Support For Older People Research Articles

Current Status and Challenges Regarding Collaboration between Care Mangers and Mental Health and Welfare Service Facilities in Supporting Older People with Mental Disorders

Current Status and Challenges Regarding Collaboration between Care Mangers and Mental Health and Welfare Service Facilities in Supporting Older People with Mental Disorders

EXPLORING THE PERCEPTION OF PATIENTS WITH DEMENTIA ABOUT A SOCIAL ROBOT PARO IN A HOSPITAL SETTING

PARO, a robotic pet, was designed to provide emotional and social support for older people with dementia. This project aims to explore the perception of persons with dementia about the role of PARO in a hospital setting. Video-ethnographic methods were applied. Patient and family partners were involved in the fieldwork of data collection and analysis. We conducted conversational interviews with ten patients with dementia staying in a geriatric unit and video observations. Thematic analysis yielded three substantive themes: (a) “it’s like a buddy”, the robot helps persons with dementia to uphold a sense of self in the world, (b) “it’s a conversation piece”, the baby seal facilitates social connection, and (c) “it’s all about love”, PARO transforms and humanizes the clinical setting. Our findings contribute to providing a better understanding of the direct perspectives of patients with dementia on the use of the social robot.

IT’S MY BUDDY: EXPLORING THE PERCEPTIONS OF PEOPLE WITH DEMENTIA ABOUT THE SOCIAL ROBOT PARO IN A HOSPITAL SETTING

New technology such as social robots opens up new opportunities in hospital settings. PARO, a robotic pet seal, was designed to provide emotional and social support for older people with dementia. This project aims to explore the perceptions of persons with dementia about PARO’s role in a hospital setting. Video-ethnographic methods were applied. We had conversational interviews with and video observations of 10 older people with dementia in the geriatric unit of a large Canadian hospital. Also, semi-structured interviews and two focus groups were conducted with 10 staff members in the local unit to gain contextual information. Thematic analysis yielded three substantive themes: (a) “it’s like a buddy”—the robot helps people with dementia uphold a sense of self in the world; (b) “it’s a conversation piece”—the baby seal facilitates social connection; and (c) “it’s all about love”—PARO transforms and humanizes the clinical setting. Our findings help provide a better understanding of the direct perspectives of patients with dementia on the use of social robots. Instead of substituting human contact, the social robot complements emotional care and supports our fundamental human need for love.

Support for Older People in Households With Bare Branches in Rural China: Vulnerability, Dilemmas, and Possible Solutions.

This study explored potential challenges and solutions for the support of older people among households with "bare branches" (unmarried men aged 28 years or older in rural China). Qualitative interviews were conducted in Ankang district of Shaanxi Province with 33 "bare branches" and 18 older parents of "bare branches." Results showed that support from sons was still the main choice for older parents of "bare branches" in later life, and that most "bare branches" were the primary carers of their older parents. Older unmarried men faced a dilemma between staying at home to provide care to their parents, and migrating to cities to seek economic and marriage opportunities, and this was more common for unmarried men without a married brother. Government support is essential in relieving the challenges in old-age support faced by households with "bare branches", such as developing social charities, training social workers, and improving social security benefits.

Pharmacists' and older adults' perspectives on the benefits and barriers of Home Medicines Reviews - a qualitative study.

Objectives Conducting a medication review is one way to optimize medications and support older people to reduce the burden of polypharmacy. In Australia, a service called a Home Medicines Review (HMR) is conducted by pharmacists as part of a nationally funded program. HMRs aim to identify and resolve problems associated with polypharmacy and improve collaboration between patient, pharmacist and general practitioner. The aim of this study was to explore the benefits of and barriers to HMRs from the perspective of older patients and pharmacists. Methods This qualitative study involved observations of HMRs ( n = 12) and telephone interviews with 32 participants including 11 accredited pharmacists, 17 older adults aged 65 years and above, with 4 of their companions, in Australia. The researcher observing took notes during the HMR and added more detail and reflections afterwards. Transcribed audio-recordings and observational notes were thematically coded using framework analysis. Results Older patients and their companions found the HMR useful and they appreciated the opportunity to learn more about their medicines. However, many did not understand the purpose of the HMR, had limited understanding about their medicines and some did not want to know more. Pharmacists found HMRs useful for identifying medication errors and improving adherence. They also reported barriers to effective HMRs relating to patients (resistance to the evaluation of their medicines, misunderstanding about the aim of the HMR) and GPs (limited information upon referral, and limited follow-up afterwards). Conclusions Older patients and pharmacists reported a range of benefits for HMRs in terms of optimizing medicines use. Barriers to effective HMR use need to be addressed, including gaps in inter-professional communication and factors related to patient involvement, such as limited medicines understanding and health literacy.

