scholarly journals Multi-Morbidity and Polypharmacy in Older People: Challenges and Opportunities for Clinical Practice

2020 ◽  
Author(s):  
Pritti Aggarwal ◽  
Stephen Woolford ◽  
Harnish Patel
Keyword(s):  
Decision Making ◽  
Clinical Practice ◽  
Older People ◽  
Social Care ◽  
Population Ageing ◽  
Care Plans ◽  
Health And Social Care ◽  
Challenges And Opportunities ◽  
Care Systems ◽  
Global Population

Multi-morbidity and polypharmacy are common in older people and pose a challenge for health and social care systems especially in context of global population ageing. They are complex and interrelated concepts in the care of older people that require early detection and patient centred decision making that are underpinned by the principles of multidisciplinary led comprehensive geriatric assessment (CGA). Personalised care plans need to remain responsive and adaptable to the needs of a patient, enabling an individual to maintain their independence.

scholarly journals Multi-Morbidity and Polypharmacy in Older People: Challenges and Opportunities for Clinical Practice

Geriatrics ◽  
2020 ◽  
Vol 5 (4) ◽  
pp. 85
Author(s):  
Pritti Aggarwal ◽  
Stephen J. Woolford ◽  
Harnish P. Patel
Keyword(s):  
Older People ◽  
Social Care ◽  
Older Person ◽  
Care Plans ◽  
Health And Social Care ◽  
Challenges And Opportunities ◽  
Care Systems ◽  
The Individual ◽  
Global Population ◽  
Multi Disciplinary Team

Multi-morbidity and polypharmacy are common in older people and pose a challenge for health and social care systems, especially in the context of global population ageing. They are complex and interrelated concepts in the care of older people that require early detection and patient-centred shared decision making underpinned by multi-disciplinary team-led comprehensive geriatric assessment (CGA) across all health and social care settings. Personalised care plans need to remain responsive and adaptable to the needs and wishes of the patient, enabling the individual to maintain their independence. In this review, we aim to give an up-to-date account of the recognition and management of multi-morbidity and polypharmacy in the older person.

scholarly journals Research with older people in a world with COVID-19: identification of current and future priorities, challenges and opportunities

2020 ◽  
Vol 49 (6) ◽  
pp. 901-906 ◽  
Author(s):  
Sarah J Richardson ◽  
Camille B Carroll ◽  
Jacqueline Close ◽  
Adam L Gordon ◽  
John O’Brien ◽  
...  
Keyword(s):  
Older People ◽  
Psychological Health ◽  
Social Care ◽  
Care Homes ◽  
Face To Face ◽  
System Reconfiguration ◽  
Health And Social Care ◽  
Challenges And Opportunities ◽  
Academic Authors ◽  
The Impact

Abstract Older people are disproportionately affected by the COVID-19 pandemic, which has had a profound impact on research as well as clinical service delivery. This commentary identifies key challenges and opportunities in continuing to conduct research with and for older people, both during and after the current pandemic. It shares opinions from responders to an international survey, a range of academic authors and opinions from specialist societies. Priorities in COVID-19 research include its specific presentation in older people, consequences for physical, cognitive and psychological health, treatments and vaccines, rehabilitation, supporting care homes more effectively, the impact of social distancing, lockdown policies and system reconfiguration to provide best health and social care for older people. COVID-19 research needs to be inclusive, particularly involving older people living with frailty, cognitive impairment or multimorbidity, and those living in care homes. Non-COVID-19 related research for older people remains of critical importance and must not be neglected in the rush to study the pandemic. Profound changes are required in the way that we design and deliver research for older people in a world where movement and face-to-face contact are restricted, but we also highlight new opportunities such as the ability to collaborate more widely and to design and deliver research efficiently at scale and speed.

scholarly journals Supporting shared decision making for older people with multiple health and social care needs: a realist synthesis

