Effectiveness of a Care Delivery Model for High-Need Older Adults in Communities

2020 ◽  
pp. 104973152098235
Author(s):  
Kuei-Min Chen ◽  
Hui-Fen Hsu ◽  
Li-Yen Yang ◽  
Chiang-Ching Chang ◽  
Yu-Ming Chen ◽  
...  
Keyword(s):  
Older Adults ◽  
Repeated Measures ◽  
Comparison Group ◽  
Care Delivery ◽  
Intervention Group ◽  
Community Dwelling ◽  
Delivery Model ◽  
Positive Effects ◽  
Repeated Measures Design ◽  
Care Delivery Model

Purpose: This study aimed to test the effectiveness of High-Need Community-Dwelling Older Adults Care Delivery Model (HCOACDM) in Taiwan. Methods: A cluster randomized controlled trial with repeated measures design was conducted in eight community care centers, involving 145 high-need older adults who were assigned to the intervention group or comparison group. The HCOACDM was provided over 6 months. Functional ability, quality of life, depressive symptoms, and health care and social service utilizations were measured at baseline, at 3 months, and 6 months into the intervention. The participants’ satisfaction was measured at the end of 6-month intervention. Results: Positive effects were shown on all variables in the intervention group at both the 3-month and 6-month intervals (all p < .05). The intervention group had a higher satisfaction with care delivery than the comparison group ( p < .05). Discussion: The promising findings supported a long-term implementation of the HCOACDM as applicable and beneficial.

scholarly journals Effectiveness of a Care Delivery Model for High-Need Community-Dwelling Older Adults

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 279-279
Author(s):  
Kuei-Min Chen ◽  
Hui-Fen Hsu
Keyword(s):  
Older Adults ◽  
Comparison Group ◽  
Care Delivery ◽  
Care Service ◽  
Intervention Group ◽  
Community Dwelling ◽  
Delivery Model ◽  
Care Services ◽  
Care Delivery Model ◽  
Community Dwelling Older Adults

Abstract The effectiveness of sufficient care coordination for high-need community-dwelling older adults has not been discussed. This study aimed to examine the effectiveness of a newly-developed care delivery model for high-need community-dwelling older adults. A cluster randomized controlled trial with repeated measures design was employed. A total of 145 high-need older adults participated in the study and were randomly assigned to either the intervention group or comparison group. A categorized list of care services based on the types of high-need older adults as the intervention allowed care coordinators to make adequate care service linkages. The intervention period ranged over 6 months with regulated home visits and assesssments. Functional ability, quality of life, depressive symptoms, and healthcare and social service utilizations were measured at baseline, and at 3 and 6 months into the intervention. The participants’ satisfaction with care delivery was measured at the end of 6-month intervention. Results showed that the intervention group had a better functional ability, a higher quality of life, reduced depressive symptoms, and more efficient healthcare and social service utilizations than the comparison group at both the 3-month and 6-month intervals (all p &lt; .05). By the end of the 6-month study, the intervention group were more satisfied with the care service linkages than the comparison group (p &lt; .05). The positive effects of providing a categorized list of care services for care coordinators to make service linkages have been evidenced by the outcomes. The promising findings supported a further longer-term implementation of the care delivery model.

scholarly journals Short-term balance training and acute effects on postural sway in balance-deficient older adults: a randomized controlled trial

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Niklas Sörlén ◽  
Andreas Hult ◽  
Peter Nordström ◽  
Anna Nordström ◽  
Jonas Johansson
Keyword(s):  
Older Adults ◽  
Postural Sway ◽  
Intervention Group ◽  
Community Dwelling ◽  
Control Group ◽  
Positive Effects ◽  
Randomized Controlled ◽  
Eyes Closed ◽  
Balance Exercise

