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Results for 'independent living'

Results 1 - 10 of 36

Simply the best? Making Leeds the best city to grow old in

MELANIE HENWOOD ASSOCIATES
2020

Research exploring the local strategic policy context for meeting the care and health need of older people in Leeds, and how the Leeds Neighbourhood Networks understand and contribute to the agenda. The Leeds Neighbourhood Network (LNN), comprised of 37 locally led ‘schemes’ operated by a number of voluntary sector organisations, provides preventative support to older people in order to enable them to continue living independently and participate in their communities. They assist with a range of services and activities that promote the independence, health and wellbeing of older people throughout Leeds. This paper outlines the number of opportunities and challenges the LNNs face within the strategic policy context, and looks at the potential for Leeds to share more widely the benefits of its approach and experience. It describes how the LNNs are firmly rooted in their local neighbourhoods and understand the needs and preferences of local citizens they are in touch with and suggests there is an opportunity for them to develop a more outward looking style and connect people to a much wider range of community assets and resources. Furthermore, the LNNs could be more closely involved in supporting self-management for people with long-term conditions, and for health practitioners to benefit from being able to access groups of people needing support with diabetes, or COPD, or similar chronic conditions. Among the challenges, the paper cites the extremely diverse nature of LNNs, the risk that other third sector organisations perceive their own contribution to be less valued, the need to constantly adjust and tailor the ‘offer’ to reflect the changing needs of the older population, the lack of synergy between the LNNs and partners, the difficulties in implementing and evidencing strengths and asset-based approaches and the uncertainty about future funding and the direction of government policy.

Help-at-home for older people: economic evidence

BAUER Annette, TINELLI Michela, GUY Danielle
2019

This case summary provides economic evidence on Help-at-home schemes for older people, drawing on an economic evaluation of a scheme run by Age UK in England. Help-at-home schemes are usually run by voluntary and community organisations, and provide older people with a range of community support services to support older people living in their own homes. These services can include emotional, social, practical and financial support. Evidence from the evaluation suggests that Help-at-home schemes save local government and the NHS around £1500 per person per year, owing to people remaining longer in their homes, fewer GP appointments, and fewer hospital admissions. Volunteers providing support may also benefit, making them more likely to find jobs after gaining skills through volunteering. The summary notes that many of the benefits of help-at-home schemes are likely to depend on local infrastructures and how such schemes are run, making it hard to generalise their value.

Impact of community care in enabling older people with complex needs to remain at home

RYAN Assumpta Ann, et al
2009

Aim. This aim of the study was to explore the impact of community care in enabling older people with complex needs to remain at home. Background. Changing demographic trends and successive government policies have led to an increase in the number of older people with complex needs residing in the community. Design. A qualitative approach using semi‐structured interviews was used to collect data from older people (n=17) and carers (n=14). Method. Social workers were asked to identify community dwelling older people (65+years) with multiple needs requiring interventions from a range of health and social care practitioners. Results. Community care enabled older people with complex needs who would otherwise have required residential or nursing home care to remain in their own homes. This was the expressed wish of both the older people and carers interviewed. Conclusions. The provision of high‐quality community care for older people is a globally significant challenge and one that requires creative solutions, both at a local and strategic level. Relevance to clinical practice. Nurses and other health and social care professionals need to understand the significance of ‘home’ for older people and take steps to ensure that additional and appropriate resources are targeted towards community care.

Interventions for preventing falls in older people living in the community (review)

GILLESPIE Lesley D., et al
2012

Background: Approximately 30 per cent of people over 65 years of age living in the community fall each year. This is an update of a Cochrane review first published in 2009.Objective: To assess the effects of interventions designed to reduce the incidence of falls in older people living in the community. Search methods: this review searched the Cochrane Bone, Joint and Muscle Trauma Group Specialised Register (February 2012), CENTRAL (The Cochrane Library2012, Issue 3), MEDLINE (1946 to March 2012), EMBASE (1947 to March 2012), CINAHL (1982 to February 2012), and online trial registers. Selection criteria: Randomised trials of interventions to reduce falls in community-dwelling older people. Main results: this review included 159 trials with 79,193 participants. Most trials compared a fall prevention intervention with no intervention or an intervention not expected to reduce falls. The most common interventions tested were exercise as a single intervention (59 trials) and multifactorial programmes (40 trials). Findings: Group and home‐based exercise programmes, usually containing some balance and strength training exercises, effectively reduced falls, as did Tai Chi. Overall, exercise programmes aimed at reducing falls appear to reduce fractures. Multifactorial interventions assess an individual's risk of falling, and then carry out treatment or arrange referrals to reduce the identified risks. Overall, current evidence shows that this type of intervention reduces the number of falls in older people living in the community but not the number of people falling during follow‐up. These are complex interventions, and their effectiveness may be dependent on factors yet to be determined. Interventions to improve home safety appear to be effective, especially in people at higher risk of falling and when carried out by occupational therapists. An anti‐slip shoe device worn in icy conditions can also reduce falls. Taking vitamin D supplements does not appear to reduce falls in most community‐dwelling older people, but may do so in those who have lower vitamin D levels in the blood before treatment. Some medications increase the risk of falling. Three trials in this review failed to reduce the number of falls by reviewing and adjusting medications. A fourth trial involving family physicians and their patients in medication review was effective in reducing falls. Gradual withdrawal of a particular type of drug for improving sleep, reducing anxiety, and treating depression (psychotropic medication) has been shown to reduce falls. Cataract surgery reduces falls in women having the operation on the first affected eye. Insertion of a pacemaker can reduce falls in people with frequent falls associated with carotid sinus hypersensitivity, a condition which causes sudden changes in heart rate and blood pressure. In people with disabling foot pain, the addition of footwear assessment, customised insoles, and foot and ankle exercises to regular podiatry reduced the number of falls but not the number of people falling. The evidence relating to the provision of educational materials alone for preventing falls is inconclusive.

