Problems of Patients and Relatives at Referral: A Preliminary Report of the Characteristics of Elderly Patients/Clients Referred to Social Service Departments - Geriatric Medicine and Psychiatric Services

1985 ◽  
pp. 421-427
Author(s):  
David Jolley ◽  
David Wilkin
Keyword(s):  
Elderly Patients ◽  
Social Service ◽  
Preliminary Report ◽  
Geriatric Medicine ◽  
Psychiatric Services ◽  
Service Departments

An End to Incrementalism? The Impact of Expenditure Restraint on Social Services Budgets 1979–1986

1989 ◽  
Vol 18 (2) ◽  
pp. 187-210 ◽  
Author(s):  
Aidan Kelly
Keyword(s):  
Social Services ◽  
Social Service ◽  
The Elderly ◽  
Activity Data ◽  
The Public ◽  
Total Budget ◽  
Service Departments ◽  
The Impact ◽  
The Relationship ◽  
Over Time

ABSTRACTThe theory of incrementalism is a long-standing and influential perspective on policy making and resource allocation in the public sector. Previous research on social services budgeting suggests that resources are allocated incrementally, although there has been some debate as to whether this would persist in an era of prolonged expenditure restraint. Incremental budgetary outcomes are operationalised as percentage changes in budgets pro-rata with percentage changes in the total budget, and as stable shares of total expenditure for each activity. Data for 99 English social service departments supports incrementalism in that budget shares change by only 1.8 per cent, but percentage allocations depart from pro-rata incrementalism by a mean of 74 per cent. The comparison of the two summary indices over time supports those who have argued that prolonged restraint would encourage non-incremental budgeting, but change in the agency's total budget does not consistently predict budgetary outcomes. The effect of restraint on incrementalism varies with the measure used and across the component activities of the measures, but there is enough evidence to suggest a significant decline in the level of incrementalism in social service departments. In particular, non-incremental budgeting is strongly associated with the growth of day centre expenditure on the mentally ill and the elderly before 1982–3, and after that with the pursuit of the ‘community care’ strategy within state provided services for the elderly and children. Incrementalism as a general theory of agency budgeting is limited in its ability to explain variations in the degree of incrementalism between agencies, between component budgets and over time. The conclusion suggests that further research should seek explanations for these variations in the varying balance of the competing forces which shape outcomes in welfare bureaucracies and in the relationship between these forces and the organisation's environment.

Team Managers in Local Social Service Departments in Israel as Bottom-Up Social Policy-Makers

2021 ◽  
pp. 324-345
Keyword(s):  
Social Workers ◽  
Social Services ◽  
Social Service ◽  
Public Discourse ◽  
Well Being ◽  
Structured Interviews ◽  
Psychosocial Services ◽  
Service Departments ◽  
New Policies

Following on Felice Perlmutter's work on the managerial role of social workers in social services, this article contributes to the still limited knowledge on the role of social workers in middle-management positions in formulating new policies `on the ground`. The study expands knowledge about policies determined by team managers in local social service departments in Israel. It occurs in the nexus between street-level bureaucracy, professionalism and managerial positions. Semi-structured interviews with 28 team managers revealed that they formulated `new` policies with regard to the provision of psychosocial services and material assistance (who gets what, when and how). This occurs when they resist official policy, when it is vague or non-existent. Most of their policy decisions are not documented and draw upon consultations with colleagues and superiors though not with clients. The team managers perceive these policies as a means for achieving balance between clients' well-being and budgetary constraints. Yet their decisions lack transparency, are decided upon without public discourse and may lead to greater inequity between clients

Effects of escitalopram on serum BDNF levels in elderly patients with depression: a preliminary report

2014 ◽  
Vol 26 (4) ◽  
pp. 461-464 ◽  
Author(s):  
Antonio Martocchia ◽  
Martina Curto ◽  
Sergio Scaccianoce ◽  
Fabrizia Comite ◽  
Dionysios Xenos ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Preliminary Report ◽  
Serum Bdnf

Advisers to Disabled—Job Analysis

1979 ◽  
Vol 42 (12) ◽  
pp. 306-307 ◽  
Author(s):  
J. Milne ◽  
P. Matthews
Keyword(s):  
Social Service ◽  
Job Analysis ◽  
The Disabled ◽  
Service Departments ◽  
Salary Negotiations

The role of the O. T. in Social Service Departments is not always fully understood. In Cambridgeshire all the O. Ts. decided to change our title to “Advisers to the Disabled” as we felt this term more appropriate to the depth and diversity of our role. Having requested a change oftitle we discovered that the confusion as to our role lay not only in the minds ofthe clients but also in the minds of our managers. In order to define our role and to assist in salary negotiations the following job analysis was drawn up.

scholarly journals The complex interaction between atrial fibrillation and heart failure in elderly patients

2019 ◽  
Vol 89 (2) ◽  
Author(s):  
Stefano Fumagalli ◽  
Giulia Pelagalli ◽  
Marta Migliorini ◽  
Serena Boni ◽  
Francesca Nigro ◽  
...  
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Elderly Patients ◽  
Beta Blockers ◽  
Geriatric Medicine ◽  
Renin Angiotensin System ◽  
Cardiac Resynchronization ◽  
Angiotensin System ◽  
Complex Patients ◽  
Important Challenge