High vision-related quality of life indices reduce the odds of depressive symptoms in aged care facilities

Objective: To examine the association between vision-related quality of life (VRQoL) and depressive symptoms in residents with vision impairment (VI) in aged care facilities.Methods: In this cross-sectional study using baseline data from a cluster-randomized controlled trial (ACTRN12615000587505) assessing the effectiveness of a novel eye care model, 186 English-speaking residents (mean age 84 years, SD[standard deviation] = 8.7; 33.9% male) with VI and moderate cognitive functioning or better were recruited from 38 facilities across Victoria, Australia. VRQoL was measured using Rasch-transformed scores from the ‘Reading’; ‘Mobility’, and ‘Emotional’ scales of the Impact of Vision Impairment for Residential Care (IVI-RC) questionnaire. Outcomes were presence of depressive symptoms (binary score: Cornell Scale for Depression in Dementia [CSDD] > 0 vs. CSDD = 0) and severity of depressive symptoms (continuous CSDD score; sample range 1-21). Independent associations with presence and severity of depressive symptoms were examined using zero-inflated logistic and linear multivariable models, respectively.Results: Of the 186 participants, n = 79 (42.5%), n = 94 (50.5%) and n = 13 (7%) reported no, mild (scores 1-7), and clinically significant depressive symptoms (score ≥8), respectively. Better vision-related Mobility (OR = 0.64; 95% CI: 0.44, 0.95, p = 0.02) was associated with reduced odds of depressive symptoms. With every unit improvement in vision-related Reading (β=-0.48; 95% CI: -0.94, -0.01, p = 0.04) and Emotional (β=-0.56; 95% CI: -1.09, -0.02, p = 0.04), severity of depressive symptoms reduced, independent of sociodemographic and medical issues.Conclusion: Better VRQoL was independently associated with reduced depressive symptoms. Supporting older people in aged care to maintain optimal levels of vision-specific functioning, independence, and emotional well-being may protect their mental health.

Supporting Older People Using Attachment-Informed and Strengths-Based Approaches, I. Blood and L. Guthrie

Supporting Older People Using Attachment-Informed and Strengths-Based Approaches, I. Blood and L. Guthrie

Can support workers from AgeUK deliver an intervention to support older people with anxiety and depression? A qualitative evaluation

BackgroundAnxiety and depression often co-exist. These disorders are under-diagnosed and under-treated, specifically among older people, and lead to increased use of health and social care services and raised mortality. Older people report a reluctance to present to their GP with depression or anxiety symptoms due to perceived stigma about mental health problems, lack of acceptable treatments and the prioritising of physical health problems. Third sector organisations, who work closely with older people in the community, are well-placed to provide additional support. We developed a brief intervention based on principles of Behavioural Activation, with encouragement to participate in a group activity, for delivery by Support Workers from AgeUK. The aim of the study was to examine whether this brief intervention could be delivered to older people with anxiety and/or depression, with sufficient fidelity, and whether this approach was acceptable to patients, GPs and AgeUK Support Workers.MethodsSemi-structured interviews with older people with self-reported anxiety and/or depression (who received the intervention), Support Workers and GPs to assess acceptability of the intervention and impact on routine care. A constant comparative approach was used to analyse the data. Intervention sessions between Support Workers and older people were digitally recorded and reviewed by the research team to assess fidelity.ResultsThe Support Workers delivered the intervention with fidelity; access to the training maual and ongoing supervision were important. Older people found the intervention acceptable and valued the one-to-one support they received; group activities suggested by Support Workers were not valued by all. GPs recognised the need for additional support for vulnerable older people, but acknowledged they could not provide this support. Participation in the study did not impact on GP routine care, other than responding to the calls from the study team about risk of self-harm.ConclusionsSupport Workers within AgeUK, can be recruited and trained to deliver an intervention, based on the principles of Behavioural Activation, to older people with anxiety and/or depression. The training and supervision model used in the study was acceptable to Support Workers, and the intervention was acceptable to older people and GPs. This model has the potential to contribute to improving the support and care of older people in primary care with anxiety and depression. Further testing is required in a full trial.Trial registrationTrial registration number ISRCTN16318986.Registered 10/11/2016.

