scholarly journals Examining Care Assessment Scores of Community-Dwelling Adults in Flanders, Belgium: The Role of Socio-Psychological and Assessor-Related Factors

2021 ◽  
Vol 18 (22) ◽  
pp. 11845
Author(s):  
Shauni Van Van Doren ◽  
David De De Coninck ◽  
Kirsten Hermans ◽  
Anja Declercq
Keyword(s):  
Informal Care ◽  
Holistic Approach ◽  
Community Dwelling ◽  
Care Needs ◽  
Related Factors ◽  
Assessment Scores ◽  
Welfare Benefits ◽  
Care Dependency ◽  
Care Assessment ◽  
Health And Social Care

One of the primary objectives of health systems is to provide a fair system by providing a comprehensive and holistic approach to caregiving rather than focusing on a single aspect of a person’s care needs. This approach is often embodied by using standardized care assessments across health and social care settings. These assessments are completed by professional assessors and yield vital information regarding a person’s health or contextual characteristics (e.g., civic engagement, psychosocial wellbeing, environmental characteristics, informal care). However, these scores may be subject to bias that endangers the fairness of the health system. In this study, we investigate to what extent socio-economic and psychological indicators and assessor-related indicators are associated with BelRAI Screener care assessment scores amongst 743 community-dwelling adults nested within 92 assessors in Flanders, Belgium. Findings indicate that there is significant variance in scores at the assessor-level. Socio-psychological characteristics of clients are associated with scores: being fluent in Dutch and providing informal care are associated with low care dependency, while living with children, feelings of depression, and the presence of an informal caregiver during assessment are associated with high care dependency. We discuss the importance of rigorous assessor training and the potential for socio-psychological factors to contribute to the allocation of welfare benefits in light of the Flemish home care system’s potential (lack of) fairness.

scholarly journals Needs of patients with dementia and their caregivers in primary care: lessons learned from the Alzheimer plan of Quebec

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Vladimir Khanassov ◽  
Laura Rojas-Rozo ◽  
Rosa Sourial ◽  
Xin Qiang Yang ◽  
Isabelle Vedel
Keyword(s):  
Primary Care ◽  
Unmet Needs ◽  
Social Care ◽  
Phase 1 ◽  
Lessons Learned ◽  
Community Dwelling ◽  
Care Plan ◽  
Phase 2 ◽  
Care Needs ◽  
Health And Social Care

Abstract Background Persons living with dementia have various health and social care needs and expectations, some which are not fully met by health providers, including primary care clinicians. The Quebec Alzheimer plan, implemented in 2014, aimed to cover these needs, but there is no research on the effect this plan had on the needs and expectations of persons living with dementia. The objective of this study is to identify persons living with dementia and caregivers’ met and unmet needs and to describe their experience. Methods This is a sequential mixed methods explanatory design: Phase 1: cross-sectional study to describe the met and unmet health and social care needs of community-dwelling persons living with dementia using Camberwell Assessment of Need of the Elderly and Carers’ Assessment for Dementia tools. Phase 2: qualitative descriptive study to explore and understand the experiences of persons living with dementia and caregivers with the use of social and healthcare services, using semi-structured interviews. Data from phase 1 was analyzed with descriptive statistics, and from phase 2, with inductive thematic analysis. Results from phases 1 and 2 were compared, contrasted and interpreted together. Results The mean total number of needs reported by the patients was 5.03 (4.48 and 0.55 met and unmet needs, respectively). Caregivers had 0.52 met needs (3.16 unmet needs). The main needs for both were memory, physical health, eyesight/hearing/communication, medication, looking after home, money/budgeting. Three categories were mentioned by the participants: Persons living with dementia and caregiver’s attitude towards memory decline, their perception of community health services and of the family medicine practice. Conclusions Our study confirms the findings of other studies on the most common unmet needs of the patients and caregivers that are met partially or not at all. In addition, the participants were satisfied with access to care, and medical services in primary practices, being confident in their family. Our results indicate persons living with dementia and their caregivers need a contact person, a clear explanation of their dementia diagnosis, a care plan, written information on available services, and support for the caregivers.

scholarly journals Health and social care services for older male adults in prison: the identification of current service provision and piloting of an assessment and care planning model

