AL), other than increased hospitalization for people with mild dementia in RC/AL compared with NHs and increased restraint use in NHs compared with RC/AL for imminently dying residents.
Conclusions. Overall, we found low or insufficient SOE regarding the effect of organizational characteristics, structures, and processes of care on health and psychosocial outcomes for people with dementia and no evidence for informal caregivers. Findings of moderate SOE indicate that pleasant sensory stimulation reduces agitation. Also, although the SOE is low, protocols for individualized care and to improve function result in better outcomes. Finally, outcomes do not differ between NHs and RC/AL except when medical care is indicated. Additional research is needed to develop a sufficient evidence base to support decisionmaking.”
Zimmerman S, Anderson W, Brode S, Jonas D, Lux L, Beeber A, Watson L, Viswanathan M, Lohr K, Middleton JC, Jackson L, Sloane P. Comparison of Characteristics of Nursing Homes and Other Residential Long-Term Care Settings for People With Dementia. Comparative Effectiveness Review No. 79. (Prepared by the RTI International–University of North Carolina Evidence-based Practice Center under Contract No. 290-2007-10056-I.) AHRQ Publication No. 12(13)-EHC127-EF. Rockville, MD: Agency for Healthcare Research and Quality; October 2012.Read Full Post | Make a Comment ( Comments Off on Comparison of Characteristics of Nursing Homes and Other Residential Long-Term Care Settings for People With Dementia – AHRQ – October 2012 )
Long-Term Care for the Elderly: Challenges and Policy Options – C.D. Howe Institute [Canada] – November 2012
Long-Term Care for the Elderly: Challenges and Policy Options – C.D. Howe Institute [Canada] – November 2012
“Policy reforms in long-term care will require methods to contain costs, to fairly divide these costs between care recipients and taxpayers, and to get more value for money in a sector that will feature prominently in future health policy debates.”
issn 0824-8001 (print);
issn 1703-0765 (online)
My home life: promoting quality of life in care homes – Joseph Rowntree Foundation – 25 October 2012
“What’s needed to promote quality of life in care homes?
A new report from JRF outlines the findings from the My Home Life project. My Home Life is a collaborative initiative between Age UK, City University, the Joseph Rowntree Foundation and Dementia UK promoting quality of life in care homes.
This study found:
- positive relationships in care homes enable staff to listen to older people, gain insights into individual needs and facilitate greater voice, choice and control;
- relationship-centred care is at the heart of many examples of best practice;
- care home managers play a pivotal role in promoting relationships between older people, staff and relatives;
- care home providers and statutory agencies should consider how their attitudes, practices and policies can create pressure and unnecessary paperwork which ultimately reduce the capacity of care homes to respond to the needs of older people; and
- negative stereotypes of care homes have an impact on the confidence of staff and managers.”
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A stronger collective voice for people with dementia – Joseph Rowntree Foundation JRF – 24 October 2012
“Can groups provide a stronger collective voice for people with dementia?
A growing number of people with dementia in the UK are becoming actively involved in groups to try to influence services and policies affecting people with dementia. The Dementia Engagement & Empowerment Project (DEEP) was a one-year investigation aiming to highlight groups and projects involving people with dementia. The report offers specific ways forward for organisations wishing to engage with people with dementia. This report found that:
- There are only a small number of groups led by, or actively involving, people with dementia that are influencing services and policies.
- ‘Influencing’ work includes national lobbying and meeting with government officials, local lobbying of services, media work, training and education, participating in advisory groups, awareness-raising, and speaking at events.
- Most groups undertook influencing work alongside peer support and social activities, and were local and relatively informal.
“The Menzies-Nous Australian Health Survey 2012 provides key findings about the views held by Australians on their own health, on the Australian health care system and on aged-care services. The 2012 survey is the third biennial national survey conducted by the Menzies Centre for Health Policy and Nous Group (Nous). Previous surveys were conducted in 2008 and 2010.
The Australian Health Survey 2012 was conducted via a phone interview of 1200 people in July 2012. To enable analysis of trends since 2008, a number of questions regarding the health of Australians and use of the health care system were consistently asked in 2008, 2010 and 2012. A number of questions were also asked for the first time this year – particularly those regarding Australian perspectives on aged-care reforms.”
Australians willing to cough up for better health – ABC report – 23 October 2012Read Full Post | Make a Comment ( Comments Off on The Menzies-Nous Australian Health Survey 2012 )
The Impact of Demographic Change on Public Services – International Longevity Centre UK – 10 October 2012
” ILC-UK has published evidence given to the new House of Lords Committee on Public Service and Demographic Change.
