Invisible cornerstones. A hermeneutic study of the experience of care partners of older people with mental health problems in home care services

2018 ◽  
Vol 14 (1) ◽  
pp. e12214 ◽  
Author(s):  
Camilla Anker-Hansen ◽  
Kirsti Skovdahl ◽  
Brendan McCormack ◽  
Siri Tønnessen
Keyword(s):  
Mental Health ◽  
Home Care ◽  
Older People ◽  
Mental Health Problems ◽  
Home Care Services ◽  
Health Problems ◽  
Care Services ◽  
Experience Of Care ◽  
Care Partners

scholarly journals Collaboration between home care staff, leaders and care partners of older people with mental health problems: a focus on personhood

2019 ◽  
Vol 34 (1) ◽  
pp. 128-138
Author(s):  
Camilla Anker‐Hansen ◽  
Kirsti Skovdahl ◽  
Brendan McCormack ◽  
Siri Tønnessen
Keyword(s):  
Mental Health ◽  
Home Care ◽  
Older People ◽  
Mental Health Problems ◽  
Health Problems ◽  
Care Staff ◽  
Care Partners

scholarly journals Bakkebyråkratiets yttergrense. Hjemmetjenestens møte med eldre med psykiske helseproblemer

2015 ◽  
Vol 11 (1) ◽  
pp. 20� ◽  
Author(s):  
Astrid Skatvedt ◽  
Ellen Andvig ◽  
Bergljot Baklien
Keyword(s):  
Mental Health ◽  
Home Care ◽  
Mental Health Problems ◽  
Care Service ◽  
Home Care Services ◽  
Health Problems ◽  
Daily Work ◽  
Outer Limit ◽  
Street Level ◽  
Street Level Bureaucrats

<strong>Street level bureaucracy’s outer limit. </strong><br /><strong>Home care service’s meeting with elderly people with mental health problems.</strong><br />This article illuminates framework for home care services’ work with older people with mental health problems living at home. We also focus upon which consequences the framework have upon home care service’s work and care for this group of elderly. The article is based on qualitative data from a municipality in Norway. Our findings point to the professionals’ experiences of limitations to provide holistic care and their various strategies for dealing with these. The professionals described a strong sense of commitment and shortcomings facing elderly with mental health problems. We call attention to a problem of responsivity, with consequences for both professionals and service users. By presenting professionals in home care service as "extreme street level bureaucrats", we expand Lipsky’s theory of street level bureaucrats. Home care service’s encounters with the this group of elderly is seen as the outer limit of street level bureaucracy, based on the major ethical dilemmas professionals experience in their daily work in connection with that they “shall not attend to” elderly’s mental health problems.

scholarly journals Predictors of clinical deterioration in patients with suspected COVID-19 managed in a ‘virtual hospital’ setting: a cohort study

BMJ Open ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. e045356
Author(s):  
Nick A Francis ◽  
Beth Stuart ◽  
Matthew Knight ◽  
Rama Vancheeswaran ◽  
Charles Oliver ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Problems ◽  
Hospital Setting ◽  
Health Problems ◽  
Clinical Deterioration ◽  
Care Services ◽  
Increased Risk ◽  
Remote Assessment ◽  
History Of

ObjectiveIdentify predictors of clinical deterioration in a virtual hospital (VH) setting for COVID-19.DesignReal-world prospective observational study.SettingVH remote assessment service in West Hertfordshire NHS Trust, UK.ParticipantsPatients with suspected COVID-19 illness enrolled directly from the community (postaccident and emergency (A&E) or medical intake assessment) or postinpatient admission.Main outcome measureDeath or (re-)admission to inpatient hospital care during VH follow-up and for 2 weeks post-VH discharge.Results900 patients with a clinical diagnosis of COVID-19 (455 referred from A&E or medical intake and 445 postinpatient) were included in the analysis. 76 (8.4%) of these experienced clinical deterioration (15 deaths in admitted patients, 3 deaths in patients not admitted and 58 additional inpatient admissions). Predictors of clinical deterioration were increase in age (OR 1.04 (95% CI 1.02 to 1.06) per year of age), history of cancer (OR 2.87 (95% CI 1.41 to 5.82)), history of mental health problems (OR 1.76 (95% CI 1.02 to 3.04)), severely impaired renal function (OR for eGFR <30=9.09 (95% CI 2.01 to 41.09)) and having a positive SARS-CoV-2 PCR result (OR 2.0 (95% CI 1.11 to 3.60)).ConclusionsThese predictors may help direct intensity of monitoring for patients with suspected or confirmed COVID-19 who are being remotely monitored by primary or secondary care services. Further research is needed to confirm our findings and identify the reasons for increased risk of clinical deterioration associated with cancer and mental health problems.

