Abuse of people with dementia

2009 ◽  
Vol 19 (1) ◽  
pp. 35-43 ◽  
Author(s):  
Amber Selwood ◽  
Claudia Cooper
Keyword(s):  
Older Adults ◽  
General Population ◽  
Older People ◽  
Memory Impairment ◽  
Social Care ◽  
Care Recipient ◽  
People With Dementia ◽  
Health And Social Care ◽  
Vulnerable People ◽  
With Memory

SummaryPeople with dementia are particularly vulnerable to abuse. It is inherently difficult to study as it is a hidden offence, perpetrated against vulnerable people with memory impairment, by those on whom they depend. In the general population, 6% of older people have experienced abuse in the last month and this rises to approximately 25% in vulnerable populations such as people with dementia. We know that various factors in the carer and the care recipient can predispose to a higher rate of abuse and this knowledge can be harnessed to try and improve prevention. There are also valid and reliable scales available to help detect abuse in vulnerable older adults. All health and social care professionals have a responsibility to act on any suspicion or evidence of significant abuse or neglect in order to ensure that appropriate management is taken.

The association of loneliness with health and social care utilisation in older adults in the general population: A systematic review

2021 ◽  
Author(s):  
Kimberley J Smith ◽  
Christina Victor
Keyword(s):  
Older Adults ◽  
General Population ◽  
Social Care ◽  
Care Home ◽  
Service Utilisation ◽  
Study Quality ◽  
Cross Sectional ◽  
Consistent Finding ◽  
Care Utilisation ◽  
Health And Social Care

Abstract Background and Objectives Loneliness is proposed to be linked with increased service use. This review examined the association of loneliness and health and social care utilisation (HSCU) in older adults from the general population. Research Design and Methods Four databases were screened for studies that examined the association of loneliness (predictor) with HSCU (outcome) in older adults (defined as majority of sample 60 or older). Study quality was assessed with the NIH scale for observational cohorts and cross-sectional studies. Results We identified 32 studies, of which 9 prospective studies were evaluated as being good or good-fair quality. Two good-fair quality studies found loneliness at baseline was associated with subsequent admission to a residential care home. There was emerging evidence that loneliness was associated with emergency department use (n=1), and CVD-specific hospitalisation (n=1). Once adjusted for confounders the highest quality studies found no association of baseline loneliness with physician utilisation, outpatient service utilisation, skilled nursing facility use, and planned or unplanned hospital admissions. The remaining, studies were cross-sectional, or of fair to poor quality, and inadequate to reliably determine whether loneliness was associated with a subsequent change in HSCU. Discussion and implications There was heterogeneity in study design, measurement, and study quality. This generated an inconsistent evidence base where we cannot determine clear inferences about the relationship between loneliness and HSCU. Only one consistent finding was observed between two good-fair quality studies regarding care home admission. To determine clinical implications and make reliable inferences additional good quality longitudinal research is needed.

scholarly journals Partnership between Primary Health and Social Care Services in the Long-Term Care of Older People with Dementia: A Vignette Study

2020 ◽  
Author(s):  
Ausrine Kontrimiene ◽  
Aurelija Blazeviciene ◽  
Ida Liseckiene ◽  
Gediminas Raila ◽  
Leonas Valius ◽  
...  
Keyword(s):  
Older People ◽  
Social Care ◽  
Informal Caregiver ◽  
Three Dimensional ◽  
Term Care ◽  
Primary Health ◽  
People With Dementia ◽  
Health And Social Care ◽  
Relationship Perception

