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  • 1
    Language: English
    In: International journal of environmental research and public health, 2020-12-03, Vol.17 (23), p.9014
    Description: Long-term care for older adults is in transition. Organizations offering long-term care for older adults are expected to provide person-centered care (PCC) in a complex context, with older adults aging in place and participating in society for as long as possible, staff shortages and the slow adoption of technological solutions. To address these challenges, these organizations increasingly use scientific knowledge to evaluate and innovate long-term care. This paper describes how co-creation, in the sense of close, intensive, and equivalent collaboration between science, care practice, and education, is a key factor in the success of improving long-term care for older adults. Such co-creation is central in the Academic Collaborative Center (ACC) Older Adults of Tilburg University. In this ACC, Tilburg University has joined forces with ten organizations that provide care for older adults and CZ zorgkantoor to create both scientific knowledge and societal impact in order to improve the quality of person-centered care for older adults. In the Netherlands, a "zorgkantoor" arranges long-term (residential) care on behalf of the national government. A zorgkantoor makes agreements on cost and quality with care providers and helps people that are in need of care to decide what the best possible option in their situation is. The CZ zorgkantoor arranges the long-term (residential) care in the south and southwest of the Netherlands. This paper describes how we create scientific knowledge to contribute to the knowledge base of PCC for older adults by conducting social scientific research in which the perspectives of older adults are central. Subsequently, we show how we create societal impact by facilitating and stimulating the use of our scientific knowledge in daily care practice. In the closing section, our ambitions for the future are discussed.
    Subject(s): Adults ; Age ; Aged ; Aging ; Caregivers ; Caregivers - education ; Caregivers - statistics & numerical data ; co-creation ; Collaboration ; Community support ; Education ; Healthy Aging ; Humans ; Independent Living - statistics & numerical data ; Intersectoral Collaboration ; Knowledge ; Knowledge bases (artificial intelligence) ; Long term health care ; Long-Term Care ; Netherlands ; Nursing homes ; older adults ; Older people ; Organizations ; Patient-centered care ; Patient-Centered Care - statistics & numerical data ; person-centered care ; perspective of older adults ; Quality control ; quality improvement ; Research ; Science ; Self Care
    ISSN: 1661-7827
    E-ISSN: 1660-4601
    Source: PubMed Central
    Source: DOAJ Directory of Open Access Journals - Not for CDI Discovery
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  • 2
    Language: English
    In: Health & social care in the community, 2020, Vol.28 (2), p.670-680
    Description: Many initiatives integrating health and social care have been implemented in order to provide adequate care and support to older people living at home. Further development of existing initiatives requires iterative processes of developing, implementing and evaluating improvements to current practice. This case study provides insight into the process of improving an existing integrated care initiative in the Netherlands. Using a participatory approach, researchers and local stakeholders collaborated to develop and implement activities to further improve collaboration between health and social care professionals. Improvement activities included interprofessional meetings focussing on reflection and mutual learning and workplace visits. Researchers evaluated the improvement process, using data triangulation of multiple qualitative and quantitative data sources. According to participating professionals, the improvement activities improved their communication and collaboration by establishing mutual understanding and trust. Enabling factors included the safe and informal setting in which the meetings took place and the personal relationships they developed during the project. Different organisational cultures and interests and a lack of ownership and accountability among managers hindered the improvement process, whereas issues such as staff shortages, time constraints and privacy regulations made it difficult to implement improvements on a larger scale. Still, the participatory approach encouraged the development of partnerships and shared goals on the level of both managers and professionals. This case study highlights that improving communication between professionals is an important first step in improving integrated care. In addition, it shows that a participatory approach, in which improvements are co-created and tailored to local priorities and needs, can help in the development of shared goals and trust between stakeholders with different perspectives. However, stakeholders' willingness and ability to participate in such an improvement process is challenged by many factors.
