ICT-based person-centered community care platform (IPC3P) to enhance shared decision-making for integrated health and social care services

Abstract Background Dementia is one of the main causes of disability and dependence in older people, and people with dementia need comprehensive healthcare services, preferably in their own homes. A well-organized home care service designed for people with dementia is necessary to meet their needs for health- and social care. Therefore, it is important to gain knowledge about how people with dementia experience the home care service and if the service responds to their wishes and needs. The aim of this study was to explore the experience of home care services among people with dementia, to understand the continuity in services, how the service was adapted to people with dementia, and how the patient experienced person-centered care and shared decision-making. Methods We used a qualitative, exploratory design based on a phenomenological-hermeneutic approach and performed individual in-depth interviews with persons with dementia. A convenience sample of 12 persons with moderate to severe degrees of dementia from four Norwegian municipalities participated in the study. The interviews were conducted in February 2019. Results The findings identified that the participants appreciated the possibility to stay safely in their own homes and mostly experienced good support from staff. They expressed various views and understanding of the service and experienced limited opportunities for user involvement and individualized, tailored service. The overall theme summarizing the findings was: “It is difficult for people with dementia to understand and influence home care services, but the services facilitate the possibility to stay at home and feel safe with support from staff.” Conclusion The participants did not fully understand the organization of the care and support they received from the home care services, but they adapted to the service without asking for changes based on their needs or desires. Although person-centered care is recommended both nationally and internationally, the participants experienced little inclusion in defining the service they received, and it was perceived as unclear how they could participate in shared decision-making.

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The Role of Information and Communication Technology (ICT) for Older Adults’ Decision-Making Related to Health, and Health and Social Care Services in Daily Life—A Scoping Review

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph19010151 ◽

2021 ◽

Vol 19 (1) ◽

pp. 151

Author(s):

Susanna Nordin ◽

Jodi Sturge ◽

Maria Ayoub ◽

Allyson Jones ◽

Kevin McKee ◽

...

Keyword(s):

Older Adults ◽

Decision Making ◽

Information And Communication Technology ◽

Communication Technology ◽

Scoping Review ◽

Social Care ◽

Care Services ◽

Health And Social Care ◽

Information And Communication

Information and communication technology (ICT) can potentially support older adults in making decisions and increase their involvement in decision-making processes. Although the range of technical products has expanded in various areas of society, knowledge is lacking on the influence that ICT has on older adults’ decision-making in everyday situations. Based on the literature, we aimed to provide an overview of the role of ICT in home-dwelling older adults’ decision-making in relation to health, and health and social care services. A scoping review of articles published between 2010 and 2020 was undertaken by searching five electronic databases. Finally, 12 articles using qualitative, quantitative, and mixed-method designs were included. The articles were published in journals representing biology and medicine, nursing, informatics, and computer science. A majority of the articles were published in the last five years, and most articles came from European countries. The results are presented in three categories: (i) form and function of ICT for decision-making, (ii) perceived value and effect of ICT for decision-making, and (iii) factors influencing ICT use for decision-making. According to our findings, ICT for decision-making in relation to health, and health and social care services was more implicitly described than explicitly described, and we conclude that more research on this topic is needed. Future research should engage older adults and health professionals in developing technology based on their needs. Further, factors that influence older adults’ use of ICT should be evaluated to ensure that it is successfully integrated into their daily lives.

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Do integrated health and social care services deliver better care for children with intellectual disabilities?

