1,227 research outputs found
Linking Community Care and Health Care: A New Role for Secondary Health Care Services
No full textThe provision of effective long-term care at home for frail older people requires planned and coordinated inputs from health and social care agencies. This is evident from a range of research studies (see, for example, Challis et al., 1995) which indicate the interplay between social care needs and clinical phenomena, and which have been reinforced by policy guidance. For example, although the level of functional impairment is an important influence upon the probability of placement in residential settings, so too is the presence of certain diagnoses (Tsuji et al., 1995; Darton et al., 1997). Rockwood et al. (1996) found that entry to a long-term care facility was associated not only with social factors and functional difficulties, such as female gender, being unmarried, the absence of a caregiver, the presence of cognitive impairment and functional impairment, but also with clinical diagnoses, such as diabetes mellitus, stroke and Parkinson's disease. They concluded that frailty is multidimensional and not simply a synonym for dependence in activities of daily living. Furthermore, the importance of the psychosocial needs of older people and their carers as determinants of placement has been identified in several studies (Jorm et al., 1993; Tsuji et al., 1995). For some individuals, particularly those with complex needs, a primary health care-led NHS may be insufficient, lacking both the range and depth of response necessary. The key question, therefore, is how to combine what kinds of inputs, whether primary or secondary, health or social, for which individuals, in what ways
The Darlington Study: Findings and Lessons for Care Management, Health Care and Community Care
No full textThis chapter has two aims. First, to summarise some of the key findings from the Darlington study in order to set the context for the rest of this book. Second, to identify some of the potential areas of development for the future of community care that are offered by these findings and this approach to care management. Thus, it links with the themes developed in the other chapters of this book. The relevance of this study is the way in which it highlights the importance of refocusing aspects of assessment and care management for the future development of community care and its relationship with health
Fen mapping for the Salmon-Challis National Forest
No full textPrepared for: Salmon-Challis National Forest.December 2017.Includes bibliographical references.The Salmon-Challis National Forest (SCNF) covers 4.3 million acres in five discontinuous units within east-central Idaho. Wetlands within the SCNF provide important ecological services to both the Forest and lands downstream. Organic soil wetlands, known as fens, are an irreplaceable resource that the U.S. Forest Service has determined should be managed for conservation and restoration. Fens are defined as groundwater-fed wetlands with organic soils that typically support sedges and low stature shrubs. In the arid west, organic soil formation can take thousands of years. Long-term maintenance of fens requires maintenance of both the hydrology and the plant communities that enable fen formation. ... This report and associated dataset provide the SCNF with a critical tool for conservation planning at both a local and Forest-wide scale. These data will be useful for the ongoing SCNF biological assessment required by the 2012 Forest Planning Rule, but can also be used for individual management actions, such as planning for timber sales, grazing allotments, and trail maintenance. Wherever possible, the Forest should avoid direct disturbance to the fens mapped through this project, and should also strive to protect the watersheds surrounding high concentrations of fens, thereby protecting their water sources
UK Long term care resident assessment instrument user's manual
No full textThe MDS manual comprises of a comprehensive background to the Minimum Data Set Resident Assessment Instrument. It consists of the policy and practice background to assessment of a clients needs from its development in the United States to its application in the United Kingdom, describing the benefits to clients, care homes and governments of a standard instrument for assessing need. An overview of the assessment tool follows with details of the 19 areas or domains that include such areas as ADL's, cognitive ability, rehabilitation, continence etc.
Finally there is a section about risk problems, or RAP's, identified by the instrument, which influence care planning by the inclusion of best practice guidelines. A photocopiable MDS form with details of the RAP's and guidelines is included in the pack. The manual is supported by a training pack that consists of notes and overheads for staff when using the MDS/RAI
Reconfiguring inpatient services for adults with mental health problems: Changing the balance of care.
No full textBackground Research suggests that a significant minority of hospital inpatients could be more appropriately supported in the community if enhanced services were available. However, little is known about these individuals or the services they require.Aims To identify which individuals require what services, at what cost.Method A ‘Balance of Care’ (BoC) study was undertaken in northern England. Drawing on routine electronic data about 315 admissions categorised into patient groups, frontline practitioners identified patients whose needs could be met in alternative settings and specified the services they required, using a modified nominal group approach. Costing employed a public sector approach. Results Community care was deemed appropriate for approximately a quarter of admissions including people with mild-moderate depression, an eating disorder or personality disorder, and some people with schizophrenia. Proposed community alternatives drew heavily on carer support services, Community Mental Health Teams and consultants, and there was widespread consensus on the need to increase out-of-hours community services. The costs of the proposed community care were relatively modest compared with hospital admission. On average social care costs increased by approximately £60 per week, but total costs fell by £1,626 per week. Conclusions The findings raise strategic issues for both national policy makers and local service planners. Patients who could be managed at home can be characterised by diagnosis. Although potential financial savings were identified, the reported cost differences do not directly equate to cost savings. It is not clear whether inpatient beds could be reduced. However, existing beds could be more efficiently used. <br/
- …