scholarly journals 9.L. Workshop: Mental health of older people

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
◽  
Keyword(s):  
Mental Health ◽  
Nursing Homes ◽  
Older People ◽  
Older Persons ◽  
Mental Health Problems ◽  
The United States ◽  
Health Problems ◽  
European Countries ◽  
Health And Wellbeing ◽  
The Impact

Abstract The world's population is aging rapidly. Globally, the population of older people will nearly double in the next 30 years, from 12% to 22%. Unfortunately, many elderly people are often vulnerable to the development of mental health problems. Besides the development of mental disorders (such as depression) or neurological disorders (such as cognitive impairment), they often experience several health ailments and loss of functionality, which negatively impacts their mental health and wellbeing. The WHO points out that mental health problems among this group of people are under-identified by healthcare professionals and by older people and their relatives themselves, and that stigma surrounding these conditions makes people often reluctant to seek help. Therefore, more scientific research and debate is needed on mental health of older persons, especially from a public health perspective. By bringing together researchers on this domain from different countries and background, this workshop aims to contribute to the scientific insight in this topic and finally to the improvement of the mental health and wellbeing of this growing group of people. In this workshop, research findings on the prevalence of (undetected) mental health problems and the impact of organizational, social and physical conditions on these problems, among older persons, both institutionalized and not, will be presented and discussed by five researchers from different European countries. Dr. Sunwoo Lee (Czech Republic) will talk about the demographic, psychosocial, and health-related risk factors for suicidal ideation among older adults in 12 European countries. Dr. Patricia De Vriendt (Belgium) will give a presentation on the unnoticed mild cognitive problems in nursing homes in Flanders. Dr. Henriette van der Roest (the Netherlands) will show the relationship between organizational adaptions in Dutch nursing homes and cognitive improvement and quality of life among older persons with dementia. Dr. Jutta Lindert (Germany) will focus on the impact of social stress and strain on the episodic memory and executive functioning of the “Midlife in the United States (MIDUS) cohort. And finally Dr. Mauro Carta (Italy) will illustrate the positive effect of moderate physical activity on cognitive functioning and general wellbeing of older people. Key messages Mental health problems among the growing group of older people are prevalent and of different kind. More scientific insight is needed on the prevalence and determinants of these problems, in order to provide timely and adequate support and prevention.

Primary care management of older people with mental health problems

2013 ◽  
Author(s):  
Louise Robinson ◽  
Carolyn Chew-Graham
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Older People ◽  
Care Management ◽  
Mental Health Problems ◽  
Age Groups ◽  
Real Life ◽  
Health Problems ◽  
Care Systems ◽  
Primary Care Management

This chapter discusses the presentation and primary care management of the commonest mental health problems in older people; these include delirium, delusions, depression and anxiety, and dementia. Primary care is on the front line in dealing with older people who have mental health problems, supporting their families to care for them and managing people with complex co-morbidities in addition to mental health issues. Older people consult their GP almost twice as often as other age groups and up to 40% may have a mental health problem. Cases drawn from the authors’ real-life practice are presented firstly to represent clinical presentations and management within primary care and secondly to demonstrate how primary care links with secondary care and the wider services. The management of patients is discussed largely within reference to UK primary care systems and policy, but the international readership should find parallels within their own healthcare systems.

scholarly journals Unmet care needs are common among community-dwelling older people with memory problems in Finland

2019 ◽  
pp. 140349481989080 ◽  
Author(s):  
Mari S. Aaltonen ◽  
Lina H. Van Aerschot
Keyword(s):  
Home Care ◽  
Older People ◽  
Home Care Services ◽  
Community Dwelling ◽  
Care Needs ◽  
Care Services ◽  
Memory Problems ◽  
More Care ◽  
Community Dwelling Older People ◽  
With Memory

Aims: Ageing in place has become a policy priority. Consequently, residential care has been reduced, and more older people with multiple care needs reside at home with the help of informal care and home care services. An increasing share of these people has memory disorders. We examined the extent to which memory problems, in addition to other individual characteristics, are associated with unmet care needs among community-dwelling older people. Methods: The study employed cross-sectional survey data from community-dwelling people aged 75+ collected in 2010 and 2015, analysed using binary logistic regression analysis. The study population consisted of people who had long-term illnesses or disabilities that limited their everyday activities ( N = 1928). Nine per cent reported substantial memory problems. Of these, 35.7% had a proxy respondent. Results: People with memory problems have more care needs than those with other types of disability or illness. They receive more care but still have more unmet needs than others. About a quarter of people with memory problems reported that they did not receive enough help. This result did not change significantly when the proxy responses were excluded. Even a combination of informal and formal home care was insufficient to meet their needs. Conclusions: Insufficient care for people with memory problems implies a serious demand for further development of home care services. The care needs of this population are often complex. Unmet needs represent a serious risk to the well-being of people with memory disorders, and may also create an extensive burden on their informal caregivers.

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