Quality in Ageing and Older Adults

Prince Agwu

Jacinta Ene

Uzoma Odera Okoye

Short commentary: What is (not) feasible to do in care for older adults in Nigeria: an application of the developmental governance framework

短评：在尼日利亚老年人护理中什么是（不）可行的：发展治理框架的应用

Fiona Mary Poland

Editorial: Innovate support for older people to reflect changing governance, values, peer and professional practices and built environments

社论：创新老年人支持体系以反映治理、价值观、同伴和专业实践以及建筑环境的变迁

Purpose The purpose of this study is to examine changes in the nature, form and range of commissioning arrangements for home care. Design/methodology/approach Data from two discrete national surveys of English local authorities with social service responsibilities were used. In the first, undertaken in 2007, responses from 111 of the 151 local authorities (74%) were received; in the second, undertaken in 2017, responses from 109 local authorities (72%) were received. A combined data set of 79 complete cases, 52% of local authorities, was created. Percentage point differences across the two time periods were calculated and tested to identify significant changes and a systematic analysis of the free-text responses regarding intended changes to the commissioning process in each data set was undertaken. Findings Findings identified substantial changes in some aspects of the commissioning of home care in the 2007-2017 decade. Collaboration between stakeholders had increased, particularly regarding the identification of future needs. Improved conditions of service and remuneration for home care workers were evident within the commissioning process. Standardised charges for home care (regardless of time and day) had also become more widespread. Initiatives to prompt providers to deliver more personalised care were more evident. Originality/value This paper describes the evolution of commissioning arrangements for home care in localities in response to national policy initiatives. It provides guidance to commissioners in meeting the needs of current service users and emphasises the importance of collaboration with stakeholders, particularly providers, in securing future capacity.

Sue Davies

Jane Hughes

Karen Davies

Elizabeth Dalgarno

Rowan Elaine Jasper

Helen Chester

Amy Roberts

David Challis

Changes in commissioning home care: an English survey

英国家庭护理委托的变化：一项调查

Purpose Managing patients in advanced age is complex, especially when it comes to multi-morbidities and polypharmacy. The purpose of this qualitative study is to investigate challenges, opportunities and potential solutions from a primary healthcare provider perspective. Design/methodology/approach Fifty-seven participants joined in group discussions on challenges and opportunities of working with advanced age. Participants included general practitioners (GPs), practice nurses, students and administration staff working in ten general practices. A thematic analysis was developed, supported by NVivo software. Findings Poor lines of communication and fragmentation of services between differing levels of health care services available for older people were highlighted. This has implications for quality of care and equity of services. Participants also reported challenges in treatment and funding regimes. Research limitations/implications The small sample size and regional nature of the study, along with the semi-structured nature of the group discussions and rigorous thematic analysis, indicate that this qualitative data is transferable, dependable, confirmable and credible. Comparing the views of tertiary and community services would be useful. Practical implications A range of potential strategies and solutions to the current fragmented services was offered by GPs. For example, adequately funded and staffed community-based health hubs; IT platforms enabling timely flow of patient information between primary and tertiary health providers and creation of medical, nursing and allied health roles aimed at improving synergy between GP and tertiary services. Originality/value Obtaining the perspectives of general practice highlights the challenges and complexities of caring for those in advanced age brings. These insights have not been previously been explored in-depth within this setting in New Zealand.

Philippa Miskelly

Ngaire Kerse

Janine Wiles

Joining-the-dots: caring for patients in advanced age

连点成线：关爱高龄患者

Fiona Poland

Editorial

社论

Purpose This study aims to explore art workshops for people living with dementia as a process enabling creative expression and fostering communication with others. Design/methodology/approach To enable detailed exploration of the expressive powers of painting and drawing, the authors draw several examples from a series of painting workshops for people living with dementia, which formed part of the PPI for research into experiences of restraint within care. Findings Artwork enabled personal expression, facilitated conversation with others and revealed hidden knowledge and abilities, but also revealed dangers of miscommunication, specifically here related to technological changes and spirituality. Research limitations/implications Individual differences in responses to painting will exist meaning that the specific findings outlined here are unique to individuals and not always generalisable. This follows from the quality of the individual communication that may be enabled by painting, meaning that close attention to each person is both fostered and required. Practical implications Art activities can provide a means to enable deep personal expression and agency in people living with dementia, which can contribute to countering dehumanisation. Social implications Attention to the process of painting can be beneficial in fostering verbal and non-verbal communication with individuals who have difficulties in communication. Attention to cultural issues in care needs to incorporate understanding of spiritual and religious issues and take note of gaps in understanding related to technological as well as cultural changes between generations. Originality/value Much work in this area explores art activities for people living with dementia in terms of beneficial outcomes. This work explores the creative process inherent in painting, drawing upon insights from art theory and providing in-depth individual insights through case studies. Both researchers in this study are artists and the work drew upon their understanding of the processes of painting.