    Subject(s): Accountability ; ADULTS ; Aged ; Aged, 80 and over ; Approaches ; case study research ; Collaboration ; Communication ; Delivery of Health Care, Integrated - standards ; health and social care ; Health care ; Health initiatives ; Health services ; Home Care Services ; Humans ; Independent living ; integrated care ; Integrated services ; Interdisciplinary aspects ; Interest groups ; Interpersonal relations ; interprofessional education and service developments ; Interprofessional Relations ; Interviews as Topic ; Learning ; multi-professional collaborations ; MULTIPLE CHRONIC CONDITIONS ; Netherlands ; Older people ; Original ; Ownership ; participative research ; Partnerships ; Privacy ; PROGRAMS ; Qualitative Research ; Quality Improvement - organization & administration ; Quantitative data ; Regulation ; Scarcity ; Shortages ; Social care ; Social Responsibility ; Social services ; Social Support ; Stakeholders ; Triangulation ; Trust ; Workplaces
    ISSN: 1365-2524
    ISSN: 0966-0410
    E-ISSN: 1365-2524
    Source: Hellenic Academic Libraries Link
    Source: Academic Search Ultimate
    Source: Sociological Abstracts
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  • 3
    Language: English
    In: Health & social care in the community, 2019, Vol.27 (5), p.e549-e566
    Description: In many integrated care programs, a comprehensive geriatric assessment (CGA) is conducted to identify older people's problems and care needs. Different ways for conducting a CGA are in place. However, it is still unclear which CGA instruments and procedures for conducting them are used in integrated care programs, and what distinguishes them from each other. Furthermore, it is yet unknown how and to what extent CGAs, as a component of integrated care programs, actually reflect the main principles of integrated care, being comprehensiveness, multidisciplinarity and person-centredness. Therefore, the objectives of this study were to: (a) describe and compare different CGA instruments and procedures conducted within integrated care programs for older people living at home, and (b) describe how the principles of integrated care were applied in these CGAs. A scoping review of the scientific literature on CGAs in the context of integrated care was conducted for the period 2006-2018. Data were extracted on main characteristics of the identified CGA instruments and procedures, and on how principles of integrated care were applied in these CGAs. Twenty-seven integrated care programs were included in this study, of which most were implemented in the Netherlands and the United States. Twenty-one different CGAs were identified, of which the EASYcare instrument, RAI-HC/RAI-CHA and GRACE tool were used in multiple programs. The majority of CGAs seemed to reflect comprehensiveness, multidisciplinarity and person-centredness, although the way and extent to which principles of integrated care were incorporated differed between the CGAs. This study highlights the high variability of CGA instruments and procedures used in integrated care programs. This overview of available CGAs and their characteristics may promote (inter-)national exchange of CGAs, which could enable researchers and professionals in choosing from the wide range of existing CGAs, thereby preventing them from unnecessarily reinventing the wheel.
    Subject(s): Aged ; Aged, 80 and over ; Capitation ; CLINICAL-TRIAL ; comprehensive geriatric assessments ; COST-EFFECTIVENESS ; DECISION-MAKING ; Delivery of Health Care, Integrated - organization & administration ; Female ; FRAIL ELDERLY-PEOPLE ; Geriatric assessment ; Geriatric Assessment - methods ; Geriatric Assessment - statistics & numerical data ; Geriatrics ; GUIDED CARE ; HEALTH-PROBLEMS ; Home Care Services - organization & administration ; Humans ; Independent living ; integrated care ; Integrated services ; Interdisciplinary aspects ; INTERVENTION MODEL ; Life Sciences & Biomedicine ; Literature reviews ; Male ; Medical screening ; MULTIPLE CHRONIC CONDITIONS ; Netherlands ; Older people ; PHYSICAL FUNCTION ; Public, Environmental & Occupational Health ; RANDOMIZED CONTROLLED-TRIAL ; Review ; Science & Technology ; scoping review ; Social Sciences ; Social Work ; Variability
    ISSN: 1365-2524
    ISSN: 0966-0410
    E-ISSN: 1365-2524
    Source: Hellenic Academic Libraries Link
    Source: Academic Search Ultimate
    Source: Web of Science - Social Sciences Citation Index – 2019〈img src="http://exlibris-pub.s3.amazonaws.com/fromwos-v2.jpg" /〉
    Source: Sociological Abstracts
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  • 4
    Language: English
    In: BMC geriatrics, 2017-12, Vol.17 (1), p.132-132
    Description: Background A wide range of initiatives on early detection and intervention have been developed to proactively identify problems related to health and wellbeing in (frail) older people, with the aim of supporting them to live independently for as long as possible. Nevertheless, it remains unclear what the best way is to design such initiatives and how older people’s needs and preferences can be best addressed. This study aimed to address this gap in the literature by exploring: 1) older people’s perspectives on health and living environment in relation to living independently at home; 2) older people’s needs and preferences in relation to initiating and receiving care and support; and 3) professionals’ views on what would be necessary to enable the alignment of early detection initiatives with older people’s own needs and preferences. Methods In this qualitative study, we conducted semi-structured interviews with 36 older people and 19 professionals in proactive elderly care. Data were analysed using the framework analysis method. Results From the interviews with older people important themes in relation to health and living environment emerged, such as maintaining independence, appropriate housing, social relationships, a supporting network and a sense of purpose and autonomy. Older people preferred to remain self-sufficient, and they would rather not ask for help for psychological or social problems. However, the interviews also highlighted that they were not always able or willing to anticipate future needs, which can hinder early detection or early intervention. At the same time, professionals indicated that older people tend to over-estimate their self-reliance and therefore advocated for early detection and intervention, including social and psychological issues. Conclusion Older people have a broad range of needs in different domains of life. Discrepancies exist between older people and professionals with regard to their views on timing and scope of early detection initiatives. This study aimed to reveal starting-points for better alignment between initiatives and older people’s needs and preferences. Such starting points may support policy makers and care professionals involved in early detection initiatives to make more informed decisions. Keywords: Early detection, Frailty, Health, Health care ,Older people, Proactive elderly care, Social care, Wellbeing, Qualitative research