The Committee will consider how the ageing population will affect public services and the relationship between people and the state. The Office of Budget Responsibility has said that if current policies go on unchanged demographic change will make the costs of public services unsustainable.
Within our response, ILC-UK argue that:
- Our society should seek to become “age neutral”. Age is a poor proxy for, for example, ability, experience, skills, knowledge, and wealth, and yet policies in the private, public and voluntary sector are far too often based on age.
- Older citizens have a responsibility to remain in the labour market longer, where possible, to enable skills retention and minimise the fiscal burdens on taxpayers.
- We are likely to need to invest more in preventative health across the life-course.
- The cost of dementia is likely to play an increasingly important role in influencing public spending.
- The transfer of wealth from young to old, and its consequent inequality, represents a challenge to the contract between generations embodied in various functions and policies of the UK state that rest on the principle of intergenerational solidarity. It is vital that public policy works to protect intergenerational solidarity.”
… continues on the site
Select Committee on Public Service and Demographic Change – ILC blog entry on this – 10 October 2012Read Full Post | Make a Comment ( Comments Off on The Impact of Demographic Change on Public Services – International Longevity Centre UK – 10 October 2012 )
Dementia guide: commitment to the care of people with dementia in hospital settings – Royal College of Nursing – 9 October 2012
“Dementia is a challenge for hospitals. Surveys show that around a quarter of hospital beds are occupied by somebody with dementia; a figure which increases in older people and individuals with a superimposed delirium. This important resource supports the further implementation of the RCN’s five principles for improving the quality of care for people with dementia and enabling the best possible support for their carers. This guide supplements the RCN’s film: Dementia: Commitment to the care of people with dementia in hospital settings.”Read Full Post | Make a Comment ( Comments Off on Dementia guide: commitment to the care of people with dementia in hospital settings – Royal College of Nursing – 9 October 2012 )
ADOPT Toolkit: Helping Organizations Design and Implement Health Technology – Center for Technology and Aging
“The Center for Technology and Aging’s ADOPT Toolkit will help you more quickly and easily design health technology-focused programs and to accelerate diffusion of proven technologies.
The tools on this website build on the Center’s broad research and real-world experience and are designed for organizations committed to using technology to dramatically improve chronic disease management.
Technologies that assist care coordination and improve the independence of older adults cover a very wide spectrum. The ADOPT Toolkit offers tools in four areas: Remote Patient Monitoring, Medication Optimization, Care Transitions, and Mobile Health.
Select a toolkit below and then a specific tool from that area’s page and you will discover practical guides, checklists, lessons learned, and other valuable resources. Tools are further organized into Workstreams that help to simplify the complex steps required to successfully deploy a technology.”Read Full Post | Make a Comment ( Comments Off on ADOPT Toolkit: Helping Organizations Design and Implement Health Technology – Center for Technology and Aging )
Understanding and improving transitions of older people: a user and carer centred approach – NHS National Institute for Health Research – September 2012
Ellins J, Glasby J, Tanner D, McIver S, Davidson D, Littlechild R, Snelling I, Miller R, Hall K, Spence K and the Care Transitions Project co-researchers. Understanding and improving transitions of older people: a user and carer centred approach. Final report. NIHR Service Delivery and Organisation programme; 2012.
Extract from the executive summary
“Older people – especially those with complex and ongoing needs – often move across service boundaries. Poorly planned and coordinated transitions can be detrimental to older people’s health and well-being, and are a source of major disagreement between service commissioners and providers. Despite positive changes following the 2001 National Service Framework for Older People, transition between services is still one of the most problematic areas of policy and practice.”
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Creating a dementia-friendly York – Joseph Rowntree Foundation – 4 October 2012
“What does it take to become a dementia-friendly city?
The York Dementia Without Walls project looked into what’s needed to make York a good place to live for people with dementia and their carers.
Dementia-friendly communities can better support people in the early stages of their illness, maintaining confidence and boosting their ability to manage everyday life. Working with people with dementia, the research team investigated how local resources can be harnessed to this end, provided there is enough awareness.”
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Dementia in Australia – AIHW – 27 September 2012
“In 2011, there were an estimated 298,000 people with dementia. This number is expected to increase markedly over time, with projections suggesting it will reach around 400,000 by 2020 and 900,000 by 2050. Dementia is a leading cause of death, accounting for 6% of all deaths in 2010. Total direct health and aged care services expenditure on people with dementia was at least $4.9 billion in 2009-10.”