Abstract Background. Dementia is considered to be a significant cause of disability and dependency for older people worldwide and it raises difficulties in providing adequate formal and informal assistance. Research on the experience of long-term care (LTC) services for older people with dementia is scarce in Eastern European countries. This study aimed to understand the system of care for older people with dementia from the perspective of health and social care workers providing LTC services in Lithuania. Methods. A total of 72 primary health care and social care professionals from public and private institutions in Kaunas city participated in this study. One-to-one interviews were conducted with family physicians, community nurses, psychiatrists, psychiatric nurses, and social workers. A vignette situation of two fictitious patients with dementia and their informal caregiver was discussed during the interviews. Data were analyzed using thematic analysis by induction approach.Results. Thematic analysis of the data revealed two main themes: LTC provision trajectory, and three-dimensional relationship perception in realization of LTC activities. LTC provision trajectory reflected activities performed as a response to the described situation embracing formal procedures for the endorsement of LTC needs as well as the range of LTC services. Three-dimensional relationship perception in realization of LTC activities mirrored the participants’ relationships with themselves, with each other, and with the informal caregiver.Conclusions. Our study revealed the potential of complex measures that could be instrumental for the refinement of the caregiving process. First, a change in the special needs’ endorsement logic is needed, shifting focus from medical diagnosis to functional abilities assessment. Second, establishing clear procedures for formal cooperation between the health and social care sectors in the trajectory of LTC service provision. Finally, finding an adequate balance between LTC and institutional care by creating a wider range of LTC services. A more consistent and coordinated delivery of services by both health and social care sectors seems to be an untapped resource for the improvement of the LTC potential.

scholarly journals Partnership between primary health and social care services in the long-term care of older people with dementia: a vignette study

2020 ◽  
Author(s):  
Ausrine Kontrimiene ◽  
Aurelija Blazeviciene ◽  
Ida Liseckiene ◽  
Gediminas Raila ◽  
Leonas Valius ◽  
...  
Keyword(s):  
Older People ◽  
Social Care ◽  
Informal Caregiver ◽  
Three Dimensional ◽  
Term Care ◽  
Primary Health ◽  
People With Dementia ◽  
Health And Social Care ◽  
Relationship Perception

Abstract Background Dementia is considered to be a significant cause of disability and dependency for older people worldwide and it raises difficulties in providing adequate formal and informal assistance. Research on the experience of long-term care (LTC) services for older people with dementia is scarce in Eastern European countries. This study aimed to understand the system of care for older people with dementia from the perspective of health and social care workers providing LTC services in Lithuania. Methods A total of 72 primary health care and social care professionals from public and private institutions in Kaunas city participated in this study. One-to-one interviews were conducted with family physicians, community nurses, psychiatrists, psychiatric nurses, and social workers. A vignette situation of two fictitious patients with dementia and their informal caregiver was discussed during the interviews. Data were analyzed using thematic analysis by induction approach. Results Thematic analysis of the data revealed two main themes: LTC provision trajectory, and three-dimensional relationship perception in realization of LTC activities. LTC provision trajectory reflected activities performed as a response to the described situation embracing formal procedures for the endorsement of LTC needs as well as the range of LTC services. Three-dimensional relationship perception in realization of LTC activities mirrored the participants’ relationships with themselves, with each other, and with the informal caregiver. Conclusions Our study revealed the potential of complex measures that could be instrumental for the refinement of the caregiving process. First, a change in the special needs’ endorsement logic is needed, shifting focus from medical diagnosis to functional abilities assessment. Second, establishing clear procedures for formal cooperation between the health and social care sectors in the trajectory of LTC service provision. Finally, finding an adequate balance between LTC and institutional care by creating a wider range of LTC services. A more consistent and coordinated delivery of services by both health and social care sectors seems to be an untapped resource for the improvement of the LTC potential.

scholarly journals Understanding Care Navigation by Older Adults With Multimorbidity: Mixed-Methods Study Using Social Network and Framework Analyses (Preprint)

2018 ◽  
Author(s):  
Jolien Vos ◽  
Kathrin Gerling ◽  
Conor Linehan ◽  
Aloysius N Siriwardena ◽  
Karen Windle
Keyword(s):  
Older Adults ◽  
Social Network ◽  
Older People ◽  
Social Care ◽  
Mixed Methods Study ◽  
Health And Social Care ◽  
Care Systems ◽  
Different Parts

