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Published: 10 December 2022
Last updated: 29 January 2023

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1

GORSKY, MARTIN. "‘To regulate and confirm inequality’? A regional history of geriatric hospitals under the English National Health Service, c.1948–c.1975." Ageing and Society 33, no. 4 (March 21, 2012): 598–625. http://dx.doi.org/10.1017/s0144686x12000098.

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ABSTRACTThe post-war history of hospital care for older people in Britain in the first phase of its National Health Service (NHS) emphasises a detrimental Poor Law legacy. This article presents a regional study, based on the South West of England, of the processes by which Victorian workhouses became the basis of geriatric hospital provision under the NHS. Its premise is that legislative and medical developments provided opportunities for local actors to discard the ‘legacy’, and their limited success in doing so requires explanation. Theoretical perspectives from the literature are introduced including political economy approaches; historical sociology of the medical profession; and path dependence. Analysis of resource allocation decisions shows a persistent tendency to disadvantage these institutions by comparison with acute care hospitals and services for mothers and children, although new ideas about geriatric medicine had some impact locally. Quantitative and qualitative data are used to examine policies towards organisation, staffing and infrastructural improvements, suggesting early momentum was not maintained. Explanations lie partly with national financial constraints and partly with the regional administrative arrangements following the NHS settlement which perpetuated existing divisions between agencies.
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2

Duke, Graeme J., Anna Barker, Cameron I. Knott, and John D. Santamaria. "Outcomes of older people receiving intensive care in Victoria." Medical Journal of Australia 200, no. 6 (April 2014): 323–26. http://dx.doi.org/10.5694/mja13.10132.

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3

Schachter, Michael E., Marc J. Saunders, Ayub Akbari, Julia M. Caryk, Ann Bugeja, Edward G. Clark, Karthik K. Tennankore, and Dan J. Martinusen. "Technique Survival and Determinants of Technique Failure in In-Center Nocturnal Hemodialysis: A Retrospective Observational Study." Canadian Journal of Kidney Health and Disease 7 (January 2020): 205435812097530. http://dx.doi.org/10.1177/2054358120975305.

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Background: Long-duration (7-8 hours) hemodialysis provides benefits compared with conventional thrice-weekly, 4-hour sessions. Nurse-administered, in-center nocturnal hemodialysis (INHD) may expand the population to whom an intensive dialysis schedule can be offered. Objective: The primary objective of this study was to determine predictors of INHD technique failure, disruptions, and technique survival. Design: This study used retrospective chart and database review methodology. Setting: This study was conducted at a single Canadian INHD program operating in Victoria, British Columbia, within a tertiary care hospital. Our program serves a catchment population of approximately 450 000 people. Patients/Sample/Participants: Forty-three consecutive incident INHD patients took part in the INHD program of whom 42 provided informed consent to participate in this study. Methods: We conducted a retrospective observational study including incident INHD patients from 2015 to 2017. The primary outcome was technique failure ≤6 months (TF ≤6). Secondary outcomes included technique survival and reasons for/predictors of INHD discontinuation or temporary disruption. Predictors of each outcome included demographics, comorbidities, and Clinical Frailty Scale (CFS) scoring. Results: Among 42 patients, mean (SD) age, dialysis vintage, CFS score, and follow-up were 63 (16) years, 46 (55) months, 4 (1), and 11 (9) months, respectively. 52% were aged ≥65 years. TF ≤6 occurred in 12 (29%) patients. One-year technique survival censored for transplants and home dialysis transitions was 60%. Discontinuation related to insomnia (32%), medical status change (27%), and vascular access (23%). In unadjusted Cox survival analysis, 1-point increases in CFS score associated with a higher risk of technique failure (hazard ratio: 2.04, 95% confidence interval [CI]: 1.26-3.31). In an adjusted analysis, higher frailty severity also associated with temporary INHD disruptions (incidence rate ratio: 2.64, 95% CI: 1.55-4.50, comparing CFS of ≥4 to 1-3). Limitations: The retrospective, observational design of this study resulted in limited ability to control for confounding factors. In addition, the relatively small number of events observed owing to a small sample size diminished statistical power to inform study conclusions. Use of a single physician to determine the clinical frailty score is another limitation. Finally, the use of a single center for this study limits generalizability to other programs and clinic settings. Conclusions: INHD is a sustainable modality, even among older patients. Higher frailty associates with INHD technique failure and greater missed treatments. Inclusion of a CFS threshold of ≤4 into INHD inclusion criteria may help to identify individuals most likely to realize the long-term benefits of INHD. Trial Registration: Due to the retrospective and observational design of this study, trial registration was not necessary.
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Meyer, Claudia, Briony Dow, Belinda E. Bilney, Kirsten J. Moore, Amanda L. Bingham, and Keith D. Hill. "Falls in older people receiving in-home informal care across Victoria: Influence on care recipients and caregivers." Australasian Journal on Ageing 31, no. 1 (December 10, 2010): 6–12. http://dx.doi.org/10.1111/j.1741-6612.2010.00484.x.

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5

Meyer, Judy, and Maria Oliva. "Beware: The Gaps in Medical Care for Older People." American Journal of Nursing 85, no. 4 (April 1985): 490. http://dx.doi.org/10.2307/3425112.

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&NA;, &NA;. "Beware: The Gaps In Medical Care For Older People." AJN, American Journal of Nursing 85, no. 4 (April 1985): 490. http://dx.doi.org/10.1097/00000446-198504000-00055.

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7

Rayner, Jo-Anne, and Michael Bauer. "“I Wouldn’t Mind Trying It. I’m in Pain the Whole Time”: Barriers to the Use of Complementary Medicines by Older Australians in Residential Aged-Care Facilities." Journal of Applied Gerontology 36, no. 9 (February 9, 2016): 1070–90. http://dx.doi.org/10.1177/0733464816629852.