Heart failure (HF) and atrial fibrillation (AF) often coexist. Subjects with permanent AF show the highest prevalence of HF. Patients with incident AF have HF in a great number of cases and, reciprocally, in patients with incident HF, an AF can be frequently found. The simultaneous presence of the two conditions is associated with mortality rates higher than those observed in individuals with only one or none of them. Interestingly, HF and AF could synergistically promote in elderly patients the development of disability and dementia. Inflammatory mechanisms coupled with changes of renin-angiotensin system, hormonal pathways and neuro-mediators could simultaneously promote left atrium remodeling and sustain both HF and AF. Beta-blockers and digoxin seem to have small therapeutic effect and limited influence on prognosis in these very complex patients. Sinus rhythm restoration could slow down the progression of disability in symptomatic subjects. Recent evidence seem to suggest that upstream therapy coupled with rehabilitation, and that AV node ablation associated with cardiac resynchronization therapy could benefit subjects with HF and AF. In conclusion, elderly patients simultaneously presenting problems of cardiac function and arrhythmia are an important challenge for geriatric medicine, and request important efforts to improve their functional profile and prognosis.

scholarly journals Prevalence of mild hyponatremia and its association with falls in older adults admitted to an emergency geriatric medicine unit (the MUPA unit)

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Sophie Boyer ◽  
Caroline Gayot ◽  
Charlotte Bimou ◽  
Thomas Mergans ◽  
Patrick Kajeu ◽  
...  
Keyword(s):  
Older Adults ◽  
Elderly Patients ◽  
Geriatric Assessment ◽  
Geriatric Medicine ◽  
Final Analysis ◽  
University Hospital ◽  
Cross Sectional ◽  
Electrolyte Disorder ◽  
Injurious Falls ◽  
Chronic Hyponatremia

Abstract Background Hyponatremia is the most common electrolyte disorder in older adults and it can increase morbidity and mortality. Approximately one in three older adults fall each year; mild chronic hyponatremia can predispose this group to injurious falls and fractures and serum levels of sodium can also influence bone health. Little is known regarding the association between mild chronic hyponatremia and injurious fall prevalence in elderly patients admitted to the Emergency Department (ED). Therefore, the present study investigated the link between mild hyponatremia and the risk of injurious falls in elderly patients admitted to the Emergency Geriatric Medicine Unit (The MUPA Unit). Methods This cross-sectional study was conducted over 4 months and included patients ≥75 years of age who were admitted to the MUPA Unit of University Hospital Center of Limoges (France). Sociodemographic factors, fall events, comorbidities, medications, and sodium levels were assessed (hyponatremia was considered as sodium level < 136 mEq/L). Additionally, the short Comprehensive Geriatric Assessment (short-CGA), the Frailty score on the Short Emergency Geriatric Assessment (SEGA), and the Katz Activity of Daily Living (ADL) scale were administered. Results Of the 696 cases included in the final analysis, the mean age was 86.1 ± 5.6 years and 63.1% were female. The prevalence of falls was 27.9% (95% confidence interval [CI]: 24.6–31.2%) and that of mild hyponatremia was 15.9% (95% CI: 13.2–18.6%). The prevalence rate of mild hyponatremia was 13.2% (95% CI: 10.1–16.3%) in patients without falls and 26.1% (95% CI: 19.8–32.4%) in patients admitted for falls. Mild hyponatremia was significantly associated with falls (P < 0.001) and the adjusted odds ratio (OR) was 3.02 (95% CI: 1.84–4.96). Conclusions Because mild hyponatremia might be a risk factor for injurious falls and ED admission, determination of sodium levels during basic biomarker assessment on ED admission could be an important component of fall prevention strategies for the elderly.

scholarly journals Services for families in crisis in Tower Hamlets: evaluations by general practitioners and social workers

1992 ◽  
Vol 16 (12) ◽  
pp. 748-750 ◽  
Author(s):  
Colin Murray Parkes
Keyword(s):  
Social Workers ◽  
Social Services ◽  
Social Service ◽  
Psychiatric Services ◽  
Short Term ◽  
Social Service Department ◽  
Problems In Living ◽  
Service Department ◽  
Crisis Services ◽  
To Come

There is widespread recognition that many who seek or are referred for help to psychiatric and social services are acutely disturbed and require only short-term help if they are to come through a period of transient disruption in their lives. The frequency with which people in crisis consult their GP or visit a local Social Service Department is uncertain but suggests that the primary carers are the first port of call for most of them. Services developed to meet the needs of these people include traditional GPs and psychiatric services directed primarily at ‘patients’ (people who meet criteria for illness), but which often offer additional help to their families; traditional social services which place no such limitation on the individuals who seek their help but are directed mainly at people with problems in living, particularly with housing, employment and money; and counselling and advisory services (such as Relate – formerly Marriage Guidance) which focus on particular problems or client groups. A few special crisis services, most of which provide a multidisciplinary team, visit clients in crisis in their homes. These are usually psychiatric services for patients with acute mental illness (Cooper, 1979).

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