International Journal of Integrated Care ◽

10.5334/ijic.1011 ◽

2012 ◽

Vol 12 (7) ◽

Cited By ~ 1

Author(s):

Axel Kaehne

Keyword(s):

Intellectual Disabilities ◽

Social Care ◽

Care Services ◽

Health And Social Care ◽

Integrated Health

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The scope of carer effects and their inclusion in decision-making: a UK-based Delphi study

BMC Health Services Research ◽

10.1186/s12913-021-06742-4 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Hareth Al-Janabi ◽

Nikolaos Efstathiou ◽

Carol McLoughlin ◽

Melanie Calvert ◽

Jan Oyebode

Keyword(s):

Decision Making ◽

Delphi Study ◽

Social Care ◽

Emotional Health ◽

Organisational Change ◽

Patient Treatment ◽

Cost Shifting ◽

Patient Decision Making ◽

Care Services ◽

Health And Social Care

Abstract Background and objective Health and social care may affect unpaid (family) carers’ health and wellbeing in addition to patients’ lives. It is recommended that such impacts (carer effects) are considered in decision-making. However, the scope of carer effects and range of decisions where carer effects should be considered is uncertain. This study aimed to identify: (i) how different categories of healthcare and social care were perceived to impact on unpaid carers; and (ii) whether there was consensus about when carer effects should be formally considered in decision-making contexts. Methods A two round, online Delphi study was conducted with 65 UK-based participants (unpaid carers, care professionals, and researchers) with expertise in dementia, mental health, and stroke. Participants considered two broad forms of ‘interventions’ (patient treatment and replacement care) and two broad forms of ‘organisational change’ (staffing and changes in timing/location of care). Participants assessed the likely impacts of these on unpaid carers and whether impacts should be considered in decision-making. Results Participants predicted interventions and organisational changes would impact on multiple domains of unpaid carers’ lives, with ‘emotional health’ the most likely outcome to be affected. Patient treatment and replacement care services (‘interventions’) were associated with positive impacts across all domains. Conversely, timing/location changes and staffing changes (‘organisational changes’) were perceived to have mixed and negative impacts. There was widespread support (80–81 %) for considering carer effects in research studies, funding decisions, and patient decision-making. Conclusions This study highlights a perception that carer effects are widespread and important to consider in economic evaluation and decision-making. It highlights the particular need to measure and value effects on carers’ emotional health and the need to use a societal perspective to avoid cost shifting to unpaid carers when introducing interventions and making organisational changes.

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Evaluating Community-Based Integrated Health and Social Care Services: The Simtegr8 Approach

2019 Winter Simulation Conference (WSC) ◽

10.1109/wsc40007.2019.9004874 ◽

2019 ◽

Author(s):

Antuela A. Tako ◽

Stewart Robinson ◽

Anastasia Gogi ◽

Zoe Radnor ◽

Cheryl Davenport

Keyword(s):

Social Care ◽

Community Based ◽

Care Services ◽

Health And Social Care ◽

Integrated Health

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Co-production in integrated health and social care programmes: a pragmatic model

Journal of Integrated Care ◽

10.1108/jica-11-2017-0044 ◽

2018 ◽

Vol 26 (1) ◽

pp. 87-96 ◽

Cited By ~ 6

Author(s):

Axel Kaehne ◽

Andrea Beacham ◽

Julie Feather

Keyword(s):

Social Care ◽

Good Practice ◽

Essential Elements ◽

Discussion Paper ◽

Content Type ◽

Academic Knowledge ◽

Care Services ◽

Current Thinking ◽

Health And Social Care ◽

Integrated Health

Purpose The purpose of this paper is to outline the current thinking on co-production in health and social care, examine the challenges in implementing genuine co-production and argue for a pragmatic version of co-production that may assist programme managers in deciding which type of co-production is most suitable for which programme. Design/methodology/approach A discussion paper based on the professional and academic knowledge and insights of the authors. A focus group interview schedule was used to guide discussions between authors. Findings The authors argue for a pragmatic approach to co-production within integrated care programmes. The authors set out the basic parameters of such an approach containing procedural rather than substantive standards for co-production activities leaving sufficient room for specific manifestations of the practice in particular contexts. Practical implications The authors put forward a pragmatic model of co-production that defines the essential elements of a process for ensuring services are designed to meet with the needs of patients yet allowing the process itself to be adapted to different circumstances. Originality/value The paper summarises the discussion on co-production in relation to integration programmes. It formulates a pragmatic model of co-production that may assist programme managers in establishing good practice co-production frameworks when designing or implementing integrated health and social care services.

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