Megan Wyatt

Paula Boddington

Painting workshops for people living with dementia as a means of expression and communication: revelations from our elders

痴呆症患者绘画工作坊：表达与沟通的途径——长者的启示

Purpose Following several prior editions and the acquisition of quantitative data indicating a 18% reduction in perceived caregiver burden and a 27% improvement in their quality of life regarding pain/mild discomfort, this present study aims to compile and examine the shared experiences of caregivers participating in the peer-to-peer Expert Caregiver Programme. The aim is to gain a deeper understanding of the programme’s inherent value. Design/methodology/approach This is a qualitative study of the Expert Caregiver Programme, a peer-to-peer support and learning initiative designed for informal caregivers of individuals with dementia. Over a span of two and a half months, this study observed a group of ten informal caregivers who were participants in the sixth edition of the Expert Caregiver Programme at a Sociosanitary Hospital in Catalonia. Findings The results have revealed the emergence of two distinct spirals. Firstly, the ongoing challenge of adapting to a degenerative process, coupled with the caregiver's sense of responsibility, leads to an overwhelming situation for the caregiver as far as caregiving and emotional management are concerned. This, in turn, exacerbates their feelings of isolation, fatigue and discouragement. On the other hand, the understanding of the disease and the sense of compassion towards the person with dementia have been identified as pivotal elements in the construction of an upward spiral, creating greater comfort for the caregiver. Consequently, these factors can be effectively addressed within the framework of a programme such as the Expert Caregiver. Originality/value The qualitative approach has allowed for a comprehensive and extensive exploration of the caregivers' experiences with individuals suffering from dementia. This has revealed the existence of a positive spiral that can be nurtured through peer support programmes.

Maribel Martínez

Elena Rovira

Carlota Riera Claret

Navigating the maze of dementia: a qualitative analysis of a peer-assisted help and support programme for informal caregiver

穿越痴呆症迷宫：非正式护理者同伴互助支持计划的定性分析

Purpose Ageing is associated with multi-morbidity, polypharmacy and medication-related harm (MRH). There is limited published literature on MRH in older Egyptian adults. This study aims to determine the incidence and risk factors associated with MRH in an Egyptian cohort of older patients in the 8-weeks period after hospital discharge. Design/methodology/approach This study recruited 400 Egyptian patients, aged = ≥ 60 years from 3 hospitals in Cairo and followed them up 8 weeks after discharge using a semi-structured telephone interview to verify MRH events (type, probability, severity and preventability) and related factors. Findings The participants’ ages ranged from 60 to 95 years with 53% females. In the final cohort of 325 patients analyzed, MRH occurred in 99 patients (incidence of 30.5%), of which 26 MRH cases (26.2%) were probable, serious and preventable. MRH included adverse drug reactions (ADRs), non-adherence and medication errors. Multivariate regression analysis showed that non-adherence and inappropriate prescription had highly significant association with MRH ( P &lt; 0.001), history of previous ADR, living alone and presence of paid caregiver had significant association (P 0.008, 0.012, 0.02 respectively), while age, medications number, length of stay (LOS) and cognitive impairment were not significantly associated with MRH. Practical implications These findings demonstrate the magnitude of MRH in Egypt affecting almost a third of older adults after leaving the hospital. These original data could guide decision-makers to enhance older patients’ medication safety through education, quality improvement and policy. Originality/value MRH in Egyptian older adults post-hospital discharge has not been adequately reported in scientific literature.

Moataz Jamil

Hala Sweed

Rania Abou-Hashem

Heba Shaltoot

Khalid Ali

Medication-related harm (MRH) in Egyptian older adults post-hospital discharge: a health-care challenge

埃及老年患者出院后药物相关伤害(MRH)：一个医疗保健挑战

短名	Qual. Ageing. Older. Adults.
Journal Impact	0.82
国际分区	GERONTOLOGY(Q4)

ISSN	1471-7794, 2042-8766
h-index	22

涉及主题	心理学医学政治学法学社会学老年学经济护理部计算机科学哲学人类学生物社会心理学社会科学业务数学老年人物理精神科定性研究内科学经济增长心理治疗师统计病理认识论
出版信息	出版商: Emerald Group Publishing Ltd.，出版周期: ，期刊类型: journal，开源期刊: 否
基本数据	创刊年份: 2000，原创研究文献占比: 92.86%，自引率:12.50%， Gold OA占比: 8.16%

Quality in Ageing and Older Adults

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Short commentary: What is (not) feasible to do in care for older adults in Nigeria: an application of the developmental governance framework

Editorial: Innovate support for older people to reflect changing governance, values, peer and professional practices and built environments

Changes in commissioning home care: an English survey

Joining-the-dots: caring for patients in advanced age

Editorial

Short commentary: What is (not) feasible to do in care for older adults in Nigeria: an application of the developmental governance framework

Editorial: Innovate support for older people to reflect changing governance, values, peer and professional practices and built environments

Painting workshops for people living with dementia as a means of expression and communication: revelations from our elders

Navigating the maze of dementia: a qualitative analysis of a peer-assisted help and support programme for informal caregiver

Medication-related harm (MRH) in Egyptian older adults post-hospital discharge: a health-care challenge