    Subject(s): Adults ; Aged ; Aged, 80 and over ; Aging ; Attitude of Health Personnel ; Attitude to Health ; Autonomy ; Clinical decision making ; Data processing ; Decision making ; Dementia ; Early detection ; Early Diagnosis ; Female ; Frail Elderly ; Frailty ; Geriatrics ; Health ; Health aspects ; Health care ; Health care policy ; Health Services Needs and Demand ; Health Status ; Housing ; Humans ; Independent Living ; Interviews ; Male ; Medical care ; Middle Aged ; Mortality ; Netherlands ; Older people ; Primary care ; Proactive elderly care ; Qualitative Research ; Research ; Social care ; Social isolation ; Social organization ; Systematic review ; Wellbeing
    ISSN: 1471-2318
    E-ISSN: 1471-2318
    Source: BioMedCentral Open Access
    Source: PubMed Central
    Source: DOAJ Directory of Open Access Journals - Not for CDI Discovery
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  • 5
    Language: English
    In: Health & social care in the community, 2022-02, Vol.30 (2), p.e469-e477
    Description: Frail older people face a range of problems and risks that could undermine their ability to live safely at home. A comprehensive overview of these risks, from a multidimensional perspective, is currently lacking. This study aims to examine the prevalence of risks in multiple domains of life among frail older people living at home. We used cross‐sectional data from 824 people aged 65 years and older, who received a comprehensive geriatric assessment (the interRAI Home Care [interRAI‐HC]) between 2014 and 2018, as part of routine care from 25 general practices in the region of West‐Friesland, the Netherlands. The interRAI‐HC identifies amenable risks related to people's clinical conditions, functioning, lifestyle and behaviour, and social and physical environment. Descriptive statistics were used to examine population characteristics (age, gender, marital status, living arrangements and presence of chronic conditions) and prevalence of risks. Most common risks were related to people's clinical conditions (i.e cardio‐respiratory health, urinary incontinence, pain), functioning (i.e. limitations in instrumental activities of daily living and mood) and social environment (i.e. limitations in informal care and social functioning). More than 80% of frail older people faced multiple risks, and often on multiple domains of life simultaneously. People experiencing multiple risks per person, and on multiple domains simultaneously, were more often widowed and living alone. The multidimensional character of risks among frail older people living at home implies that an integrated approach to care, comprising both health and social care, is necessary. Insight in the prevalence of these risks can give direction to care allocation decisions.
    Subject(s): Activities of Daily Living ; Aged ; Built environment ; care of elderly people ; Chronic illnesses ; Chronic pain ; Conditions ; Cross-Sectional Studies ; Emotions ; Family medicine ; Frail ; Frail Elderly ; Frailty ; Geriatric assessment ; Geriatric Assessment - methods ; Health care ; health needs assessment ; Health services ; Home care ; Home health care ; Humans ; Incontinence ; Independent living ; Informal care ; Integrative approach ; Living alone ; Living arrangements ; Marital status ; Medical screening ; multi‐disciplinary ; Netherlands - epidemiology ; Older people ; Personal safety ; Population characteristics ; Primary care ; Primary Health Care ; Risk ; risk assessment ; risk in community care ; Safety and security measures ; Social care ; Social environment ; Social functioning ; Social services ; Urinary incontinence
    ISSN: 0966-0410
    E-ISSN: 1365-2524
    Source: Hellenic Academic Libraries Link
    Source: Sociological Abstracts
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  • 6
    Language: English
    In: International journal of integrated care, 2018, Vol.18 (1), p.6-6
    Description: Introduction: Integrated care programmes are increasingly being put in place to provide care to older people who live at home. Knowledge of how to further develop integrated care and how to transfer successful initiatives to other contexts is still limited. Therefore, a cross-European research project, called Sustainable Tailored Integrated Care for Older People in Europe (SUSTAIN), has been initiated with a twofold objective: 1. to collaborate with local stakeholders to support and monitor improvements to established integrated care initiatives for older people with multiple health and social care needs. Improvements focus on person-centredness, prevention orientation, safety and efficiency; 2. to make these improvements applicable and adaptable to other health and social care systems, and regions in Europe. This paper presents the overall structure and approach of the SUSTAIN project. Methods: SUSTAIN uses a multiple embedded case study design. In three phases, SUSTAIN partners: (i) conduct interviews and workshops with stakeholders from fourteen established integrated care initiatives to understand where they would prefer improvements to existing ways of working; (ii) collaborate with local stakeholders to support the design and implementation of improvement plans, evaluate implementation progress and outcomes per initiative, and carry out overarching analyses to compare the different initiatives, and; (iii) translate knowledge and experience to an online roadmap. Discussion: SUSTAIN aims to generate evidence on how to improve integrated care, and apply and transfer the knowledge gained to other health and social care systems, and regions. Lessons learned will be brought together in practical tools to inform and support policy-makers and decision-makers, as well as other stakeholders involved in integrated care, to manage and improve care for older people living at home.
