Integrating Health and Social Care at the Micro Level: Health Care Professionals as Care Managers for Older People

2003 ◽  
Vol 37 (5) ◽  
pp. 498-515 ◽  
Author(s):  
Kate Weiner ◽  
Jane Hughes ◽  
David Challis ◽  
Irene Pedersen
Keyword(s):  
Health Care ◽  
Older People ◽  
Health Care Professionals ◽  
Social Care ◽  
Care Managers ◽  
Health And Social Care ◽  
Micro Level

The factors influencing access to health and social care in the farming communities of County Down, Northern Ireland

2006 ◽  
Vol 26 (3) ◽  
pp. 373-391 ◽  
Author(s):  
DEIRDRE HEENAN
Keyword(s):  
Health Care ◽  
Northern Ireland ◽  
Older People ◽  
Social Care ◽  
Service Providers ◽  
Farming Communities ◽  
Access To Health ◽  
Health And Social Care ◽  
County Down ◽  
Farming Families

Against a background of limited previous research, this paper examines the access to health and social care among older people in the farming communities of County Down, Northern Ireland. In-depth interviews were conducted with 45 people aged 60 or more years living on family farms to collect information about health care needs and service use and adequacy. In addition, interviews with service providers provided information on their perceptions of the farming communities' needs. The findings indicate that there are specific rural dimensions of access to services and that among the respondents there was substantial unmet need. For many farming families, using services is determined by much more than being able to reach them physically. The lack of reliable information, the culture of stoicism and the absence of appropriate services impeded obtaining effective support. Recent health care policies and strategies have stressed the importance of developing local services that are responsive to need in consultation with service users, but there is worryingly little evidence that this has occurred. It is concluded that if effective outcomes are to be achieved, policies must recognise the specific characteristics of rural populations and be sensitive to the needs, attitudes and expectations of farming families. The current lack of understanding about the distinct needs of these communities at present exacerbates the isolation and marginalisation of already vulnerable older people.

scholarly journals THE EVALUATION OF INTERPROFESSIONAL EDUCATION IN PRIMARY CARE: A SOCIAL NETWORK ANALYSIS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S47-S47
Author(s):  
Linda C Smit ◽  
Jeroen Dikken ◽  
Nienke M Moolenaar ◽  
Marieke J Schuurmans ◽  
Niek J De Wit ◽  
...  
Keyword(s):  
Social Network ◽  
Social Network Analysis ◽  
Network Analysis ◽  
Older People ◽  
Health Care Professionals ◽  
Interprofessional Education ◽  
Social Care ◽  
Care Providers ◽  
Frail Older People ◽  
Health And Social Care

Abstract Effective, safe, person-centred care relies on skilled interprofessional collaboration (IPC) and practice. Little is known about interprofessional education (IPE) to increase IPC in the context of care for frail older people in the community. This study evaluates the effectiveness of IPE on IPC of primary health and social care providers providing care to frail older people in three districts in the Netherlands. A before-after study among 55 health care professionals using social network analysis was performed. The number of contacts increased on average with two contacts. The reciprocity in the districts increased with 15%, 2% and 13%. The diversity of contacts increased between 6% and 10% (p <.001; p .055; p .371). The IPE effectuated a larger, more collaborative, and diverse interprofessional network of health and social care professionals providing care to frail older people suggesting a ripple-effect of networked interventions.

scholarly journals 532 CARING FOR AND CARING ABOUT OLDER PEOPLE LIVING WITH SEVERE FRAILTY DURING COVID-19

2021 ◽  
Vol 50 (Supplement_2) ◽  
pp. ii8-ii13
Author(s):  
R Green ◽  
H King ◽  
C Nicholson
Keyword(s):  
Health Care ◽  
Older People ◽  
Health Care Services ◽  
Social Care ◽  
Social Contact ◽  
Care Services ◽  
Poor Access ◽  
Health And Social Care ◽  
Video And Audio ◽  
The Impact

Abstract Introduction An ongoing study collected survey and interview data from older people with frailty living in the community near end-of-life during the Covid-19 pandemic. Methods Unstructured interviews with older people with frailty living in the community (N = 10), which included accounts from unpaid carers (N = 5), were video and audio recorded between October–November 2021. Six of these older people have died since fieldwork completion. A face-to-face survey collected data from a further 10 older people. Participants ages ranged from 70–99, 11, men, and 9 women, living in owned, rented, or sheltered accommodation, with Clinical Frailty Scores of 6 (N = 8), 7 (N = 9), and 8 (N = 3). Results Topics raised in relation to the pandemic included loss of social contact and increased loneliness, concern about not physically getting out, and losing physical function. Older people struggled to gain access to health and social care for support and previously received services were withdrawn. Most participants did not have access to internet and relied heavily on families to facilitate virtual contact with health professionals. Families and friends were the main anchor in facilitating social and health care including chasing up medications, liaising with social care to ensure quality and consistency of care provided, and monitoring older people’s health. Where older people’s conditions worsened family provided intense support, though family carers described the strain and unsustainability of this provision. Older people and their families felt they had been forgotten. Conclusions These are insights from hard-to-reach population that are frequently invisible. Greater examination of the impact of using communication technologies in care provision on those with poor access to and capabilities with using these technologies is required. Unpaid carers need more information and resources to support the care they provide and to facilitate access to appropriate social and health care services for those they care for.

