What does it take to make integrated care work? A ‘cookbook’ for large-scale deployment of coordinated care and telehealth

The Advancing Care Coordination & Telehealth Deployment (ACT) Programme is the first to explore the organisational and structural processes needed to successfully implement care coordination and telehealth (CC&TH) services on a large scale. A number of insights and conclusions were identified by the ACT programme. These will prove useful and valuable in supporting the large-scale deployment of CC&TH. Targeted at populations of chronic patients and elderly people, these insights and conclusions are a useful benchmark for implementing and exchanging best practices across the EU. Examples are: Perceptions between managers, frontline staff and patients do not always match; Organisational structure does influence the views and experiences of patients: a dedicated contact person is considered both important and helpful; Successful patient adherence happens when staff are engaged; There is a willingness by patients to participate in healthcare programmes; Patients overestimate their level of knowledge and adherence behaviour; The responsibility for adherence must be shared between patients and health care providers; Awareness of the adherence concept is an important factor for adherence promotion; The ability to track the use of resources is a useful feature of a stratification strategy, however, current regional case finding tools are difficult to benchmark and evaluate; Data availability and homogeneity are the biggest challenges when evaluating the performance of the programmes

More and Better Jobs in Home-Care Services

[Excerpt] This study examines recruitment and retention measures in community-based care and support services for adults with disabilities and health problems. It focuses on 10 EU Member States: Austria, Bulgaria, Denmark, France, Germany, the Netherlands, Poland, Portugal, Spain and the United Kingdom. It examines 30 case studies from these countries, analysing initiatives that were successful either in creating more jobs in the provision of health and social care for adults in the community or in improving the quality of jobs, with the aim of both attracting new recruits and retaining existing staff

Seeing the wood for the trees. Carer related research and knowledge: A scoping review

This NIHR-SSCR funded scoping review provides a comprehensive mapping of what is known about carers and caring, and aims to help inform policy, practice and research in relation to carers. The review was undertaken by searching 10 electronic bibliographic databases, supplemented by additional web searches to identify academic research, grey literature and wider knowledge. The analysis adopts a selective thematic approach covering: carer variables - the characteristics of different types of carer and different caring situations; types of care - the nature of needs of the cared for person and the features of the care situation; the impact of caring – resilience and coping, employment and health; and carer support and needs assessment. The final section highlights key messages identified from the review. It found that caring involves all sections and age groups of the population, with people are likely to experience one or more periods of caregiving over their lifetime. The uniqueness of each caring relationship is also highlighted. In relation to types of carers, knowledge about ‘hard to reach’ groups, such as BAME and LGBT carers, remains sparse. Older carers are also relatively invisible in policy and research terms. It found that much of the knowledge about carers identified in the review relates to their characteristics, their lived experience and the nature of their caregiving, with relatively less being known about the effectiveness of interventions to support them. The report concludes by offering suggestions for policy and practice. An appendix provides a bibliography of the 3,434 items identified in review, classified into 17 types of reference

A methodological approach to evaluate elderly-robot interactions

The relevance in the study of interaction between elderly and robots may depend on the choice of activities that robots can be developed to perform and the assessment of their impact and importance for older people. This research requires coordinated research between computer engineers and specialists in the humanities and social sciences. Being a recent research area, it is particularly relevant to carefully select the behavioural variables to be analyzed, the methodology adopted and the instruments that allow for a rigorous evaluation. Based on these assumptions, the present study aims to develop Innovative Initiatives for the Promotion of Active Aging in the EUROACE Region. The authors propose an appropriate methodology and instruments to evaluate the impact of the human-robot interaction in the promotion of a more active aging in a group of elderly in a nursing home. The analyzed variables focus on the involvement of the elderly in the activities, their capacity for initiative and to establish social interactions, indicators of well-being and a proactive attitude. The methodology of the study is mixed (qualitative and quantitative), organized as an exploratory case study. Data collection is based on naturalistic observation but variables are quantitatively assessed in a pre/post-test design. The research design identified the narratives of the elderly and the staff of the institution regarding the needs and interests of each elderly person, classified the participants according to the levels of prevailing social interactions, involvement and initiative in activities, considered important variables for an active ageing and, in this sense, demonstrated its adequacy to be used to evaluate the results of the intervention using social assistive robots.info:eu-repo/semantics/publishedVersio

Food for talk: photo frames to support social connectedness for elderly people in a nursing home

Social connectedness is crucial to someone’s well-being. A case study is conducted to test whether the social connectedness of elderly people living in a nursing home and their family and friends can be improved through a photo frame. A SIM-based photo frame is used to keep the elderly people informed about the comings and goings of their loved ones. Eight elderly people living in a nursing home participated in this case study for 6-7 weeks. A content analysis of the photos revealed that the photos often were related to special events or holidays that happened in the past. Interviews indicated that the photos mainly served as food for talk, i.e. the photos initiated conversations between the elderly people mutually, with their family members and with the healthcare professionals. They all liked the photo frame and it didn’t serve as a means to exchange news, but as a catalyst to talk –mainly- about the past

Addressing the Health Needs of an Aging America: New Opportunities for Evidence-Based Policy Solutions

This report systematically maps research findings to policy proposals intended to improve the health of the elderly. The study identified promising evidence-based policies, like those supporting prevention and care coordination, as well as areas where the research evidence is strong but policy activity is low, such as patient self-management and palliative care. Future work of the Stern Center will focus on these topics as well as long-term care financing, the health care workforce, and the role of family caregivers

Economic evaluation of a nursing-led intermediate care unit

Objectives: The aim of this paper is to examine the costs of introducing a nursing-led ward program together with examining the impact this may have on patients' outcomes. Methods; The study had a sample size of 177 patients with a mean age of 77, and randomized to either a treatment group (care on a nursing-led ward, n = 97) or a control group (standard care usually on a consultant-led acute ward, n = 80). Resource use data including length of stay, tests and investigations performed, and multidisciplinary involvement in care were collected. Results: There were no significant differences in outcome between the two groups. The inpatient costs for the treatment group were significantly higher, due to the longer length of stay in this group. However, the postdischarge costs were significantly lower for the treatment group. Conclusions: The provision of nursing-led intermediate care units has been proposed as a solution to inappropriate use of acute medical wards by patients who require additional nursing rather than medical care. Whether the treatment group is ultimately cost-additive is dependent on how long reductions in postdischarge resource use are maintained