Abstract Background We aimed to determine the effectiveness of 4 weeks of balance exercise compared with no intervention on objectively measured postural sway. Methods This was a single-center parallel randomized controlled, open label, trial. A six-sided dice was used for allocation at a 1:1-ratio between exercise and control. The trial was performed at a university hospital clinic in Sweden and recruited community-dwelling older adults with documented postural instability. The intervention consisted of progressively challenging balance exercise three times per week, during 4 weeks, with follow-up at week five. Main outcome measures were objective postural sway length during eyes open and eyes closed conditions. Results Sixty-five participants aged 70 years (balance exercise n = 32; no intervention n = 33) were randomized. 14 participants were excluded from analysis because of early dropout before follow-up at week five, leaving 51 (n = 22; n = 29) participants for analysis. No significant differences were detected between the groups in any of the postural sway outcomes. Within-group analyses showed significant improvements in hand grip strength for the intervention group, while Timed Up & Go improvements were comparable between groups but only statistically significant in the control group. Conclusions Performing balance exercise over a four-week intervention period did not acutely improve postural sway in balance-deficient older adults. The lower limit in duration and frequency to achieve positive effects remains unclear. Trial registration Clinical trials NCT03227666, July 24, 2017, retrospectively registered.

scholarly journals Effectiveness of a Treadmill Training Programme in Improving the Postural Balance on Institutionalized Older Adults

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Natalia Moya Pereira ◽  
Marcel Jean Pierre Massè Araya ◽  
Marcos Eduardo Scheicher
Keyword(s):  
Older Adults ◽  
Gait Speed ◽  
Postural Balance ◽  
Intervention Group ◽  
Community Dwelling ◽  
Treadmill Walking ◽  
Control Group ◽  
Timed Up And Go ◽  
Positive Effects ◽  
Before And After

Background. Institutionalized older adults have increased gait and balance impairment compared with community-dwelling older adults. The use of the treadmill for the rehabilitation process has been studied in different groups, but not in the institutionalized elderly. Objectives. The objective of this study was to assess the effects of a treadmill walking workout program on the postural balance of institutionalized older adults. Methods. Postural balance was assessed by the Berg Balance Scale (BBS), Short Physical Performance Battery (SPPB), gait speed, and Timed Up and Go Test (TUG) on 37 institutionalized older adults (23 in the intervention group and 14 in the control group). Training consisted of a 20-minute treadmill walking workout carried out twice a week for 10 weeks. Measurements were obtained before and after 10 weeks and with 1 month of follow-up for the intervention group. For the control group, the data were obtained before and after the training period. Results. Significant improvement occurred in all motor function parameters (BBS: p<0.01; gait speed: p<0.001; SPPB: p<0.001; and TUG: p<0.001). Conclusions. The present results permit us to conclude that a treadmill walking program had positive effects on the postural balance of institutionalized older adults.

Development of a Care Delivery Model for High-Need Older Adults in the Community

2019 ◽  
Vol 68 (5) ◽  
pp. 390-397 ◽  
Author(s):  
Hui-Fen Hsu ◽  
Kuei-Min Chen ◽  
Yu-Ming Chen ◽  
Chiang-Ching Chang ◽  
Meng-Chin Chen ◽  
...  
Keyword(s):  
Older Adults ◽  
Care Delivery ◽  
Delivery Model ◽  
Care Delivery Model

scholarly journals Safer cycling in older age (SiFAr): a protocol of a randomized controlled trial

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hanna Maria Siebentritt ◽  
Veronika Keppner ◽  
Sabine Britting ◽  
Robert Kob ◽  
Anja Rappl ◽  
...  
Keyword(s):  
Older Adults ◽  
Randomized Controlled Trial ◽  
Controlled Trial ◽  
Intervention Group ◽  
Community Dwelling ◽  
Older Age ◽  
Control Group ◽  
Positive Effects ◽  
Randomized Controlled ◽  
Link Type

