scholarly journals Extra Care Housing: The Current State of Research and Prospects for the Future

2021 ◽  
pp. 1-12
Author(s):  
Robin A. Darton
Keyword(s):  
Care Needs ◽  
Eligibility Criteria ◽  
Supportive Environment ◽  
Current State ◽  
People With Dementia ◽  
Care And Support ◽  
Balance Of Care ◽  
State Of Research ◽  
Extra Care Housing

Extra care housing aims to meet the housing, care and support needs of older people, while maintaining their independence in self-contained accommodation. Evidence from several studies suggests that it has benefits for residents in terms of costs and outcomes, and can provide a supportive environment for people with dementia, although the benefits for residents with greater care needs are less clear. Budgetary pressures and increasing eligibility criteria are altering the balance of care between residents and resulting in more task-focused, less personalised care. An increasing shortfall in provision and incentives for developers to concentrate on ‘lifestyle’ provision raise questions about the long-term viability of the model for supporting local authority-funded residents. Responses to the coronavirus pandemic also raise questions about future housing and care arrangements, and these need to be addressed in the government’s long-delayed plans for social care.

scholarly journals Can extra care housing support the changing needs of older people living with dementia?

Dementia ◽  
2018 ◽  
Vol 19 (5) ◽  
pp. 1492-1508 ◽  
Author(s):  
Simon Chester Evans ◽  
Teresa Atkinson ◽  
Ailsa Cameron ◽  
Eleanor K Johnson ◽  
Randall Smith ◽  
...  
Keyword(s):  
Older People ◽  
Living Alone ◽  
Care Staff ◽  
Key Factors ◽  
Care Needs ◽  
People With Dementia ◽  
Care And Support ◽  
Acceptable Quality ◽  
Extra Care Housing

With over two-thirds of people with dementia living in the community and one-third of those living alone, it is important to consider the future housing needs of this population, particularly as symptoms of cognitive impairment increase. Policy in England has focused on enabling people living with dementia to remain in their own homes for as long as possible, often with the support of a family carer. However, many people struggle to maintain an acceptable quality of life in their own homes as their dementia advances, often due to the design limitations of mainstream housing and the challenge of finding specialist domiciliary care that is affordable and of sufficient quality. Extra care housing offers a model that aims to support older people living in their own apartments, whilst also offering specialist person-centred care as and when it is needed. This paper reports on a longitudinal project that explored how extra care housing can respond to the changing social care needs of residents, including those living with dementia. Participants included residents and staff from four extra care housing schemes, one of which was a specialist dementia scheme, in two regions of England. Interviews were carried with 51 residents across 4 rounds at 5 month intervals between October 2015 and June 2017. Interviews were also carried out with 7 managers, 20 care staff and 2 local authority commissioners of housing for older people. Key factors included person-centred care and support, flexible commissioning and staffing, appropriate design of the environment and suitable location of the scheme within the wider community. The challenge of delivering services that addresses these issues during a period of reduced public spending is acknowledged. Further research is suggested to compare different approaches to supporting people with dementia, including integrated and separated accommodation, and different stages of dementia.

Deciding to move into extra care housing: residents’ views

2011 ◽  
Vol 32 (7) ◽  
pp. 1215-1245 ◽  
Author(s):  
THERESIA BÄUMKER ◽  
LISA CALLAGHAN ◽  
ROBIN DARTON ◽  
JACQUETTA HOLDER ◽  
ANN NETTEN ◽  
...  
Keyword(s):  
Older People ◽  
Living Arrangements ◽  
Independent Living ◽  
Living Environment ◽  
Care Needs ◽  
Care And Support ◽  
Care Assessment ◽  
Social Leisure ◽  
Leisure Facilities ◽  
Extra Care Housing

