Why deprescribing antipsychotics in older people with dementia in long‐term care is not always successful: Insights from the HALT study

2019 ◽  
Vol 34 (11) ◽  
pp. 1572-1581 ◽  
Author(s):  
Liesbeth Aerts ◽  
Monica Cations ◽  
Fleur Harrison ◽  
Tiffany Jessop ◽  
Allan Shell ◽  
...  
Keyword(s):  
Older People ◽  
Long Term Care ◽  
Term Care ◽  
People With Dementia

Future costs of dementia-related long-term care: exploring future scenarios

2010 ◽  
Vol 23 (1) ◽  
pp. 20-30 ◽  
Author(s):  
Adelina Comas-Herrera ◽  
Sara Northey ◽  
Raphael Wittenberg ◽  
Martin Knapp ◽  
Sarmishtha Bhattacharyya ◽  
...  
Keyword(s):  
Older People ◽  
Long Term Care ◽  
Base Case ◽  
Future Scenarios ◽  
Methodological Issues ◽  
Small Reduction ◽  
Term Care ◽  
Forecasting Methods ◽  
People With Dementia

ABSTRACTBackground: This study explores how the views of a panel of experts on dementia would affect projected long-term care expenditure for older people with dementia in England in the year 2031.Methods: A Delphi-style approach was used to gather the views of experts. The projections were carried out using a macro-simulation model of future demand and associated expenditure for long-term care by older people with dementia.Results: The panel chose statements that suggested a small reduction in the prevalence of dementia over the next fifty years, a freeze in the numbers of people in care homes, and an increase in the qualifications and pay of care assistants who look after older people with dementia. Projections of expenditure on long-term care that seek to capture the views of the panel suggest that future expenditure on long-term care for this group will rise from 0.6% of GDP in 2002 to between 0.82% and 0.96% of GDP in 2031. This range is lower than the projected expenditure of 0.99% of GDP in 2031 obtained under a range of base case assumptions.Conclusions: This paper attempts to bridge the gap between qualitative forecasting methods and quantitative future expenditure modelling and has raised a number of important methodological issues. Incorporating the panel's views into projections of future expenditure in long-term care for people with dementia would result in projected expenditure growing more slowly than it would otherwise.

scholarly journals Levels of physical activity and sleep patterns among older people with dementia living in long-term care facilities: A 24-h snapshot

Maturitas ◽  
2017 ◽  
Vol 102 ◽  
pp. 62-68 ◽  
Author(s):  
Wendy Moyle ◽  
Cindy Jones ◽  
Jenny Murfield ◽  
Brian Draper ◽  
Elizabeth Beattie ◽  
...  
Keyword(s):  
Physical Activity ◽  
Older People ◽  
Long Term Care ◽  
Sleep Patterns ◽  
Term Care ◽  
People With Dementia ◽  
Care Facilities

Working in long-term care settings for older people with dementia: nurses’ aides

2005 ◽  
Vol 14 (5) ◽  
pp. 587-593 ◽  
Author(s):  
Huei-chuan Sung ◽  
Shu-min Chang ◽  
Chuan-shoiu Tsai
Keyword(s):  
Older People ◽  
Long Term Care ◽  
Term Care ◽  
People With Dementia

scholarly journals Critical Contextual Elements in Facilitating and Achieving Success with a Person-Centred Care Intervention to Support Antipsychotic Deprescribing for Older People in Long-Term Care

2018 ◽  
Vol 2018 ◽  
pp. 1-12 ◽  
Author(s):  
Lynn Chenoweth ◽  
Tiffany Jessop ◽  
Fleur Harrison ◽  
Monica Cations ◽  
Janet Cook ◽  
...  
Keyword(s):  
Older People ◽  
Long Term Care ◽  
Direct Care ◽  
Care Staff ◽  
Care Homes ◽  
Term Care ◽  
Train The Trainer ◽  
People With Dementia ◽  
Contextual Elements

Antipsychotic and other tranquilising medicines are prescribed to help care staff manages behaviour in one-quarter of older people living in Australian long-term care homes. While these medicines pose significant health risks, particularly for people with dementia, reliance on their use occurs when staff are not educated to respond to resident behaviour using nonpharmacological approaches. The Halting Antipsychotic use in Long-Term care (HALT) single-arm study was undertaken to address this issue with 139 people 60 years and over with behaviours of concern for staff living in 24 care homes. A train-the-trainer approach delivered person-centred care education and support for 22 HALT (nurse) champions and 135 direct care staff, dementia management education for visiting general practitioners (GP) and pharmacists, use of an individualised deprescribing protocol for residents, and awareness-raising for the resident’s family. The HALT champions completed open-ended questionnaires and semistructured interviews to identify the contextual elements they considered most critical to facilitating, educating care staff, and achieving success with the study intervention. They reported that person-centred approaches helped care staff to respond proactively to resident behaviours in the absence of antipsychotic medicines; the champions considered that this required strong managerial support, champion empowerment to lead change, reeducation of care staff, and the cooperation of families and GPs.

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