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Results 21 - 30 of 364

Comprehensive care: older people living with frailty in hospitals

NIHR DISSEMINATION CENTRE
2017

This review looks at the concept of 'frailty' in older people and what can be done to raise awareness amongst hospital staff, so that they can better identify and manage the needs of this ‘frail’ older people. It features 53 completed and ongoing studies funded by the National Institute of Health Research. The review covers four key aspects of caring for older people living with frailty in hospital: assessment; identifying and managing symptoms associated with frailty in hospital; discharge planning; and caring environments which consider the context in which inpatient diagnosis and treatment is delivered. The review highlights promising evaluations of workplace training and interventions. It also identifies a number of tools, such as the Frailty Index, that can help hospital staff to identify the severity of needs and help to provide targeted support. It also finds good evidence that the Comprehensive Geriatric Assessment (CGA) is a reliable way of diagnosing and meeting the needs of older people with input from multi-disciplinary teams. It also identifies areas where more research is needed, which include: maintaining activities of daily living for people admitted to hospital; and the effectiveness and cost-effectiveness of different models of delivering care. The review also includes a series of questions that hospital boards, staff and families can ask about the care of older people with frailty in hospitals. Summaries of the 53 studies are also included.

Community services: what do we know about quality? Briefing

O'DOWD Nora Cooke, DORNING Holly
2017

This briefing looks at trends in national measures in English community trusts to try to gain a view of quality in community services more generally. The analysis examines trends in routinely collected national quality measures in 18 community trusts in England, which account for a quarter of all community health services delivered in the NHS. Some of the key findings are: care in community trusts was predominantly delivered by professionally qualified clinical staff such as community health nurses, allied health professionals and community health visitors – staff numbers in the 18 trusts stayed roughly stable between late 2013 and 2016, although demand has almost certainly increased; these staff were roughly as satisfied with their jobs as staff in all NHS trusts, although they were less likely to recommend their trust as a place to work; the median waiting time for an outpatient appointment was three days longer in the community than across all trusts in England; patients using services offered by community trusts would generally recommend them to a friend and were less likely to experience harm compared to those using services provided by non-community trusts. The briefing concludes that the difficulties experienced in gathering useful information on community services indicate that the national lack of community data needs to be resolved before questions of quality can be meaningfully answered.

Room to improve: the role of home adaptations in improving later life

CENTRE FOR AGEING BETTER
2017

This report summarises the findings from an evidence review on how home adaptations can improve later lives and provides recommendations to improve access to, and delivery of, home adaptation and repair services. It shows that both minor and major home adaptations are an effective intervention to improve outcomes for people in later life, including improved performance of everyday activities, improved mental health and preventing falls and injuries. It also identifies good evidence that greatest outcomes are achieved when individuals and families are involved in the decision-making process, and when adaptations focus on individual goals. Based on the findings, the report makes recommendations for commissioners and service provides. These include for Local Sustainability and Transformation partnerships to put in place preventative strategies to support people at risk in their home environment; for local authorities to make use of the Disabled Facilities Grant to fund both major and minor adaptations; and for local authorities to ensure people have access to information and advice on how home adaptations could benefit them, in line with the Care Act 2014.

The role of home adaptations in improving later life

POWELL Jane, et al
2017

A systematic review of evidence on the effectiveness and cost effectiveness on how home adaptations can contribute in helping older people to maintain their independence for as long as possible and what works best to improve the health and wellbeing. Conducted by a team from the University of the West of England, the review covered peer-reviewed literature and professional and practitioner-led grey literature published between 2000 and 2016. It found evidence that both minor and major home adaptations can improve outcomes for people in later life, including improved performance of everyday activities, improved mental health and preventing falls and injuries. It also identified good evidence that greatest outcomes are achieved when individuals and families are involved in the decision-making process, and when adaptations focus on individual goals. It also found strong evidence that minor home adaptations are an effective and cost-effective intervention. The report also includes analysis from the Building Research Establishment which shows that home interventions to prevent falls on stairs, can lead to savings of £1.62p for every £1 spent. Based on the findings, the report makes recommendations for commissioners and service provides. These include for Local Sustainability and Transformation partnerships to put in place preventative strategies to support people at risk in their home environment; for local authorities to make use of the Disabled Facilities Grant to fund both major and minor adaptations; and for local authorities to ensure people have access to information and advice on how home adaptations could benefit them, in line with the Care Act 2014.

