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Mental health problems in old age have attracted policy attention in the UK over the past decade. An important issue is how to improve services for people who have both mental…
Abstract
Mental health problems in old age have attracted policy attention in the UK over the past decade. An important issue is how to improve services for people who have both mental health and other problems. This article sets out some of the challenges facing planners and commissioners in developing integrated services for older adults, by using the case study of people with dementia and incontinence problems. It uses integrated service models and observations from the EVIDEM‐C study to suggest some incremental actions that would help develop the long‐term strategy for integrated services.
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We understand that at the Annual Meeting of the Iron and Steel Institute it was decided to expel all the alien‐enemy members of that body. In commenting upon this action The…
Abstract
We understand that at the Annual Meeting of the Iron and Steel Institute it was decided to expel all the alien‐enemy members of that body. In commenting upon this action The Engineer observes that it is some time since the name of the German Emperor was removed from the list of honorary members of the Institution of Civil Engineers, but that up to the present time ordinary alien‐enemy members of this Institution have not been expelled. The same observation applies to the Institution of Mechanical Engineers.
Paul Clarkson, Rebecca Hays, Sue Tucker, Katie Paddock and David Challis
A growing ageing population with complex healthcare needs is a challenge to the organisation of healthcare support for older people residing in care homes. The lack of specialised…
Abstract
Purpose
A growing ageing population with complex healthcare needs is a challenge to the organisation of healthcare support for older people residing in care homes. The lack of specialised healthcare support for care home residents has resulted in poorer outcomes, compared with community-dwelling older people. However, little is known about the forms, staff mix, organisation and delivery of such services for residents’ physical healthcare needs. The paper aims to discuss these issues.
Design/methodology/approach
This systematic review, following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, aimed to provide an overview of the range of healthcare services delivered to care homes and to identify core features of variation in their organisation, activities and responsibilities. The eligibility criteria for studies were services designed to address the physical healthcare needs of older people, permanently residing in care homes, with or without nursing. To search the literature, terms relating to care homes, healthcare and older people, across ten electronic databases were used. The quality of service descriptions was appraised using a rating tool designed for the study. The evidence was synthesised, by means of a narrative summary, according to key areas of variation, into models of healthcare support with examples of their relative effectiveness.
Findings
In total, 84 studies, covering 74 interventions, identified a diverse range of specialist healthcare support services, suggesting a wide variety of ways of delivering healthcare support to care homes. These fell within five models: assessment – no consultant; assessment with consultant; assessment/management – no consultant; assessment/management with consultant; and training and support. The predominant model offered a combination of assessment and management. Overall, there was a lack of detail in the data, making judgements of relative effectiveness difficult. Recommendations for future research include the need for clearer descriptions of interventions and particularly of data on resident-level costs and effectiveness, as well as better explanations of how services are implemented (review registration: PROSPERO CRD42017081161).
Originality/value
There is considerable debate about the best means of providing healthcare to older people in care homes. A number of specialist initiatives have developed and this review seeks to bring these together in a comparative approach deriving models of care of value to policy makers and commissioners.
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This paper aims to provide strategies for individuals with limited work capacity (LWC) to build workplace friendships and foster inclusion, which can benefit their mental health.
Abstract
Purpose
This paper aims to provide strategies for individuals with limited work capacity (LWC) to build workplace friendships and foster inclusion, which can benefit their mental health.
Design/methodology/approach
The paper integrates key theories such as social exchange theory and the similarity-attraction paradigm to analyze the dynamics of relationships. Practical tips grounded in the existing literature are outlined.
Findings
Effective communication, building trust, showing mutual respect and discovering common interests can facilitate friendship development for employees with LWC. Supportive organizational policies and culture are also critical.
Social implications
By building workplace bonds and inclusion, individuals with LWC may experience greater social support, more engagement and better mental well-being. This also helps to diminish stigma and marginalization.
Originality/value
This viewpoint provides practical guidance specifically designed for individuals with Limited Work Capacity (LWC) to overcome workplace obstacles and build social relationships. It addresses an existing gap in the interpersonal facets of disability inclusion.
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The purpose of this paper is to describe service user involvement, explain some of the key issues that define, affect or protect mental health in later life and show how…
Abstract
Purpose
The purpose of this paper is to describe service user involvement, explain some of the key issues that define, affect or protect mental health in later life and show how involvement may contribute to better mental health in later life.
Design/methodology/approach
The paper reviews existing definitions of involvement and mental health in later life; provides a more detailed review of some examples of involvement at a range of levels and illustrates how these could have a positive impact on mental health.
Findings
Active involvement and engagement at all levels offers significant opportunities for older people to protect and improve their own mental health and the mental health of society as a whole.
Research limitations/implications
This research does not set out to promote any particular intervention or involvement technique. The examples given have been evaluated in a variety of ways.
Practical implications
Service user involvement should be considered as an important potential contributor to mental health in later life.
Social implications
The paper encourages people in later life to be considered as a community resource rather than a problem that needs to be solved.
Originality/value
This paper brings together existing research with a focus on the relationship between involvement and individual and collective mental health.
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Reading and writing are crucial components of the research process and academic life as a whole. The purpose of this paper is to ask if conventional reading and writing practices…
Abstract
Purpose
Reading and writing are crucial components of the research process and academic life as a whole. The purpose of this paper is to ask if conventional reading and writing practices are fit for marketing purpose.
Design/methodology/approach
The paper consists of an extended autobiographical essay, which reflects on the relevance of academic research output. The concerns of marketing thought leaders are also incorporated as required.
Findings
Academic articles are unreadable and unread. This is due to extant writing practices which result in characterless papers with little reader appeal.
