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Results for 'home care'

Results 1 - 10 of 30

Interventions to prevent or delay long-term nursing home placement for adults with impairments: a systematic review of reviews

DUAN-PORTER Wei, et al
2020

Background: With continued growth in the older adult population, US federal and state costs for long-term care services are projected to increase. Recent policy changes have shifted funding to home and community-based services (HCBS), but it remains unclear whether HCBS can prevent or delay long-term nursing home placement (NHP). Methods: This study searched MEDLINE (OVID), Sociological Abstracts, PsycINFO, CINAHL, and Embase (from inception through September 2018); and Cochrane Database of Systematic Reviews, Joanna Briggs Institute Database, AHRQ Evidence-based Practice Center, and VA Evidence Synthesis Program reports (from inception through November 2018) for English-language systematic reviews. This study also sought expert referrals. Eligible reviews addressed HCBS for community-dwelling adults with, or at risk of developing, physical and/or cognitive impairments. Two individuals rated quality (using modified AMSTAR 2) and abstracted review characteristics, including definition of NHP and interventions. From a prioritized subset of the highest-quality and most recent reviews, this study abstracted intervention effects and strength of evidence (as reported by review authors). Results: Of 47 eligible reviews, most focused on caregiver support (n = 10), respite care and adult day programs (n = 9), case management (n = 8), and preventive home visits (n = 6). Among 20 prioritized reviews, 12 exclusively included randomized controlled trials, while the rest also included observational studies. Prioritized reviews found no overall benefit or inconsistent effects for caregiver support (n = 2), respite care and adult day programs (n = 3), case management (n = 4), and preventive home visits (n = 2). For caregiver support, case management, and preventive home visits, some reviews highlighted that a few studies of higher-intensity models reduced NHP. Reviews on other interventions (n = 9) generally found a lack of evidence examining NHP. Discussion: Evidence indicated no benefit or inconsistent effects of HCBS in preventing or delaying NHP. Demonstration of substantial impacts on NHP may require longer-term studies of higher-intensity interventions that can be adapted for a variety of settings.

SCIE research briefing 36: reablement: a cost-effective route to better outcomes

FRANCIS Jennifer, FISHER Mike, RUTER Deborah
2011

One in a series of research briefings about preventive care and support for adults. This briefing focuses on reablement services. It summarises the findings from existing research evidence and covers: the outcomes of reablement; people's views about reablement; funding and organisational implications; costs and cost-effectiveness of reablement. The briefing also looks at whether reducing the need for home care and improving people's independence will improve their overall wellbeing. The briefing reports that good research evidence exists to suggest that reablement improves service outcomes, removing or reducing the need for standard home care. Although studies report a higher cost than traditional home care, they also indicate a strong possibility of longer-term savings. Gaps in the research evidence are also discussed.

Interventions to promote early discharge and avoid inappropriate hospital (re)admission: a systematic review

COFFEY Alice, et al
2019

Increasing pressure on limited healthcare resources has necessitated the development of measures promoting early discharge and avoiding inappropriate hospital (re)admission. This systematic review examines the evidence for interventions in acute hospitals including (i) hospital-patient discharge to home, community services or other settings, (ii) hospital discharge to another care setting, and (iii) reduction or prevention of inappropriate hospital (re)admissions. Academic electronic databases were searched from 2005 to 2018. In total, ninety-four eligible papers were included. Interventions were categorized into: (1) pre-discharge exclusively delivered in the acute care hospital, (2) pre- and post-discharge delivered by acute care hospital, (3) post-discharge delivered at home and (4) delivered only in a post-acute facility. Mixed results were found regarding the effectiveness of many types of interventions. Interventions exclusively delivered in the acute hospital pre-discharge and those involving education were most common but their effectiveness was limited in avoiding (re)admission. Successful pre- and post-discharge interventions focused on multidisciplinary approaches. Post-discharge interventions exclusively delivered at home reduced hospital stay and contributed to patient satisfaction. Existing systematic reviews on tele-health and long-term care interventions suggest insufficient evidence for admission avoidance. The most effective interventions to avoid inappropriate re-admission to hospital and promote early discharge included integrated systems between hospital and the community care, multidisciplinary service provision, individualization of services, discharge planning initiated in hospital and specialist follow-up.

In-home use of personalized music for persons with dementia

KULIBERT Danica, et al
2019

Although evidence is mounting that personalised music has beneficial effects for long-term care residents with dementia, little research has examined the effects of personalised music for the majority of persons with dementia living at home. These individuals live at home with care partners who may also benefit from having music that is personalised for their loved one. Using the Music & MemorySM program of personalised playlists delivered via iPod Shuffles®, the current study examined the effects of the Music & Memory program for persons with dementia by using the Bath Assessment of Subjective Quality of Life in Dementia scale and a Music Listening Experience Scale developed for this study. This study also administered three scales that captured care partner experiences. Transcripts of the Bath Assessment of Subjective Quality of Life in Dementia administrations at the beginning of the study and 3 months later, plus interviews about the Music & Memory program, were then analysed using the interpretive phenomenological analysis method. Themes about the Music & Memory program and life living with dementia for from diagnosed persons and their care partners are discussed.

