Planning for Community Care

1991 ◽  
Vol 158 (2) ◽  
pp. 190-196 ◽  
Author(s):  
P. Clifford ◽  
A. Charman ◽  
Y. Webb ◽  
S. Best
Keyword(s):  
Community Care ◽  
Usual Definition ◽  
Community Placement ◽  
Number Of Patients ◽  
Diagnosis Of Dementia

Using the Community Placement Questionnaire, the long-stay populations of five hospitals were surveyed. The results suggest that there is little need for large hospitals if adequate community provision is made. However, a small number of patients continue to accumulate for whom community placement is hard to envisage. Investigating the characteristics of the ‘new long-stay’ patients suggests that the usual definition should be extended to include those over 65 years old with no diagnosis of dementia and those in hospital for 1–10 years. About 20% of ‘new long-stay’ patients have organic diagnoses and the needs of this group require assessment.

The Use and Cost of Community Care Services by Elders with Unimpaired Cognitive Function, with Cognitive Impairment/No Dementia and with Dementia

1997 ◽  
Vol 16 (4) ◽  
pp. 665-681 ◽  
Author(s):  
Evelyn Shapiro ◽  
Robert B. Tate
Keyword(s):  
Cognitive Impairment ◽  
Daily Living ◽  
Community Care ◽  
Independent Predictor ◽  
Living Arrangement ◽  
The Elderly ◽  
Mental Functioning ◽  
Care Services ◽  
Diagnosis Of Dementia ◽  
Cognitive Impairment No Dementia

ABSTRACTData from the Manitoba Study of Health and Aging were used to compare the utilization and direct costs of formal community care services among the elderly diagnosed as persons with no cognitive impairment, with cognitive impairment/no dementia and with dementia. The results of the analyses indicate that, in addition to living arrangement and limitation on basic and instrumental activities of daily living, mental function diagnosis is an independent predictor of community care use. A diagnosis of dementia increases the likelihood of community care use over those with unimpaired mental functioning, whereas cognitive impairment without dementia does not. The three diagnostic groups differ in the type of services used. Standardization by age, sex and the other variables which significantly affect the need for community care can help a program improve its ability to project realistic cost estimates.

scholarly journals DEMENTIA IN ONCOLOGICAL PATIENTS

2021 ◽  
Author(s):  
Sophio Brunjadze ◽  
Shorena Vashadze ◽  
Ketevan Dolidze ◽  
Mikheil Artmeladze
Keyword(s):  
Medical History ◽  
Cancer Patients ◽  
Cognitive Functions ◽  
Cortical Atrophy ◽  
Physiological Data ◽  
High Tech ◽  
Number Of Patients ◽  
The World ◽  
Diagnosis Of Dementia ◽  
The Brain

Oncological diseases are one of the main causes of morbidity and mortality in the world. The problem is quite topical since the number of patients with cancer is a sensitive theme. At present, there are about 20 million people having the disease all over the world. Hence, the number of elderly people with the disease is about 10-15%. The purpose of our research was to study dementia in cancer patients. The study was conducted in the Batumi high-tech hospital (Batumi Oncological Center). 100 patients aged 25 to 75 participated in this study. Among them, the 60 patients were female and 40 were male. At the same time, only 45 patients were operated on. Of these, 16 patients were operated after chemotherapy, 4 patients after radiotherapy and 35 patients during combination therapy. 6 patients with lung cancer, 22 patients with breast cancer, 6 patients with skin cancer, 7 patients with gastric cancer, 4 patients with bladder cancer, 15 patients with ovarian cancer, 25 patients with uterine cancer were examined. In the study, three of them had the family history of dementia. We studied the patient's medical history, physiological data, assessed their mental and cognitive functions to determine the diagnosis of dementia. We studied the patient's medical history, physiological data, assessed their mental and cognitive functions, mini-mental state examination, and carried out a survey of family members as the patients often had difficulty precisely describing the symptoms to determine the diagnosis of dementia. Out of 100 patients, 20% of them had mild dementia, 44% - moderate dementia and 35 % - severe dementia. Among the patients examined, dementia was not observed in 1%. Computed tomography of the brain was performed on the examined patients. Cerebral atrophy, a decrease in brain mass and volume in 34%, cortical atrophy in 60% of patients and the expansion of the ventricle system of the brain in 35% were revealed in the pathomorphological picture. The atrophic process is strongly expressed in the pariental (17%), frontal and temporal lobes (76%). Therefore, dementia is quite common in cancer patients with severe and moderate depression, predominant in 79%. Dementia was not observed only in one case, which is very important. The researchers point out reversible dementia after chemotherapy, which is reversible after a while. Community involvement has great importance for the treatment and psychological adaptation to the new reality of cancer patients. It is necessary to develop educational programs aimed at providing assistance from the moment of diagnosis to the end of treatment.