2013 ◽  
Vol 1 (5) ◽  
pp. 1-138 ◽  
Author(s):  
J Senior ◽  
K Forsyth ◽  
E Walsh ◽  
K O'Hara ◽  
C Stevenson ◽  
...  
Keyword(s):  
Social Care ◽  
Qualitative Interviews ◽  
Research Programme ◽  
Older Men ◽  
Care Needs ◽  
Care Services ◽  
Older Prisoners ◽  
Care Assessment ◽  
Health And Social Care ◽  
The Impact

AbstractBackgroundOlder prisoners are the fastest growing subgroup in the English and Welsh prison estate. Existing research highlights that older prisoners have high health and social care needs and that, currently, these needs routinely remain unmet.Objectives(1) To explore the needs of men entering and leaving prison; (2) to describe current provision of services, including integration between health and social care services; and (3) to develop and pilot an intervention for identifying health and social care needs on reception into prison, ensuring that these are systematically addressed during custody.MethodsThe research programme was a mixed-methods study comprising four parts: (1) a study of all prisons in England and Wales housing older adult men, establishing current availability and degree of integration between health and social care services through a national survey and qualitative interviews; (2) establishing the health and social care needs of older men entering prison, including experiences of reception into custody, through structured (n = 100) and semistructured (n = 27) interviews; (3) the development and implementation of an intervention to identify and manage the health, social care and custodial needs of older men entering prison; and (4) exploration of the health and social care needs of older men released from prison into the community through qualitative interviews with older prisoners prior to and following discharge from prison. Descriptive statistics were produced for all quantitative data, and qualitative data were analysed using the constant comparison method.ResultsThe number of older prisoner leads has increased in recent years but they do not all appear always to be active in their roles, nor in receipt of specialist training. Nearly half (44%) of establishments do not have an older prisoner policy. There is a lack of integration between health and social care services because of ambiguity regarding responsibility for older prisoners' social care. The responsible social service may be located a considerable distance from where the prisoner is held; in such instances, local social services do not co-ordinate their care. The most frequent unmet need on prison entry was the provision of information about care and treatment. Release planning for older prisoners was frequently non-existent.LimitationsThe study used a cut-off age of 60 years as the lower limit for the definition of an older prisoner; evidence has emerged that supports a redefinition of that cut-off to 50 years. Our study examined the care provided for men and this should be considered if contemplating using the Older prisoner Health and Social Care Assessment and Plan (OHSCAP) with older women in prison.ConclusionThe OHSCAP, developed as part of this study, provided a feasible and acceptable means of identifying and systematically addressing older prisoners' health and social care needs. Future work will include the conduct of a randomised controlled trial to examine the impact of the OHSCAP in terms of improving a range of outcomes, including economic impact.FundingThe National Institute for Health Research Health Services and Delivery Research programme.

scholarly journals The effectiveness of the Older prisoner Health and Social Care Assessment and Plan (OHSCAP): a randomised controlled trial

2017 ◽  
Vol 5 (31) ◽  
pp. 1-186 ◽  
Author(s):  
Katrina Forsyth ◽  
Laura Archer-Power ◽  
Jane Senior ◽  
Rachel Meacock ◽  
Roger Webb ◽  
...  
Keyword(s):  
Social Care ◽  
Unit Cost ◽  
Well Being ◽  
Functional Health ◽  
Care Needs ◽  
Care Plans ◽  
Older Prisoners ◽  
Care Assessment ◽  
Health And Social Care