The Kirklees Do Your Thing project

ALLEN Helen
2017

An evaluation of the Kirklees Do Your Thing project, delivered by Community Catalysts, to develop new innovative community-based activities for individuals with learning disabilities and/or autism. The two-year project, which employed a local catalyst, undertook a thorough community scoping exercise to identify organisations and people in Kirklees who might add value to the project; met people with a learning disability and/or autism interested in running an activity (called group leaders) and their supporters; supported group leaders to identify and connect with potential group members; identified community venues which could be used at no or little cost by group leaders to run their activities and formed strong working links with their managers; captured the journeys of the group leaders and showcased the outcomes of their work throughout the life of the project; established and strengthened a circle of formal and informal supports around each group leader to ensure the sustainability of their activity as the project came to end; and developed a set of ‘top tips’ for commissioners and other organisations keen to help other people with disabilities use their talents and interests to set up groups and make a contribution. The evaluation finds that with the right kind of help and support people with learning disabilities and/or autism will readily use their often-unappreciated gifts and talents to set up groups and activities that benefit other people. The project has also successfully challenged negative perceptions of people with learning disabilities and/or autism, helping professionals and families to recognise their strengths and gifts and the contribution they can make with the right kind of support. Key learning points include: it takes time to embed a project like this which brings radically new thinking into an area; some people prefer to work alone, and peer support groups may not work for everybody; establish the boundaries and be clear about the types of support that potential group leaders could or could not expect from the project; focus on the people who are really motivated; and work at people’s own pace.

Releasing Somerset's capacity to care: community micro-providers in Somerset. The impact and outcomes of the Community Catalysts project

COMMUNITY CATALYSTS
2017

An evaluation of the Community Catalysts project in Somerset. Community Catalysts is a social enterprise working across the UK to make sure that people who need care and support to live their lives can get help in ways, times and places that suit them, with real choice of attractive local options. In Somerset, the project aimed to increase the number of flexible, responsive, high quality local services and supports that can give people real choice and control over their care. As part of the project Community Catalysts has worked with partners to develop the Community Somerset Community Micro-enterprise Directory. The directory features 275 community-enterprises all of whom offer services linked to health, care or wellbeing. 223 offer help to older people to enable them to stay at home. 58% of these providers offer personal care services, including for people with more complex care needs. This care is often provided alongside home help, domestic and social support. 42% offer home help type services including support, companionship, domestic help, gardening, cleaning, trips out, transport. 3,500 hours of care a week are delivered by Community micro-enterprises in Somerset. Community Catalysts also undertook a survey of 45 families who have used both a micro-provider and a traditional domiciliary agency. The results showed that community micro-providers are able to deliver strong and valued outcomes for the people they support, and significantly outperform traditional domiciliary care delivery. The evaluation indicates that 32 community micro-enterprises in rural West Somerset are delivering £134,712 in annual savings. Projected across the 223 micro-enterprises supported by Community Catalysts in Somerset, the project delivers: £938,607 in annual savings; 56% of people supported use direct payments, showing £525,619 of direct and ongoing annual savings to the council.

Physical activity interventions for treatment of social isolation, loneliness or low social support in older adults: a systematic review and meta-analysis of randomised controlled trials

SHVEDKO Anastasia, et al
2018

Objectives: This article reviews the effects of physical activity (PA) interventions on social isolation, loneliness or low social support in older adults. Design: Systematic review and meta-analysis of randomised controlled trials (RCTs). Method: MEDLINE, EMBASE, PsycINFO, the Cochrane CENTRAL, CINAHL, were screened up to February 2017. RCTs comparing PA versus non-PA interventions or control (sedentary) condition were included. Risk of bias was assessed using the 12 criteria Cochrane Review Book Group risk of bias. The outcome measures were: social isolation, loneliness, social support, social networks, and social functioning. Standardised mean differences (SMDs) with associated 95% confidence intervals (CIs) were calculated for continuous outcomes. Meta-analysis was performed using a random effects model. Results: The search strategy identified 38 RCTs, with a total of 5288 participants, of which 26 had a low risk of bias and 12 had a high risk of bias. Meta-analysis was performed on 23 RCTs. A small significant positive effect favouring the experimental condition was found for social functioning with strongest effects obtained for PA interventions, diseased populations, group exercise setting, and delivery by a medical healthcare provider. No effect of PA was found for loneliness, social support, or social networks. Conclusion: This review shows, for social functioning, the specific aspects of PA interventions can successfully influence social health. PA did not appear to be effective for loneliness, social support and social networks.