Planning for community care: The Community Placement Questionnaire

1991 ◽  
Vol 30 (3) ◽  
pp. 193-211 ◽  
Author(s):  
P. Clifford ◽  
A. Charman ◽  
Y. Webb ◽  
T. J. K. Craig ◽  
D. Cowan
Keyword(s):  
Community Care ◽  
Community Placement

Biochemical investigations in patients with dementia

2002 ◽  
Vol 39 (3) ◽  
pp. 211-220 ◽  
Author(s):  
Alison Green
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Acetylcholinesterase Inhibitors ◽  
Amyloid Peptide ◽  
Number Of Patients ◽  
Diagnosis Of Dementia ◽  
Jakob Disease ◽  
Β Amyloid ◽  
Detection And Diagnosis ◽  
Β Amyloid Peptide

The recent development of acetylcholinesterase inhibitors to treat patients with Alzheimer's disease has increased interest in the use of biochemical markers for the early detection and diagnosis of dementia, but only the measurement of the protein 14-3-3 in cerebrospinal fluid (CSF) to help diagnose sporadic Creutzfeldt-Jakob disease has become accepted clinical practice. CSF concentrations of t protein and β-amyloid peptide 42 have been widely investigated as potential diagnostic tests for Alzheimer's disease, but neither has shown sufficient sensitivity and specificity for clinical use. Preliminary investigations suggest that β-amyloid peptide 42 may be useful in monitoring disease progression, but this needs to be verified. In addition, biochemical investigations may help to identify the small number of patients with treatable causes of dementia such as hypothyroidism and vitamin B12 deficiency, as well as any other compounding condition such as anaemia or diabetes mellitus that increase morbidity.

scholarly journals LO35: Impact of EMS direct referral to community care on services received

CJEM ◽  
2017 ◽  
Vol 19 (S1) ◽  
pp. S39-S40
Author(s):  
K. Van Aarsen ◽  
A. Dukelow CHE ◽  
M. Lewell ◽  
J.R. Loosley ◽  
S. Pancino
Keyword(s):  
Home Care ◽  
Local Community ◽  
Community Care ◽  
Care Service ◽  
Community Services ◽  
Primary Objective ◽  
Direct Result ◽  
Care Access ◽  
Number Of Patients ◽  
Direct Referral

Introduction: The Community Referral by Emergency Medical Services (CREMS) program was implemented in January 2015 in Southwestern Ontario. The program allows Paramedics, who are interacting with a patient as a direct result of a call to 9-1-1, to directly refer patients in need of home care support to their local Community Care Access Centre (CCAC) for needs assessment. If indicated, subsequent referrals are made to specific services (e.g. nursing, physiotherapy and geriatrics) by the CCAC. Ideally, CREMS connects each patient with appropriate, timely care, supporting individual needs. Similar referral programs have been implemented in communities with preliminary data showing positive results. The primary objective of this project was to evaluate the success of the CREMS program by determining the number of referrals made by EMS in London-Middlesex to CCAC since implementation as well as the proportion of referred patients receiving a new or increase in service due to EMS referral. Methods: Data for all CCAC referrals from London-Middlesex EMS was collected for a thirteen month period (February 2015-February 2016). Data was evaluated for quantity of referrals and proportion that led to a patient receiving new or increased home care service. Results: There were 436 referrals made in the study period which represented 391 individuals. 54% of patients were between 65-84 years of age. Of the 391 patients, 162 (41%) were not known to CCAC and of those 119 (73%) received a new service due to EMS referral. The most common new services were occupational therapy (61%) and nursing (47%). Of the 229 (59%) of patients that were already known to CCAC, 101 (44%) received an increase in service due to EMS referral. No patients refused a new or increase in service. Conclusion: Of all patients referred to CCAC, 56% received a new service or had a change in existing services which suggests that a large number of patients benefited from early EMS referral to community services. The results of this project provide impetus to continue and expand the CREMS program. Future studies will evaluate if the implementation of this program has reduced patient reliance on 911 requests for paramedic care as well as Emergency Department transports.

scholarly journals Alzheimer's disease: classification and diagnosis criteria

2021 ◽  
Vol 11 (7) ◽  
pp. 22-29
Author(s):  
Katarzyna Swakowska ◽  
Anna Staniszewska
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Population Aging ◽  
Acetylcholinesterase Inhibitor ◽  
Alpha Synuclein ◽  
Disease Classification ◽  
Psychotic Symptoms ◽  
Global Deterioration Scale ◽  
Number Of Patients ◽  
Diagnosis Of Dementia

