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Savage KT, Chen J, Schlenker K, Pugliano-Mauro M, Carroll BT. Geriatric Dermatologic Surgery Part II: Peri and intraoperative considerations in the geriatric dermatologic surgery patient. J Am Acad Dermatol 2024:S0190-9622(24)00546-2. [PMID: 38580086 DOI: 10.1016/j.jaad.2024.02.060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 02/12/2024] [Accepted: 02/28/2024] [Indexed: 04/07/2024]
Abstract
Geriatric patients compose a growing proportion of the dermatologic surgical population. Dermatologists and dermatologic surgeons should be cognizant of the unique physiologic considerations that accompany this group to deliver highly effective care. The purpose of this article is to discuss the unique preoperative, intraoperative, and postoperative considerations geriatric patients present with to provide goal-concordant care. Preoperative considerations include medication optimization and anxiolysis. Intraoperative considerations such as fall-risk assessment and prevention, sundowning, familial support, and pharmacologic interactions will be discussed. Lastly, effective methods for optimizing post-operative wound care, home care, and follow up are reviewed.
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Affiliation(s)
- Kevin T Savage
- Department of Dermatology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Jeffrey Chen
- University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | | | | | - Bryan T Carroll
- Department of Dermatology, University Hospitals, Cleveland Medical Center, Cleveland, OH, USA; Case Western Reserve University School of Medicine, Cleveland, OH, USA; Adjunct Professor, Department of Pharmacology, University of Pittsburgh, Pittsburgh, PA, USA.
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Darwich AS, Boström AM, Guidetti S, Raghothama J, Meijer S. Investigating the Connections Between Delivery of Care, Reablement, Workload, and Organizational Factors in Home Care Services: Mixed Methods Study. JMIR Hum Factors 2023; 10:e42283. [PMID: 37389904 PMCID: PMC10365606 DOI: 10.2196/42283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 04/27/2023] [Accepted: 04/29/2023] [Indexed: 07/01/2023] Open
Abstract
BACKGROUND Home care is facing increasing demand due to an aging population. Several challenges have been identified in the provision of home care, such as the need for support and tailoring support to individual needs. Goal-oriented interventions, such as reablement, may provide a solution to some of these challenges. The reablement approach targets adaptation to disease and relearning of everyday life skills and has been found to improve health-related quality of life while reducing service use. OBJECTIVE The objective of this study is to characterize home care system variables (elements) and their relationships (connections) relevant to home care staff workload, home care user needs and satisfaction, and the reablement approach. This is to examine the effects of improvement and interventions, such as the person-centered reablement approach, on the delivery of home care services, workload, work-related stress, home care user experience, and other organizational factors. The main focus was on Swedish home care and tax-funded universal welfare systems. METHODS The study used a mixed methods approach where a causal loop diagram was developed grounded in participatory methods with academic health care science research experts in nursing, occupational therapy, aging, and the reablement approach. The approach was supplemented with theoretical models and the scientific literature. The developed model was verified by the same group of experts and empirical evidence. Finally, the model was analyzed qualitatively and through simulation methods. RESULTS The final causal loop diagram included elements and connections across the categories: stress, home care staff, home care user, organization, social support network of the home care user, and societal level. The model was able to qualitatively describe observed intervention outcomes from the literature. The analysis suggested elements to target for improvement and the potential impact of relevant studied interventions. For example, the elements "workload" and "distress" were important determinants of home care staff health, provision, and quality of care. CONCLUSIONS The developed model may be of value for informing hypothesis formulation, study design, and discourse within the context of improvement in home care. Further work will include a broader group of stakeholders to reduce the risk of bias. Translation into a quantitative model will be explored.