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Older people living in the community use complementary medicine (CM) to manage the symptoms of chronic illness; however, little is known about CM use by older people living in care settings. Using focus groups and individual interviews, this study explored the use of CM from the perspective of 71 residents, families, and health professionals from six residential aged-care facilities in Victoria, Australia. Residents used CM to manage pain and improve mobility, often covertly, and only with the financial assistance of their families. Facility policies and funding restrictions constrained CM use at the individual and facility level. An absence of evidence to support safety and efficacy coupled with the risk of interactions made doctors wary of CM use in older people. These findings have relevance for the large number of CM using “baby-boomers” as they move into residential aged-care.
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8

Tinker, Anthea, Victoria Berdugo, Michael Buckland, Lois Crabtree, Anistta Maheswaran, Andrea Ong, Jasmine Patel, Emilia Pusey, and Chandini Sureshkumar. "Volunteering with older people in a care home." Working with Older People 21, no. 4 (December 11, 2017): 229–35. http://dx.doi.org/10.1108/wwop-08-2017-0019.

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Purpose The purpose of this paper is to investigate the influence that volunteering before medical school with older people in a care home has on the perceptions of older people. Design/methodology/approach Eight medical students answered an anonymous questionnaire relating to their experiences of volunteering in a care home before medical school. This was combined with an analysis of the relevant literature. Findings All the students had initially volunteered to enhance their CV for medical school. After volunteering, they had a greater realisation of the variety of older people. They also gained a number of transferable skills related to communicating with older people, especially those with cognitive impairment. The greatest learning experience was around the issues to do with dementia. Research limitations/implications The research is based on eight students although they were from different areas. Practical implications It would be beneficial if care homes could be more proactive in encouraging prospective medical students to volunteer. Medical schools could also provide clearer advice or take a more active stance such as encouraging prospective students to volunteer with older people. Further research should be with a larger sample to gain insight into varying perspectives. It would also be useful to conduct research into older adults’ attitudes towards the contribution of potential medical students to their own lives and to the home. Social implications Volunteering before medical school should be encouraged as it will enhance the chances of getting a place as well as being an eye opening experience and equip them with lifelong skills. Originality/value Original.
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9

Winterton, Rachel, Kathleen Brasher, and Mark Ashcroft. "Evaluating the Co-design of an Age-Friendly, Rural, Multidisciplinary Primary Care Model: A Study Protocol." Methods and Protocols 5, no. 2 (March 7, 2022): 23. http://dx.doi.org/10.3390/mps5020023.

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In the context of increased rates of frailty and chronic disease among older people, there is a need to develop age-friendly, integrated primary care models that place the older person at the centre of their care. However, there is little evidence about how age-friendly integrated care frameworks that are sensitive to the challenges of rural regions can be developed. This protocol paper outlines a study that will examine how the use of an age-friendly care framework (the Indigo 4Ms Framework) within a co-design process can facilitate the development of models of integrated care for rural older people within the Upper Hume region (Victoria, Australia). A co-design team will be assembled, which will include older people and individuals from local health, aged care, and community organisations. Process and outcome evaluation of the co-design activities will be undertaken to determine (1) the processes, activities and outputs that facilitate or hinder the co-design of a 4Ms integrated approach, and (2) how the use of the Indigo 4Ms Framework within a co-design process contributes to more integrated working practices. This protocol contributes to the development of a field of study examining how rural health and aged care services can become more age-friendly, with an emphasis on the role of co-design in developing integrated approaches to health care for older adults.
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Kidana, Kiwami, Shinya Ishii, Itsuki Osawa, Ayu Yoneda, Kiyoshi Yamaguchi, Yumi Yamaguchi, Kanao Tsuji, Masahiro Akishita, and Takashi Yamanaka. "Medication prescription in older people receiving home medical care services." Geriatrics & Gerontology International 19, no. 12 (December 2019): 1292–93. http://dx.doi.org/10.1111/ggi.13793.

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11

Paskulin, Lisiane Manganelli Girardi, Carla Cristiane Becker Kottwitz Bierhals, Daiany Borghetti Valer, Marinês Aires, Nara Veras Guimarães, Anemarie Raymundo Brocker, Laís Haase Lanziotti, and Eliane Pinheiro de Morais. "Health literacy of older people in primary care." Acta Paulista de Enfermagem 25, spe1 (2012): 129–35. http://dx.doi.org/10.1590/s0103-21002012000800020.

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OBJECTIVE: To analyze how elderly people linked to health education groups of a primary care unit seek, understand and share information, aiming to maintain and promote health throughout life. METHODS: Qualitative descriptive study, conducted with 30 elderlies linked to three groups of health education during the second semester of 2009. The data collection was performed through interviews and thematic analysis with the assistance of the NVivo software. RESULTS: Five categories of analysis were elaborated - Interest/concern in health, search, understanding, sharing and impact of information on the elderly. CONCLUSIONS: The health literacy in the groups developed in an individual perspective, focused on the prevention and treatment of injuries, respecting the history and knowledge of the subjects and appreciating the possibilities of exchange among them. The results support the planning, implementation and improvement of actions in health education with older people in primary care.
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12

Livingston, Gill, Monica Manela, and Cornelius Katona. "Cost of community care for older people." British Journal of Psychiatry 171, no. 1 (July 1997): 56–59. http://dx.doi.org/10.1192/bjp.171.1.56.

