scholarly journals Older Adults’ Demand for Integrated Care and Its Influencing Factors: A Scoping Review

2021 ◽  
Vol 21 (4) ◽  
pp. 28
Author(s):  
Zhenyu Wang ◽  
Zhihan Liu
Keyword(s):  
Older Adults ◽  
Integrated Care ◽  
Influencing Factors ◽  
Scoping Review

scholarly journals What does integrated care mean from an older person’s perspective? A scoping review

BMJ Open ◽  
2020 ◽  
Vol 10 (1) ◽  
pp. e035157
Author(s):  
Michael T. Lawless ◽  
Amy Marshall ◽  
Manasi Murthy Mittinty ◽  
Gillian Harvey
Keyword(s):  
Older Adults ◽  
Integrated Care ◽  
Scoping Review ◽  
Data Extraction ◽  
Grey Literature ◽  
Secondary Outcome ◽  
Coordinated Care ◽  
Healthcare Settings ◽  
Care Relationships ◽  
Integrated Or

ObjectiveTo systematically map and synthesise the literature on older adults’ perceptions and experiences of integrated care.SettingVarious healthcare settings, including primary care, hospitals, allied health practices and emergency departments.ParticipantsAdults aged ≥60 years.InterventionsIntegrated (or similarly coordinated) healthcare.Primary and secondary outcome measuresUsing scoping review methodology, four electronic databases (EMBASE, CINAHL, PubMed and ProQuest Dissertation and Theses) and the grey literature (Open Grey and Google Scholar) were searched to identify studies reporting on older adults’ experiences of integrated care. Studies reporting on empirical, interpretive and critical research using any type of methodology were included. Four independent reviewers performed study selection, data extraction and analysis.ResultsThe initial search retrieved 436 articles, of which 30 were included in this review. Patients expressed a desire for continuity, both in terms of care relationships and management, seamless transitions between care services and/or settings, and coordinated care that delivers quick access, effective treatment, self-care support, respect for patient preferences, and involves carers and families.ConclusionsParticipants across the studies desired accessible, efficient and coordinated care that caters to their needs and preferences, while keeping in mind their rights and safety. This review highlights the salience of the relational, informational and organisational aspects of care from an older person’s perspective. Findings are transferable and could be applied in various healthcare settings to derive patient-centred success measures that reflect the aspects of integrated care that are deemed important to older adults and their supporters.

scholarly journals Integrated Primary Care and Social Services for Older Adults With Multimorbidity in England: A Scoping Review

2021 ◽  
Author(s):  
Hajira Dambha-Miller ◽  
Glenn Simpson ◽  
Lucy Hobson ◽  
Paul Roderick ◽  
Paul Little ◽  
...  
Keyword(s):  
Older Adults ◽  
Primary Care ◽  
Integrated Care ◽  
Population Health ◽  
Social Services ◽  
Scoping Review ◽  
Integrated Primary Care ◽  
Integration Of Services ◽  
Multi Level ◽  
Sector Integration

Abstract Background: As the prevalence of older adults with multimorbidity increases, greater integration of services is necessary to manage the range of physical and social needs of the population. The aim of this study is to describe and summarise current evidence, clinical provision and progress towards integrated primary care and social services for older adults with multimorbidity in an English context. Methods: A scoping review was conducted which included a systematic electronic search of Medline, EMBASE, The Cochrane Library, Web of Science, the Cumulative Index to Nursing and Allied Health Literature, Science and Social Science Citation Indices and Opengrey from data inception until the 16th June 2020. Articles were screened and extracted in duplicate by two independent reviewers. Data were extracted onto a charting sheet and thematic synthesis used to summarise findings.Results: Our search yielded 7656 papers of which 84 papers were included. Three themes were identified: (1) diverse focus on individual level services rather than multi-level or multi-sector integration, with an increasing emphasis on the need to consider broader determinants of population health as critical to integrated care in multimorbidity; (2) time was needed for integration to embed to allow new structures and relationships to develop and mature; and (3) we identified inherent tension between top-down and bottom-up driven approaches to integrated care that requires a whole-systems structure while allowing for local flexibilities.Conclusions: There is limited evidence of multi-level and multi-sector integration of services for older adults with multimorbidity in an English context. The literature increasingly acknowledges wider determinants of population health that are likely to require integration beyond primary care and social services. Improving clinical care in one or two sectors may not be as effective as simultaneously improving the organisation or design across services as one single system of provision. This may take time to establish and will require local input.

scholarly journals Integrated primary care and social services for older adults with multimorbidity in England: a scoping review

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hajira Dambha-Miller ◽  
Glenn Simpson ◽  
Lucy Hobson ◽  
Paul Roderick ◽  
Paul Little ◽  
...  
Keyword(s):  
Older Adults ◽  
Primary Care ◽  
Integrated Care ◽  
Population Health ◽  
Social Services ◽  
Scoping Review ◽  
Integrated Primary Care ◽  
Integration Of Services ◽  
Multi Level ◽  
Sector Integration