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Affiliation(s)
- Adam S Darwich
- Division of Health Informatics and Logistics, Department of Biomedical Engineering and Health Systems, KTH Royal Institute of Technology, Huddinge, Stockholm, Sweden
| | - Anne-Marie Boström
- Division of Nursing, Department of Neurobiology, Care Science and Society, Karolinska Institutet, Huddinge, Sweden
- Theme Inflammation and Aging, Karolinska University Hospital, Huddinge, Sweden
- Research and Development Unit, Stockholms Sjukhem, Stockholm, Sweden
| | - Susanne Guidetti
- Division of Occupational Health, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
- Theme Women's Health and Allied Professionals, Medical Unit Occupational Therapy and Physiotherapy, Karolinska University Hospital, Stockholm, Sweden
| | - Jayanth Raghothama
- Division of Health Informatics and Logistics, Department of Biomedical Engineering and Health Systems, KTH Royal Institute of Technology, Huddinge, Stockholm, Sweden
| | - Sebastiaan Meijer
- Division of Health Informatics and Logistics, Department of Biomedical Engineering and Health Systems, KTH Royal Institute of Technology, Huddinge, Stockholm, Sweden
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Viscogliosi C, Dame N, Mino-Roy J, Rahimaly S, Breton V, Déry J, Chassé B, Couturier Y, Giroux D, Renaud C, Provencher V. [Trouble neurocognitif majeur et méthodes optimisant l'apprentissage]. Can J Aging 2023; 42:189-198. [PMID: 35971842 DOI: 10.1017/s0714980822000216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Les difficultés cognitives consécutives aux troubles neurocognitifs majeurs (TNCM) engendrent des enjeux dans la réalisation d'activités de la vie quotidienne. Ce projet visait à identifier auprès des proches aidants et des intervenants des situations nécessitant des méthodes optimisant l'apprentissage pour faciliter l'engagement de personnes vivant avec un TNCM dans leurs activités de la vie quotidienne. Des entrevues individuelles semi-dirigées, d'une durée de 60 à 90 minutes, ont été menées auprès de proches aidants et d'intervenants. Les résultats montrent que les activités quotidiennes et domestiques sont notamment affectées par les difficultés à repérer ou à utiliser les objets, à garder en tête la tâche en cours, à mettre en séquences des étapes, à ne pas se laisser distraire par autre chose et à constater ses difficultés pour s'y adapter. Les proches aidants souhaitent du soutien dans l'application des méthodes optimisant l'apprentissage pour contribuer au maintien de l'autonomie des personnes vivant avec un TNCM.
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Affiliation(s)
- Chantal Viscogliosi
- Université de Sherbrooke et Centre de recherche sur le vieillissement du CIUSSS de l'Estrie-CHUS, Sherbrooke, Québec, Canada
| | - Nathalie Dame
- Université de Sherbrooke et Centre de recherche sur le vieillissement du CIUSSS de l'Estrie-CHUS, Sherbrooke, Québec, Canada
| | - Jordan Mino-Roy
- Université de Sherbrooke et Centre de recherche sur le vieillissement du CIUSSS de l'Estrie-CHUS, Sherbrooke, Québec, Canada
| | - Sarah Rahimaly
- Université de Sherbrooke et Centre de recherche sur le vieillissement du CIUSSS de l'Estrie-CHUS, Sherbrooke, Québec, Canada
| | | | - Jessica Déry
- Centre Intégré Universitaire de Santé et de Services Sociaux de la Mauricie et du Centre-du-Québec (CIUSSS MCQ), Bécancour, Québec, Canada
| | - Bernard Chassé
- Société Alzheimer des Maskoutains - Vallée des Patriotes, St-Hilaire, Québec, Canada
| | - Yves Couturier
- Université de Sherbrooke et Centre de recherche du Centre hospitalier universitaire de Sherbrooke, Sherbrooke, Québec, Canada
| | - Dominique Giroux
- Université Laval et Centre de recherche en santé durable VITAM, Québec, Québec, Canada
| | | | - Véronique Provencher
- Université de Sherbrooke et Centre de recherche sur le vieillissement du CIUSSS de l'Estrie-CHUS, Sherbrooke, Québec, Canada
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Mendieta MJ, De Geest SM, Goderis G, Yip O, Deschodt M, Dhaini S. A multi-level perspective on perceived unmet needs for home support in home-dwelling older adults in the Swiss context: a secondary data analysis of a population study. BMC Geriatr 2022; 22:833. [PMID: 36329389 PMCID: PMC9635119 DOI: 10.1186/s12877-022-03479-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 09/26/2022] [Indexed: 11/06/2022] Open
Abstract