Abstract Background Cycling has positive effects on health and the proportion of older cyclists is rising. However, the risk for older adults to be injured or killed by a bicycle accident increases. The aim of the ongoing project “Safer Cycling in Older Age (SiFAr)” is to promote safer cycling in community-dwelling older adults with a structured, multi-component exercise training. Methods SiFAr is a randomized, controlled trial with a duration of 3 months for the intervention and a 6–9 months follow-up. We address community-dwelling persons aged 65 years and older living in the area Nürnberg-Fürth-Erlangen (Germany) who are either 1) beginners with the e-bike or 2) feeling self-reported unsteadiness when cycling or 3) uptaking cycling after a longer break. Long-term, experienced cyclists without subjectively reported limitations or worries when cycling are excluded. Participants are either randomized 1:1 to an intervention group (IG; receiving multi-component exercise program related to cycling, MEPC) or an active control group (aCG; receiving health and bicycle-related presentations, HRP). The purpose of this study is to investigate if the cycling competence of the IG will improve compared to the aCG. The cycling competence as primary outcome is tested not blinded in a standardized cycle course prior and after the intervention period, which consists of variant tasks requiring motor and cognitive skills related to traffic situations in daily life. Additional assessments such as physical functioning, quality of life, fear of falling, questionnaires regarding cycling behavior are obtained. To investigate the primary objective, regression analyses with difference of errors in the cycling course as independent variable and group as dichotomous dependent variable adjusted for covariates (sex, bicycle type) will be performed. The trial design is described in the present manuscript, using the extended CONSORT checklist for reporting pragmatic trials. Discussion Since there is a lack of cycling-related interventions for older people, SiFAr aims to evaluate a standardized intervention to enhance cycling safety. The results of the SiFAr trial could contribute to the implementation of an evaluated cycling course concept promoting mobility and independence of older adults. Trial registration This study was registered with clinicaltrials.gov: NCT04362514 on April 27, 2020

Telehealth as a new care delivery model: The headache provider experience

2021 ◽  
Author(s):  
Mia T. Minen ◽  
Christina L. Szperka ◽  
Kayla Kaplan ◽  
Annika Ehrlich ◽  
Nina Riggins ◽  
...  
Keyword(s):  
Care Delivery ◽  
Delivery Model ◽  
Care Delivery Model ◽  
Provider Experience

Abstract 2552: Adapting a novel cancer care delivery model: identifying barriers unique to care coordination for LGBTQ cancer survivors

2021 ◽  
Author(s):  
Nicolas Francone ◽  
Jonathan Alhalel ◽  
Will Dunne ◽  
Sankirtana Danner ◽  
Nihmotallahi Adebayo ◽  
...  
Keyword(s):  
Cancer Survivors ◽  
Care Coordination ◽  
Cancer Care ◽  
Care Delivery ◽  
Delivery Model ◽  
Care Delivery Model

An advanced self-care delivery model for leg ulcer management: a service evaluation

2021 ◽  
Vol 30 (9) ◽  
pp. 751-762
Author(s):  
Laura Hallas-Hoyes ◽  
Stephanie Williamson ◽  
Andrew Kerr ◽  
Trevor Andrews ◽  
Leanne Calladine
Keyword(s):  
Lower Limb ◽  
Care Delivery ◽  
Self Care ◽  
Clinical Effectiveness ◽  
Service Evaluation ◽  
Delivery Model ◽  
Suitability Assessment ◽  
Care Delivery Model ◽  
Professional Contact ◽  
The Uk

Background: Lower limb ulceration is a common cause of suffering in patients and its management poses a significant burden on the NHS, with venous leg ulcers (VLUs) being the most common hard-to-heal wound in the UK. It is estimated that over one million patients in the UK have lower limb ulceration, of which 560,000 were categorised as VLUs, with a cost burden of over £3 billion each year. Objective: The aim of this service evaluation was to assess the effects of implementing a self-care delivery model on clinical outcomes with the intention of limiting face-to-face health professional contact to one appointment every 6 weeks. Method: A suitability assessment was conducted and a cohort of patients were moved to a self-care delivery model. Patient data were collected, anonymised and independently analysed, comparing time to healing against data on file from a previous report. Results: This highlighted that, in 84 of the 95 patients selected, the VLUs had healed by week 24 on the pathway, a further 10 patients' VLUs had healed by week 42 and only one remaining patient reached 42 weeks without healing. Conclusion: These results support the hypothesis that patients with VLUs can self-care and deliver clinical effectiveness. It is recommended that all services explore the possibility of introducing a self-care model for VLU care.

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