Research limitations/implications
The best way forward is to look back at the approaches that prevailed prior to marketing's mid‐'60s “scientific revolution”. If adopted, they'll make learned research papers and monographs much more readable than they are at present.
Practical implications
If marketing academics embrace this paper's recommendations, their writings are more likely to be read and acted upon by practitioners, policy makers and other important stakeholders.
Originality/value
The style of the article is in keeping with the content. It demonstrates as well as describes.
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David Robertshaw and Ainslea Cross
Effective integrated healthcare systems require capable, trained workforces with leadership, shared governance and co-ordination. The purpose of this paper is to characterise…
Abstract
Purpose
Effective integrated healthcare systems require capable, trained workforces with leadership, shared governance and co-ordination. The purpose of this paper is to characterise roles and responsibilities in relation to integrated care from the perspective of massive open online course (MOOC) participants.
Design/methodology/approach
MOOC discussion board posts were analysed using framework analysis consisting of transcription, familiarisation, coding, developing an analytical framework and application of the framework.
Findings
Boundaries and key issues surrounding roles and responsibilities were highlighted and participants suggested a number of enablers which could enhance integrated care in addition to barriers to consider and overcome.
Originality/value
Enablers included introduction of shared communication and IT systems to support continuity of care. Awareness and understanding of dementia was seen as crucial to promote person-centred care and care planning. The roles of education and experience were highlighted. Barriers preventing effective roles and suitable responsibility include funding, role conflicts, time constraints and time-consuming paperwork.
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David Bogataj, Valerija Rogelj, Marija Bogataj and Eneja Drobež
The purpose of this study is to develop new type of reverse mortgage contract. How to provide adequate services and housing for an increasing number of people that are dependent…
Abstract
Purpose
The purpose of this study is to develop new type of reverse mortgage contract. How to provide adequate services and housing for an increasing number of people that are dependent on the help of others is a crucial question in the European Union (EU). The housing stock in Europe is not fit to support a shift from institutional care to the home-based independent living. Some 90% of houses in the UK and 70%–80% in Germany are not adequately built, as they contain accessibility barriers for people with emerging functional impairments. The available reverse mortgage contracts do not allow for relocation to their own adapted facilities. How to finance the adaptation from housing equity is discussed.
Design/methodology/approach
The authors have extended the existing loan reverse mortgage model. Actuarial methods based on the equivalence of the actuarial present values and the multiple decrement approach are used to evaluate premiums for flexible longevity and lifetime long-term care (LTC) insurance for financing adequate facilities.
Findings
The adequate, age-friendly housing provision that is appropriate to support the independence and autonomy of seniors with declining functional capacities can lower the cost of health care and improve the well-being of older adults. For financing the development of this kind of facilities for seniors, the authors developed the reverse mortgage scheme with embedded longevity and LTC insurance as a possible financial instrument for better LTC services and housing with care in assisted-living facilities. This kind of facilities should be available for the rapid growth of older cohorts.
Research limitations/implications
The numerical example is based on rather crude numbers, because of lack of data, as the developed reverse mortgage product with LTC insurance is a novelty. Intensity of care and probabilities of care in certain category of care will change after the introduction of this product.
Practical implications
The model results indicate that it is possible to successfully tie an insurance product to the insured and not to the object.
Social implications
The introduction of this insurance option will allow many older adult with low pension benefits and a substantial home equity to safely opt for a reverse mortgage and benefit from better social care.
Originality/value
While currently available reverse mortgage contracts lapse when the homeowner moves to assisted-living facilities in any EU Member State, in the paper a new method is developed where multiple adjustments of housing to the functional capacities with relocation is possible, under the same insurance and reverse mortgage contract. The case of Slovenia is presented as a numerical example. These insurance products, as a novelty, are portable, so the homeowner can move in own specialised housing unit in assisted-living facilities and keep the existing reverse mortgage contract with no additional costs, which is not possible in the current insurance products. With some small modifications, the method is useful for any EU Member State.
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Michael Clark, Neil Moreland, Ian Greaves, Nicola Greaves and David Jolley
The purpose of this article is to discuss the policy developments of integration and personalisation within the context of Primary Care, specifically an innovative Memory Service…
Abstract
Purpose
The purpose of this article is to discuss the policy developments of integration and personalisation within the context of Primary Care, specifically an innovative Memory Service provided within a General Practice. It examines how these policies work together in this context to deliver a high quality service that is responsive to individual needs in an area of care: memory disorder or dementia, which has often relied heavily on secondary care services.
Design/methodology/approach
The article is a case study analysis of integration and personalisation in Primary Care, allowing for examination and elaboration of both concepts as applied in this setting; and their contribution to a better quality care Memory Service. The analysis is produced by independent researchers (MC and NM), background and facts by service personnel (IG, NG and DJ).
Findings
The innovative Memory Service operates as a person‐centred facility, integrating into the surgery, expertise that would traditionally be locked into secondary care health services. It makes maximum use of locally available knowledge of the patient, their family and formal and informal sources of support and therapy through links which cross agency boundaries. These links are identified and utilised in tailored support for individuals by the practice‐based Dementia Advisor. Outcomes include improved dynamics of identification, diagnosis and after care, high satisfaction amongst patients and families and reduced utilisation and expenditure of other healthcare facilities.
Practical implications
Personalisation and integration can be united in the development of innovative and improved Memory Services centred in Primary Care.
Social implications
Maintaining a focus on the needs of people within their social contexts (being person‐centred) is a powerful means of driving better integrated care in Primary Care for people living with dementia and related disorders.
Originality/value
This is the first examination of personalisation and integration as coupled concepts to lead the improvement of care, specifically a Memory Service, in Primary Care.
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