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BackgroundThere has been no published study that considers actual costs in a representative sample of people aged ???? 65 years. The present study describes the financial cost of formal community services for elderly people with dementia, depression, anxiety disorders or physical disability.MethodPsychiatric morbidity, physical disability and services received were assessed by standardised questionnaire in randomly selected Islington enumeration districts. Subjects were interviewed at home (.=700).ResultsDementia was the most expensive disorder per sufferer in terms of formal services. Those with depression were also high users of health services. Despite presenting to health services, 90% were not treated with appropriate drugs. In contrast, social services were received by people who were activity-limited or with dementia. The highest service cost for the population as a whole was for the physically disabled. In multivariate analysis the significant predictors of high service costs were living alone, being physically ill, depression, dementia and increasing age.ConclusionsFailure to detect and treat depression and the anxiety disorders in older people, despite their presentation to medical services, may have major economic consequences as well as contributing to individual suffering.
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13

Maidment, Jane, Ronnie Egan, and Jane Wexler. "Social work with older people from culturally and linguistically diverse backgrounds: Using research to inform practice." Aotearoa New Zealand Social Work 23, no. 3 (July 8, 2016): 3–15. http://dx.doi.org/10.11157/anzswj-vol23iss3id156.

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This research investigated the views of older culturally and linguistically diverse (CALD) people, their families and paid workers about experiences of giving and receiving care services in the Barwon region of Victoria, Australia. The project was conducted in collaboration with Diversitat, Geelong. While the research process incorporated a range of qualitative techniques this article is confined to reporting selected findings from the individual interviews and a focus group discussion. These findings demonstrated that particular caregiver personal attributes strengthened the relationship between older people and caregivers; differing interpretations were offered up about the use of time; multiple barriers for older CALD people using health and social services were identified; and that experiences of ageism within the health services were reported along with infrequent use of interpreter services. The article concludes with a discussion about the implications for social work practice and education with older CALD people.
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14

Shurgaya, Marina A., S. S. Memetov, and L. V. Silenko. "OLDER GENERATION: MEDICAL AND SOCIAL PROBLEMS." Medical and Social Expert Evaluation and Rehabilitation 20, no. 2 (June 15, 2017): 86–88. http://dx.doi.org/10.18821/1560-9537-2017-20-2-86-88.

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In an article there are presented results of a sociological survey of elderly people who underwent inpatient treatment at the State Budget Institution «Hospital for Veterans of Wars» in the Rostov Region in 2016. The survey was implemented according to a specially developed questionnaire. The respondents included 220 cases of elderly and senile age. The results of the survey showed the majority of elderly respondents, including disabled people, as to mention the main problems of elderly people as health problems and access to medical care as note a high level of anxiety.
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Ryan, Davinia, and Joseph Harbison. "Stroke as a medical emergency in older people." Reviews in Clinical Gerontology 21, no. 1 (October 18, 2010): 45–54. http://dx.doi.org/10.1017/s095925981000033x.

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SummaryIn the last 20 years a realization has developed that acute stroke is a condition that benefits from early intensive investigation and treatment. Older people are historically less likely to receive such active management through a combination of limited evidence due to their exclusion from clinical trials and a level of ‘therapeutic nihilism’ regarding older subjects with severe, acute illness.There is increasing evidence that many acute therapies, including thrombolysis, benefit older stroke patients. Older subjects may not achieve as good results as younger groups but differential benefits are often comparable when expected outcomes are considered. Risk of haemorrhagic complications with thrombolysis is not substantially increased and older subjects are now receiving this therapy despite a dearth of relevant trial data.Intensive physiological monitoring and stroke unit care has been found to be of benefit to patients of all ages. Surgical options for intracerebral haemorrhage are limited, but there is little difference in the management of intracranial haemorrhage in older people. There is unlikely to be a benefit to surgical hemicraniectomy for cerebral infarction in those >60 years. In conclusion, active management for acute stroke in older people is frequently beneficial and age should not be a barrier to such care.
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Morris, Jackie, and Gurcharan S. Rai. "Care of the Elderly: Medical and social care of highly dependent older people." Clinical Risk 9, no. 1 (January 1, 2003): 25–27. http://dx.doi.org/10.1258/135626203762301887.

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17

Ray-Chaudhuri, Arijit, Ryan C. Olley, Rupert S. Austin, and Jennifer E. Gallagher. "The Oral Health Needs of Older People in General Medical Practice: An Overview." InnovAiT: Education and inspiration for general practice 5, no. 10 (January 5, 2012): 614–19. http://dx.doi.org/10.1093/innovait/inr216.

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As the UK population ages and older people retain their natural teeth for longer, the complexity of the oral health needs in older people is becoming more challenging. Older patients are often registered with a GP and will increasingly be likely to require dental care. Older people in particular may benefit from dental care but may not have a dentist or perceive any risk of oral disease. This article therefore provides practical insight into the oral health management of older people to assist in addressing their oral health needs.
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Yang, Wei. "UNDERSTANDING NON-MEDICAL COSTS FOR HEALTH CARE: EVIDENCE FROM INPATIENT CARE FOR OLDER PEOPLE IN CHINA." Innovation in Aging 3, Supplement_1 (November 2019): S733. http://dx.doi.org/10.1093/geroni/igz038.2686.

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Abstract Non-medical costs can constitute a substantial part of total health care costs, especially for older people. Costs associated with carers, travel, food and accommodation for family members accompanying and caring for older people during their medical visits can be hefty. This study seeks to examine the effects of non-medical costs on catastrophic health payments and health payment-induced poverty among older people in rural and urban China. Using data from the China Health and Retirement Longitudinal Survey 2015, this study finds that inpatient costs account for a significant proportion of household expenditure, and non-medical costs can account for approximately 18% of total costs. That share is highest for those who belong to the lowest wealth groups. Non-medical costs increase the chances of older people incurring catastrophic health payments and suffering from health payment-induced poverty. Such effects are more concentrated among the poor than the rich. The results also show that the rural population are more likely to incur catastrophic health payments and suffer from health payment induced poverty compared to the urban population. This paper urges policy makers to consider reimbursing the non-medical costs of patient care, improving health care systems in general and for the rural populations specifically.
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Atwell, R., I. Correa‐Velez, and S. Gifford. "Ageing Out of Place: Health and Well‐Being Needs and Access to Home and Aged Care Services for Recently Arrived Older Refugees in Melbourne, Australia." International Journal of Migration, Health and Social Care 3, no. 1 (July 1, 2007): 4–14. http://dx.doi.org/10.1108/17479894200700002.