Adaptation and validation of the Instrumental Expressive Social Support Scale in Portuguese older individuals.

Objective to adapt and validate the Instrumental Expressive Social Support Scale (IESS) in a sample of older people.Method methodological study. The sample of 964 community-dwelling older people was randomly divided into two groups. The first group was used as a calibration sample to study the number of factors underlying social support through Principal Axis Factoring, and the second group as a validation sample to test the “best fit” model through Confirmatory Factor Analysis.Results exploratory Factor Analysis suggested a three-factor solution, which was confirmed by Confirmatory Factor Analysis. The factors were similar to those in the pre-existing dimensions of the original instrument and were named as Sense of control (α = 0.900), Financial support (α = 0.802), Familiar and socio-affective support (α = 0.778). Confirmatory Factor Analysis showed acceptable fit. The model’s goodness-of-fit indexes were satisfactory (χ2/df = 5.418; CFI = 0.903; NFI = 0.884; RMSEA = 0.098). The convergent validity was supported by associations between social support and medication adherence and positive affect. The discriminant validity was evidenced by association with negative affect. The reliability analysis showed high values of internal consistency.Conclusion the instrument proved to be a valid measure for the assessment of social support in older people.

Developing an interprofessional training for primary care: a co-creation with practice, education and research

An introduction: Care for older people with multiple chronic conditions and complex care require different disciplines which are often simultaneously involved. Interprofessional collaboration between professionals from medical and social care in the community is necessary to enhance quality of life and support of older people. Short description of practice change implemented: An interprofessional training IPT for professionals working with older people in primary care was developed and pilot tested. Three central themes for the training were defined: collaboration, role identity and communication. Aim and theory of change: The aim of the IPT is to enhance collaboration and communication between multiple professionals in primary care so that they are adequately equipped to provide integrated care for older people. Professionals learn from and with each other how collaboration in primary care can be improved and what they need from each other. The IPT consisted of two teaching days within the community and multiple online and onsite assignments e.g. blended learning. Targeted population and stakeholders: To enhance the fit between the needs and wishes of the professionals and the goals of the IPT, an expert team consisting of multiple stakeholders were involved e.g. general practitioner, practical nurses, specialized nurses, and social work. The expert team was consulted about the content and form of the training several times to ensure co-creation. In total, twenty-three primary care professionals e.g. community nurses, general practitioners, nurse practitioners, pharmacists, social workers, and welfare professionals were trained in three communities. Timeline: The training duration was six weeks. Highlights innovation, Impact and outcomes: The IPT is evaluated on three interprofessional outcomes defined by Reeves 20161. The first and second outcome evaluates reaction, knowledge- and skills. These two outcomes were positively evaluated during the pilot. Third, behavioral change in the collaboration between the professionals was measured with Social Network Analysis to explore what changes took place in terms of size and strength of the collaboration. Sustainability: The IPT will be sustained by a non-profit organization that offers training on collaborative practice at community level. Furthermore, elements of the training will be embedded in the bachelor nursing education at the University of Applied Sciences Utrecht. Transferability: The content of the training can be integrated in bachelor nursing education and the outline of the training has an excellent fit with clinical practice due to the blended character. Conclusions: The IPT is experienced as positive by all community teams. The results regarding the size and strength of the collaboration between the professionals i.e. evaluation of behavioral change, will be expected begin 2018. Discussion: Little is known about IPT in the context of home and community care of older adults2. Therefore, this IPT serves as an example in developing and evaluating an IPT in primary care settings. Lessons learned: Co-creation appears to be essential in the development of IPT because equivalent influence of all involved stakeholders including the target population can guaranteed an optimal fit for primary care practice.