BACKGROUND Health and social care systems were designed to be used primarily by people with single and acute diseases. However, a growing number of older adults are diagnosed with multiple long-term conditions (LTCs). The process of navigating the intricacies of health and social care systems to receive appropriate care presents significant challenges for older people living with multiple LTCs, which in turn can negatively influence their well-being and quality of life. OBJECTIVE The long-term goal of this work is to design technology to assist people with LTCs in navigating health and social care systems. To do so, we must first understand how older people living with LTCs currently engage with and navigate their care networks. No published research describes and analyses the structure of formal and informal care networks of older adults with multiple LTCs, the frequency of interactions with each type of care service, and the problems that typically arise in these interactions. METHODS We conducted a mixed-methods study and recruited 62 participants aged ≥55 years who were living in England, had ≥2 LTCs, and had completed a social network analysis questionnaire. Semistructured interviews were conducted with roughly a 10% subsample of the questionnaire sample: 4 women and 3 men. On average, interviewees aged 70 years and had 4 LTCs. RESULTS Personal care networks were complex and adapted to each individual. The task of building and subsequently navigating one’s personal care network rested mainly on patients’ shoulders. It was frequently the patients’ task to bridge and connect the different parts of the system. The major factor leading to a satisfying navigation experience was found to be patients’ assertive, determined, and proactive approaches. Furthermore, smooth communication and interaction between different parts of the care system led to more satisfying navigation experiences. CONCLUSIONS Technology to support care navigation for older adults with multiple LTCs needs to support patients in managing complex health and social care systems by effectively integrating the management of multiple conditions and facilitating communication among multiple stakeholders, while also offering flexibility to adapt to individual situations. Quality of care seems to be dependent on the determination and ability of patients. Those with less determination and fewer organization skills experience worse care. Thus, technology must aim to fulfill these coordination functions to ensure care is equitable across those who need it.

scholarly journals Lack of Coordination between Health Care and Social Care in Multi-Professional Teamwork - the Obstacle for Coherent Care of Older People Suffering from Multi-Morbidity

2020 ◽  
Author(s):  
Ulla Melin Emilsson ◽  
Anna-Lena Strid ◽  
Maria Söderberg
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Older People ◽  
Focus Groups ◽  
Social Care ◽  
The Elderly ◽  
Frail Older People ◽  
Care Needs ◽  
Health And Social Care ◽  
Coordination And Collaboration

Abstract The lack of a cohesive health and social care is a well-known problem of significance for ageing people in general and frail older people in particular. Responsibility for organising and conducting social care and healthcare for the elderly rests on different principals in different countries but difficulties with organisational coordination and collaboration between professions and authorities in social care and healthcare is an extensive concern worldwide. Regardless of the distribution of responsibilities, collaboration and coordination structures are complex and often lead to problems. However, the gap in the coordination between different organisations and the collaboration between professions, implying that frail older people with major care needs still living in their own homes are pinched, has received hardly any recognition. By closely following an implementation project focused on teamwork in order to improve collaboration and coordination between social care and healthcare, the purpose of this article is to fill this gap with the help of an example from Sweden. Data consisted of event diaries, observations, focus groups, structured questionnaires and interviews. Findings showed that multi-professional teams certainly were established, but did not work or last. Among the obstacles found the most prominent features were the various professions’ own organisations, territorial thinking and rivalries. The whole idea of the initiative to achieve a cohesive healthcare and social care for ageing frail older people fell through. By letting this happen, not only did the project hinder the development of better practice in serving older adults, but also cemented the problematic structures it was intended to dissolve.