ABSTRACTExtra care housing aims to meet the housing, care and support needs of older people, while helping them to maintain their independence in their own private accommodation. In 2003, the Department of Health announced capital funding to support the development of extra care housing, and made the receipt of funding conditional on participating in an evaluative study. Drawing on information collected directly from residents in 19 schemes, this paper presents findings on the factors motivating older people to move to extra care housing, their expectations of living in this new environment, and whether these differ for residents moving to the smaller schemes or larger retirement villages. In total, 949 people responded, 456 who had moved into the smaller schemes and 493 into the villages. Of the residents who moved into the villages most (75%) had not received a care assessment prior to moving in, and had no identified care need. There was evidence that residents with care needs were influenced as much by some of the attractions of their new living environment as those without care needs who moved to the retirement villages. The most important attractions of extra care housing for the vast majority of residents were: tenancy rights, flexible onsite care and support, security offered by the scheme and accessible living arrangements. The results suggest that, overall, residents with care needs seem to move proactively when independent living was proving difficult rather than when staying put is no longer an option. A resident's level of dependency did not necessarily influence the importance attached to various push and/or pull factors. This is a more positive portrayal of residents’ reasons for moving to smaller schemes than in previous UK literature, although moves did also relate to residents’ increasing health and mobility problems. In comparison, type of tenure and availability of social/leisure facilities were more often identified as important by those without care needs in the villages. Therefore, as in other literature, the moves of village residents without care needs seemed to be planned ones mostly towards facilities and in anticipation of the need for care services in the future.

scholarly journals Ageing in extra-care housing: preparation, persistence and self-management at the boundary between the third and fourth age

2019 ◽  
Vol 40 (12) ◽  
pp. 2711-2731 ◽  
Author(s):  
Eleanor K. Johnson ◽  
Ailsa Cameron ◽  
Liz Lloyd ◽  
Simon Evans ◽  
Robin Darton ◽  
...  
Keyword(s):  
Older People ◽  
Longitudinal Research ◽  
Self Management ◽  
Care Needs ◽  
The Third ◽  
The United Kingdom ◽  
Care And Support ◽  
Care Workers ◽  
Operational Practices ◽  
Extra Care Housing

AbstractExtra-care housing (ECH) has been hailed as a potential solution to some of the problems associated with traditional forms of social care, since it allows older people to live independently, while also having access to care and support if required. However, little longitudinal research has focused on the experiences of residents living in ECH, particularly in recent years. This paper reports on a longitudinal study of four ECH schemes in the United Kingdom. Older residents living in ECH were interviewed four times over a two-year period to examine how changes in their care needs were encountered and negotiated by care workers, managers and residents themselves. This paper focuses on how residents managed their own changing care needs within the context of ECH. Drawing upon theories of the third and fourth age, the paper makes two arguments. First, that transitions across the boundary between the third and fourth age are not always straightforward or irreversible and, moreover, can sometimes be resisted, planned-for and managed by older people. Second, that operational practices within ECH schemes can function to facilitate or impede residents’ attempts to manage this boundary.

scholarly journals Exclusion of Pregnant Women from Clinical Trials during the Coronavirus Disease 2019 Pandemic: A Review of International Registries

2020 ◽  
Vol 37 (08) ◽  
pp. 792-799 ◽  
Author(s):  
Devin D. Smith ◽  
Jessica L. Pippen ◽  
Adebayo A. Adesomo ◽  
Kara M. Rood ◽  
Mark B. Landon ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Pregnant Women ◽  
World Health ◽  
Eligibility Criteria ◽  
Current State ◽  
Key Points ◽  
State Of Research ◽  
Novel Coronavirus ◽  
Health Organization ◽  
Clinical Trials Registry

Objective Pregnant women have been historically excluded from clinical trials for nonobstetric conditions, even during prior epidemics. The objective of this review is to describe the current state of research for pregnant women during the coronavirus disease 2019 (COVID-19) pandemic. Study Design We conducted a search of international trial registries for trials relating to the novel coronavirus. The eligibility criteria for each trial were reviewed for inclusion/exclusion of pregnant women. Relevant data were extracted and descriptive statistics were calculated for individual and combined data. The total number of trials from each registry were compared, as well as the proportions of pregnancy-related trials within each. Results Among 621,370 trials in the World Health Organization International Clinical Trials Registry, 927 (0.15%) were COVID-19 related. Of those, the majority (52%) explicitly excluded pregnancy or failed to address pregnancy at all (46%) and only 16 (1.7%) were pregnancy specific. When categorized by region, 688 (74.2%) of COVID-19 trials were in Asia, followed by 128 (13.8%) in Europe, and 66 (7.2%) in North America. Of the COVID-19 trials which included pregnant women, only three were randomized-controlled drug trials. Conclusion Approximately 1.7% of current COVID-19 research is pregnancy related and the majority of trials either explicitly exclude or fail to address pregnancy. Only three interventional trials worldwide involved pregnant women. The knowledge gap concerning the safety and efficacy of interventions for COVID-19 created by the exclusion of pregnant women may ultimately harm them. While “ethical” concerns about fetal exposure are often cited, it is in fact unethical to habitually exclude pregnant women from research. Key Points