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Recently arrived older refugees in resettlement countries are a particularly vulnerable population who face many risks to their health and well‐being, and many challenges in accessing services. This paper reports on a project undertaken in Victoria, Australia to explore the needs of older people from 14 recently arrived refugee communities, and the barriers to their receiving health and aged care. Findings from consultations with community workers and service providers highlight the key issues of isolation, family conflict and mental illness affecting older refugees, and point to ways in which policy‐makers and service providers can better respond to these small but deserving communities.
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Wagg, A., D. Lowe, P. Peel, and J. Potter. "Continence Care for Older People in England and Wales." Journal of Wound, Ostomy and Continence Nursing 35, no. 2 (March 2008): 215–20. http://dx.doi.org/10.1097/01.won.0000313646.44870.d3.

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McCabe, Marita P., Tanya Davison, David Mellor, and Kuruvilla George. "Barriers to Care for Depressed Older People: Perceptions of Aged Care among Medical Professionals." International Journal of Aging and Human Development 68, no. 1 (January 2009): 53–64. http://dx.doi.org/10.2190/ag.68.1.c.

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22

Wilson, Mark AG, Susan E. Kurrle, and Ian Wilson. "Understanding Australian medical student attitudes towards older people." Australasian Journal on Ageing 37, no. 2 (January 14, 2018): 93–98. http://dx.doi.org/10.1111/ajag.12495.

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23

Harvey, Desley, Michele Foster, Rachel Quigley, and Edward Strivens. "Care transition types across acute, sub-acute and primary care." Journal of Integrated Care 26, no. 3 (July 2, 2018): 189–98. http://dx.doi.org/10.1108/jica-12-2017-0047.

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PurposeThe purpose of the paper is to examine the care transitions of older people who transfer between home, acute and sub-acute care to determine if there were common transition types and areas for improvements.Design/methodology/approachA longitudinal case study design was used to examine care transitions of 19 older people and their carers as a series of transitions and a whole-of-system experience. Case study accounts synthesising semi-structured interviews with function and service use data from medical records were compared.FindingsThree types of care transitions were derived from the analysis: manageable, unstable and disrupted. Each type had distinguishing characteristics and older people could experience elements of all types across the system. Transition types varied according to personal and systemic factors.Originality/valueThis study identifies types of care transition experiences across acute, sub-acute and primary care from the perspective of older people and their carers. Understanding transition types and their features can assist health professionals to better target strategies within and across the system and improve patient experiences as a whole.
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BUCHIGNANI, NORMAN, and CHRISTOPHER ARMSTRONG-ESTHER. "Informal care and older Native Canadians." Ageing and Society 19, no. 1 (January 1999): 3–32. http://dx.doi.org/10.1017/s0144686x99007254.

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The number and relative proportion of older Native people in Canada are both increasing rapidly. So also is a social problems discourse asserting that informal care of older Native people by family and kin is traditional, and highly appropriate today. However, neither this discourse nor previous research satisfactorily address the informal care requirements of older Native people nor the gendered implications that high levels of informal care provision may have for Native caregivers. Informal care is provided to Canada's non-Native elderly people primarily by resident wives and non-resident daughters, and secondarily by husbands and sons. Data from the pan-provincial Alberta Native Seniors Study demonstrate that Native people aged 50 or more have comparatively high overall care requirements. Older Native Albertans are poor, and make extensive use of some government income support programmes. They also make moderate use of medical services. Extensive dependence on informal care, institutional barriers and local service unavailability lead Native seniors to under-utilise other formal programmes aimed generically at the older provincial population. Native seniors are much more likely to live with kin than are other Canadians. Informal care appears equally available to older women and men, and is provided chiefly by resident daughters, sons and spouses, and by non-resident daughters, sisters and sons. Extensive elderly caregiving requirements may impose a growing, double burden on many, who are also providing care for dependent children. Without further support, current and future requirements may significantly limit the options of caregiving women and men.
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Beech, Roger, Bie Nio Ong, Sue Jones, and Vicky Edwards. "Delivering person-centred holistic care for older people." Quality in Ageing and Older Adults 18, no. 2 (June 12, 2017): 157–67. http://dx.doi.org/10.1108/qaoa-05-2016-0019.

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Purpose This paper is an evaluated case study of the Wellbeing Coordinator (WBC) service in Cheshire, UK. WBCs are non-clinical members of the GP surgery or hospital team who offer advice and support to help people with long-term conditions and unmet social needs remain independent at home. The paper aims to discuss this issue. Design/methodology/approach A mixed method design assessed the outcomes of care for recipients and carers using interviews, diaries and validated wellbeing measures. Service utilization data, interviews and observations of WBC consultations enabled investigation of changes in processes of care. Data were analysed using simple descriptive statistics, established instrument scoring systems and accepted social science conventions. Findings The WBC complements medical approaches to supporting people with complex health and social care problems, with support for carers often a key service component. Users reported improvements in their wellbeing, access to social networks, and maintenance of social identity and valued activities. Health and social care professionals recognized the value of the service. Practical implications The WBC concept relieves the burden on health and social care professionals as the social elements of ill-health are addressed. A shift in thinking from ill-health to wellbeing means older people feel more able to regain control over their own lives, being less dependent on consulting professionals. Originality/value The WBC is a new service focussing on the individual in their health, social and economic context. Process and outcomes evaluations are rare in this field.
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Wang, Zhenyu, Hanchun Wei, and Zhihan Liu. "Older Adults’ Demand for Community-Based Adult Services (CBAS) Integrated with Medical Care and Its Influencing Factors: A Pilot Qualitative Study in China." International Journal of Environmental Research and Public Health 19, no. 22 (November 11, 2022): 14869. http://dx.doi.org/10.3390/ijerph192214869.