The effectiveness of e-interventions on reducing social isolation in older persons: a systematic review of systematic reviews

CHIPPS Jennifer, JARVIS Mary Ann, RAMIALL Suvira
2017

As the older adult population group has been increasing in size, there has been evidence of growing social isolation and loneliness in their lives. The increased use of information communication technology and Internet-supported interventions has stimulated an interest in the benefits of e-Interventions for older people and specifically in having a role in increasing social networks and decreasing loneliness. A systematic review of e-Interventions to reduce loneliness in older people was conducted with the aim to synthesize high quality evidence on the effectiveness of e-Interventions to decrease social isolation/loneliness for older people living in community/residential care. A systematic search of 12 databases for reviews published between 2000–2017 was conducted using search term synonyms for older people, social isolation and interventions. Three independent researchers screened articles and two reviewers extracted data. The Revised-Assessment of Multiple Systematic Reviews was used to assess the quality of reviews. The final search identified 12 reviews, which included 22 unique primary research studies evaluating e-Interventions for social isolation or loneliness. The reviews were of moderate quality and the primary studies showed a lack of rigor. Loneliness was most frequently measured using the University California Los Angeles Loneliness Scale. Despite the limitations of the reviewed studies, there is inconsistent and weak evidence on using e-Interventions for loneliness in older people.

Social prescribing: less rhetoric and more reality. A systematic review of the evidence

BICKERDIKE Liz, et al
2017

Objectives: Social prescribing is a way of linking patients in primary care with sources of support within the community to help improve their health and well-being. Social prescribing programmes are being widely promoted and adopted in the UK National Health Service and this systematic review aims to assess the evidence for their effectiveness. Setting/data sources: Nine databases were searched from 2000 to January 2016 for studies conducted in the UK. Relevant reports and guidelines, websites and reference lists of retrieved articles were scanned to identify additional studies. All the searches were restricted to English language only. Participants: Systematic reviews and any published evaluation of programmes where patient referral was made from a primary care setting to a link worker or facilitator of social prescribing were eligible for inclusion. Risk of bias for included studies was undertaken independently by two reviewers and a narrative synthesis was performed. Primary and secondary outcome measures: Primary outcomes of interest were any measures of health and well-being and/or usage of health services. Results: A total of 15 evaluations of social prescribing programmes were included. Most were small scale and limited by poor design and reporting. All were rated as a having a high risk of bias. Common design issues included a lack of comparative controls, short follow-up durations, a lack of standardised and validated measuring tools, missing data and a failure to consider potential confounding factors. Despite clear methodological shortcomings, most evaluations presented positive conclusions. Conclusions: Social prescribing is being widely advocated and implemented but current evidence fails to provide sufficient detail to judge either success or value for money. If social prescribing is to realise its potential, future evaluations must be comparative by design and consider when, by whom, for whom, how well and at what cost.

Demonstrating the health and social cost-benefits of lifestyle housing for older people

HOUSING LEARNING AND IMPROVEMENT NETWORK
2017

This report, commissioned by Keepmoat Regeneration/ENGIE, sets out the evidence for the benefits of developing specialist retirement housing for people aged over 55, including cost savings. It focuses on the benefits of age restricted retirement housing or sheltered accommodation, care villages and specialist extra care housing with services and care on-site. Part one lists key facts and figures on the health and social care cost-benefits of lifestyle housing for older people. Part two provides more detailed findings of the potential benefits including the areas of: social connectedness and reducing loneliness; life expectancy, keeping couples together and supporting informal carers, financial savings in adult social care and the NHS, and preventing the need for institutional care. References and links are listed at the end of the document.

Results 21 - 30 of 364

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