Service dominant logic and primary care services

2019 ◽  
Vol 11 (1) ◽  
pp. 127-140 ◽  
Author(s):  
May-Kristin Vespestad ◽  
Anne Clancy
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Health Care Professionals ◽  
Health Care Services ◽  
Theoretical Framework ◽  
Content Type ◽  
Care Services ◽  
Primary Care Services ◽  
Health And Social Care ◽  
Micro Level

Purpose The purpose of this study is to explore perceptions of successful collaboration by a group of professionals in primary health care, using service-dominant logic (SDL) as a theoretical framework. Design/methodology/approach This study carries out secondary analysis of the results from a Norwegian national survey on collaboration amongst professionals in primary health care services. Findings Findings illustrate that SDL can provide a theoretical framework for understanding health and social care services. The study provides evidence for the relevance of the theory at micro level. Viewing primary care through the lens of SDL enables an understanding of the applicability of market principles to health and social care. The study illustrates the relevance of the following principles: services are the fundamental basis of exchange; indirect exchange can mask the fundamental basis of exchange. Operant resources are the fundamental source of strategic benefit; actors cannot deliver value but can participate in the creation and offering of value propositions. Social implications Awareness of the use of SDL in health care services can be positive for service provision and it could be incorporated as a supplementary perspective in educational programs for health care professionals. Originality/value Applying principles from SDL as a theoretical framework for primary care services challenges the conventional understanding of marketing in health services. This paper responds to the need for a more in-depth understanding of how SDL can help health care professionals recognize their role as participants in providing seamless health care at micro level.

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 “To be seen” – older adults and their relatives’ care experiences given by a geriatric mobile team (GerMoT)

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Iréne Ericsson ◽  
Anne W. Ekdahl ◽  
Ingrid Hellström
Keyword(s):  
Health Care ◽  
Older People ◽  
Usual Care ◽  
Health Care Professionals ◽  
Intervention Group ◽  
Community Dwelling ◽  
World Health ◽  
Secondary Outcome ◽  
Health And Social Care ◽  
Community Dwelling Older People

Abstract Background The proportion of older people in the population has increased globally and has thus become a challenge in health and social care. There is good evidence that care based on comprehensive geriatric assessment (CGA) is superior to the usual care found in acute hospital settings; however, the evidence is scarcer in community-dwelling older people. This study is a secondary outcome of a randomized controlled trial of community-dwelling older people in which the intervention group (IG) received CGA-based care by a geriatric mobile geriatric team (GerMoT). The aim of this study is to obtain a better understanding, from the patients’ perspective, the experience of being a part of the IG for both the participants and their relatives. Methods Qualitative semistructured interviews of twenty-two community dwelling participants and eleven of their relatives were conducted using content analysis for interpretation. Results The main finding expressed by the participants and their relatives was in the form of feelings related to safety and security and being recognized. The participants found the care easily accessible, and that contacts could be taken according to needs by health care professionals who knew them. This is in accordance with person-centred care as recommended by the World Health Organisation (WHO) for older people in need of integrated care. Other positive aspects were recurrent health examinations and being given the time needed when seeking health care. Not all participants were positive as some found the information about the intervention to be unclear especially regarding whom to contact when in different situations. Conclusions CGA-based care of community-dwelling older people shows promising results as the participants in GerMoT found the care was giving a feeling of security and safety. They found the care easily accessible and that it was provided by health care professionals who knew them as a person and knew their health care problems. They found this to be in contrast to the usual care provided, but GerMoT care did not fulfill some people’s expectations.

scholarly journals A narrative review of literature on the use of health and social care by older trans adults: what can United Kingdom services learn?

2021 ◽  
pp. 1-22
Author(s):  
Susan Mary Benbow ◽  
Charlotte Eost-Telling ◽  
Paul Kingston
Keyword(s):  
Health Care ◽  
Social Care ◽  
The United States ◽  
Narrative Review ◽  
Cultural Humility ◽  
Service Improvement ◽  
Service Users ◽  
Strong Argument ◽  
Health And Social Care ◽  
Economic Inequalities

Abstract We carried out a narrative review and thematic analysis of literature on the physical health care, mental health care and social care of trans older adults to ascertain what is known about older trans adults’ contacts with and use of health and social care. Thirty papers were found: a majority originated in the United States of America. Five themes were identified: experience of discrimination/prejudice and disrespect; health inequalities; socio-economic inequalities; positive practice; and staff training and education. The first three themes present challenges for providers and service users. Experiences of discrimination/prejudice and disrespect over the course of their lives powerfully influence how older trans adults engage with care services and practitioners. Health and socio-economic inequalities suggest that older trans adults are likely to have greater need of services and care. The remaining two themes offer opportunities for service improvement. We conclude that more research is needed, that there is a strong argument for taking a lifecourse perspective in a spirit of cultural humility, and that contextual societal factors influence service users and providers. We identify positive trans-inclusive practices which we commend to services. More needs to be done now to make older adult services appropriate and welcoming for trans service users.

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