Background Unmet needs for home support occur when any support services perceived by older people as needed are not being received. Not meeting these needs can negatively impact older adults’ quality of life, and increase health care utilization, hospitalizations, institutionalizations, or death. To date there is no consensus in how to define and assess these unmet needs. In parallel, previous research of factors associated with unmet needs for home support has mostly focused on factors at the micro level. Thus, this paper aims to identify the prevalence of unmet needs for home support among a home-dwelling older population and the factors at the macro, meso and micro levels contributing to them. Methods Using an ecological approach we identified multi-level factors associated with the presence of unmet needs for home support among the home-dwelling older population (aged 75+) in Switzerland. This is a secondary cross-sectional analysis of the INSPIRE Population Survey of home-dwelling older adults (n = 8,508) living in Basel-Landschaft in Switzerland, conducted as part of the TRANS-SENIOR Project. Prevalence of perceived unmet needs for home support was self-reported, using a dichotomized question. Multiple logistic regression analyses were performed to investigate the associations of factors at each level with unmet needs for home support. Results 4.3% of participants reported unmet needs for home support, with a median age of 81 years. 45.1% had private health insurance and 6.3% needed additional government support. Being a recipient of other type of government support (OR = 1.65; 95% CI = 1.17–2.29) (macro-); the use of transportation services (OR = 1.74; 95% CI = 1.15–2.57) (meso-); and feeling depressed (OR = 1.40; 95% CI = 1.06–1.85) or abandoned (OR = 2.60; 95% CI = 1.96–3.43) (micro-) increased odds of having perceived unmet needs for home support. Having a private health insurance (macro-) (OR = 0.63; 95% CI = 0.49–0.80), speaking Swiss-German (OR = 0.44; 95% CI = 0.24–0.88) or German (OR = 0.47; 95% CI = 0.24–0.98), having a high level of education [primary (OR = 0.48; 95% CI = 0.24–1.02); secondary (OR = 0.49; 95% CI = 0.25–1.03); tertiary (OR = 0.38; 95% CI = 0.19–0.82); other (OR = 0.31 (0.12–0.75)], having a high score of self-perceived health status [score ≥ 76 (OR = 0.42; 95% CI = 0.20–0.96)] and having informal care (OR = 0.57; 95% CI = 0.45–0.73), among others (micro-) were associated with decreased odds of having perceived unmet needs for home support. Conclusion Our study findings highlight the role of socio-economical inequality in the perception of unmet needs for home support in home-dwelling older adults. In order to address unmet needs in home-dwelling older adults, healthcare leaders and policy makers should focus on strategies to reduce socio-economic inequalities at the different levels in this population. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-022-03479-5.
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Affiliation(s)
- Maria Jose Mendieta
- grid.6612.30000 0004 1937 0642Department of Public Health, Institute of Nursing Science, University of Basel, Basel, Switzerland ,grid.5596.f0000 0001 0668 7884Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, KU Leuven, Leuven, Belgium
| | - Sabina M De Geest
- grid.6612.30000 0004 1937 0642Department of Public Health, Institute of Nursing Science, University of Basel, Basel, Switzerland ,grid.5596.f0000 0001 0668 7884Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, KU Leuven, Leuven, Belgium ,grid.6612.30000 0004 1937 0642Medizinische Fakultät, Department of Public Health (DPH), Universität Basel, Bernoullistrasse 28, 4056 Basel, Switzerland
| | - Geert Goderis
- grid.5596.f0000 0001 0668 7884Department of Public Health and Primary Care, Academic Center of General Practice, KU Leuven, Leuven Belgium
| | - Olivia Yip
- grid.6612.30000 0004 1937 0642Department of Public Health, Institute of Nursing Science, University of Basel, Basel, Switzerland
| | - Mieke Deschodt
- grid.5596.f0000 0001 0668 7884Department of Public Health and Primary Care, Gerontology and Geriatrics, KU Leuven, Leuven Belgium ,grid.410569.f0000 0004 0626 3338Competence Center of Nursing, University Hospitals Leuven, Leuven, Belgium
| | - Suzanne Dhaini
- grid.6612.30000 0004 1937 0642Department of Public Health, Institute of Nursing Science, University of Basel, Basel, Switzerland