In recent  years, the intensity of population aging has increased and the incidence of senile diseases, including dementia, has significantly increased. With the aging of populations in Europe, knowledge about the detection and diagnosis of dementia has increased in the last decade. Due to the increase in the number of patients, new therapies and precise diagnostic criteria have been introduced, contributing to faster diagnosis of the disease. Alzheimer's disease (AD) is the biggest cause of dementia in old age. It is characterized by progressive cognitive deficits, especially memory, and disorders such as: apathy, agitation and psychotic symptoms. Alzhaimer's disease is a degenerative brain disease caused by the deposition of pathological B-amyloid protein tau and alpha-synuclein in the brain, causing atrophy of neurons and their connections. The basis for diagnosis of dementia in the course of Alzheimer's disease are ICD-10 or DSM-IV criteria. The clinical course and symptoms in the course of AD are defined by the Global Deterioration Scale (GDS), the scale also determines the stage of the disease. Acetylcholinesterase inhibitor drugs and memantine are used to treat the symptoms of Alzheimer's disease. Prompt diagnosis and treatment significantly delays the progression of the disease and helps to prolong normal functioning of the patient.

Empowerment, quality of life and service satisfaction: comparisons between a hospital and community placement group

2008 ◽  
Vol 25 (2) ◽  
pp. 40-45
Author(s):  
Keith Kerrigan ◽  
Gavin Davidson ◽  
Ciaran Shannon
Keyword(s):  
Quality Of Life ◽  
Life Satisfaction ◽  
Research Design ◽  
Living Arrangements ◽  
Community Care ◽  
Service Satisfaction ◽  
Care Group ◽  
Continuing Care ◽  
Community Placement

AbstractObjectives: Recent advances in mental healthcare policy and service delivery have lead to the development of community care initiatives which have enabled those individuals traditionally cared for in hospital environments to be resettled successfully in community living arrangements that foster an ethos of empowerment and recovery. This study sought to identify differences between a hospital continuing care group (n = 16) and a community placement group (n = 20) in relation to quality of life, satisfaction and levels of empowerment.Method: The study was a cross-sectional design. It follows up a cohort of individuals identified as the ‘hospital continuing care group’ (365+ consecutive days in psychiatric hospital care) by Homefirst Community Trust in Northern Ireland. A proportion of this population has been resettled into community care environments and some continue to reside in hospital. Patients both in the hospital continuing care group and the community placement group completed two standard questionnaires that covered a number of variables including empowerment, quality of life and service satisfaction.Results: There were significant differences between the hospital continuing care and community placement groups across scores on service satisfaction, quality of life, and empowerment in the current study. Hypotheses relating to service satisfaction (z = −4.117; p < 0.01 ), quality of life (z = −3.944; p < 0.01) and empowerment (z = −4.645; p < 0.01) were supported with higher levels of each evidenced by the community placement group.Conclusions: The results are supportive of continued resettlement from continuing care in traditional psychiatric hospitals and suggests that such resettlement increases quality of life, satisfaction with services and levels of empowerment. The limitations of the research design are empowerment. The limitations of the research design are also discussed.

The Inpatient Service: Therapeutic Community versus Community Therapy

1972 ◽  
Vol 17 (6_suppl) ◽  
pp. 51-55 ◽  
Author(s):  
S. J. J. Freeman ◽  
J. D. Burch ◽  
R. Pinto
Keyword(s):  
Community Psychiatry ◽  
Community Care ◽  
Therapeutic Community ◽  
Statistical Evidence ◽  
Alternative Form ◽  
Inpatient Service ◽  
Short Term ◽  
Community Model ◽  
Number Of Patients ◽  
And Coping

The 'therapeutic community' model of ward organization has many advantages and proved to be helpful to a number of patients, who were able to repattern many of their interpersonal and coping techniques in this milieu. This paper is not intended as an attack on this concept of hospital management but rather is an attempt to point out that it is probably not appropriate in certain situations. The first of these occurs when all patients presented to a hospital ward must be admitted for short-term hospital stabilization and subsequent outpatient and/ or community care. The second situation in which the efficacy of the therapeutic community model may be doubted is where there is a surfeit of staff and facilities. An alternative form of ward organization based on community psychiatry principles is described and some statistical evidence is presented to support the contention that it is the more appropriate model for these situations.