    Subject(s): ADULTS ; COMPREHENSIVE CARE ; COST ; European research ; FRAILTY ; FRAMEWORK ; HEALTH-CARE ; implementation science ; integrated care ; knowledge translation ; long-term care ; mixed methods ; MULTIPLE CHRONIC CONDITIONS ; older people ; PROGRAMS ; RANDOMIZED CONTROLLED-TRIAL ; Research and Theory
    ISSN: 1568-4156
    E-ISSN: 1568-4156
    Source: NORA - Norwegian Open Research Archives
    Source: Academic Search Ultimate
    Source: PubMed Central
    Source: DOAJ Directory of Open Access Journals - Not for CDI Discovery
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  • 7
    Language: English
    In: International journal of integrated care, 2020, Vol.20 (4), p.1-1
    Description: Introduction: While many different factors can undermine older people’s ability to live safely at home, safety as an explicit aspect of integrated care for older people living at home is an underexplored topic in research. In the context of a European project on integrated care, this study aims to improve our understanding of how safety is addressed in integrated care practices across Europe. Methods: This multiple case study included thirteen integrated care sites from seven European countries. The Framework Method guided content analyses of the case study reports. Activities were clustered into activities aimed at identifying and managing risks, or activities addressing specific risks related to older people’s functioning, behaviour, social environment, physical environment and health and social care receipt. Results: Case studies included a broad range of activities addressing older people’s safety. Although care providers felt they sufficiently addressed safety issues, older people were often concerned and insecure about their safety. Attention to the practical and social aspects of safety was often insufficient. Conclusions and discussion: Integrated care services across Europe address older people’s safety in many ways. Further integration of health and social care solutions is necessary to enhance older people’s perceptions of safety.
    Subject(s): case study ; integrated care ; older people living at home ; prevention ; Research and Theory ; risks ; safety
    ISSN: 1568-4156
    E-ISSN: 1568-4156
    Source: Academic Search Ultimate
    Source: PubMed Central
    Source: DOAJ Directory of Open Access Journals - Not for CDI Discovery
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  • 8
    Language: English
    In: International journal of environmental research and public health, 2022-04-14, Vol.19 (8), p.4739
    Description: Relocation of residents within or between long-term care facilities occurs regularly. To mitigate potential negative consequences, supportive relocation initiatives have been developed. This scoping review addresses types, aspects, and impact of relocation initiatives developed to relocate residents between or within long-term care facilities. A total of 704 articles were identified in a systematic literature search of 11 databases between April and July 2021. Using predefined eligibility criteria, two researchers independently screened titles and abstracts, resulting in 36 articles for full-text screening. Finally, six articles were included. Analysis was performed using thematic coding. Three types of relocation initiatives were identified, namely, interventions ( = 3), guidelines ( = 2), and a plan ( = 1). These initiatives described specific aspects of relocation, namely, spatial orientation ( = 3), practical assistance ( = 3), psychological support ( = 3), staff preparation ( = 2), and client engagement ( = 2). Only three intervention studies reported the impact of relocation initiatives on residents, namely, improved mental health ( = 3), spatial orientation ( = 2), self-reliance ( = 2), and social behavior ( = 1). The scope of the found relocation initiatives was often limited as they focused on specific designs, aspects, and residents. Therefore, the complexity of relocation processes is often overlooked, and more comprehensive relocation initiatives should be developed.