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Welberry HJ, Jorm LR, Barbieri S, Hsu B, Brodaty H. The impact of dementia on aged care service transitions in the last five years of life. Age Ageing 2021; 50:1159-1165. [PMID: 33270824 DOI: 10.1093/ageing/afaa254] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE To investigate the impact of dementia on aged care service use at end-of-life. METHODS Our retrospective data linkage study in New South Wales, Australia, used survey data from participants in the 45 and Up Study who died between July 2011-June 2014 linked to routinely collected administrative data for 2006-2014. We investigated movement between aged care "states" (No Services, Home Care including Home Support and Low-and High-Level Home Care and Residential Care) in the last five years of life. The dementia cohort comprised decedents with a dementia diagnosis recorded in hospital records, death certificates or who had claims for dementia-specific medicines prior to death (n = 2,230). The comparison cohort were decedents with no dementia diagnosis, matched 1:1 on age-at-death, sex, income and location. RESULTS Compared to those without dementia, people with dementia were more likely to: use home care (67 versus 60%, P < 0.001), enter residential care (72 versus 30%, P < 0.001) and stay longer in residential care (median 17.9 versus 12.7 months, P < 0.001). Five years before death, more people with dementia were within residential care (6 versus 4%; RR = 1.61, 95%CI = 1.23-2.10) and these rates diverged at the end-of-life (69 versus 28%, RR = 2.48, 95%CI = 2.30-2.66). Use of home-based care was higher among people with dementia five years from death (20 versus 17%; RR = 1.15, 95%CI = 1.02-1.30) but lower at end-of-life (13 versus 24%, RR = 0.55, 95%CI = 0.49-0.63). CONCLUSION Dementia-specific aged care trajectories were dominated by residential care. Home care use declined towards end-of-life for people with dementia and may not be meeting their needs.
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Affiliation(s)
- Heidi J Welberry
- Centre for Big Data Research in Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Louisa R Jorm
- Centre for Big Data Research in Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Sebastiano Barbieri
- Centre for Big Data Research in Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Benjumin Hsu
- Centre for Big Data Research in Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Henry Brodaty
- Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia
- Dementia Centre for Research Collaboration, School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia
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Smith L, Smith M, Thomson WM. Recommendations for improving dental care for dentate home-based older people: A qualitative New Zealand study. Gerodontology 2021; 39:187-196. [PMID: 33817899 DOI: 10.1111/ger.12553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND AND OBJECTIVE A small number of national studies have explored the barriers to older people accessing dental care; however, to date none have investigated older people's recommendations for overcoming these barriers. METHODS Semi-structured interviews were conducted with 40 dentate older people (65 years and over) who resided in New Zealand's Otago region and received home-support. A joint inductive thematic analysis was undertaken, based on the constant comparative method. RESULTS Recommendations for boosting community-dwelling older people's access to dental care included publicly funding or subsiding the cost of dental care for older people, aligning the pension with the real cost of living, and making the environment at Work and Income less hostile and the emergency dental grant more readily available, making dental clinics more accessible, initiating domiciliary dental care, having mobile dental clinics visit neighbourhoods with high proportions of older people, as well as subsidised transport to the dental clinic. Other suggestions were having GPs, pharmacists and social workers emphasise oral health during appointments, along with dental education campaigns. CONCLUSION In order to boost the rates of dental care access among older New Zealanders who receive home support, multiple structural changes are necessary, but these should primarily focus on reducing the cost and increasing accessibility.
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Affiliation(s)
- Lee Smith
- Whitireia WelTec, Lower Hutt, New Zealand
| | - Moira Smith
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - W Murray Thomson
- Department of Oral Sciences/Sir John Walsh Research Institute, School of Dentistry, University of Otago, Dunedin, New Zealand
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Assumpta Ortiz-Collado M, Cabana Salgado V, Chakir Turqui S, Amstutz Bonnefoy H. [Role of early childhood nurses in supporting vulnerable mothers at risk of postnatal depression]. Soins Pediatr Pueric 2020; 41:40-47. [PMID: 32200971 DOI: 10.1016/j.spp.2019.12.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Postnatal depression is a priority public health problem. Its prevalence and its impact on women and their children justify the implementation of specific nursing interventions to prevent the disease from settling in and becoming chronic. This problem was the focus of a study by the Haute École de la santé de Lausanne in Lausanne, Switzerland.