Abstract Background As the prevalence of older adults with multimorbidity increases, greater integration of services is necessary to manage the physical and psycho-social needs of this cohort. This study describes and summarises current evidence, clinical provision and progress towards integrated primary care and social services for older adults with multimorbidity in England. Methods A scoping review was conducted involving systematic searches of a range of electronic academic and policy databases. Articles were screened and extracted in duplicate by two independent reviewers. Data were extracted onto a charting sheet and thematic synthesis was used to summarise findings. Articles were included if published in English and related to primary care, social care and multimorbidity in older adults in England. Conceptually, the review was framed using the Rainbow Model of Integrated Care. Results The search yielded 7656 articles of which 84 were included. Three themes were identified: (1) a focus on individual level services rather than multi-level or multi-sector integration, with an increasing emphasis on the need to consider broader determinants of population health as critical to integrated care for older adults with multimorbidity; (2) the need for policymakers to allow time for integration to embed, to enable new structures and relationships to develop and mature; and (3) the inherent tension between top-down and bottom-up driven approaches to integrated care requires a whole-systems structure, while allowing for local flexibilities. Conclusions There is limited evidence of multi-level and multi-sector integration of services for older adults with multimorbidity in England. The literature increasingly acknowledges wider determinants of population health that are likely to require integration beyond primary care and social services. Improving clinical care in one or two sectors may not be as effective as simultaneously improving the organisation or design across services as one single system of provision. This may take time to establish and will require local input.

scholarly journals Effectiveness of Tai Chi for Health Promotion of Older Adults: A Scoping Review of Meta-Analyses

2021 ◽  
pp. 155982762110012
Author(s):  
Fei-Chi Yang ◽  
Aishwarya B. Desai ◽  
Pelareh Esfahani ◽  
Tatiana V. Sokolovskaya ◽  
Doreen J. Bartlett
Keyword(s):  
Older Adults ◽  
Health Promotion ◽  
Health Outcomes ◽  
Scoping Review ◽  
General Health ◽  
Tai Chi ◽  
Well Being ◽  
Cochrane Library ◽  
Care Providers ◽  
Meta Analyses

Background. Tai Chi is a form of exercise that is accessible to people from different socioeconomic backgrounds, making it a potentially valuable activity for health promotion of older adults. Purpose. The objective of this scoping review was to summarize the current knowledge about the effectiveness of Tai Chi for older adults across a range of general health outcomes from published, peer reviewed, unique meta-analyses. Methods. Meta-analyses were retrieved from Medline, Embase, AMED, CINAHL, SPORTDiscus, PsychINFO, Web of Science, PubMed Health, and the Cochrane Library from database inception to late August 2019. Multistage deduplication and screening processes identified eligible full-length meta-analyses. Two people independently appraised 27 meta-analyses based on the GRADE system and organized results into 3 appendices subsequently collated into heterogeneous, statistically significant, and statistically insignificant tables. Results. “High” and “moderate” quality evidence extracted from these meta-analyses demonstrated that practicing Tai Chi can significantly improve balance, cardiorespiratory fitness, cognition, mobility, proprioception, sleep, and strength; reduce the incidence of falls and nonfatal stroke; and decrease stroke risk factors. Conclusions. Health care providers can now recommend Tai Chi with high level of certainty for health promotion of older adults across a range of general health outcomes for improvement of overall well-being.

Parental Bereavement in Older Age: A Scoping Review

2021 ◽  
pp. 105413732199581
Author(s):  
Patricia Moyle Wright
Keyword(s):  
Older Adults ◽  
Scoping Review ◽  
Adult Child ◽  
Older Age ◽  
Parental Bereavement ◽  
Older Parents ◽  
Physical Decline ◽  
Scoping Reviews ◽  
Cultural Mores ◽  
Meta Analyses

A scoping review of parental bereavement in older age was conducted to identify the unique needs of older adults after the loss of an adult child. Inclusion and exclusion criteria were developed in accordance with the stated objectives of this review, which was guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). In total, 26 research studies were included. The data were then analyzed using a systematic approach for organizing and synthesizing key data. The results indicated that some consequences and mediators of parental bereavement are similar regardless of age. But, older adults experience greater loneliness, isolation, and stigma than their younger counterparts. Older parents are also at greater risk for physical decline, mortality, and institutionalization following the death of an adult child. Religious and cultural mores also have influence on the bereavement process.

The Socialization of Unpaid Family Caregivers: A Scoping Review

2021 ◽  
pp. 016402752110050
Author(s):  
Kirstie McAllum ◽  
Mary Louisa Simpson ◽  
Christine Unson ◽  
Stephanie Fox ◽  
Kelley Kilpatrick
Keyword(s):  
Older Adults ◽  
Family Caregivers ◽  
Scoping Review ◽  
Family Caregiving ◽  
Family Processes ◽  
Future Research ◽  
Socialization Process ◽  
Role Negotiation ◽  
Role Learning ◽  
Socialization Agents

As unpaid family caregiving of older adults becomes increasingly prevalent, it is imperative to understand how family caregivers are socialized and how they understand the caregiving role. This PRISMA-ScR-based scoping review examines the published literature between 1995–2019 on the socialization of potential and current unpaid family caregivers of older adults. Of 4,599 publications identified, 47 were included. Three perspectives of socialization were identified: (1) role acculturation; (2) role negotiation and identification; and (3) specialized role learning. The findings show how socialization involves different contexts (e.g., cultures), imperatives for action (e.g., circumstances), socialization agents (e.g., family), processes (e.g., modeling), and internal (e.g., normalization) and external (e.g., identification) consequences for caregivers. Future research could fruitfully explore how caregivers manage key turning points within the socialization process, disengage from the caregiving role, and negotiate the socialization and individualization processes within diverse cultural and funding contexts.

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