Secondary medical prevention in patients with peripheral arterial disease - Prescriptions of vascular surgeons and medical doctors (angiologists) in a multidisciplinary vascular centre

VASA ◽  
2010 ◽  
Vol 39 (2) ◽  
pp. 145-152 ◽  
Author(s):  
Klein-Weigel ◽  
Gutsche-Petrak ◽  
Wolbergs ◽  
Köning ◽  
Flessenkamper
Keyword(s):  
Peripheral Arterial Disease ◽  
Oral Anticoagulants ◽  
Arterial Disease ◽  
Disease Stage ◽  
Channel Blockers ◽  
Medical Doctors ◽  
Vascular Surgeon ◽  
Medical Prevention ◽  
Number Of Patients ◽  
Peripheral Arterial

Background: We compared medical secondary prevention in patients with peripheral arterial disease stage II (Fontaine) located in the femoro-popliteal artery managed by vascular surgeons and medical doctors / angiologists in our multidisciplinary vascular center. Patients and methods: We retrospectively analyzed demission protocols of in-hospital treatments between 01.01.2007 and 20.06.2008. Results: We surveyed 264 patients (54.2 % women; mean age 67.52 ± 8.98 yrs), 179 (67.8 %) primarily treated by medical doctors / angiologists and 85 (32.2 %) primarily managed by vascular surgeons. Medical doctors / angiologists treated more women (n = 109) than men (n = 34), (p = 0.002) and documented smoking and diabetes mellitus more often (p < 0.001) than vascular surgeons. Besides, patients had similar cardiovascular risk profiles and concomitant diseases, vascular surgeons prescribed 5.47 ± 2.26 drugs, medical doctors / angiologists 6.37 ± 2.67 (p = 0.005). Overall, 239 (90.5 %) patients were on aspirin, 180 (68.2 %) on clopidogrel, and 18 (6.9 %) on oral anticoagulants. Significantly more patients treated by medical doctors / angiologists received clopidogrel (169 versus 11; p < 0.001), significantly more surgical patients received oral anticoagulants (11 versus 7; p = 0.016). The number of patients without prescriptions for any antithrombotic therapy was 6 (6.9 %) in patients treated by vascular surgeons and 0 (0 %) in patients managed by medical doctors / angiologists (p = 0.001). Prescription-rates of β-blockers, ACE-inhibitors, Angiotensin II-antangonists, calcium channel blockers, and diuretics were statistically not different between the two disciplines, but statins were prescribed significantly more often by medical doctors / angiologists (139 versus 49; p < 0001). With the exceptions of Clopidogrel (women > men) and diuretics (men > women) we observed no gender-specific prescriptions. Conclusions: We observed high prescriptions rates of secondary medical prevention in patients primarily treated by medical doctors / angiologists and vascular surgeons. We believe that this result is highly influenced by our multidisciplinary approach. Nevertheless, efforts have to be made to raise vascular surgeon’s awareness of statin use and complete prescription of antithrombotic and antiplatelet drugs.

Analysis of Deliberate Self-Wrist-Cutting Episodes Presenting to the Emergency Department

Crisis ◽  
2016 ◽  
Vol 37 (2) ◽  
pp. 155-160 ◽  
Author(s):  
Jin Kim ◽  
Han Joon Kim ◽  
Soo Hyun Kim ◽  
Sang Hoon Oh ◽  
Kyu Nam Park
Keyword(s):  
Emergency Department ◽  
Medical Records ◽  
Attempted Suicide ◽  
Suicide Attempts ◽  
Psychiatric Interview ◽  
Clinical Variables ◽  
Completed Suicide ◽  
Number Of Patients ◽  
Group A ◽  
Efficacy Of Treatment

Abstract. Background: Previous suicide attempts increase the risk of a completed suicide. However, a large proportion of patients with deliberate self-wrist cutting (DSWC) are often discharged without undergoing a psychiatric interview. Aims: The aims of this study were to investigate the differences in the characteristics and outcomes of patients with DSWC and those with deliberate self-poisoning (DSP) episodes. The results of this study may be used to improve the efficacy of treatment for DSWC patients. Method: We retrospectively reviewed the medical records of 598 patients with DSWC and DSP who were treated at the emergency department of Seoul Saint Mary's Hospital between 2008 and 2013. We assessed sociodemographic information, clinical variables, the reasons for the suicide attempts, and the severity of the suicide attempts. Results: A total of 141 (23.6%) patients were included in the DSWC group, and 457 (76.4%) were included in the DSP group. A significantly greater number of patients in the DSWC group had previously attempted suicide (p = .014). A total of 63 patients (44.7%) in the DSWC group and 409 patients (89.5%) in the DSP group underwent psychiatric interviews. Conclusion: More DSWC patients had previously attempted suicide, but fewer of them underwent psychiatric interviews compared with the DSP patients.

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