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Introduction: The number of older people in China who require formal care is increasing. In response, China is creating a service delivery mode of health and social care combination for older people—community-based adult services (CBAS) integrated with medical care—in some provincial capital cities, such as Changsha. However, the needs of most older people for this service delivery mode are not well understood. Aim: To assess older people’s awareness of and demand for CBAS integrated with medical care and to determine influencing factors. Methods: Semi-structured guideline interviews were conducted with 20 older people (aged 65+ years) from two communities at different economic development levels and from a nursing home in Changsha, China. Interviews were analyzed using qualitative content analysis. Results: The specific needs that older adults expect from CBAS integrated with medical care involve daily care, primary care, self-management guidance, rehabilitation therapy services, and mental health services. Contrary to expectations, most interviewees showed low awareness of and demand for CBAS integrated with medical care. Individual, family, and community factors influence older people’s demand, as do exogenous variables such as gender and number of children. Discussion: The influencing mechanism of older people’s demand for CBAS integrated with medical care is complex and multifaceted. To implement and promote CBAS integrated with medical care, attention should be given to older people’s individual needs, family backgrounds and community environment improvement. Furthermore, improving awareness of integrated care and increasing ageing-in-place opportunities for more older adults is essential and urgent.
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Travis, Catherine E., and Caren McHenry Martin. "ADA Standards of Medical Care in Diabetes: implications for Older Adults." Senior Care Pharmacist 35, no. 6 (June 1, 2020): 258–65. http://dx.doi.org/10.4140/tcp.n.2020.258.

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Each year, new literature and recommendations are incorporated into updates in the American Diabetes Association's Standards of Medical Care in Diabetes. The 2020 update increased the focus on the rising cost of care for diabetes, long-term outcomes of newer antihyperglycemics in reducing macrovascular and microvascular complications of diabetes, and the importance of individualized treatment goals. These principles are of particular significance when managing older people with diabetes. This article focuses on updates pertinent to care of the older people.
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Travis, Catherine E., and Caren McHenry Martin. "ADA Standards of Medical Care in Diabetes: implications for Older Adults." Senior Care Pharmacist 35, no. 6 (June 1, 2020): 258–65. http://dx.doi.org/10.4140/tcp.n.2020.258.

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Each year, new literature and recommendations are incorporated into updates in the American Diabetes Association's Standards of Medical Care in Diabetes. The 2020 update increased the focus on the rising cost of care for diabetes, long-term outcomes of newer antihyperglycemics in reducing macrovascular and microvascular complications of diabetes, and the importance of individualized treatment goals. These principles are of particular significance when managing older people with diabetes. This article focuses on updates pertinent to care of the older people.
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Bruce, Rhiannon, and Philip Mendes. "Young people, prostitution and state out-of-home care: The views of a group of child welfare professionals in Victoria." Children Australia 33, no. 4 (2008): 31–37. http://dx.doi.org/10.1017/s1035077200000432.

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Previous research suggests a link between experiences of state out-of-home care – particularly residential care – and involvement in prostitution. This study explored the nature of this relationship via semi-structured interviews with nine Victorian health and welfare professionals who had worked with young people living in residential care. The findings suggest a complex interaction between precare and in-care factors. Environmental and systemic factors within residential care that may contribute to prostitution involvement include peer influence, older males, drug use, staffing factors, poor provision of sex and relationship education, placement decisions, and social isolation. Some significant implications for policy and service delivery are identified.
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Winter, Jane, Sarah A. McNaughton, and Caryl A. Nowson. "Nutritional care of older patients: experiences of general practitioners and practice nurses." Australian Journal of Primary Health 23, no. 2 (2017): 178. http://dx.doi.org/10.1071/py16021.

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Older people living in the community face unique nutritional issues that put them at risk of undernutrition, which is associated with increased morbidity and mortality. Primary healthcare staff such as general practitioners (GPs) and practice nurses (PNs) are well placed to identify nutritional problems early and intervene. The aim of this study was to understand the experiences and current practices in a sample of GPs and PNs with regards to nutritional care of elderly patients. An online survey of GPs and PNs working in regional Victoria was conducted. Among the 45 respondents, 89% reported encountering consultations with a nutritional component for older patients within the previous 3 months, and 94% of those took some action, most commonly referrals, dietary advice or prescribing supplements. Although the majority (63%) felt confident in providing appropriate nutritional recommendations for patients, 68% reported a desire for further professional development in the area. Given the frequency of nutritional issues presenting, further work is required to determine how well equipped primary healthcare staff are to provide nutritional advice to older patients.
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Soulis, George, and Marco Inzitari. "Medical care emerging challenges for older people during early COVID-19 pandemic." European Geriatric Medicine 13, no. 2 (February 14, 2022): 505–6. http://dx.doi.org/10.1007/s41999-022-00611-x.

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Conroy, Simon, Cassandra Ferguson, James Woodard, and Jay Banerjee. "Interface geriatrics: evidence-based care for frail older people with medical crises." British Journal of Hospital Medicine 71, no. 2 (February 2010): 98–101. http://dx.doi.org/10.12968/hmed.2010.71.2.46488.