Background Older people are the fastest-growing group in prisons in England and Wales and have complex health and social care needs that often remain unmet. Objectives (1) Evaluate the efficacy of the Older prisoner Health and Social Care Assessment and Plan (OHSCAP) in improving (i) the ability to meet older male prisoners’ health and social care needs, (ii) health-related quality of life (HRQoL), (iii) depressive symptoms and (iv) functional health and well-being and activities of daily living; (2) assess the quality of care plans produced; (3) explore the experiences of older prisoners receiving, and staff conducting, the OHSCAP; and (4) evaluate the cost-effectiveness of the OHSCAP compared with treatment as usual (TAU). Design Multicentre, parallel-group randomised controlled trial (RCT) with follow-up at 3 months, with a nested qualitative study and quality audit of care plans (n = 150, 68%). Setting Ten English prisons. Participants Four hundred and ninety-seven newly arrived male prisoners aged ≥ 50 years with a discharge date at least 3 months from recruitment. A total of 14 prisoners and 11 staff participated in qualitative interviews. Intervention Randomisation to OHSCAP or TAU. The OHSCAP group had health and social needs assessed by a trained health-care worker or prison officer. Care plans were devised and subsequent actions included professional support and appropriate referrals. Main outcome measures Primary outcome measure – mean number of unmet health and social care needs as measured by the Camberwell Assessment of Need – Short Forensic Version. Secondary outcome measures – measures of functional health and well-being, depressive symptoms and HRQoL. A health economic evaluation was undertaken using service contact between baseline and follow-up and appropriate unit cost information. Results A total of 497 prisoners were recruited (248 to OHSCAP and 249 to TAU). The 404 completed follow-ups were split evenly between the trial arms. No significant differences were observed between the intervention and TAU groups in relation to the primary outcome measure. The OHSCAP did not demonstrate convincing benefits in HRQoL over TAU, and there were no significant differences in relation to costs. Audit and qualitative data suggest that the intervention was not implemented as planned. Limitations As a result of the limited follow-up period, potential long-term gains of the intervention were not measured. Some of the standardised tools had limited applicability in prison settings. Cost-effectiveness data were limited by unavailability of relevant unit cost data. Conclusions The OHSCAP failed in its primary objective but, fundamentally, was not implemented as planned. This appears to have been attributable, in some part, to wider difficulties currently affecting the prison landscape, including reduced levels of staffing, the loss of specialist support roles for such initiatives and increased prevalence of regime disruption. Future work Partnership working and information sharing across disciplines within prison settings require improvement. Research should explore the potential involvement of other prisoners and third-sector organisations in identifying and addressing older prisoners’ health and social care needs to better match community provision. Further examination should be undertaken of how the prison regime and system affects the well-being of older prisoners. Future prison-based RCTs should carefully balance the fidelity of initiatives being evaluated and testing in a ‘real-life’ setting. Trial registration Current Controlled Trials ISRCTN11841493. Funding This project was funded by the National Institute for Health Research (NIHR) Health Services and Delivery Research programme and will be published in full in Health Services and Delivery Research; Vol. 5, No. 31. See the NIHR Journals Library website for further project information.

scholarly journals The older prisoner health and social care assessment and plan (OHSCAP) versus treatment as usual: a randomised controlled trial

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Katrina Forsyth ◽  
Roger T. Webb ◽  
Laura Archer Power ◽  
Richard Emsley ◽  
Jane Senior ◽  
...  
Keyword(s):  
Randomised Controlled Trial ◽  
Unmet Needs ◽  
Social Care ◽  
Controlled Trial ◽  
Care Needs ◽  
Treatment As Usual ◽  
Prisoner Health ◽  
Care Assessment ◽  
Health And Social Care ◽  
Randomised Controlled

