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 Effect of an integrated care model for pre-frail and frail older people living in community

2020 ◽  
Vol 49 (6) ◽  
pp. 1048-1055
Author(s):  
Ruby Yu ◽  
Cecilia Tong ◽  
Jean Woo
Keyword(s):  
Health Services ◽  
Older People ◽  
Integrated Care ◽  
Intervention Group ◽  
Community Dwelling ◽  
Control Group ◽  
Care Model ◽  
Health And Social Care ◽  
Community Dwelling Older People

Abstract Objectives to evaluate the effect of an integrated care model for pre-frail and frail community-dwelling older people. Design a quasi-experimental design. Setting and participants we enrolled people aged ≥60 years from a community care project. An inclusion criterion was pre-frailty/frailty, as measured by a simple frailty questionnaire (FRAIL) with a score of ≥1. Methods we assigned participants to an intervention group (n = 183) in which they received an integrated intervention (in-depth assessment, personalised care plans and coordinated care) or a control group (n = 270) in which they received a group education session on frailty prevention. The outcomes were changes in frailty, individual domains of frailty (‘fatigue’, ‘resistance’, ‘ambulation’, ‘illnesses’ and ‘loss of weight’) and health services utilisation over 12 months. Assessments were conducted at baseline and at the 12-month follow-up. Results the mean age of the participants (n = 453) at baseline was 76.1 ± 7.5 years, and 363 (80.1%) were women. At follow-up, the intervention group showed significantly greater reductions in FRAIL scores than the control group (P < 0.033). In addition, 22.4% of the intervention and 13.7% of the control participants had reverted from pre-frail/frail to robust status, with the difference reaching significance when the intervention was compared with the control group (odds ratio [OR] 1.6, 95% confidence interval [CI] 1.0–2.4) after adjustments for age, sex, living arrangement/marital status and hypercholesterolemia. For individual domains of frailty, the adjusted OR for improved ‘resistance’ was 1.7 (95% CI 1.0–2.8). However, no effects were found on reducing use of health services. Conclusion the integrated health and social care model reduced FRAIL scores in a combined population of pre-frail/frail community-dwelling older people attending older people’s centres.

Determinants for preventive oral health care need among community-dwelling older people: a population-based study

2013 ◽  
Vol 34 (1) ◽  
pp. 19-26 ◽  
Author(s):  
Kaija Komulainen ◽  
Pekka Ylöstalo ◽  
Anna-Maija Syrjälä ◽  
Piia Ruoppi ◽  
Matti Knuuttila ◽  
...  
Keyword(s):  
Health Care ◽  
Oral Health ◽  
Older People ◽  
Oral Health Care ◽  
Population Based ◽  
Community Dwelling ◽  
Population Based Study ◽  
Health Care Need ◽  
Community Dwelling Older People

The ideal neighbourhood for ageing in place as perceived by frail and non-frail community-dwelling older people

2014 ◽  
Vol 35 (8) ◽  
pp. 1771-1795 ◽  
Author(s):  
HANNA M. VAN DIJK ◽  
JANE M. CRAMM ◽  
JOB VAN EXEL ◽  
ANNA P. NIEBOER
Keyword(s):  
Older People ◽  
Q Methodology ◽  
Community Dwelling ◽  
World Health ◽  
Frail Older People ◽  
Ageing In Place ◽  
Physical Conditions ◽  
Age In Place ◽  
Community Dwelling Older People ◽  
Neighbourhood Characteristics

ABSTRACTDue to demographic changes and a widely supported policy of ageing in place, the number of community-dwelling older people will increase immensely. Thus, supportive neighbourhoods enabling older people to age in place successfully are required. Using Q-methodology, we examined older people's perceptions of the comparative importance of neighbourhood characteristics for ageing in place. Based on the World Health Organization's Global Age-friendly Cities guide, we developed 26 statements about physical and social neighbourhood characteristics. Thirty-two older people in Rotterdam, half of whom were frail, rank-ordered these statements. Q-factor analysis revealed three distinct viewpoints each among frail and non-frail older people. Comparisons within and between groups are discussed. Although both frail and non-frail older people strongly desired a neighbourhood enabling them to age in place, they have divergent views on such a neighbourhood. Older people's dependence on the neighbourhood seems to be dynamic, affected by changing social and physical conditions and levels of frailty.

scholarly journals Home‐care aides’ self‐perception of oral health‐care provision competency for community‐dwelling older people

2018 ◽  
Vol 69 (2) ◽  
pp. 158-164
Author(s):  
Yao‐Ming Cheng ◽  
Chang‐Chih Ping ◽  
Ching‐Sung Ho ◽  
Shou‐Jen Lan ◽  
Yen‐Ping Hsieh
Keyword(s):  
Health Care ◽  
Oral Health ◽  
Home Care ◽  
Older People ◽  
Community Dwelling ◽  
Health Care Provision ◽  
Care Provision ◽  
Self Perception ◽  
Community Dwelling Older People ◽  
Care Aides

scholarly journals Using Participatory Observation to Understand Older People’s Experiences: Lessons from the Field

2015 ◽  
Author(s):  
Josephine Tetley
Keyword(s):  
Older People ◽  
Qualitative Methods ◽  
Research Study ◽  
Social Care ◽  
Participant Observation ◽  
Community Dwelling ◽  
Care Services ◽  
Health And Social Care ◽  
Community Dwelling Older People ◽  
Participatory Observation

This article describes how participant observation and a reflective diary were used in a study that aimed to explore how three different groups of community dwelling older people experienced and made choices about using, or refusing, a range of health and social care services. The roles of these qualitative methods are highlighted to demonstrate how they enhanced the insights gained during the course of a research study.