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Testrow, Sean, Ryan McGovern, and Vicki Tully. "Secondary care interface: optimising communication between teams within secondary care to improve the rehabilitation journey for older people." BMJ Open Quality 10, no. 1 (February 2021): e001274. http://dx.doi.org/10.1136/bmjoq-2020-001274.

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Effective communication between members of the multidisciplinary team is imperative for patient safety. Within the Medicine for the Elderly wards at Royal Victoria Hospital (RVH) in Dundee, we identified an inefficient process of information-sharing between the orthopaedics outpatient department (OPD) at the main teaching hospital and our hospital’s rehabilitation teams, and sought to improve this by introducing several changes to the work system. Our aim was for all patients who attended the OPD clinic to have a plan communicated to the RVH team within 24 hours.Before our intervention, clinic letters containing important instructions for ongoing rehabilitation were dictated by the OPD team, transcribed and uploaded to an electronic system before the RVH team could access them. We analysed clinic attendances over a 4-week period and found that it took 15 days on average for letters to be shared with the RVH teams. We worked with both teams to develop a clinical communication tool and new processes, aiming to expedite the sharing of key information. Patients attended the OPD with this form, the clinician completed it at the time of their appointment and the form returned with the patient to RVH on the same day.We completed multiple Plan–Do–Study–Act cycles; before our project was curtailed by the COVID-19 pandemic. During our study period, seven patients attended the OPD with a form, with all seven returning to RVH with a completed treatment plan documented by the OPD clinician. This allowed rehabilitation teams to have access to clinic instructions generated by orthopaedic surgeons almost immediately after a patient attended the clinic, essentially eliminating the delay in information-sharing.The introduction of a simple communication tool and processes to ensure reliable transfer of information can expedite information-sharing between secondary care teams and can potentially reduce delays in rehabilitation.
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Dow, Briony, Marcia Fearn, Betty Haralambous, Jean Tinney, Keith Hill, and Stephen Gibson. "Development and initial testing of the Person-Centred Health Care for Older Adults Survey." International Psychogeriatrics 25, no. 7 (April 29, 2013): 1065–76. http://dx.doi.org/10.1017/s1041610213000471.

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ABSTRACTBackground: Health services are encouraged to adopt a strong person-centered approach to the provision of care and services for older people. The aim of this project was to establish a user-friendly, psychometrically valid, and reliable measure of healthcare staff's practice, attitudes, and beliefs regarding person-centered healthcare.Methods: Item reduction (factor analysis) of a previously developed “benchmarking person-centred care” survey, followed by psychometric evaluations of the internal consistency reliability and construct validity, was conducted. The initial survey was completed by 1,428 healthcare staff from 17 health services across Victoria, Australia.Results: After removing 17 items from the previously developed “benchmarking person-centred care” survey, the revised 31-item survey (Person-Centred Health Care for Older Adults Survey) attained eight factors that explain 62.7% of the total variance with a Cronbach's α coefficient of 0.91, indicating excellent internal consistency. Expert consultation confirmed that the revised survey had content validity.Conclusions: The results indicated that the Person-Centred Health Care for Older Adults Survey is a user-friendly, psychometrically valid, and reliable measure of staff perceptions of person-centered healthcare for use in hospital settings.
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Forbat, Liz, Michael Chapman, Clare Lovell, Wai-Man Liu, and Nikki Johnston. "Improving specialist palliative care in residential care for older people: a checklist to guide practice." BMJ Supportive & Palliative Care 8, no. 3 (August 2, 2017): 347–53. http://dx.doi.org/10.1136/bmjspcare-2017-001332.

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ObjectivesPalliative care needs rounds are triage meetings that have been introduced in residential care for older adults to help identify and prioritise care for people most at risk for unplanned dying with inadequately controlled symptoms. This study sought to generate an evidence-based checklist in order to support specialist palliative care clinicians integrate care in residential nursing homes for older people.MethodsA grounded theory ethnographic study, involving non-participant observation and qualitative interviews. The study was conducted at four residential facilities for older people in one city. Observations and recordings of 15 meetings were made, and complimented by 13 interviews with staff attending the needs rounds.ResultsThe palliative care needs round checklist is presented, alongside rich description of how needs rounds are conducted. Extracts from interviews with needs rounds participants illustrate the choice of items within the checklist and their importance in supporting the evolution towards efficient and effective high-quality specialist palliative care input to the care of older people living in residential care.ConclusionsThe checklist can be used to support the integration of specialist palliative care into residential care to drive up quality care, provide staff with focused case-based education, maximise planning and reduce symptom burden for people at end of life.
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Matthews, Doug. "In-home care and ‘supported independence’ for the frail elderly: A social work perspective." Aotearoa New Zealand Social Work 24, no. 1 (July 8, 2016): 3–13. http://dx.doi.org/10.11157/anzswj-vol24iss1id137.

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The article focuses on role of social workers in providing in-home care and assistance with the activities of daily living (ADL) for older people in New Zealand. From the physician- and hospital-based medical care for older people, a shift back to home-based medical care was emphasized by the Ministry of Social Development in April 2001. The New Zealand Health of Older People Strategy was implemented with the aim of achieving positive aging, quality of life and independence.
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Latimer, Joanna. "Socialising Disease: Medical Categories and Inclusion of the Aged." Sociological Review 48, no. 3 (August 2000): 383–407. http://dx.doi.org/10.1111/1467-954x.00222.