Developing citizen advocacy for adults with intellectual disability

In 2010, the Report of Disability Policy Review Keogh 2010 was prepared on behalf of the Expert Reference Group on Disability Policy and its findings contributed to the subsequent Value for Money and Policy Review of Disability Service in Ireland Report DoH 2012, which evaluated the efficiency and effectiveness of Health Service Executive HSE funded statutory and non-statutory disability services in Ireland. The Keogh 2010 report emphaisised the importance of advocacy in developing person centred care services. This imptus became more important as various media scandals highlighted some incidents of poor care to people with intellectual disability. In 2016, Sage Advocacy & Support for Older People were given funding to develop a citizen advocacy project for adults with itellectual disability in Ireland. This study presents the findings from engagement with adults with intellectual disability, their families and formal caregivers. This project sought to gain understanding and depth into the perspectives of people with intellectual disability on their life world and to generate other stakeholders’ perspectives regarding caring for this population. Consequently, the study used a qualitative approach, which enables deep and rich insights to people’s lives and experiences and is valuable in examining the interpersonal aspects of care important to patients. Specifically narrative inquiry has the potential to produce themes from the accounts of the study participants. Ethics approval was gained from University College Dublin. Participants were recruited from contacting the facilities who provided care to adults with intellectual disability. Nine focus groups 5 with service users and 4 with service providers were held as well as 4 semi structured interviews 4 with family members of the person and 2 with key stakeholders with intellectual disability and a survey with the Irish Association of Social Workers. Data were analysed using Braun & Clarke's thematic anlysis approach with the assistance fo NVIVO 10. Five themes were developed: Personhood, Service Challenges, Family experiences, Society’s approach to people with intellectual disability, The need for my voice to be heard. These themes enabled multiple perspectives to be considered, particualarly emphasing the need to priortise the will, preference, values and beliefs of people with intellectual disabiity and the need for service users and families to empower rather than be paternalistic. Limitations of the study will also be presented.

Towards a new care paradigm: the development of the INClusive CAre framework

Introduction: One of the most thriving gerontological concepts in policy and practice is ‘ageing in place’. Given the profound effects of this policy perspective on the every day life, it is imperative that care and support services pave the way of this aspiration of both older individuals and governments. Yet, care and support services have a hard time to respond adequately on the complex needs of frail people due to weak integration and fragmention of the care provision. Although many efforts have concentrated on the modification of health and social responses to enhance older people’s chances to ‘stay put’ as long as possible, effective frailty management is hampered as a consequence of ignoring the dynamic and intertwining person-environment relationship. Moreover, frail people have often been perceived as passive consumers that do not have mastery over their life. Methods: A cutting-edge integrated care framework was developed based on a mixed-method approach in Brussels during 2017. Both qualitative N=237 and quantitative N=602 measures were used to achieve insights in both the supply and demand side of care and support of older people, aiming at effective frailty management to age in place. Results and lessons learned: Analyses reveal four conditions for effective frailty management, which were incorporated in the development of the INClusive CAre framework INCCA: Take an empowering perspective on and in the organisation of care and support; Include the context of care receivers in the care organisation; Take a multidisciplinary approach to care and support; and Facilitate the access to care and support. Discussions and conclusions: The INClusive CAre framework stresses the importance of the neighbourhood in frailty management. It offers each neighbourhood an action list of needs to be tackled on two levels: 1 the micro level, and 2 the meso level. Moreover, the application of modularity enables responding to the changing needs of frail people and their context. Additionally, access to care is positioned at the core of the model, for all forces in the care process congregate in one central access point. As the framework of inclusive care recognises the multidisciplinary side of frailty management, it transcends the unilateral focus of health care. Moreover, it takes both an ecological approach and an empowering perspective by guiding people in their frailty management through the adoption of a more active management style and by redefining the boundaries between formal and informal care. Hence, our framework for inclusive care allows responding to the diversity in demand through customising the care contents to a specific neighbourhood and its inhabitants. Limitations and suggestions for future research: Three main research streams should be developed to operationalise the framework. First, the importance to study the relation between the capabilities of frail people in managing their frailty, and the emergence of needs is stressed. Second, the need to further profile neighbourhoods to create a more adequate care system is demonstrated. Third, more insight in capacity building of both formal and informal caregivers is required to facilitate the self-management of frailty.