ISBN 978-1-74249-349-7; Cat. no. AGE 70; 280pp.Read Full Post | Make a Comment ( Comments Off on Dementia in Australia – AIHW – 27 September 2012 )
Aged care packages in the community 2010-11: a statistical overview – AIHW – 19 September 2012
“Aged care packages in the community 2010 -11 describes the key characteristics of services and recipients and also looks at the distribution of services relative to the needs of the population. At 30 June 2011, there were 50, 900 recipients of care packages. About 1,200 providers delivered low-care packages, 500 delivered high-care packages and 340 providers delivered high-care specialised dementia packages.”
ISSN 1329-5705; ISBN 978-1-74249-344-2; Cat. no. AGE 69; 82pp
Residential aged care in Australia 2010-11: a statistical overview – AIHW – 19 September 2012
“Residential aged care in Australia 2010-11 provides comprehensive statistical information on residential aged care facilities, their residents, admissions and separations, and residents’ dependency levels. At 30 June 2011, there were nearly 185,500 residential aged care places, an increase of more than 2,600 places compared with 30 June 2010. More than 85,200 permanent residents (52%) had a recorded diagnosis of dementia at 30 June 2011. Other recorded health conditions included circulatory diseases (40,000 residents) and diseases of the musculoskeletal and connective tissue (29,400 residents).”
ISSN 1329-5705; ISBN 978-1-74249-343-5; Cat. no. AGE 68; 100pp.
“The number of aged care places in Australia is continuing to rise, according to two reports released today by the Australian Institute of Health and Welfare (AIHW).
The reports, Residential aged care in Australia 2010-11: a statistical overview and Aged care packages in the community 2010-11: a statistical overview, provide comprehensive information on Australia Government-funded aged care.
The reports show the number of residential aged care places grew to 185,482 at 30 June 2011-an increase of 2,632 (1.4%) since the previous year.
The number of care packages, which allow older Australians to receive care in their own homes and communities, grew to 57,922 in 2010-11, a 13% increase over the previous year. These include Community Aged Care Packages, Extended Aged Care at Home, and Extended Aged Care at Home Dementia.”
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Hoenig, S.A., and Page. A.R.E., (2012). Counting on Care Work in Australia. Report prepared by AECgroup Limited for economic Security4Women, Australia.
Extract from the summary of key findings:
“The care sector is highly significant to Australia, worth an estimated $762.5 billion in 2009-10 ($112.4 billion paid care and $650.1 billion imputed value of unpaid care).
This sector provides nearly 20% of all paid employment in Australia.
For the purposes of this report, the care sector is defined as “the total (paid and unpaid) labour required to meet the needs of children to be cared for and educated, everybody’s physical and mental health that requires attention, and the needs of individuals who require assistance with the activities of daily living because of illness, age or disability” (Albelda et al., 2009, p.4). The care sector is comprised of paid care, unpaid care and government investment in the care sector.”
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Explaining variation in use of emergency hospital beds by patients over 65 – The King’s Fund – 9 August 2012
This paper explores factors that might be driving the significant variation in use of hospital beds by patients over 65 admitted as an emergency. It considers the contribution made by patient-based (demand-side) factors, hospital (supply-side) factors, the availability of community services and resources, and broader system relationships (how care systems and staff work together and relate to each other) in driving the observed variation in length of stay and rate of admission. Its conclusions are based on new analysis by The King’s Fund of Hospital Episode Statistics (HES) and local population -based data.”Read Full Post | Make a Comment ( Comments Off on Explaining variation in use of emergency hospital beds by patients over 65 – The King’s Fund – 9 August 2012 )
Assistive technology as a means of supporting people with dementia: A Review – Housing LIN – 24 July 2012
“To coincide with the Housing LIN’s involvement in the Prime Minister’s challenge on dementia, we have published this helpful review of how AT can support people with dementia. Co-authored by Tahir Idris and Steve Bonner, they indicate that awareness of the products, devices and solutions available is still sketchy and variable around the UK and there is almost a ‘postcode lottery’ relating to the quality of AT solutions available to people with dementia due to the varying approaches taken around the country. This paper captures examples of innovation and how AT can help to make a difference.”