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Affiliation(s)
| | - Vanesa Cabana Salgado
- Institut et Haute École de la santé La Source, HES-SO, Avenue Vinet 30, CH-1004 Lausanne, Suisse
| | - Souad Chakir Turqui
- Institut et Haute École de la santé La Source, HES-SO, Avenue Vinet 30, CH-1004 Lausanne, Suisse
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Ahmed S, Hughes J, Davies S, Stewart K, Orrell M, Clarkson P, Challis D. Specialist services in early diagnosis and support for older people with dementia in England: Staff roles and service mix. Int J Geriatr Psychiatry 2018; 33:1280-1285. [PMID: 29932255 DOI: 10.1002/gps.4925] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Accepted: 05/08/2018] [Indexed: 11/05/2022]
Abstract
OBJECTIVES This study investigated staff roles and tasks in Community Mental Health Teams (CMHT) and memory clinics, which are provided within a framework determined by local Clinical Commissioning Groups. METHODS A cross-sectional survey design was used to collect data in England in 2015. Teams were identified by mental health providers (n = 68) and invited to complete a questionnaire. RESULTS Fifty-one NHS Trusts responded to the request. The response rate varied. Data were obtained for all Clinical Commissioning Groups areas in 3 of the 9 regions in England, but only half in one of them. CMHTs were significantly more likely to have larger staff groups. Compared with memory clinics they were also more likely to have staff that were not professionally qualified. The occupational therapist role showed a strong association with the provision of all services in CMHTs. Both CMHTs and memory clinics provided information and advice about dementia. CMHTs provided more services associated with the support of a person with dementia at home. CONCLUSION Variations in the staff mix in CMHTs and memory clinics reflected their different functions. There was limited evidence in both of profession specific interventions relating to the provision of support, information, therapy and education, associated with either diagnosis or long-term support. The potential for a single service to undertake both diagnostic and long-term support and the associated costs and benefits are areas for future research.
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Affiliation(s)
- Saima Ahmed
- Personal Social Services Research Unit (PSSRU), The University of Manchester, Manchester, UK
| | - Jane Hughes
- Personal Social Services Research Unit (PSSRU), The University of Manchester, Manchester, UK
| | - Sue Davies
- Personal Social Services Research Unit (PSSRU), The University of Manchester, Manchester, UK
| | - Karen Stewart
- Personal Social Services Research Unit (PSSRU), The University of Manchester, Manchester, UK
| | - Martin Orrell
- The University of Nottingham, Institute of Mental Health, Nottingham, UK
| | - Paul Clarkson
- Personal Social Services Research Unit (PSSRU), The University of Manchester, Manchester, UK
| | - David Challis
- Personal Social Services Research Unit (PSSRU), The University of Manchester, Manchester, UK
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Clarkson P, Davies L, Jasper R, Loynes N, Challis D. A Systematic Review of the Economic Evidence for Home Support Interventions in Dementia. Value Health 2017; 20:1198-1209. [PMID: 28964453 DOI: 10.1016/j.jval.2017.04.004] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2016] [Revised: 04/04/2017] [Accepted: 04/08/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND Recent evidence signals the need for effective forms of home support to people with dementia and their carers. The cost-effectiveness evidence of different approaches to support is scant. OBJECTIVES To appraise economic evidence on the cost-effectiveness of home support interventions for dementia to inform future evaluation. METHODS A systematic literature review of full and partial economic evaluations was performed using the British National Health Service Economic Evaluation Database supplemented by additional references. Study characteristics and findings, including incremental cost-effectiveness ratios, when available, were summarized narratively. Study quality was appraised using the National Health Service Economic Evaluation Database critical appraisal criteria and independent ratings, agreed by two reviewers. Studies were located on a permutation matrix describing their mix of incremental costs/effects to aid decision making. RESULTS Of the 151 articles retrieved, 14 studies met the inclusion criteria: 8 concerning support to people with dementia and 6 to carers. Five studies were incremental cost-utility analyses, seven were cost-effectiveness analyses, and two were cost consequences analyses. Five studies expressed incremental cost-effectiveness ratios as cost per quality-adjusted life-year (£6,696-£207,942 per quality-adjusted life-year). In four studies, interventions were dominant over usual care. Two interventions were more costly but more beneficial and were favorable against current acceptability thresholds. CONCLUSIONS Occupational therapy, home-based exercise, and a carers' coping intervention emerged as cost-effective approaches for which there was better evidence. These interventions used environmental modifications, behavior management, physical activity, and emotional support as active components. More robust evidence is needed to judge the value of these and other interventions across the dementia care pathway.