Does diagnosis determine delivery? The Islington study of older people's needs and health care costs

2004 ◽  
Vol 34 (1) ◽  
pp. 147-155 ◽  
Author(s):  
T. NELSON ◽  
J.-L. FERNANDEZ ◽  
G. LIVINGSTON ◽  
M. KNAPP ◽  
C. KATONA
Keyword(s):  
Health Care ◽  
Older People ◽  
Health Care Costs ◽  
Social Care ◽  
Living Alone ◽  
Service Usage ◽  
Factors Associated ◽  
People With Dementia ◽  
Health And Social Care ◽  
Care Costs

Background. Little is known about the factors associated with the receipt of care by older people. This study investigates the use, costs and factors associated with service usage among people aged 65 or older living in inner London.Method. A community-based survey, using questionnaires, examined psychiatric and physical morbidity, formal and informal care. The relationships between demographic, pathological features and the costs of health and social care were explored using multivariate regression.Results. A total of 1085 people were interviewed at home of these 18% did not receive any service at all. The total cost of services per week for people with dementia was £109, with activity limitation £14 and with depression £12. The greatest effect of physical limitation was on the receipt of social care. Dementia had the strongest effect on receipt of social care services. Depression increased health care costs to a much greater degree than social care costs. Despite presenting to services, black elders received significantly less health care than other people with the same needs. Older people living alone were more likely to receive social care support and appeared less likely to use health services.Conclusions. Physical dependency significantly affects both health and social care costs. Increasing cognitive impairment mainly leads to increasing social care costs. Overall costs are increased by physical dependency, dementia, depression, subjective health problems, living alone and are negatively affected by being black.

scholarly journals How are people with dementia involved in care-planning and decision-making? An Irish social work perspective

Dementia ◽  
2018 ◽  
Vol 18 (7-8) ◽  
pp. 2985-3003 ◽  
Author(s):  
Sarah Donnelly ◽  
Emer Begley ◽  
Marita O’Brien
Keyword(s):  
Decision Making ◽  
Social Work ◽  
Older People ◽  
Social Workers ◽  
Social Care ◽  
Practice Research ◽  
Care Planning ◽  
Client Group ◽  
People With Dementia ◽  
Health And Social Care

In recent years, there have been national and international policy advances around capacity and decision-making and an apparent burgeoning rights-based approach to the issue, all of which have the potential to impact on the experience for people with dementia in Ireland. There is little evidence however on whether these policies and principles are being translated into practice and whether traditional paternalistic approaches to decision-making are being challenged. To gain insight into current practice, research was undertaken with social workers working with older people in Ireland; reporting on the involvement of people living with dementia in care-planning processes. Data collection included a mixed method approach; an on-line survey of social workers from across the country who reported on their open caseload during the month of June 2015 (N = 38 social workers reporting on the experiences of 788 older people, of which 39% of older people had a formal diagnosis of dementia). In addition, semi-structured telephone interviews were conducted with social workers working in the nine Community Health Organisation areas (N = 21). Findings show that people with dementia were high users of social work services, accounting for 44.5% of the client group. Social workers reported that there were no standardised approaches to how Health and Social Care Professionals involved people with dementia in care planning and decision-making. Overall, people with dementia were more likely to be excluded from decision-making processes due to (i) assumptions that they lacked capacity, (ii) family members preferences that the person was not involved, (iii) communication difficulties, (iv) time constraints, (v) little or no opportunity given or (vi) the person delegated decision-making to others. Good practices were identified through multidisciplinary team approaches and formal care planning meetings. This research highlights variability in how people with dementia participate in decision-making around their care. It sheds light on existing barriers which challenge the full implementation of the Irish Assisted Decision-Making legislation; highlighting the need for appropriate guidance and education for Health and Social Care Professionals. The findings also show that family dynamics and existing relationships can play a role in how people with dementia participate and are involved. To ensure consistent opportunities for participation, effective practices and approaches to supporting the participation of people living with dementia in care planning needs to be developed and rolled out in all care settings through increased training and adoption of standardised approaches.