Abstract Background Older people are the fastest-growing demographic group among prisoners in England and Wales and they have complex health and social care needs. Their care is frequently ad hoc and uncoordinated. No previous research has explored how to identify and appropriately address the needs of older adults in prison. We hypothesised that the Older prisoner Health and Social Care Assessment and Plan (OHSCAP) would significantly increase the proportion of met health and social care needs 3 months after prison entry, compared to treatment as usual (TAU). Methods The study was a parallel randomised controlled trial (RCT) recruiting male prisoners aged 50 and over from 10 prisons in northern England. Participants received the OHSCAP or TAU. A clinical trials unit used minimisation with a random element as the allocation procedure. Data analysis was conducted blind to allocation status. The intervention group had their needs assessed using the OHSCAP tool and care plans were devised; processes that lasted approximately 30 min in total per prisoner. TAU included the standard prison health assessment and care. The intention to treat principle was followed. The trial was registered with the UK Clinical Research Network Portfolio (ISRCTN ID: 11841493) and was closed on 30 November 2016. Results Data were collected between 28 January 2014 and 06 April 2016. Two hundred and forty nine older prisoners were assigned TAU of which 32 transferred prison; 12 were released; 2 withdrew and 1 was deemed unsafe to interview. Two hundred and fifty three 3 prisoners were assigned the OHSCAP of which 33 transferred prison; 11 were released; 6 withdrew and 1 was deemed unsafe to interview. Consequently, data from 202 participants were analysed in each of the two groups. There were no significant differences in the number of unmet needs as measured by the Camberwell Assessment of Needs – Forensic Short Version (CANFOR-S). The mean number of unmet needs for the OHSCAP group at follow-up was 2.03 (SD = 2.07) and 2.06 (SD = 2.11) for the TAU group (mean difference = 0.088; 95% CI − 0.276 to 0.449, p = 0.621). No adverse events were reported. Conclusion The OHSCAP was fundamentally not implemented as planned, partly due to the national prison staffing crisis that ensued during the study period. Therefore, those receiving the OHSCAP did not experience improved outcomes compared to those who received TAU. Trial registration Current Controlled Trials: ISRCTN11841493, 25/10/2012.

Attitudes Towards Changing Care Needs and Experiences of Social Care for People Aged 95 years and Older Living At Home: A Population-Based Study

2020 ◽  
Author(s):  
Jackie Buck ◽  
Rehana Di Rico ◽  
Fiona Scheibl ◽  
Stephen Barclay ◽  
Morag Farquhar ◽  
...  
Keyword(s):  
Informal Care ◽  
Social Care ◽  
Oldest Old ◽  
Unmet Need ◽  
Population Based ◽  
Community Dwelling ◽  
Formal Care ◽  
Old People ◽  
Care Needs ◽  
Care Services

Abstract Background: The ‘oldest old’ are amongst the largest recipients of social care services and informal care, yet they are under-represented in research and service-user experience surveys. The aim of this study was to understand experiences of receiving social care from formal services and informal carers amongst very old people living in the community. Method: Framework analysis of qualitative data from 36 interviews with community-dwelling people aged 95-101 (n=24) and/or their relatives/carers participating in the UK population-based Cambridge City over-75s Cohort (CC75C) study.Results: Fifty-eight percent lived alone, 75% were disabled, and 42% moderately or severely cognitively impaired. Sixty-seven percent had contact with formal care services and 85% with relatives at least weekly. Informal care mainly supported instrumental activities of daily living, though substituted for, and complemented, formal care at low and higher disability levels respectively. Impractical service delivery and lack of awareness of social care processes and entitlements caused unnecessary distress. Lack of meaningful social interaction, difficulties with bathing and management of continence were key areas of unmet need. Poor continuity of service and frequent changes of formal carers posed a threat to older people’s autonomy, dignity and safety.Conclusions: This study revealed a rich complexity of older old care recipients’ responses and attitudes not adequately captured in national surveys. As the urgent need to review social care provision receives more attention, there are valuable opportunities to incorporate the views of older old people into service design and delivery, honouring policy directives for person-centred care and improved quality of life.

scholarly journals Optimizing healthy ageing in disadvantaged communities: insights into older people’s use of health and social care services

2012 ◽  
Vol 2 (1) ◽  
pp. 11
Author(s):  
Josephine Tetley
Keyword(s):  
Older People ◽  
Participant Observation ◽  
Health Care Systems ◽  
Support Service ◽  
Community Dwelling ◽  
Healthy Ageing ◽  
Care Needs ◽  
Care Services ◽  
Health And Social Care ◽  
Care Systems

The European Year of Healthy Ageing recognizes that health care systems need to be improved and reorganized if services are to optimize the opportunities for people to stay healthy and well in their own homes for as long as possible. However, current services tend to be fragmented and insensitive to the needs of older people and their carers resulting in services being underused or refused leading to increased admissions into acute hospital care that could have been prevented. The main aim of the study reported in this paper was to identify the factors that affected older peoples’ decision and choice-making processes, when using or contemplating the use of care services. Using a constructivist methodology, this study used participant observation and 23 interviews in three study settings: an African Caribbean support service, day centers for people with memory and cognition problems and luncheon clubs for older people. An inductive analysis of the data revealed that when older community dwelling people found themselves struggling with certain aspects of their daily care needs; they used adapting, coping and seeking as strategies to manage. Additional issues of how well services were able to meet individual’s aspirations for care and support were identified through themes of match-mismatch, fair-unfair, independence-dependence. The findings reported in this study provide important insights as to how people’s needs are complex yet are negatively affected by rigid state controlled services that ultimately affect individual decisions to use or refuse services.

