Unmet needs in social care among older people

Ipsos MORI and partners including AgeUK, NatCen Social Research and Independent Age has published Unmet Need For Care.

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Image source: http://www.ipsos.com

This report highlights the experiences of unmet need for care among older people living in their own homes.  The research for this report used secondary analysis of survey data from the English Longitudinal Study of Ageing (ELSA) and Health Survey for England (HSE) using data from 2011 – 13.

The report is set against a background of an increasingly ageing population and cuts to budgets placing pressure on services. At the same time, the Care Act 2014 has introduced a national eligibility framework and an emphasis on prevention and on well-being

Research with Care Homes

Advancing Care provides an overview of recent NIHR research on improving the health and care of care home residents.

This report published by the National Institute for Health Research  highlights current research taking place now and explores new approaches being developed in this important area.

It reports on three themes relating to the care of older people in care homes: Living well – maintaining good health and quality of life, ageing well – managing long term conditions associated with ageing, and dying well – ensuring a good quality end of life.

It features:

  • 23 published studies
  • 21 ongoing studies
  • Quotes from care home owners, managers, staff and researchers
  • Where next for care home research?

The publication can be downloaded here

Dementia numbers set to rise to 1.2 million by 2040 in England & Wales

Experts are predicting that there will be 1.2 million people in England and Wales living with dementia by 2040 – a rise of 57% from 2016 – due to increased life expectancy.

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A study  published in The BMJ  says that although the number of newly diagnosed cases of dementia is falling, the overall prevalence will increase substantially as people live longer and deaths from other causes, such as heart disease, continue to decline.

The team of researchers  based at University College London (UCL) and the University of Liverpool, set out to predict the future burden of dementia with more certainty by developing a mathematical model that takes account of disease trends and death rates alongside the effects of increasing life expectancy.  They calculated that there were currently 767,000 people living with dementia in England and Wales and the number would increase to more than 1.2 million by 2040.

Full story at OnMedica

Full reference: Ahmadi-Abhari, S et al.  Temporal trend in dementia incidence since 2002 and projections for prevalence in England and Wales to 2040: modelling study BMJ Published 05 July 2017

 

 

Recognising and managing frailty in primary care

This updated document summarises guidance and evidence for managing frailty. It is based on national guidance and existing sources of synthesised and quality-assessed evidence | University of York Centre for Health Economics | Yorkshire and Humber AHSN Improvement Academy

Image source: Keromi Keroyama – Flickr // CC BY 2.0

  • Frailty is a distinct health state where a minor event can trigger major changes in health from which the patient may fail to return to their previous level of health.
  • Simple tests that have been recommended by NICE for frailty in primary care are gait speed, self-reported health status and the PRISMA 7 questionnaire.
  • Exercise programmes, particularly high intensity interventions, may improve gait, balance and strength and have positive effects on fitness.
  • Medication review forms part of the holistic medical review of people with frailty.
  • Supported self-management can improve health outcomes. However, the value of case management is still to be proven.
  • Discussion about end-of-life care is important to most older people, but is often neglected.

Full document: Effectiveness Matters. Recognising and managing frailty in primary care

Economic evaluations of seasonal influenza vaccination for the elderly

The Council of the European Union (EU) has recommended that action should be taken to increase influenza vaccination in the elderly population | BMJ Open

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Image source: Joe The Goat Farmer – Flickr // CC BY 2.0

Objectives: The aims were to systematically review and critically appraise economic evaluations for influenza vaccination in the elderly population in the EU.

Results: Of the 326 search results, screening identified eight relevant studies. Results varied widely, with the incremental cost-effectiveness ratio ranging from being both more effective and cheaper than no intervention to costing €4 59 350 per life-year gained. Cost-effectiveness was most sensitive to variations in influenza strain, vaccination type and strategy, population and modelling characteristics.

Conclusions: Most studies suggest that vaccination is cost-effective (seven of eight studies identified at least one cost-effective scenario). All but one study used economic models to synthesise data from different sources. The results are uncertain due to the methods used and the relevance and robustness of the data used. Sensitivity analysis to explore these aspects was limited. Integrated, controlled prospective clinical and economic evaluations and surveillance data are needed to improve the evidence base. This would allow more advanced modelling techniques to characterise the epidemiology of influenza more accurately and improve the robustness of cost-effectiveness estimates.

Full reference: Shields. G.E. et al. (2017) Systematic review of economic evaluations of seasonal influenza vaccination for the elderly population in the European Union. BMJ Open. 7:e014847

 

Technostress: measuring a new threat to well-being in later life

Galit Nimrod | Technostress: measuring a new threat to well-being in later life
Aging & Mental Health | published online 31st May 2017

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Objectives: Technostress is stress induced by Information and Communication Technology (ICT) use. Research on the topic has focused primarily on the workforce and tended to overlook senior citizens. This study presents the development of a new scale, which was designed to measure technostress specifically among older adults.

Method: The scale explores five constructs: overload, invasion, complexity, privacyand inclusion. The initial 20-item measure was tested in a pilot study and then included in an online survey of 537 Internet users aged 60 years and over.

Results: Based on the statistical analysis, the scale was reduced to 14 items. The constructs had good internal homogeneity, significant inter-construct correlations and high loadings on a single latent factor. The scores were well distributed along the range. Concurrent validity was assessed using the Satisfaction with Life Scale. A significant negative association was found between the two scales – a correlation that remained significant even after controlling for background variables.

Conclusion: The new scale is useful for measuring technostress in older people, and technostress ought to be considered a particular threat to well-being in later life. Future research should explore its antecedents and consequences and identify interventions useful in alleviating its harmful effect on older ICT users.

The future burden of disability in the UK

2.8 million people over 65 will need nursing and social care by 2025 – largely because of a significant rise in dementia-related disability, research finds.

Research published by the Lancet Public Health medical journal says cases of disability related to dementia will rise by 40% among people aged 65 to 84, with other forms of disability increasing by about 31%.

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The investigators used a detailed model to produce estimates of the prevalence of disability due to cardiovascular disease, dementia, and other causes in people aged 65 years or older in England and Wales to the year 2025.

They found a 25% increase from 2015 in the number of older people who will be living with disability, representing 560 000 additional elderly people in England and Wales who will need care for their disabling condition, and showed that the largest relative increases will be in dementia cases.  They also predicted that although life expectancy among people older than 65 years will increase by 1·7 years, 0·7 of these years will be lived with disability.

Having identified these challenges, the authors have recommended increased capacity in formal social care and improved support for informal social care arrangements, along with enhanced interventions against predictable risk factors for non-communicable diseases disability, such as smoking, diet, and physical activity.

Full reference: Guzman-Castillo, Maria et al. | Forecasted trends in disability and life expectancy in England and Wales up to 2025: a modelling studyThe Lancet Public Health Published online 23rd May 2017