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When older peoples' troubles are categorised as social rather than medical, hospital care can be denied them. Drawing on an ethnography of older people admitted as emergencies to an acute medical unit, the article demonstrates how medical categories can provide shelter for older people. By holding their clinical identity on medical rather than social grounds, physicians who specialise in gerontology in the acute medical domain can help prevent the over-socialising of an older person's health troubles. As well as helping the older person to draw certain resources to themselves, such as treatment and care, this inclusion in positive medical categories can provide shelter for the older person, to keep at bay their effacement as ‘social problems'. These findings suggest that contemporary sociological critique of biomedicine may underestimate how medical categorising, as the obligatory passage through which to access important resources and life chances, can constitute a process of social inclusion.
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Ab Ghani, Nor Nadiya, Aniawanis Makhtar, Sharifah Munirah Syed Elias, Norfadzilah Ahmad, and Salizar Mohamed Ludin. "Knowledge, Practice and Needs of Caregiver in the Care of Older People: A Review." INTERNATIONAL JOURNAL OF CARE SCHOLARS 5, no. 3 (November 30, 2022): 70–78. http://dx.doi.org/10.31436/ijcs.v5i3.269.

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Caregivers play a significant role in the care of older people. However, their knowledge, practice and needs in the care of older people have been poorly characterised. Therefore, this review was performed to provide an overview of caregivers’ knowledge, practice and needs in the care of older people. A literature search was conducted using the following electronic databases: ProQuest Health and Medical Complete, Wiley Online Library, EBSCO Host, Science Direct and Scopus. Search terms used were “older people”, “caregiver”, “knowledge”, “practice” and “needs”. Two reviewers independently screened the studies and the extracted data. A total of 117 articles were initially found using the above keywords. After using a set of criteria in the screening process, nine articles were found relevant to include in this review. This review of the articles presents a summary of (1) caregivers’ knowledge about the care of older people, (2) caregivers’ practice in the care of older people and (3) caregivers’ needs in the care of older people. The analysis reveals that most of the caregivers addressed a lack of knowledge about and poor practice in the care of older people. This review also offers important insight into the needs of caregivers. Hence, this review recommends further studies on knowledge, practice and needs in the care of older people to identify contextual challenges and provide evidence-based solutions to improve caregivers’ knowledge, practice and needs in the care of older people.
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Folsom, David P., Margaret McCahill, Stephen J. Bartels, Laurie A. Lindamer, Theodore G. Ganiats, and Dilip V. Jeste. "Medical Comorbidity and Receipt of Medical Care by Older Homeless People With Schizophrenia or Depression." Psychiatric Services 53, no. 11 (November 2002): 1456–60. http://dx.doi.org/10.1176/appi.ps.53.11.1456.

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Korchagina, Irina I., and Lidia M. Prokofieva. "Long-term care needs assessments: French and Russian experience." POPULATION 23, no. 3 (2020): 59–70. http://dx.doi.org/10.19181/population.2020.23.3.6.

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Social support of older people is given a very great attention. In many countries, older people receive long-term care at home. The long-term care (LTC) is actively developed worldwide over the past 20 years. LTC improves the life quality of older people and people with disabilities. Such system includes medical and social services. Currently, in many OECD countries, from a half to three quarters of older people receive long-term care at home. France is one of those countries in which the social support of older people is given a very great attention. In Russia, long-term care is a task of family. Our country is taking first steps in creation of a long-term care system. It is important to take into account the experience of countries that already have specialized social services for older people with loss of autonomy. A new and important element of the LTC system will be a special scale for determining the level of need for long-term care. Such scale helps to differentiate the needs of each elderly person or person with a disability. This paper analyses the methods of determining the level of need for long-term care, used in France and in Russia and describes the advantages and disadvantages of these methods.
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Alldred, David P., Claire Standage, Arnold G. Zermansky, Nicholas D. Barber, D. K. Raynor, and Duncan R. Petty. "The recording of drug sensitivities for older people living in care homes." British Journal of Clinical Pharmacology 69, no. 5 (January 28, 2010): 553–57. http://dx.doi.org/10.1111/j.1365-2125.2010.03631.x.

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Menz, H. B., K. P. Jordan, E. Roddy, and P. R. Croft. "Musculoskeletal foot problems in primary care: what influences older people to consult?" Rheumatology 49, no. 11 (July 25, 2010): 2109–16. http://dx.doi.org/10.1093/rheumatology/keq206.

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Beswick, AD, R. Gooberman-Hill, A. Smith, V. Wylde, and S. Ebrahim. "Maintaining independence in older people." Reviews in Clinical Gerontology 20, no. 2 (April 7, 2010): 128–53. http://dx.doi.org/10.1017/s0959259810000079.

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SummaryAppropriate social and medical interventions may help maintain independence in older people. Determinants of functional decline, disability and reduced independence are recognized and specific interventions target the treatment of clinical conditions, multiple health problems and geriatric conditions, prevention of falls and fractures, and maintenance of physical and cognitive function and social engagement.Preventive strategies to identify and treat diverse unmet needs of older people have been researched extensively. We reviewed systematically recent randomized controlled trials evaluating these ‘complex’ interventions and incorporated the findings of 21 studies into an established meta-analysis that included 108,838 people in 110 trials. There was an overall benefit of complex interventions in helping older people to live at home, explained by reduced nursing home admissions rather than death rates. Hospital admissions and falls were also reduced in intervention groups. Benefits were largely restricted to earlier studies, perhaps reflecting general improvements in health and social care for older people. The wealth of high-quality trial evidence endorses the value of preventive strategies to help maintain independence in older people.
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Yang, Wei. "Understanding the Non-medical Costs of Healthcare: Evidence from Inpatient Care for Older People in China." China Quarterly 242 (September 16, 2019): 487–507. http://dx.doi.org/10.1017/s0305741019001115.