scholarly journals Unmet health and social care needs and associated factors among elderly people aged ≥ 80 years in Balçova, Izmir, Turkey

2021 ◽  
Author(s):  
Hatice Simsek ◽  
Erdem Erkoyun ◽  
Ali Akoz ◽  
Alp Ergor ◽  
Reyhan Ucku
Keyword(s):  
Risk Factor ◽  
Low Income ◽  
Associated Factors ◽  
Social Care ◽  
Community Dwelling ◽  
Care Needs ◽  
Income Status ◽  
Healthcare Needs ◽  
Unmet Healthcare Needs ◽  
Health And Social Care

Background: The health and social care needs of people aged ≥ 80 years are a neglected topic. Aims: To determine the prevalence of unmet health and social care needs and associated factors in community-dwelling individuals aged ≥ 80 years in Izmir District of Balçova, Turkey. Methods: There were 1075 participants aged ≥ 80 years. The dependent variables were unmet health and social care needs. Independent variables were sociodemographic, socioeconomic and lifestyle characteristics. The data were collected in face-to-face interviews conducted at the homes and analysed by multiple logistic regression model. Ethical approval was obtained from the Non-Invasive Research Ethics Board of Dokuz Eylul University Medical Faculty (2017/26-24). Results: The mean age was 84.1 (3.7) years and 61.0% were female. Healthcare needs were expressed by 88.2% of the participants and 78.9% claimed that they had social care needs. Prevalence of unmet health and social care needs was 32.5% and 46.6%, respectively. Approximately 90.0% of their needs were covered by families. Perceived low-income status was a risk factor for unmet healthcare needs, and lack of social support was a risk factor for unmet social care needs. Additionally, not receiving formal education was a protective factor in unmet social care needs. Conclusion: Public health policy should be developed to enable better access to care, especially for the oldest people, considering that nearly one third of the participants in this study had unmet healthcare needs and almost half had unmet social care needs.

scholarly journals The Older Prisoner Health and Social Care Assessment and Plan (OHSCAP) versus Treatment as Usual: A Randomised Controlled Trial

2020 ◽  
Author(s):  
Katrina Forsyth ◽  
Roger T Webb ◽  
Laura Archer Power ◽  
Richard Emsley ◽  
Jane Senior ◽  
...  
Keyword(s):  
Randomised Controlled Trial ◽  
Unmet Needs ◽  
Social Care ◽  
Controlled Trial ◽  
Care Needs ◽  
Treatment As Usual ◽  
Prisoner Health ◽  
Care Assessment ◽  
Health And Social Care ◽  
Randomised Controlled

Abstract Background Older adults are the fastest-growing subgroup among prisoners in England and Wales and have more health and social care needs than their younger counterparts and those the same age living in the community . We hypothesised that the Older prisoner Health and Social Care Assessment and Plan (OHSCAP) would significantly increase the proportion of met health and social care needs three months after prison entry, compared to treatment as usual (TAU).MethodsA parallel randomised controlled trial (RCT) was conducted at ten prisons in the North of England. Males aged 50 and over received the OHSCAP or TAU. The allocation procedure was minimisation with a random element. The OHSCAP process involved individuals having their needs assessed, care plans being created and reviewed. TAU encompassed the standard prison health assessment. The trial was registered with the UK Clinical Research Network Portfolio (ISRCTN ID: 11841493) and was closed on 30th November 2016.ResultsData were collected between 28th January 2014 and 06th April 2016. 249 older prisoners were assigned TAU of which 32 transferred prison; 12 were released; 2 withdrew and 1 was deemed unsafe to interview. 253 prisoners were assigned the OHSCAP of which 33 transferred prison; 11 were released; 6 withdrew and 1 was deemed unsafe to interview. Consequently, data from 202 participants were analysed in each of the two groups. There were no significant differences in the number of unmet needs as measured by the Camberwell Assessment of Needs – Forensic Short Version (CANFOR-S). The mean number of unmet needs for the OHSCAP group at follow-up was 2.03 (SD=2.07) and 2.06 (SD= 2.11) for the TAU group (RR = 0.088; 95% CI -0.276 to 0.449, p = 0.621). No adverse events were reported. Conclusion Those received the OHSCAP did not experience an improvement to the meeting of the needs in comparison to the TAU g. This was largely due to the OHSCAP not being implemented as planed due to a national prison crisis.The OHSCAP was fundamentally not implemented as planned, partly due to the national prison staffing crisis that ensued during the study period. Therefore, those receiving OHSCAP did not experience improved outcomes compared to those who received TAU. Trial RegistrationISRCTN11841493 25/10/2013Protocol available at: http://www.isrctn.com/ISRCTN11841493

