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Results for 'prevention'

Results 1 - 10 of 111

Occupational therapy fall prevention interventions for community-dwelling older adults: a systematic review

ELLIOTT Sharon, LELAND Natalie E.
2018

OBJECTIVE: Accidental falls among community-dwelling older adults are preventable and increase the risk of morbidity, hospitalization, and institutionalization. We updated and broadened a 2008 systematic review examining the evidence for the effectiveness of fall prevention interventions in improving fall-related outcomes, occupational performance, quality of life, and health care facility readmissions for community-dwelling older adults., METHOD: Literature published from 2008 to 2015 from five electronic databases was searched and analysed, RESULTS: Fifty articles met the inclusion criteria and were critically appraised and synthesized-37 provided Level I; 5, Level II; and 8, Level III evidence. Analysis was organized into four intervention themes: single component, multicomponent, multifactorial, and population based. Mixed evidence was found for single-component and multifactorial interventions, strong evidence was found for multicomponent interventions, and moderate evidence was found for population-based interventions., CONCLUSION: These findings can inform the delivery and integration of fall prevention interventions from acute care to community discharge.Copyright © 2018 by the American Occupational Therapy Association, Inc.

Ageing Better: national evaluation short Learning Report – July 2018

CAMPBELL Diarmid, COX Korina
2018

Shares learning from the 14 partners of the Ageing Better programme, which aim to support people aged over 50 who are experiencing, or at risk of, social isolation and loneliness. The report draws on surveys of programme participants, visits to each of the 14 programme areas, and feedback from stakeholders from the partnerships. It reports that. to date, Ageing Better partnerships have worked with approximately 70,000 participants and 13,250 volunteers. The report also shows how Ageing Better, participants are, on average, less socially isolated and lonely, taking a more active role in their communities, have improved health and wellbeing, and are getting involved in delivering and designing projects. It also highlights benefits for volunteers and how Ageing Better is helping organisations improve partnership working and increasing skills, capacity and knowledge among participants helping to deliver and design programmes. Links to the partnership websites are also included.

Strategies employed by older people to manage loneliness: systematic review of qualitative studies and model development

KHARICHA Kalpa, et al
2018

Objectives: To (i) systematically identify and review strategies employed by community dwelling lonely older people to manage their loneliness and (ii) develop a model for managing loneliness. Methods: A narrative synthesis review of English-language qualitative evidence, following Economic and Social Research Council guidance. Seven electronic databases were searched (1990–January 2017). The narrative synthesis included tabulation, thematic analysis, and conceptual model development. All co-authors assessed eligibility of final papers and reached a consensus on analytic themes. Results: From 3,043 records, 11 studies were eligible including a total of 502 older people. Strategies employed to manage loneliness can be described by a model with two overarching dimensions, one related to the context of coping (alone or with/in reference to others), the other related to strategy type (prevention/action or acceptance/endurance of loneliness). The dynamic and subjective nature of loneliness is reflected in the variety of coping mechanisms, drawing on individual coping styles and highlighting considerable efforts in managing time, contacting others, and keeping loneliness hidden. Cognitive strategies were used to re-frame negative feelings, to make them more manageable or to shift the focus from the present or themselves. Few unsuccessful strategies were described. Conclusion: Strategies to manage loneliness vary from prevention/action through to acceptance and endurance. There are distinct preferences to cope alone or involve others; only those in the latter category are likely to engage with services and social activities. Older people who deal with their loneliness privately may find it difficult to articulate an inability to cope.

Living well for longer: the economic argument for investing in the health and wellbeing of older people in Wales

EDWARDS Rhiannon Tudor, et al
2018

This report, commissioned by Public Health Wales, explores the economic case for investing in older people in Wales to support people to live longer in good health in older age. It looks at investing in older people as assets, highlighting the importance of their contribution to the economy in Wales and the importance of housing and enabling independence in later life. It then draws on the results of rapid reviews of international and UK evidence to show the relative cost-effectiveness and return on investment on preventing loneliness and social isolation; caring for older carers; and preventing falls. It concludes that enabling people to work for longer, facilitating volunteering and supporting working parents through care of grandchildren brings many economic returns in terms of improving wellbeing; reducing loneliness, and supporting formal and wider community services. In addition co-production enables older people to remain active in the community and provides intergenerational benefits within the community and public sector services. The report concludes that Wales should focus investment on: fully integrated health and care services; maintaining physical and mental well being in older age, with a focus on reducing social isolation and loneliness; maintaining services to promote prevention (particularly falls prevention), rehabilitation and reablement; investment in sustainable homes, transport and communities; and support for informal carers.