The Social Significance of Sleep for Older People with Dementia in the Context of Care

2007 ◽  
Vol 12 (5) ◽  
pp. 235-247 ◽  
Author(s):  
Wendy Martin ◽  
Helen Bartlett
Keyword(s):  
Older People ◽  
Social Care ◽  
The Body ◽  
Care Staff ◽  
Family Carers ◽  
Social Significance ◽  
Night Time ◽  
People With Dementia ◽  
The Social ◽  
Health And Social Care

While the social aspects of dementia have been increasingly researched over the past decade, there has been little focus on sleep and its significance to older people with dementia within the context of care. This paper attempts to address this knowledge gap by exploring the experiences of sleep among older people with dementia and the perceptions of family carers and care staff in different care settings. The paper is drawn from a larger research project that explored the empowerment of older people with dementia, and involved 18 in-depth interviews with older people with dementia and 8 focus groups with health and social care staff and family carers. The discourses of the older people with dementia and family carers, emphasised vulnerabilities associated with sleep, thematically represented as: (1) interconnections between health, care, the body and sleep; (2) memory loss and perceptions of sleep, time and place; and (3) a sense of vulnerability around night-time, sleep and safety. The sleep discourses of the older people with dementia and their family carers focused on meanings associated with experiential dimensions of sleep and were closely connected to their social identities and roles. The key concern for the health and social care staff was the organisation of sleep, including: (1) temporal management of sleep and sleep practices, and (2) management of sleep across public/private space: safety, surveillance and privacy. The sleep discourses of the health and social care staff predominately focused on sleep practices and environmental dimensions of sleep. These different perspectives denote varying positions and concerns in relation to sleep between waking conscious actors and dormant bodies, thereby highlighting the social significance of power relations and vulnerabilities within the context of care for older people with dementia.

scholarly journals Partnership between Primary Health and Social Care Services in the Long-Term Care of Older People with Dementia: A Vignette Study

2021 ◽  
Vol 58 ◽  
pp. 004695802110119
Author(s):  
Ausrine Kontrimiene ◽  
Aurelija Blazeviciene ◽  
Ida Liseckiene ◽  
Gediminas Raila ◽  
Leonas Valius ◽  
...  
Keyword(s):  
Older People ◽  
Long Term Care ◽  
Social Care ◽  
Informal Caregiver ◽  
Three Dimensional ◽  
Term Care ◽  
Primary Health ◽  
People With Dementia ◽  
Health And Social Care

Dementia is considered to be a significant cause of disability and dependency for older people worldwide and it raises difficulties in providing adequate formal and informal assistance. Research on the experience of long-term care (LTC)services for older people with dementia is scarce in Eastern European countries. This study aimed to understand the system of care for older people with dementia from the perspective of health and social care workers providing LTC services in Lithuania. A total of 72 primary health care and social care professionals from public and private institutions in Kaunas city participated in this study. One-to-one interviews were conducted with family physicians, community nurses, psychiatrists, psychiatric nurses, and social workers. A vignette situation of 2 fictitious patients with dementia and their informal caregiver was discussed during the interviews. Data were analyzed using thematic analysis by induction approach. The data revealed 2 main themes: LTC provision trajectory, and three-dimensional relationship perception in realization of LTC activities. LTC provision trajectory reflected activities performed as a response to the described situation embracing formal procedures for the endorsement of LTC needs as well as the range of LTC services. The three-dimensional perception of relationships in LTC services’ implementation reflected the participants’ personal approach toward LTC, relationship with different specialists, and the informal caregiver. Our study revealed the potential of complex measures that could be instrumental for the refinement of the caregiving process. First, a change in the additional care requirements endorsement logic is needed, shifting focus from medical diagnosis to functional abilities assessment. Second, to establish clear procedures for formal cooperation between the health and social care sectors in the trajectory of LTC service provision. Finally, to find an adequate balance between LTC and institutional care by creating a more comprehensive range of LTC services. A more consistent and coordinated delivery of services by both health and social care sectors seems to be an untapped resource for the improvement of the LTC potential.

Sign in / Sign up

Export Citation Format

Share Document