Thailand

2019 ◽  
pp. 93-100
Author(s):  
Sookjaroen Tangwongchai ◽  
Chavit Tunvirachaisakul ◽  
Thitiporn Supasitthumrong ◽  
Kanitpong Phabphal ◽  
Pichet Udomratn
Keyword(s):  
Public Awareness ◽  
Universal Coverage ◽  
The Elderly ◽  
Multidisciplinary Teams ◽  
Thai Population ◽  
Term Care ◽  
People With Dementia ◽  
Care And Support ◽  
Care System

Thailand has unique advantages and challenges in caring for people with dementia. Thailand is in the process of launching its National Dementia Strategy, based on the previously developed care and support policies for the elderly. Currently, care for people with dementia is provided through integrated community care by family and health volunteers, and care costs are covered by the Universal Coverage Scheme. The main challenges are to raise public awareness of dementia, to improve healthcare capacity, and to prepare for a long-term care system. There needs to be focus on innovative medical management and prevention strategies to tackle dementia in Thailand. In the future, Thailand expects to see an improvement in public education about dementia, an increase in specialist training involving multidisciplinary teams, the emergence of sustainable long-term community-based care, and the expansion of an accessible care system with adequate standards for the Thai population.

Delirium – Does it Matter?

2008 ◽  
Vol 9 (3) ◽  
pp. 248-249 ◽  
Author(s):  
Valerie Page
Keyword(s):  
Critical Care ◽  
Cognitive Impairment ◽  
Icu Patients ◽  
Current State ◽  
Disturbance Of Consciousness ◽  
State Of Research ◽  
New Onset

Delirium is a disturbance of consciousness associated with new-onset changes in cognition. It is associated with increased mortality and long-term cognitive impairment for ICU patients. This article reviews the current state of research in delirium in critical care.

scholarly journals Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis: A Guide for Nurses

2020 ◽  
Vol 31 (3) ◽  
pp. 281-295
Author(s):  
Leah M. Hanson ◽  
Amanda P Bettencourt
Keyword(s):  
Toxic Epidermal Necrolysis ◽  
Nursing Care ◽  
Psychosocial Support ◽  
Wound Care ◽  
Stevens Johnson Syndrome ◽  
Care Needs ◽  
Current State ◽  
Johnson Syndrome ◽  
State Of The Science

Nurses are central to the care of patients with Stevens-Johnson syndrome and toxic epidermal necrolysis. Patients with these conditions present with nuanced symptoms and have complex nursing care needs. Although much of the exact pathophysiology of these diseases is not known, all nurses benefit from a fundamental understanding of the genesis of skin manifestations, associated pharmacology, and prognosis. The care of patients hospitalized with Stevens-Johnson syndrome and toxic epidermal necrolysis consists of wound care, infection prevention, comfort management, hydration and nutrition, psychosocial support, and the prevention of long-term complications. This article provides an overview of these diseases, including clinical diagnosis, history and physical assessment, related pharmacology, and nursing care priorities. A description of the current state of the science in clinical management for nurses at all levels is provided, with an emphasis on nursing’s contribution to the best possible patient outcomes.