Capabilities of older people in adjusting to frailty

Introduction: External factors influence older people’s changes to successfully age in place, as do intrapersonal factors, which allow people to adjust to changes in daily life. Although research on active and healthy ageing has shown the importance of a multidisciplinary perspective, less thought has been given to the direct environment an ageing person spends his time in. Additionally, research about psychosocial experiences has mainly focused on frailty as a physical concept without taking the subjective perspective into account. Research was seldom directed at the older people as care receivers, but at the perspective of formal care. Consequently, this study starts where others ended, namely in addressing home-dwelling older people themselves, by examining how they cope with current and future frailty. Methods: The technique of focus group interviews N=137 older people was used and data was collected through a semi-structered questionnaire on place and care. The transcripts were thematically and narratively analysed by an iterative coding proces based on the coping model of Duner & Nordstrom 2 and the conceptualisation of frailty by De Witte et al. 1. Results: Our analysis identified an additional managing style of ‘rejective managing’ next to the three styles suggested by Duner & Nordstrom 2: 1 active, 2 adaptive, and 3 passive. As the way older people act on their changing situations can be defined on their degree of dependency and their degree of activeness, the study unfolds that both dimensions are not necessarily correlated with what was stated by Duner and Nordstrom 2, as rejective older people are independent and do not act. Discussion: Managing styles and frailty dimensions become dynamic as managing one dimension of frailty leads to managing other dimensions i.e. spillover effect, and as active managing enables even more activeness i.e. amplifying effect. Moreover, the need for care and support of older people varies according to frailty and managing styles. Conclusion: The study identifies subjective factors influencing the relationship between the individual and the environment. How people act on frailty underpins not only the ability to manage specific changes but also depicts the intertwining relation between the different dimensions of frailty. Lessons learned: Definition of management capabilities; Identification of managing styles; Introduction of an empowering perspective in frailty literature; and Creation of a tool to guide policy and practice in empowering frail people. Limitations: The narratives were approached in a positive way, which could enable emphasising a more active managing style rather then rejecting managing. Additionally, ‘categorisation’ neglects the interchangeability between the person and the environment. Suggestions for future research: A longitudinal multilevel study is suggested to get a comprehensive understanding of the dynamic process between managing styles and multi-dimensional frailty, as is repeating the study in other environments to assess and compare contexts.

Can smart home technology support older people?