Physical activity programs for older people in the community receiving home care services: systematic review and meta-analysis

BURTON Elissa, et al
2019

The proportion of older adults is increasing around the world and most wish to live in their home until they die. To achieve this, many will require services in the home to remain living independently. To maintain function (ie, strength, balance, and endurance), physical activity needs to be undertaken on a regular basis, and is essential as a person ages. Unfortunately, as people age there is a tendency to reduce activity levels, which often leads to loss of function and frailty, and the need for home care services. This updated systematic review includes a mix of study methodologies and meta-analysis, and investigated the effectiveness of physical activity/exercise interventions for older adults receiving home care services. Eighteen studies including ten randomized controlled trials meeting the selection criteria were identified. Many of the studies were multi-factorial interventions with the majority reporting aims beyond solely trying to improve the physical function of home care clients. The meta-analysis showed limited evidence for effectiveness of physical activity for older adults receiving home care services. Future exercise/physical activity studies working with home care populations should consider focusing solely on physical improvements, and need to include a process evaluation of the intervention to gain a better understanding of the association between adherence to the exercise program and other factors influencing effectiveness.

Giving medicines covertly: A quick guide for care home managers and home care managers providing medicines support

SOCIAL CARE INSTITUTE FOR EXCELLENCE, NATIONAL INSTITUTE FOR HEALTH AND CARE EXCELLENCE
2019

This quick guide will help care home and home care managers to ensure that decisions about giving medicines covertly are made in the person’s best interests. It covers: capacity and consent; making a decision to give medicines covertly; urgent decisions; and involving others. It has been co-produced by NICE and SCIE and is based on NICE’s guidelines and quality standards.

The impact of attending day care designed for home-dwelling people with dementia on nursing home admission: a 24-month controlled study

ROKSTAD Anne Marie Mork, et al
2018

Background: Day care services offer meaningful activities, a safe environment for attendees and respite for family caregivers while being expected to delay the need for nursing home (NH) admission. However, previous research has shown inconsistent results regarding postponement of NH admission. The objective of the study was to explore the influence of a day care programme designed for home-dwelling people with dementia on NH admission. Method: A quasi-experimental trial explored the proportion of patients permanently admitted to nursing homes after 24 months as the main outcome by comparing a group of day care attendees (DG) and a group of participants without day care (CG). In all, 257 participants were included (181 in DG and 76 in CG). A logistic regression model was developed with NH admission as the outcome. Participant group (DG or CG) was the main predictor, baseline patient and family caregiver characteristics and interactions were used as covariates. Results: The mean age of participants was 81.5 (SD 6.4), 65% were women and 53% lived alone. The mean MMSE score was 20.4 (SD 3.5). In all, 128 (50%) of the participants were admitted to a nursing home by the 24-month follow-up, 63 participants (25%) completed the follow-up assessment and 66 (26%) dropped out due to death (8%) and other reasons (18%). In the logistic unadjusted regression model for NH admission after 24 months, participant group (DG or CG) was not found to be a significant predictor of NH admission. The results from the adjusted model revealed that the participant group was associated with NH admission through the interactions with age, living conditions, affective symptoms, sleep symptoms and practical functioning, showing a higher probability for NH admission in DG compared to CG. Conclusion: The study reveals no evidence to confirm that day care services designed for people with dementia postpone the need for NH admission. Admission to nursing homes seems to be based on a complex mix of personal and functional characteristics both in the person with dementia and the family caregivers. The findings should be considered in accordance with the limitation of inadequate power and the high drop-out rate.

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.

The homecare deficit 2016: a report on the funding of older people’s homecare across the United Kingdom

UNITED KINGDOM HOMECARE ASSOCIATION
2016

Drawing on data obtained from freedom of information requests, this report analyses average prices paid by councils for home care services across all four administrations of the United Kingdom. It also provides a breakdown by England’s nine government regions. The data were obtained during a sample week in April 2016 following the introduction of the new National Living Wage. The analysis found that only one in ten authorities paid an average price at or above UKHCA’s minimum price of £16.70 per hour. It also found that seven authorities paid average prices which the UKHCA believe are unlikely even to cover care workers’ wages and on-costs of £11.94 per hour. Only 24 councils had completed calculations for the costs of home care. The report highlights the low rates that many councils are paying independent and voluntary homecare providers. It argues that this underfunding is a root cause of the instability of local homecare markets and the low pay and conditions of the homecare workforce. The analysis also exposes the level of risk that councils place on a system intended to support older and disabled people. The report makes a number of recommendations, which include the need for local authorities to provide calculations of their costs of homecare.

Quick guide: improving hospital discharge into the care sector

NHS ENGLAND, et al
2015

This quick guide provides ideas and practical tips to commissioners and providers on how to improve hospital discharge for people with care home places or packages of care at home. The guide identifies areas for improvement, setting out checklist actions for local health economies to consider and examples of practical solutions and links to resources. The areas identified are: culture of collaboration between care sector, NHS and social care; improving communication; clarity on information sharing and information governance; difficulties with achieving the ‘home before lunch’ ambition; assessments undertaken in hospital leading to ‘deconditioning’ and longer, unnecessary hospital stays; delays to discharge due to awaiting for assessment; capacity of community-based services; and patient experience and involvement.

Results 1 - 10 of 30

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News

Moving Memory

Moving Memory Practice example about how the Moving Memory Dance Theatre Company is challenging perceived notions of age and ageing.

Chatty Cafe Scheme

Chatty Cafe Scheme Practice example about how the Chatty Cafe Scheme is helping to tackle loneliness by bringing people of all ages together

Oomph! Wellness

Oomph! Wellness Practice example about how Oomph! Wellness is supporting staff to get older adults active and combat growing levels of social isolation

KOMP

KOMP Practice example about how KOMP, designed by No Isolation is helping older people stay connected with their families

LAUGH research project

LAUGH research project Practice example about a research project to develop highly personalised, playful objects for people with advanced dementia
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