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Affiliation(s)
- Paul Clarkson
- Personal Social Services Research Unit (PSSRU), Division of Population Health, Health Services Research and Primary Care, University of Manchester, Manchester, UK.
| | - Linda Davies
- Division of Population Health, Health Services Research and Primary Care, Centre for Health Economics, University of Manchester, Manchester, UK
| | - Rowan Jasper
- Personal Social Services Research Unit (PSSRU), Division of Population Health, Health Services Research and Primary Care, University of Manchester, Manchester, UK
| | - Niklas Loynes
- Personal Social Services Research Unit (PSSRU), Division of Population Health, Health Services Research and Primary Care, University of Manchester, Manchester, UK
| | - David Challis
- Personal Social Services Research Unit (PSSRU), Division of Population Health, Health Services Research and Primary Care, University of Manchester, Manchester, UK
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Chester H, Clarkson P, Hughes J, Russell I, Beresford J, Davies L, Jolley D, Peconi J, Poland F, Roberts C, Sutcliffe C, Challis D; Members of the HoSt-D (Home Support in Dementia) Programme Management Group. Evaluating the effectiveness of different approaches to home support for people in later stage dementia: a protocol for an observational study. Int Psychogeriatr 2017; 29:1213-21. [PMID: 28266281 DOI: 10.1017/S1041610217000291] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
BACKGROUND Dementia is a major health problem with a growing number of people affected by the condition, both directly and indirectly through caring for someone with dementia. Many live at home but little is known about the range and intensity of the support they receive. Previous studies have mainly reported on discrete services within a single geographical area. This paper presents a protocol for study of different services across several sites in England. The aim is to explore the presence, effects, and cost-effectiveness of approaches to home support for people in later stage dementia and their carers. METHODS This is a prospective observational study employing mixed methods. At least 300 participants (people with dementia and their carers) from geographical areas with demonstrably different ranges of services available for people with dementia will be selected. Within each area, participants will be recruited from a range of services. Participants will be interviewed on two occasions and data will be collected on their characteristics and circumstances, quality of life, carer health and burden, and informal and formal support for the person with dementia. The structured interviews will also collect qualitative data to explore the perceptions of older people and carers. CONCLUSIONS This national study will explore the components of appropriate and effective home support for people with late stage dementia and their carers. It aims to inform commissioners and service providers across health and social care.
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Giebel C, Roe B, Hodgson A, Britt D, Clarkson P. Effective public involvement in the HoST-D Programme for dementia home care support: From proposal and design to methods of data collection (innovative practice). Dementia (London) 2017; 18:3173-3186. [PMID: 28073297 DOI: 10.1177/1471301216687698] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Public involvement is an important element in health and social care research. However, it is little evaluated in research. This paper discusses the utility and impact of public involvement of carers and people with dementia in a five-year programme on effective home support in dementia, from proposal and design to methods of data collection, and provides a useful guide for future research on how to effectively involve the public. The Home SupporT in Dementia (HoST-D) Programme comprises two elements of public involvement, a small reference group and a virtual lay advisory group. Involving carers and people with dementia is based on the six key values of involvement - respect, support, transparency, responsiveness, fairness of opportunity, and accountability. Carers and people with dementia gave opinions on study information, methods of data collection, an economic model, case vignettes, and a memory aid booklet, which were all taken into account. Public involvement has provided benefits to the programme whilst being considerate of the time constraints and geographical locations of members.
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Affiliation(s)
- Clarissa Giebel
- School of Health Sciences, University of East Anglia, UK; Division of Neuroscience and Experimental Psychology, University of Manchester, UK
| | - Brenda Roe
- Personal Social Services Research Unit, The University of Manchester, UK
| | | | | | - Paul Clarkson
- Personal Social Services Research Unit, The University of Manchester, UK
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Walker BP. Independent Living for the Elderly at Home: What is Required? Can Fam Physician 1986; 32:2692-2698. [PMID: 20469462 PMCID: PMC2327488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
Home care is vital to healthy aging, since living autonomously in the community is the primary interest of the elderly. Breaking the cycle which locks many frail and disabled individuals into a position of dependency requires shared input from a variety of resources in society. Success depends on an accurate assessment of functional ability, knowledge of community support services, and the willingness of health professionals to work co-operatively with others to provide a balance of assistance which is realistic for the local community.
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