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The Mental Health and Substance Use Workforce for Older Adults: In Whose Hands? – Institute of Medicine – 10 July 2012
“At least 5.6 million to 8 million – nearly one in five – older adults in America have one or more mental health and substance use conditions, which present unique challenges for their care. With the number of adults age 65 and older projected to soar from 40.3 million in 2010 to 72.1 million by 2030, the aging of America holds profound consequences for the nation.
For decades, policymakers have been warned that the nation’s health care workforce is ill-equipped to care for a rapidly growing and increasingly diverse population. In the specific disciplines of mental health and substance use, there have been similar warnings about serious workforce shortages, insufficient workforce diversity, and lack of basic competence and core knowledge in key areas.
Following its 2008 report highlighting the urgency of expanding and strengthening the geriatric health care workforce, the IOM was asked by the Department of Health and Human Services to undertake a complementary study on the geriatric mental health and substance use workforce. An expert committee assessed the needs of this population and the workforce that serves it. The breadth and magnitude of inadequate workforce training and personnel shortages have grown to such proportions, says the committee, that no single approach, nor a few isolated changes in disparate federal agencies or programs, can adequately address the issue. Overcoming these challenges will require focused and coordinated action by all.”Read Full Post | Make a Comment ( Comments Off on The Mental Health and Substance Use Workforce for Older Adults: In Whose Hands? – Institute of Medicine – 10 July 2012 )
Demographic futures: addressing inequality and diversity among older people – British Academy – June 2012
New Paradigms in Public Policy
by Pat Thane FBA
Extract from the executive summary
“There are three paradigms prevalent in current discussions about an ageing population, its implications and policies to deal with those implications.
1. The dominant paradigm about Britain’s demographic future focuses on the rapid ageing of the population combined with shrinking numbers of younger people of working age due to falling fertility in the recent past. It assumes this trend imposes an unprecedented economic burden on health and social services, and pensions, and suggests solutions such as increasing the state pension age.
2. The second stresses the great diversity within an ‘age-group’ said to extend from around age 60 to past 100, in terms of health, income, capacity for independent living, culture and experience. It emphasises the considerable contributions of many older people to society and the economy, through paid and unpaid work, tax, spending and substantial gifts to younger people. It criticises the dominant paradigm which blames ageing people for costs that are linked to other causes: for example, the cost of health care is affected by rising costs of changing technology and NHS salaries, as well as an ageing population.
3. The third speaks of ‘intergenerational inequity’ between ‘baby-boomers’ and younger people. It overlooks extreme socio-economic inequalities within generations and the extensive lifetime financial transfers from older to younger generations.
The evidence below suggests that the second paradigm presents the strongest basis for realistic, evidence-based policies in the UK.”Read Full Post | Make a Comment ( Comments Off on Demographic futures: addressing inequality and diversity among older people – British Academy – June 2012 )
The Silver Book. Quality Care for Older People with Urgent and Emergency Care Needs – University of Leicester, Department of Cardiovascular Sciences
Despite the majority of urgent care being delivered in the primary care setting, an increasing number of older people are attending emergency departments and accessing urgent health and social care services. This is partly related to the demographic shift that has resulted in a rapid increase in the number of older people, but may also be due to lower thresholds for accessing urgent care. Over the next 20 years, the number of people aged 85 and over is set to increase by two-thirds, compared with a 10 per cent growth in the overall population. Recent national reports including from Patient UK, Care Quality Commission, NCEPOD and the Health Service Ombudsman highlighted major deficiencies in the care of older people in acute hospitals ranging from issues around privacy and dignity to peri-operative care. Older people are admitted to hospital more frequently, have longer length of stay and occupy more bed days in acute hospitals compared to other patient groups. There is a pressing need to change how we care for older people with urgent care needs, to improve quality, outcomes and efficiency. Emergency departments need to be supported to deliver the right care for these patients, as no one component of the health and social care systems can manage this challenge in isolation; implementation of improved care for older people requires a whole system approach.
Important factors in primary care that impact on the use of urgent care services include a timely primary care response and ready access to general practitioners. More community based services with a rapid response time may reduce the need to access secondary care. There needs to be better communication between ‘in-hours’ and out of hours services. The ambulance service has a key role to play and can be an important contributor in doing things differently – for example, referring non-conveyed patients directly to urgent care, community and primary care services, including falls services.