    Subject(s): Age ; Aged ; Disabled people ; Family physicians ; Homes for the Aged ; Humans ; Initiatives ; Intellectual disabilities ; Intervention ; Long term care insurance ; Long term health care ; Long-Term Care ; Medical research ; Mental Health ; Nurses ; Nursing Homes ; Older people ; Physicians ; Relocation ; relocation initiative ; scoping review ; Skilled Nursing Facilities ; Social behavior ; Stress ; transfer ; transition
    ISSN: 1661-7827
    E-ISSN: 1660-4601
    Source: PubMed Central
    Source: DOAJ Directory of Open Access Journals - Not for CDI Discovery
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  • 9
    Language: English
    In: International journal of environmental research and public health, 2022-03-15, Vol.19 (6), p.3468
    Description: During the COVID-19 outbreak in March 2020, restrictive measures (e.g., prohibiting physical visits and group activities) were introduced in nursing homes to protect older residents. Although the importance of social contacts and social activities to fulfill social needs and avoid loneliness is known, these were challenged during the pandemic. This qualitative study specifically focused on how residents, close relatives, and volunteers in nursing homes experienced the restrictive measures in retrospect and gained insights into the impact of the restrictive measures on social needs and loneliness, and the lessons that could be learned. Thirty semi-structured, face-to-face interviews with residents and close relatives, and one online focus group with ten volunteers, were conducted. Recruitment took place at psychogeriatric and somatic units in the Northern, Eastern and Southern regions of the Netherlands and Flanders, Belgium. The interviews and focus group were transcribed verbatim, and an open, inductive approach was used for analysis. Alternative ways of social contact could not fully compensate for physical visits. Generally, participants reported that it was a difficult time, indicated by feelings of loneliness, fear, sadness, and powerlessness. A great diversity in loneliness was reported. The most important reasons for feeling lonely were missing close social contacts and social activities. The diversity in the impact of restrictive measures depended on, e.g., social needs, coping strategies, and character. Restrictive COVID-19 measures in nursing homes resulted in negative emotions and unmet social needs of residents, close relatives, and volunteers. During future outbreaks of the COVID-19 virus or another virus or bacterium, for which restrictive measures may be needed, nursing homes should actively involve residents, close relatives, and volunteers to balance safety, self-determination, and well-being.
    Subject(s): Bans ; Codes ; Collaboration ; Coronaviruses ; COVID-19 ; COVID-19 - epidemiology ; COVID-19 pandemic ; Data collection ; Dementia ; Disease transmission ; Emotions ; Epidemics ; Focus groups ; Humans ; Interviews ; Loneliness ; Loneliness - psychology ; Medical research ; Nursing Homes ; Older people ; Outbreaks ; Pandemics ; Qualitative research ; Quality of life ; Research methodology ; Researchers ; residents ; social contacts ; social needs ; Social research ; Viral diseases ; Viruses ; Volunteers
    ISSN: 1661-7827
    E-ISSN: 1660-4601
    Source: PubMed Central
    Source: DOAJ Directory of Open Access Journals - Not for CDI Discovery
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  • 10
    Language: English
    In: International journal of integrated care, 2020, Vol.20 (2), p.16-16
    Description: Introduction: Although person-centredness is a key principle of integrated care, successfully embedding and improving person-centred care for older people remains a challenge. In the context of a cross-European project on integrated care for older people living at home, the objective of this paper is to provide insight at an overarching level, into activities aimed at improving person-centredness within the participating integrated care sites. The paper describes experiences with these activities from the service providers’ and service users’ perspectives. Methods: A multiple embedded case study design was conducted that included thirteen integrated care sites for older people living at home. Results: Service providers were positive about the activities that aimed to promote person-centred care and thought that most activities (e.g. comprehensive needs assessment) positively influenced person-centredness. Experiences of service users were mixed. For some activities (e.g. enablement services), discrepancies were identified between the views of service providers and those of service users. Discussion and conclusion: Evaluating activities aimed at promoting person-centredness from both the service providers’ and service users’ perspectives showed that not all efforts were successful or had the intended consequences for older people. Involvement of older people in designing improvement activities could ensure that care and support reflect their needs and preferences, and build positive experiences of care and support.
    Subject(s): ADULTS ; COMPREHENSIVE CARE ; European research ; HEALTH-CARE ; implementation science ; integrated care ; INVENTORY ; INVOLVEMENT ; mixed methods ; MULTIPLE CHRONIC CONDITIONS ; older people ; PARTICIPATION ; PATIENT-CENTEREDNESS ; person-centredness ; PROGRAMS ; Research and Theory ; SHARED DECISION-MAKING
    ISSN: 1568-4156
    E-ISSN: 1568-4156
    Source: Academic Search Ultimate
    Source: PubMed Central
    Source: DOAJ Directory of Open Access Journals - Not for CDI Discovery
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