From the Max Planck Society...
Tuesday 27 August 2013
Hunt backs flexibility for carers
Health secretary Jeremy Hunt has called for working carers to be given greater flexibility over their workplace commitments. The Conservative minister said employers should allow staff who care for...
Heineken steps up efforts to woo older drinkers
Heineken is beginning to test crowdsourced ideas for products designed for older drinkers, such as bottle shapes and beer recipes as it looks to innovation to offset ongoing declines in Western Eur
Crossing the divide with a Click!
The confidence levels of older people in their IT skills has increased by a massive 180%, thanks to ClickSilver a project being piloted by Business in the Community in Nottingham, with support from Capital One.
Public response praised for replacing pensioner's stolen chairs
A PENSIONER has praised community spirit after well-wishers replaced furniture that had been stolen from his garden.
Surge in Older Workers is 'Key' to Strengthening UK Economy, says Government
The number of people aged between 50 and 64 and in employment in the UK, has increased by almost 2 million over the past 15 years, official statistics show. This age group has also bucked the trend, with a higher employment rate than before the recession, unlike any other age group. The latest employment figures released by the Office for National Statistics (ONS) show an extra 54,000 workers aged 50-64 during the last quarter (April to June 2013), bringing the total number of employees in this age group to almost 7.7 million. Pensions Minister, Steve Webb said: “Britain is in…
Paisley Daily Express news: Take tea with older people
A charity which is dedicated to tackling loneliness and isolation among older people is urgently appealing for volunteers living in and around the Paisley area.
'Living within your limits': activity restriction in older people experiencing chronic pain
Background: although maintaining activity is key to successful pain management, and important to health and wellbeing, it is known that older people in pain frequently alter or reduce activity levels. A ‘fear-avoidance’ model is often used to explain avoidance of activity in the face of pain. However, this model is not intended to take account of the wider context in which activity changes take place, nor older people's own explanations for their behaviour.
Objective: to investigate the reasons why older people in the community adjust their activity levels when living with chronic pain.
Methods: thirty-one people aged between 67 and 92 were purposively sampled from respondents to a community-based cross-sectional survey. All participants had reported long-term pain and were interviewed about this. Data were collected and analysed using a qualitative constructivist grounded theory approach.
Findings: explanations for deliberative reduction or ceasing of activities reflected a desire to prevent pain exacerbation, thereby avoiding medical intervention. It also reflected a desire to safeguard autonomy in the face of pain in older age. Restrictions were often rationalised as normal in older age, although co-existing accounts of perseverance and frustration with limitation were also evident.
Conclusions: a rational desire to avoid pain exacerbation and medical intervention motivated restrictions to activity. However, deliberative limitation of activity has the potential to compromise autonomy by increasing social isolation and de-conditioning. Supporting older people with pain to be active requires sensitivity to the function of activity restriction, especially as a means of preventing deterioration.
Do older patients find multi-compartment medication devices easy to use and which are the easiest?
Background: multi-compartment medication devices (MMDs) are widely used, primarily by older people, to aid correct-medication taking. Several MMD types are available yet little is known about the ease with which patients with varying functional ability use these devices and whether some types are easier than others. Such knowledge would assist healthcare practitioners in advising patients on a suitable choice of device.
Objective: this study investigates the ease with which patients with differing functional ability use three types of MMD.
Method: participants were recruited from an older person's medical ward. Demographic and medication information, cognitive function, visual acuity and manual dexterity were recorded. The Venalink®, Nomad Clear® and Dosett® MMDs were tested. Participants rated each MMD according to text readability, ease of opening, ease of medication removal, transportability and overall rating. These ratings were compared between MMDs for all patients and for subgroups with differing functional abilities.
Results: the MMDs were trialled by 50 patients; the majority rated text readability well but rated MMDs poorly according to the other criteria. Cognitively impaired participants may encounter difficulties in opening and removing medication from Venalink® and Nomad®. The Dosett® consistently rated better across all criteria. Transportability was the most influential criterion for overall MMD usability.
Conclusion: the poor patient rating of MMDs which are widely used in practice is of concern. Some MMDs may be difficult to open and access, especially for patients with cognitive impairment. This offers some guidance to health professionals in advising patients on MMD choice however, overall MMD rating appears dominated by transportability.
Effectiveness of a multi-component intervention to reduce delirium incidence in elderly care wards
Objective: to examine the effect of a multi-component, delirium prevention intervention on rates of incident delirium for patients admitted to specialist elderly care wards.
Design: ‘before’ and ‘after’ study.
Setting: three specialist elderly care wards in a general hospital.
Subjects: older people admitted as emergencies.
Methods: a multi-component delirium prevention intervention that targeted delirium risk factors was implemented by clinical staff. Demographic information and assessments for delirium risk factors were recorded by research staff within 24 h of admission to the ward. New onset (incident) delirium was diagnosed by daily research staff assessments using the Confusion Assessment Method and Delirium Rating Scale-Revised-98.
Results: a total of 436 patients were recruited (249 in the ‘before’ and 187 in the ‘after’ group). Incident delirium was significantly reduced (‘before’ = 13.3%; ‘after’ = 4.6%; P = 0.006). Delirium severity and duration were significantly reduced in the ‘after’ group. Mortality, length of stay, activities of daily living score at discharge and new discharge to residential or nursing home rates were similar for both groups.
Conclusions: a multi-component, delirium prevention intervention directed at delirium risk factors and implemented by local clinical staff can reduce incident delirium on specialist elderly care wards.
Comparison of effects between home visits with telephone calls and telephone calls only for transitional discharge support: a randomised controlled trial
Background: home visits and telephone calls are two often used approaches in transitional care but their differential effects are unknown.
Objective: to examine the overall effects of a transitional care programme for discharged medical patients and the differential effects of telephone calls only.
Design: randomised controlled trial.
Setting: a regional hospital in Hong Kong.
Participants: patients discharged from medical units fitting the inclusion criteria (n = 610) were randomly assigned to: control (‘control’, n = 210), home visits with calls (‘home’, n = 196) and calls only (‘call’, n = 204).
Intervention: the home groups received alternative home visits and calls and the call groups calls only for 4 weeks. The control group received two placebo calls. The nurse case manager was supported by nursing students in delivering the interventions.
Results: the home visit group (after 4 weeks 10.7%, after 12 weeks 21.4%) and the call group (11.8, 20.6%) had lower readmission rates than the control group (17.6, 25.7%). Significance differences were detected in intention-to-treat (ITT) analysis for the home and intervention group (home and call combined) at 4 weeks. In the per-protocol analysis (PPA) results, significant differences were found in all groups at 4 weeks. There was significant improvement in quality of life, self-efficacy and satisfaction in both ITT and PPA for the study groups.
Conclusions: this study has found that bundled interventions involving both home visits and calls are more effective in reducing readmissions. Many of the transitional care programmes use all-qualified nurses, and this study reveals that a mixed skills model seems to bring about positive effects as well.
Pensioner confronts minister over property tax
A disabled pensioner who opposes paying the property tax yesterday confronted Labour party housing minister Jan O'Sullivan with a message to "keep your hands off my pension".
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