British Journal of Community NursingVol. 23, No. 9 Care of the Older PersonCan smart home technology support older people?Catriona HumphreysCatriona HumphreysSearch for more papers by this authorCatriona HumphreysPublished Online:29 Aug 2018https://doi.org/10.12968/bjcn.2018.23.9.435AboutSectionsView articleView Full TextPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareShare onFacebookTwitterLinked InEmail View article References Alwan M. Passive in-home health and wellness monitoring: overview value and examples in: 31st Annual International Conference of the IEEE EMBS. Conf Proc IEEE Eng Med Biol Soc. 2009; 43(10): https://doi.org/https://doi.org/10.1109/IEMBS.2009.5333799 Google ScholarDemiris G, Hensel B. Technologies for an ageing society: A systematic review of “smart home” applications. Yearb Med Inform. 2008;17(1):33-40 https://doi.org/https://doi.org/10.1055/s-0038-1638580 Crossref, Google ScholarFrost H, Haw S, Frank J. Interventions in community settings that prevent or delay disablement in later life: an overview of the evidence. Qual Ageing Older Adults. 2012; 13(3):212-230 https://doi.org/https://doi.org/10.1108/14717791211264241 Crossref, Google ScholarHawley-Hague H, Boulton E, Hall A et al.. Older adults' perceptions of technologies aimed at falls prevention, detection or monitoring: a systematic review. Int J Med Inform. 2014; 83(6):416-26 https://doi.org/https://doi.org/10.1016/j.ijmedinf.2014.03.002.i-Scoop. Crossref, Medline, Google ScholarDigital transformation: online guide to digital business transformation. 2018. https://tinyurl.com/yav9x6rx (accessed 19 July 2018) Google ScholarKim K, Gollamundi S, Steinbul S. Digital technology to enable ageing in place. Exp Gerontol. 2017;88(2):25-31 https://doi.org/https://doi.org/10.1016/j.exger.2016.11.013 Crossref, Medline, Google ScholarLiu L, Stroulia E, Nikolaidis I et al.. Smart homes and home health monitoring technologies for older adults: a systematic review. Int J Med Inform. 2016;91(77):44-59 https://doi.org/https://doi.org/10.1016/j.ijmedinf.2016.04.007 Crossref, Medline, Google ScholarMaeder A, Poultney N, Morgan G et al.. Patient compliance in home-based self-care telehealth projects. J Telemedicine Telecare. 2015. 21(8): 439-442 https://doi.org/https://doi.org/10.1177/1357633X15612382 Crossref, Medline, Google ScholarNHS. Transforming digital health. 2018b. https://tinyurl.com/y829hado (accessed 26 July 2018) Google ScholarNHS England. Local digital roadmaps. 2018a. https://tinyurl.com/ya73wry3 (accessed 19 July 2018) Google ScholarPeetoom K, Lexis M, Joore M et al.. Literature review on monitoring technologies and their outcomes in independently living elderly people. Disabil Rehabil Assist Tech. 2014. 10(4):271-294 https://doi.org/https://doi.org/10.3109/17483107.2014.961179 Crossref, Medline, Google ScholarPietrzak E, Cotea C, Pullman, S. Does smart home technology prevent falls in community-dwelling older adults: a literature review. Inform Primary Care. 2014; 21:105-112 https://doi.org/https://doi.org/10.14236/jhi.v21i3.64 Medline, Google ScholarReeder B, Meyer E, Lazar A et al.. Framing the evidence for health smart homes and home-based consumer health technologies as a public health intervention for independent ageing: a systematic review. Int J Med Inform. 2013;82:565-579 https://doi.org/https://doi.org/10.1016/j.ijmedinf.2013.03.007 Crossref, Medline, Google ScholarSekhon M, Catrwright M, Francis J. Acceptability of healthcare interventions: an overview of reviews and development of a theoretical framework. BMC Health Services Research. 2017; https://doi.org/https://doi.org/10.1186/s12913-017-2031-8 Crossref, Medline, Google ScholarSitton-Kent L, Humphreys C, Miller P. Supporting the spread of health technology in community services. Br J Community Nurs. 2018. 23(3):118-122 https://doi.org/https://doi.org/10.12968/bjcn.2018.23.3.118 Link, Google ScholarStewart L, McKinstry B. Fear of falling and the use of telecare by older people. Br J Occupat Therapy. 2012. 75(7): 304-312 https://doi.org/https://doi.org/10.4276%2F030802212X13418284515758 Crossref, Google ScholarTakahashi P, Pecina J, Upatising B et al.. A randomized controlled trial of telemonitoring in older adults with multiple health issues to prevent hospitalizations and emergency department visits. Arch Int Med. 2012. 172(10):773-779 https://doi.org/https://doi.org/10.1001/archinternmed.2012.256 Crossref, Medline, Google ScholarThe Enterprisers Project. What is digital transformation. 2018. https://tinyurl.com/y9bac9oo (accessed 19 July 2018) Google Scholar FiguresReferencesRelatedDetails 2 September 2018Volume 23Issue 9ISSN (print): 1462-4753ISSN (online): 2052-2215 Metrics History Published online 29 August 2018 Published in print 2 September 2018 Information© MA Healthcare LimitedPDF download

“It just happens”. Care home residents’ experiences and expectations of accessing GP care

BackgroundCare homes provide personal care and support for older people who can no longer be supported in the community. As part of a larger study of integrated working between the NHS and care homes we asked older people how they accessed health care services. Our aim was to understand how older people resident in care homes access health services using the Andersen model of health care access. MethodsCase studies were conducted in six care homes with different socio-economic characteristics, size and ownership in three study sites. Residents in all care homes with capacity to participate were eligible for the study. Interviews explored how residents accessed NHS professionals. The Andersen model of health seeking behaviour was our analytic framework. FindingsThirty-five participants were interviewed with an average of 4 different conditions. Expectations of their health and the effectiveness of services to mitigate their problems were low. Enabling factors were the use of intermediaries (usually staff, but also relatives) to seek access. Residents expected that care home staff would monitor changes in their health and seek appropriate help unprompted. ConclusionsCare home residents may normalise their health care needs and frame services as unable to remediate these which may combine to disincline older care home residents to seek care. Care access was enabled using intermediaries -either staff or relatives-and the expectation that staff would proactively seek care when they observed new/changed needs. Residents may over-estimate the health-related knowledge of care home staff and their ability to initiate referrals to NHS professionals.