Special Pharmacy Challenges for Older People in Difficult Times

2020 ◽  
Vol 35 (3) ◽  
pp. 108-109
Author(s):  
Chris Alderman
Keyword(s):  
Health Care ◽  
Older People ◽  
Natural Disasters ◽  
Health Care Professionals ◽  
World Health ◽  
Duty Of Care ◽  
The World ◽  
Difficult Times

Older people are especially vulnerable to the impacts of natural disasters such as the fires in Australia and elsewhere around the world. Health care professionals have a duty of care under these circumstances, and among those who respond are pharmacists who contribute their expertise, energy, and dedication to help where needed.

scholarly journals Modelling the Economic Impact of Reducing Loneliness in Community Dwelling Older People in England

2021 ◽  
Vol 18 (4) ◽  
pp. 1426
Author(s):  
David McDaid ◽  
A-La Park
Keyword(s):  
Cost Effectiveness ◽  
Cost Saving ◽  
Older People ◽  
Social Care ◽  
Intervention Group ◽  
Community Dwelling ◽  
Sensitivity Analyses ◽  
Social Activities ◽  
Potential Cost ◽  
Health And Social Care

Loneliness has been associated with poor mental health and wellbeing. In England, a 2018 national strategy on loneliness was published, and public health guidelines recommend participation in social activities. In the absence of existing economic evidence, we modelled the potential cost effectiveness of a service that connects lonely older people to social activities against no-intervention. A 5-year Markov model was constructed from a health and social care perspective. Parameters were drawn from the literature, with the intervention structure based on an existing loneliness alleviation programme implemented in several settings across England. Univariate and probabilistic sensitivity analyses were undertaken. The total expected cost per participant in the intervention group is £7131 compared to £6783 in the usual care group with 0.45 loneliness free years (LFY) gained. The incremental cost per LFY gained is £768; in the probabilistic sensitivity analysis the intervention is cost saving in 3.5% of iterations. Potentially such interventions may be cost-effective but are unlikely to be cost-saving even allowing for sustained effects and cumulative adverse health and social care events averted. Empirical studies are needed to determine the cost-effectiveness of these interventions, ideally mapping changes in loneliness to the quality of life, in order to allow the key metric in health economic studies, cost per quality adjusted life year to be estimated.

THE VALIDITY OF THE SUNFRAIL TOOL: A CROSS-SECTIONAL STUDY AMONG DUTCH COMMUNITY-DWELLING OLDER PEOPLE

2020 ◽  
pp. 1-7
Author(s):  
R.J.J. Gobbens ◽  
M. Maggio ◽  
Y. Longobucco
Keyword(s):  
Health Care ◽  
Health Care Utilization ◽  
Older People ◽  
Health Care Professionals ◽  
Cross Sectional Study ◽  
Criterion Validity ◽  
Adverse Outcomes ◽  
Community Dwelling ◽  
Care Utilization ◽  
Cross Sectional

Background: Early detection of frail older people is important. Timely intervention may allow health care professionals to prevent or delay the occurrence of adverse outcomes such as disability, increases in health care utilization, and premature death. Objectives: We assessed the construct and criterion validity of the SUNFRAIL tool, a questionnaire for measuring frailty among older people. Design, Setting and Participants: This cross-sectional study was carried out in a sample of Dutch citizens. A total of 195 community-dwelling persons aged 71 years and older completed the questionnaire. Measurements: Construct validity was examined by determining the correlation between the SUNFRAIL tool and the Tilburg Frailty Indicator (TFI). Criterion validity for the SUNFRAIL tool was determined by establishing the correlations with chronic diseases and adverse outcomes of frailty (disability, falls, indicators of health care utilization). Disability was measured using the Groningen Activity Restriction Scale. Participants also answered questions regarding falls and health care utilization. Results: The construct validity of this tool was good and showed significant correlations with the TFI. The correlation between SUNFRAIL total and TFI total was 0.624. The criterion validity of the SUNFRAIL tool was good for chronic diseases and good-to-excellent for adverse outcomes disability, receiving nursing care, and falls. The area under the curve for these outcomes was 0.840 (95% CI 0.781–0.899), 0.782 (95% CI 0.696–0.868), and 0.769 (95% CI 0.686–0.859), respectively. Conclusions: The results of our study suggest that the SUNFRAIL tool is a valid instrument for assessing frailty in community-dwelling older people. It is an attractive instrument for use in practice because it takes little time for health care professionals and older people to complete the questionnaire, and it expresses the integral functioning of human beings.

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