scholarly journals ’n Pastoraatsperspektief op dreigende werksverlies

2008 ◽  
Vol 64 (2) ◽  
Author(s):  
Roelf Schoeman ◽  
Yolanda Dreyer
Keyword(s):  
Pastoral Care ◽  
Holistic Approach ◽  
Psychological Approach ◽  
Care Needs ◽  
Employment Insecurity ◽  
Cognitive Behavioural ◽  
Employment Situation ◽  
Counselling Process ◽  
Pastoral Support ◽  
Therapeutic Model

A pastoral perspective on the threatening loss of employment The changing employment situation in South Africa is currently characterized by the various challenges it poses to individuals in the workplace, such as affirmative action, voluntary severance packages and discharges. Discharges are often associated with employment insecurity and the threatening loss of employment. A psychological approach to the threatening loss of employment is on its own inadequate. The aim of this article is to investigate the possibilities of a holistic approach as part of pastoral support to persons experiencing the threat of losing their employment. It aims to argue that pastoral care can benefit from a multi- disciplinary approach to the threatening loss of employment. However, pastoral care needs guidelines to facilitate its relationship with psychology and to assist in dealing with faith in the counselling process. This article makes use of Gerkin’s model for pastoral care in order to provide some guidelines for pastoral care for individuals who are experiencing a protracted threat of loss of employment. Gerkin’s model will be brought into dialogue with a cognitive behavioural therapeutic model.

scholarly journals Related Factors and Clinical Outcomes of Osteosarcopenia: A Narrative Review

Nutrients ◽  
2021 ◽  
Vol 13 (2) ◽  
pp. 291
Author(s):  
Tatsuro Inoue ◽  
Keisuke Maeda ◽  
Ayano Nagano ◽  
Akio Shimizu ◽  
Junko Ueshima ◽  
...  
Keyword(s):  
Older Adults ◽  
Longitudinal Studies ◽  
Clinical Outcomes ◽  
Daily Living ◽  
Community Dwelling ◽  
Related Factors ◽  
Cross Sectional ◽  
Meta Analyses ◽  
Community Dwelling Older Adults

Osteopenia/osteoporosis and sarcopenia are common geriatric diseases among older adults and harm activities of daily living (ADL) and quality of life (QOL). Osteosarcopenia is a unique syndrome that is a concomitant of both osteopenia/osteoporosis and sarcopenia. This review aimed to summarize the related factors and clinical outcomes of osteosarcopenia to facilitate understanding, evaluation, prevention, treatment, and further research on osteosarcopenia. We searched the literature to include meta-analyses, reviews, and clinical trials. The prevalence of osteosarcopenia among community-dwelling older adults is significantly higher in female (up to 64.3%) compared to male (8–11%). Osteosarcopenia is a risk factor for death, fractures, and falls based on longitudinal studies. However, the associations between osteosarcopenia and many other factors have been derived based on cross-sectional studies, so the causal relationship is not clear. Few studies of osteosarcopenia in hospitals have been conducted. Osteosarcopenia is a new concept and has not yet been fully researched its relationship to clinical outcomes. Longitudinal studies and high-quality interventional studies are warranted in the future.

Sign in / Sign up

Export Citation Format

Share Document