Intellectual Potential of a Complex-Structured Region as an Object of Management in the Period of Digitalization

2020 ◽  
Vol 9 (4) ◽  
pp. 5-7
Author(s):  
Muhabbat Mahmudova
Keyword(s):  
Regional Economy ◽  
The State ◽  
Current State ◽  
Scientific Organizations ◽  
Regional Trends ◽  
Research Sector ◽  
State Of Research ◽  
Intellectual Potential ◽  
Term Maintenance

Objective: to assess the state of research potential of the Tyumen region in the conditions of digitalization of the regional economy. Methods: on the basis of comparative analysis and graphical interpretation of data, modern regional trends in the state and development of intellectual potential are identified. Results: during the analyzed period, the scientific sector of the regional economy showed trends in increasing the level of activation, as a result of stimulating the growth of the effectiveness of research institutions on the part of local authorities. Conclusions: the current state of the regional research sector, the intensity and direction of its development, as well as the effectiveness of the functioning of scientific organizations correspond to the level and specialization of the Tyumen region; and for the long-term maintenance of digital transformation, it is necessary to properly support the implementation of the digitalization policy in an unstable economic environment.

scholarly journals Older people's perspectives on living in integrated housing and care settings: the case of extra care housing

2020 ◽  
Vol 28 (3) ◽  
pp. 281-290
Author(s):  
Ailsa Cameron ◽  
Eleanor K Johnson ◽  
Simon Evans
Keyword(s):  
Qualitative Data ◽  
Care Needs ◽  
Housing Service ◽  
Content Type ◽  
Levels Of Care ◽  
Care And Support ◽  
Care Workers ◽  
Practical Implications ◽  
Extra Care Housing

PurposeThis paper explores residents' perceptions and experiences of extra care housing as an integrated model of housing with care.Design/methodology/approachData were collected in a longitudinal qualitative study based on four extra care housing schemes. Data from interviews with residents, care workers, managers and local commissioners were analysed thematically.FindingsThe integration of housing with care enabled many older people to manage their care proactively. However, the increasing number of residents with complex health and care needs, including chronic illness, led some residents to question the ability of the model to support residents to live independently.Research limitations/implicationsThe study struggled to recruit sufficient residents from the specialist dementia setting who were able to communicate their consent to take part in the research. In addition, the quality of qualitative data collected in interviews with participants at this setting reduced over successive rounds of interviews.Practical implicationsThe study suggests the need to ensure that residents are fully informed about levels of care and support is available when considering a move into extra care housing.Originality/valueThis paper provides a timely opportunity to consider extra care housing as an example of an integrated housing service, particularly in light of the current challenges facing the sector.

scholarly journals VARIABILITY IN ACCESS TO VA’S AID AND ATTENDANCE PENSION BENEFIT: A MIXED-METHODS STUDY

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S744-S745
Author(s):  
Kali S Thomas ◽  
Emily Corneau ◽  
Stefanie Gidmark ◽  
Taylor Rickard ◽  
Susan Allen
Keyword(s):  
Mixed Methods ◽  
Low Income ◽  
Mixed Methods Study ◽  
Service Organizations ◽  
Pension Benefit ◽  
Care Needs ◽  
Eligibility Criteria ◽  
Term Care ◽  
Medical Centers

Abstract The Veterans Benefit Administration’s (VBA) Aid and Attendance enhanced pension benefit (A&A) is available to older, low-income Veterans who require assistance meeting their daily needs. However, reports indicate that A&A is underutilized with only 1/3 of eligible Veterans receiving this benefit. The objective of this mixed methods study is to characterize the variability in A&A enrollment across VA Medical Centers (VAMCs) and determine factors attributable to the variation. Using VA administrative data, we calculated the rate of enrollment in A&A among Veterans receiving pension. We then purposefully sampled 16 Chiefs of Social Work at VAMCs with the highest (n=7) and lowest (n=9) rates of enrollment. Interviews were transcribed, coded, and analyzed using conventional qualitative research methods. The rate of enrollment in A&A varies from <1% to 23% across VAMCs. VAMCs that had higher rates of enrollment were larger and more likely to be located in the South and Mid-Atlantic regions. Respondents at sites with low rates of enrollment indicate that education around the eligibility criteria is needed for VAMC staff. They also report that outreach to Veterans about this benefit is limited. Respondents at VAMCs with high rates of enrollment indicate that the relationships with VBA and Veterans Service Organizations facilitates access. Universally, respondents viewed the A&A benefit positively and note that it helps meet Veterans’ long-term care needs. As the Veteran population continues to age, it is important that VA ensure equal access to A&A for eligible Veterans. Implications of these findings and next steps will be discussed.

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