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.

Electronic assistive technology for community-dwelling solo-living older adults: a systematic review

SONG Yu, van der CAMMEN Tischa J.M.
2019

The proportion of older adults who live alone in single households is growing continuously. In the care of these solo-living older adults, electronic assistive technology (EAT) can play an important role. The objective of this review is to investigate the effects of EAT on the wellbeing of community-dwelling older adults living alone in single households. A systematic review of English articles was conducted based on PMC, Scopus, Web of Science and the Cochrane database. Additional studies were identified from the references. In total, 16 studies were identified, six of them with follow-up. There is evidence that EAT can improve the physical and mental wellbeing of older adults. There was little evidence that EAT can improve social wellbeing. We conclude that more personalized designs and interventions, and more user engagement could be embedded in the design of EAT for solo-living community-dwelling older adults and that more evidence is needed regarding the effects of those interventions.

Arts on prescription for community‐dwelling older people with a range of health and wellness needs

POULOS Roslyn G., et al
2019

Published evidence for the role of participatory art in supporting health and well‐being is growing. The Arts on Prescription model is one vehicle by which participatory art can be delivered. Much of the focus of Arts on Prescription has been on the provision of creative activities for people with mental health needs. This Arts on Prescription program, however, targeted community‐dwelling older people with a wide range of health and wellness needs. Older people were referred to the program by their healthcare practitioner. Professional artists led courses in visual arts, photography, dance and movement, drama, singing, or music. Classes were held weekly for 8–10 weeks, with six to eight participants per class, and culminated with a showing of work or a performance. Program evaluation involved pre‐ and postcourse questionnaires, and focus groups and individual interviews. Evaluation data on 127 participants aged 65 years and older were available for analysis. This study found that Arts on Prescription had a positive impact on participants. Quantitative findings revealed a statistically significant improvement in the Warwick–Edinburgh Mental Well‐being Scale (WEMWBS) as well as a statistically significant increase in the level of self‐reported creativity and frequency of creative activities. Qualitative findings indicated that the program provided challenging artistic activities which created a sense of purpose and direction, enabled personal growth and achievement, and empowered participants, in a setting which fostered the development of meaningful relationships with others. This evaluation adds to the evidence base in support of Arts on Prescription by expanding the application of the model to older people with a diverse range of health and wellness needs.

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.

Disabled Facilities Grant (DFG) and other adaptations: external review

MACKINTOSH Shelia, et al
2018

This review, commissioned by the Department of Health and Social Care, looks at how the Disabled Facilities Grant (DFG) currently operates and makes evidence based recommendations for how it should change in the future. It review aims to develop more effective ways of supporting more people to live in suitable housing so they can stay independent for longer and makes the case for more joint working across housing, health and social care. The focus of the review is on how the disabled or older person can be put at the centre of service provision and what would make it easier for them to access services. It also looks at the role of DFG in prevention and how it can deliver this more effectively. It draws on a range of evidence, including: analysis of data from LOGASnet returns; consultation events attended by local authorities and home improvement agencies; interviews with staff from selected local authorities; and a short review of the academic, policy and practice literature. The conclusions and recommendations include: renaming the grant to reflect that it is part of a broader set interventions to help people remain independent; improved integration of services; better partnership working between health and care and different professions; raising the upper limit of the grant; and changes to the current formula for allocating funding; and updating of the existing means testing regulations. The review also identifies additional research to be carried out.

Managing better: a critical prevention study

CARE AND REPAIR CYMRU
2018

A case study of Bridgend County Care and Repair's Managing Better service. The service is a three year programme funded by the Welsh Government, which has been co-produced by Care & Repair Cymru, RNIB Cymru and Action on Hearing Loss Cymru. The report shows how Managing Better is working across primary, secondary, and social care, to develop interventions and prevent avoidable pressures on public services. The service has a focus on increasing independence, reducing dependency and improving personal resilience. Individual case studies are included which show how Managing Better has operated in Bridgend and that by effectively targeting interventions service users' quality of life can be much improved and pressure on public services can be reduced. The case studies include services for patients moving from hospital to home patients, and helping people with visual impairment or hearing impairment to live independently at home. It is estimated that every £1 invested in Managing Better yields a £4 saving in other services.

Results 1 - 10 of 36

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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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