Attendance at the Emergency Department is associated with a high risk of admission for older people, so the nature of the service and the environment in which it is provided needs to change to reflect the changing nature of health care in the 21st century, the bulk of which relates to older people, and increasingly frail older people. Dedicated teams delivering comprehensive geriatric assessment can support this, but in themselves are not sufficient to realise whole system change. Services in all settings including health and social care need to improve their communication and handover, and greater use of the voluntary sector is to be encouraged. In acute medical units, greater use of geriatric liaison services should increase the proportion of older people able to be managed in the community setting.”
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Keeping patients safe when they transfer between care providers – getting the medicines right. Final report – Royal Pharmaceutical Society – June 2012
“A new report published today by the Royal Pharmaceutical Society calls for improvements to the transfer of information about medicines when patients move between care settings.
Keeping patients safe when they transfer between care providers: Getting the medicines right outlines the results of a six-month project involving over 30 healthcare organisations which volunteered to implement RPS guidance on transfer of medicines information. The guidance was endorsed by the Royal College of General Practitioners, the Royal College of Nursing, the Royal College of Physicians and the Academy of Medical Royal Colleges and had a joint foreward from the Medical Director of the NHS, the Chief Nursing Officer and the Chief Pharmaceutical Officer.
The likelihood that an elderly medical patient will be discharged on the same medicines that they were admitted on is less than 10%. Between 28-40% of medicines are discontinued during hospitalisation and 45% of medicines prescribed at discharge are new medicines. Around 60% of patients have 3 or more medicines changed during their hospital stay and adverse drug events occur in up to 20% of patients after discharge.
“Getting the transfer of medicines information right can be challenging as patients follow complex pathways and systems vary between providers. However, it’s totally unacceptable that poor transfer of medicines information continues to compromise patient care” said RPS Policy and Practice Lead Heidi Wright.
“Strategies must improve and the experiences of the volunteer sites in driving change in their organisations have created a set of recommendations which should be adopted across the NHS”.
The recommendations of the report are:”
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Delivering Dignity: Securing dignity in care for older people in hospitals and care – Local Government Association, NHS Confederation, Age UK – 18 June 2012
“Delivering Dignity is the final report of the Commission on Dignity in Care for Older People and sets out the Commission’s work and recommendations on how to tackle the underlying causes of poor care.
Rather than a repetition of the well documented problems or a best practice guide for managers and staff, it focuses on how to tackle the underlying causes of poor care.
Some hospitals and care homes are already providing dignified care for older people; this report and the follow-up programme of activities are intended to build on existing good practice, so that we get it right for every person, every time.
This final report is based on the knowledge of the commissioners themselves, the many witnesses who gave written and oral evidence, and almost 230 submissions from organisations and individuals in response to our February 2012 consultation document.”Read Full Post | Make a Comment ( Comments Off on Delivering Dignity: Securing dignity in care for older people in hospitals and care – Local Government Association, NHS Confederation, Age UK – 18 June 2012 )
Breaking new ground: the quest for dementia friendly communities – Housing LIN [UK] – 12 June 2012
“This Housing LIN Viewpoint no 25 – and it’s accompagnying checklist ‘At a Glance’ – examines current policy and practice in relation to delivering housing and neighbourhoods for people with dementia and draws on latest research that considers the role design for dementia can play in achieving the quest for dementia friendly communities.
It offers useful checklists on designing dementia friendly communities and, importantly, seeks to provide a catalyst for developing a robust evidence base in housing with care field thereby ensuring that Housing LIN members are fully engaged when planning, designing and delivering housing that older people want and can break new ground locally.”Read Full Post | Make a Comment ( Comments Off on Breaking new ground: the quest for dementia friendly communities – Housing LIN [UK] – 12 June 2012 )
Care at Home: Older people’s experiences of domiciliary care – Patient and Client Council [Ireland] – June 2012
Extract from the executive summary
“The purpose of this report is to record the experiences of older people receiving a domiciliary care service as well as the views of carers. The report provides a timely illustration of older people’s perspectives on domiciliary care, within the context of the review of health and social care currently being undertaken in Northern Ireland and the existing debate around care provision for a rapidly ageing population.
A total of 1161 people took part in this process; 700 people completed a questionnaire outlining their experiences of receiving domiciliary care, 38 people in receipt of an intensive home care service took part in an interview, 170 people participated in small discussion groups and 253 members of the public filled out a short questionnaire.
Through this combined approach of quantitative and qualitative methods, including one-to-one interviews with older people and their carers, this report expands on themes indentified by service users in previous surveys, as well as providing fresh insight into home care services and a deeper understanding of older people’s experience of domiciliary care.”
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