2018 ◽  
Vol 18 (1) ◽  
Author(s):  
Frances Bunn ◽  
Claire Goodman ◽  
Bridget Russell ◽  
Patricia Wilson ◽  
Jill Manthorpe ◽  
...  
Keyword(s):  
Decision Making ◽  
Older People ◽  
Shared Decision Making ◽  
Social Care ◽  
Realist Synthesis ◽  
Shared Decision ◽  
Care Needs ◽  
Health And Social Care ◽  
Multiple Health

scholarly journals Geographies of Ageing: A Visuospatial Approach to Demographic Change in Australia

2021 ◽  
Author(s):  
Hamish Robertson ◽  
Nick Nicholas
Keyword(s):  
Social Care ◽  
Population Ageing ◽  
Limited Information ◽  
Australian Health ◽  
Situational Contexts ◽  
Health And Social Care ◽  
Organ Specific ◽  
Care Systems ◽  
Data Informed ◽  
Limited Service

The global phenomenon of population ageing is both complex and multi-layered. We know at a global level that different countries are progressing towards becoming aged societies at different rates. We know that within national borders some regions, mainly rural, are affected by ageing more than others. We also know the health and social care systems struggle to respond effectively to ageing because it is complex and, often, runs counter to the structural design of healthcare systems with their emphasis on clinical and organ-specific problems. Ageing challenges these conventional approaches and is compounded by the prevalence of wide-spread ageism at the societal and systemic levels. Therefore, if we are to adapt to population ageing and care for older people effectively, we need to better understand them and their situational contexts. This includes where they live and how their social, biological and clinical trajectories are progressing. Synthesising this kind of multi-layered information also presents challenges because many health and social care systems operate in silos, with limited information exchanges and limited service coordination. One strategy is the concept of a visuospatial data-informed approach. Here we present a conceptual basis for this approach drawn from our work in the Australian health and ageing contexts.

Health of older people

2021 ◽  
pp. 507-522
Author(s):  
Samir K. Sinha ◽  
Brittany Ellis
Keyword(s):  
Older People ◽  
Chronic Diseases ◽  
Social Care ◽  
Population Ageing ◽  
Care Needs ◽  
Delivery Of Care ◽  
Socioeconomic Groups ◽  
Increased Risk ◽  
Health And Social Care ◽  
Wide Range

Declines in mortality and fertility have largely contributed to population ageing and an accompanying epidemiological transition from infectious to chronic diseases. Significant improvements in life expectancy have occurred overall, although these have not been equally distributed between socioeconomic groups or across countries. Ageing is associated with increased health and social care needs due to the increased risk and prevalence of chronic diseases, dementia, multimorbidity, and disability that demand different types of and approaches to care. Older people benefit from a wide range of preventive interventions that reduce morbidity earlier in life, and prevent disability later on, as well as gerontological and geriatric expertise related to the delivery of care, support, and services to meet their unique needs. This chapter considers the phenomenon of population ageing, the unique health needs of older people, and specific approaches to providing health and social care to them.

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 Models of healthcare for older people

2017 ◽  
pp. 143-152
Author(s):  
Kaisu Pitkala ◽  
John Gladman ◽  
Martin Connolly
Keyword(s):  
Older People ◽  
Social Care ◽  
Developed Countries ◽  
Health Problems ◽  
Health And Social Care ◽  
Wide Range ◽  
Older Users ◽  
Care Systems ◽  
Chronic Health Problems

Older people are major users of health and social care in many developed countries, and so all health and social care systems in such countries need to be fit for older users such as those with deafness, blindness, or dementia. Despite this, specific services for older people with the most complex or challenging problems have developed. These models of healthcare for older people are diverse. They can deal with both acute and chronic health problems including rehabilitation. They can be provided in or across community, long-stay, and hospital settings, and often involve a wide range of professionals. They have developed in different ways in different countries. This chapter describes specific models of older people’s care, and outlines the role of geriatricians and other professionals in the models.

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