Small but significant: the impact and cost benefits of handyperson services

ADAMS Sue
2018

An evaluation of the impacts and cost benefits of handyperson services carrying out small repairs and minor adaptations in the home for older people. It looks at how handyperson service fit into the current policy landscape summarises current evidence on their impact and cost effectiveness. It then provides an in depth evaluation of the of Preston Care and Repair handyperson service, with analysis of outputs, outcomes and examines the cost benefits in relation to falls prevention. The evaluation involved data analysis of jobs completed, a survey of users of the service and interviews with staff and service users. It reports that during the 9 month evaluation period 1,399 jobs were carried out in the homes of 697 older people, which exceeded outcome targets. Of people using the service, 46 percent were over 80 years and 72 percent were older people living alone. Older people also valued the service. Ninety-six percent of those surveyed said that the Preston Care and Repair handyperson service made them less worried about their home and 100 percent said that they would recommend the service to others. Analysis of the falls prevention impact on a small number of higher risk cases, found that for every £1 spent on the handyperson service the saving to health and care was £4.28. Other health and social care related outcomes included a risk reduction for hospital admission risk reduction and faster discharge to home, improved wellbeing, safer independent living, and reduced isolation. The report illustrates the impacts of handyperson services cover health, housing and social care aims and objectives. They also offer a cost effective solution with significant cost benefits and a high rate of return on investment, both financial and social.

Cognitive behavioural therapy for fear of falling and balance among older people: a systematic review and meta-analysis

LIU Tai-Wa, et al
2018

Background: fear of falling is prevalent among older people and associated with various health outcomes. A growing number of studies have examined the effects of interventions designed to reduce the fear of falling and improve balance among older people, yet our current understanding is restricted to physiological interventions. Psychological interventions such as cognitive behavioural therapy (CBT) have not been reviewed and meta-analysed. Objective: to perform a systematic review and meta-analysis evaluating the effects of CBT on reducing fear of falling and enhancing balance in community-dwelling older people. Method: randomised controlled trials (RCTs) addressing fear of falling and balance were identified through searches of six electronic databases, concurrent registered clinical trials, forward citation and reference lists of three previous systematic reviews. Results: a total of six trials involving 1,626 participants were identified. Four studies used group-based interventions and two adopted individual intervention. Intervention period ranged from 4 to 20 weeks, and the number and duration of face-to-face contact varied. Core components of the CBT intervention included cognitive restructuring, personal goal setting and promotion of physical activities. The risk of bias was low across the included studies. Our analysis suggests that CBT interventions have significant immediate and retention effects up to 12 months on reducing fear of falling, and 6 months post-intervention effect on enhancing balance. Conclusions: CBT appears to be effective in reducing fear of falling and improving balance among older people. Future researches to investigate the use of CBT on reducing fear of falling and improving balance are warranted.

Staying on my feet. Falls prevention: best practice guide for care homes in Wales

MY HOME LIFE CYMRU
2018

This best practice guide, which has been funded by the Welsh Government, explores what works well in supporting care home residents to remain mobile and to reduce their risk of falling. It draws on the experiences of care home staff attending events in Wales to share their expertise and stories of good practice. The guide includes examples on how care home practitioners can support residents to navigate safely around the home; how they can help residents feel motivated to get out of their chair and engage in physical activity, and how they can encourage residents to drink or eat properly. It also shows how staff have to consider how they help get the balance between reducing the risks of falling with the rights of these individuals to make choices. The guide highlights a number of creative individual strategies. It also includes a Care Home Falls Prevention Wheel which identifies 8 key areas that together can support best practice.