Developing innovative interdisciplinary technological solutions for caregivers of older adults within Canada's technology and aging network

Caregivers are critical to the health and support of older people with disabilities. Canada's technology and aging network, AGE-WELL (agewell-nce.ca), is dedicated to the creation of technologies and services that benefit older adults and caregivers. One important research theme within this network focuses on the development of novel technological solutions to address caregivers’ needs. This presentation reports on AGE-WELL activities that seek to gain insight as to how to support care providers of older adults with disabilities. We use a mixed methods approach to contribute to a growing body of knowledge about the complexity and diversity of caregivers’ lives and needs. Our inclusive research approach captures, and integrates a breadth of stakeholders and disciplines. An overview of 10 ongoing and completed projects with a balance between discovery and application-based research is provided. These range from surveying caregivers to better understand their needs and challenges, to developing online assistive technology rating and recommendation systems for caregivers. The projects consider different care recipient conditions (cognitive and physical limitations), caregiver needs (physical, social, emotional, and financial) and caregiver groups (paid work roles and family caregivers). The results also highlight shared tools and strategies used by the researchers all focusing on the needs of caregivers, to optimize resources and increase visibility; these include a repository of scientific paper citations and promotional videos. This presentation offers an example of collaborative research that seeks to develop a wide range of innovative technological solutions that can benefit both the lives of disabled older adults and their caregivers.

Specialist services in early diagnosis and support for older people with dementia in England: Staff roles and service mix.

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. 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. 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. 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.

Number of children and social contacts among older people: the moderating role of filial norms and social policies

Social contacts offer opportunities for provision of emotional and instrumental support that enhances well-being throughout the life course, and the importance of these contacts is especially evident at advanced ages. In this paper, we take a cross-country comparative perspective to examine the association between the number of children and the frequency of social contacts among older people. Using data from the European Quality of Life Survey, we employ multilevel models with cross-level interactions between the number of children and macro-level indicators of filial norms and social policies supporting older people. Our results suggest that older adults with children are more likely than older adults without children to have frequent social interactions, but that the number of children does not affect social contact frequency. The magnitude of the association between having children and social contact frequency varies across European societies. The social contact frequency gap between older adults with children and older adults without children is larger in more familialistic countries with strong filial norms. Our results do not confirm that having children affects social contact frequency less in countries where the state provides more support for older people.

Care coordination for older people in England: Does context shape approach?

Summary Policy and practice developments in adult social care in England and elsewhere recognise the increasing role of the non-statutory sector. Care coordination services are central to the delivery of tailored support. This qualitative study focuses on support for older people and reports an analysis of 13 non-statutory sector services providing care coordination, grouped into four service types. Semi-structured interviews explored the influence of service context on the nature of practice. Findings Particular elements of care coordination (e.g. assessment) were found to be shaped by the specific aims and purpose of each service type, such as extent to which they had a commissioning or provider role and the nature of their target group. Aspects of a range of case and care management approaches were in use throughout the sample, varying in relation to the distinct features of the service type. A set of overarching standards was found to be relevant to all services considered. Non-statutory sector services were found to provide innovative support which both complemented and sometimes substituted for the statutory sector. Applications Findings point to the continued importance of social work values and methods to the work of non-statutory sector services providing care coordination and to current limitations in relation to what the sector can provide. These are issues which employers and service commissioners need to address to ensure that non-statutory sector services have the capacity and standards of practice to meet the demands made of them. Further areas of research are identified.

The Development of Assistive Systems to Support Older People: Issues that Affect Success in Practice

Due to an aging population in Europe, the development of Ambient Assisted Living technologies (AAL) is increasingly the target of research financing. These technologies promise to enable older people to remain in their own homes longer, something many people report wanting and which may also reduce the costs of care. To date however there are few systems on the market. Other studies have tried to understand this by looking at user acceptance. However, by looking only at the user acceptance, we may miss important aspects to explain why systems went wrong in the first place, since decisions made during the development may affect the success later. To address this, we report on a study in which we applied qualitative methods, including workshops and an interactive poster, to consult with people who have experience in the development of these technologies. We present the common issues reported across various AAL development projects done in Europe that the participants thought were important to the success or failure of projects. We also describe some ideas from participants for addressing some of these problems. The results demonstrate the importance of issues related to financing with grants for projects but also the need for improved user-centered practice.