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AbstractNon-medical costs, including costs associated with carers, travel, food and accommodation for family members who care for older people during their medical visits, can constitute a substantial part of total healthcare costs, especially for older people. Using data from the 2015 China Health and Retirement Longitudinal Survey, this study examines the effects of such non-medical costs on catastrophic health payments and health payment-induced poverty among older people in China. Results indicate that non-medical costs account for approximately 18 per cent of total inpatient costs. The percentage is highest for those in the lowest economic brackets. Rural populations are more likely than urban populations to incur catastrophic health payments and suffer from health payment-induced poverty. Non-medical costs increase the chances of older people incurring catastrophic health payments and suffering from health payment-induced poverty. These findings suggest that policymakers should look to develop new policies that facilitate reimbursement of non-medical costs, particularly for the rural population.
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Karlsson, Staffan, Anna-Karin Edberg, Albert Westergren, and Ingalill Rahm Hallberg. "Older People Receiving Public Long-Term Care in Relation to Consumption of Medical Health Care and Informal Care." Open Geriatric Medicine Journal 1, no. 1 (February 8, 2008): 1–9. http://dx.doi.org/10.2174/1874827900801010001.

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Linichenko, Yu V., A. B. Zudin, O. E. Konovalov, and M. D. Vasiliev. "OPINION OF OLDER AGE GROUPS OF MEDICAL, SOCIAL AND GERIATRIC CARE." NAUKA MOLODYKH (Eruditio Juvenium) 9, no. 1 (March 31, 2021): 44–50. http://dx.doi.org/10.23888/hmj20219144-50.

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Background. The article deals with measures for providing medical and social assistance with the aim of preservation of health, improvement of the quality of life of the elderly and senile, and of their adaptation in the society. Aim. study of the opinion of elderly and senile people of the rendered medical, social and geriatric care. Materials and Methods. A survey of 456 residents of the Moscow region older than working age was conducted. All respondents at one time were patients of the Moscow Regional Hospital of Wars Veterans. Results. The majority of respondents noted availability of various types of medical care, but only a small part of them evaluated its quality positively. Among the reasons for dissatisfaction, the most frequently cited were the lack of specialist doctors, spending much time in the waiting room in visiting therapists and narrow specialists, ineffective treatment, payment for necessary medical services, waiting lists for inpatient treatment, and in some cases violation of the patients rights. Dissatisfaction with medical and social assistance was mainly related to the problems of disability registration and implementation of individual rehabilitation programs. Conclusion. The results of the survey for studying satisfaction of older people with medical, social and geriatric care should be used for elaboration of proposals for its improvement.
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Kim, Hwa-Joon, Young Koh, Eun-Jeong Chun, Soong-Nang Jang, and Chang-Yup Kim. "Subjective Satisfaction with Medical Care among Older People: Comprehensiveness, General Satisfaction and Accessibility." Journal of Preventive Medicine and Public Health 42, no. 1 (2009): 35. http://dx.doi.org/10.3961/jpmph.2009.42.1.35.

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Jönsson, Marie, Peter Appelros, and Carin Fredriksson. "Older people readmitted to hospital for acute medical care – Implications for occupational therapy." Scandinavian Journal of Occupational Therapy 24, no. 2 (September 16, 2016): 143–50. http://dx.doi.org/10.1080/11038128.2016.1227367.

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Duffy, Francis. "A Critical Perspective on Advance Care Planning for Older People." British Journal of Social Work 50, no. 4 (August 8, 2019): 1013–30. http://dx.doi.org/10.1093/bjsw/bcz092.

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Abstract How older people plan ahead for ageing in relation to accommodation, care arrangements, healthcare and medical treatment, and end of life decisions has attracted particular attention in recent years and as a result there has been considerable promotion of the importance of planning ahead and executing planning instruments with the aim of making one’s wishes and preferences known in advance. Planning ahead is promoted as allowing older people to have their voices heard, to advance their autonomy, choice and self-determination and to allow them to decide what treatment they may not want to receive. This article provides a critique of advance care planning, based on a subset of findings from a qualitative intergenerational study on ageing in Australia. The findings suggest that advance care planning is a much more complex and at times problematic endeavour, compared to what is promoted about advance care planning, in particular with regard to the use of planning instruments.
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Benca, R., R. Ferziger, E. M. Wickwire, S. Bertisch, J. Biddle, M. Boustani, L. Culpepper, et al. "0543 Implementing Insomnia Care Paths for Older Adults and People with Dementia." Sleep 43, Supplement_1 (April 2020): A208. http://dx.doi.org/10.1093/sleep/zsaa056.540.

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Abstract Introduction Despite the high prevalence of insomnia in older adults and those with dementia, screening and treatment remain inconsistent and suboptimal. Implementing a care path in a health system, though, is difficult. To determine what issues are relevant for implementation, a consensus meeting was convened, which included discussion, voting on components, and further consensus-building. Methods All N=20 participants, representing a wide range of stakeholders including research, industry, sleep, primary care, implementation science, and others, voted whether they agreed or disagreed with 36 different statements regarding what issues are important for implementing geriatric insomnia care paths. These represented a range of items addressing strategies for identifying and incentivizing stakeholders, identifying patients in most need and who would receive benefit, addressing comorbidities and multiple specialties, understanding how specific organizations make decisions about and changes to care, size and scope of the care path, determining the process for implementation, how it will improve outcomes, addressing specific needs of primary care, and addressing costs, reimbursements, and liabilities. Items were scored as 0=strongly agree, 1=agree, 2=disagree, and 3=strongly disagree. Mean scores were evaluated and responses were dichotomized to agree/disagree). Results Despite the diversity among attendees, median rate of agreement for was 95% (IQR=90-95%). All items were endorsed by >=80% of respondents. Mean score was 0.48 (SD=1.85). 95%CIs were computed for each proportion and compared to the mean. The only item that significantly differed from the mean score indicated that understanding benefits of a care path to the general community is less important of an issue than others (M=0.85). Conclusion Implementing an insomnia care path for older adults in an institution will likely require addressing a wide range of issues, including questions about stakeholders, the health system/context, patients, and practical considerations. Support Merck Research Labs provided support
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