“It was the whole picture” a mixed methods study of successful components in an integrated wellness service in North East England

CHEETHAM M., et al
2018

Background: A growing number of Local Authorities (LAs) have introduced integrated wellness services as part of efforts to deliver cost effective, preventive services that address the social determinants of health. This study examined which elements of an integrated wellness service in the north east of England were effective in improving health and wellbeing (HWB). Methods: The study used a mixed-methods approach. In-depth semi-structured interviews (IVs) were conducted with integrated wellness service users (n = 25) and focus groups (FGs) with group based service users (n = 14) and non-service users (n = 23) to gather the views of stakeholders. Findings are presented here alongside analysis of routine monitoring data. The different data were compared to examine what each data source revealed about the effectiveness of the service. Results: Findings suggest that integrated wellness services work by addressing the social determinants of health and respond to multiple complex health and social concerns rather than single issues. The paper identifies examples of ‘active ingredients’ at the heart of the programme, such as sustained relationships, peer support and confidence building, as well as the activities through which changes take place, such as sports and leisure opportunities which in turn encourage social interaction. Wider wellbeing outcomes, including reduced social isolation and increased self-efficacy are also reported. Practical and motivational support helped build community capacity by encouraging community groups to access funding, helped navigate bureaucratic systems, and promoted understanding of marginalised communities. Fully integrated wellness services could support progression opportunities through volunteering and mentoring. Conclusions: An integrated wellness service that offers a holistic approach was valued by service users and allowed them to address complex issues simultaneously. Few of the reported health gains were captured in routine data. Quantitative and qualitative data each offered a partial view of how effectively services were working.

Preventive interventions for the second half of life: a systematic review

HAJAT Cother, et al
2018

Objective: Recent improvements in life expectancy globally require intensified focus on noncommunicable diseases and age-related conditions. The purpose of this article is to inform the development of age-specific prevention guidelines for adults aged 50 and above, which are currently lacking. Data Source: PubMed, Cochrane database, and Google Scholar and explicit outreach to experts in the field. Study Inclusion and Exclusion Criteria: Meta-analyses, intervention-based, and prospective cohort studies that reported all-cause mortality, disease-specific mortality, or morbidity in adults were included. Data Extraction: A systematic review was undertaken in 2015 using search terms of a combination of and “intervention,” “mortality,” “reduction,” “improvement,” “death,” and “morbidity.” Data Synthesis: Interventions were categorized according to the Center for Evidence-Based Medicine Level of Evidence framework. Results: A summary table reports for each intervention the impact, strength of evidence, initiation, duration, and details of the intervention. Age-decade-specific preventive recommendations have been proposed relating to physical activity, diet, tobacco and alcohol use, medication adherence, screening and vaccination, and mental and cognitive health. Conclusion: Clear recommendations have been made according to the existing evidence base, but further research investment is needed to fill the many gaps. Further, personalized approaches to healthy aging complemented by population-wide approaches and broader cross-sector partnerships will help to ensure greater longevity is an opportunity, rather than a burden, for society.

Interventions to reduce social isolation and loneliness among older people: an integrative review

GARDINER Clare, GELDENHUYS Gideon, GOTT Merryn
2018

Loneliness and social isolation are major problems for older adults. Interventions and activities aimed at reducing social isolation and loneliness are widely advocated as a solution to this growing problem. The aim of this study was to conduct an integrative review to identify the range and scope of interventions that target social isolation and loneliness among older people, to gain insight into why interventions are successful and to determine the effectiveness of those interventions. Six electronic databases were searched from 2003 until January 2016 for literature relating to interventions with a primary or secondary outcome of reducing or preventing social isolation and/or loneliness among older people. Data evaluation followed Evidence for Policy and Practice Information and Co‐ordinating Centre guidelines and data analysis was conducted using a descriptive thematic method for synthesising data. The review identified 38 studies. A range of interventions were described which relied on differing mechanisms for reducing social isolation and loneliness. The majority of interventions reported some success in reducing social isolation and loneliness, but the quality of evidence was generally weak. Factors which were associated with the most effective interventions included adaptability, a community development approach, and productive engagement. A wide range of interventions have been developed to tackle social isolation and loneliness among older people. However, the quality of the evidence base is weak and further research is required to provide more robust data on the effectiveness of interventions. Furthermore, there is an urgent need to further develop theoretical understandings of how successful interventions mediate social isolation and loneliness.

Results 1 - 10 of 111

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