Establishing an integrated model of subacute care for the frail elderly

2018 ◽  
Vol 31 (4) ◽  
pp. 133-136 ◽  
Author(s):  
Mary Boutette ◽  
Akos Hoffer ◽  
Jennifer Plant ◽  
Benoit Robert ◽  
Danielle Sinden
Keyword(s):  
Older Adults ◽  
Frail Elderly ◽  
Care Delivery ◽  
Care Plan ◽  
Retirement Home ◽  
Frail Older Adults ◽  
Subacute Care ◽  
Prolonged Hospitalization ◽  
Care Delivery Model ◽  
Alternate Level Of Care

The current health system in Ontario is not designed to meet the needs of frail older adults. This is particularly true for older adults hospitalized due to exacerbation of chronic illness or medical crisis. This article describes the Subacute Care Unit for the Frail Elderly (SAFE) program, one which is designed to serve frail older patients who are at risk of deconditioning or disability associated with prolonged hospitalization but who may safely return home or to a retirement home following up to 4 weeks of subacute care in a restorative environment. The program centres on an intense restorative and integrated care delivery model. The patient population is medically complex, requiring medical supervision and regular adjustment to the care plan to optimize medical status. Individuals are no longer acutely ill and are considered stable or stabilizing. Care and services are designed to improve outcomes for hospitalized frail older adults by proactively addressing the conditions that contribute to alternate level of care before the deconditioning associated with prolonged hospitalization is experienced.

Effectiveness of a Care Delivery Model for High-Need Older Adults in Communities

2020 ◽  
pp. 104973152098235
Author(s):  
Kuei-Min Chen ◽  
Hui-Fen Hsu ◽  
Li-Yen Yang ◽  
Chiang-Ching Chang ◽  
Yu-Ming Chen ◽  
...  
Keyword(s):  
Older Adults ◽  
Repeated Measures ◽  
Comparison Group ◽  
Care Delivery ◽  
Intervention Group ◽  
Community Dwelling ◽  
Delivery Model ◽  
Positive Effects ◽  
Repeated Measures Design ◽  
Care Delivery Model

Purpose: This study aimed to test the effectiveness of High-Need Community-Dwelling Older Adults Care Delivery Model (HCOACDM) in Taiwan. Methods: A cluster randomized controlled trial with repeated measures design was conducted in eight community care centers, involving 145 high-need older adults who were assigned to the intervention group or comparison group. The HCOACDM was provided over 6 months. Functional ability, quality of life, depressive symptoms, and health care and social service utilizations were measured at baseline, at 3 months, and 6 months into the intervention. The participants’ satisfaction was measured at the end of 6-month intervention. Results: Positive effects were shown on all variables in the intervention group at both the 3-month and 6-month intervals (all p < .05). The intervention group had a higher satisfaction with care delivery than the comparison group ( p < .05). Discussion: The promising findings supported a long-term implementation of the HCOACDM as applicable and beneficial.

scholarly journals Effectiveness of a Care Delivery Model for High-Need Community-Dwelling Older Adults

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 279-279
Author(s):  
Kuei-Min Chen ◽  
Hui-Fen Hsu
Keyword(s):  
Older Adults ◽  
Comparison Group ◽  
Care Delivery ◽  
Care Service ◽  
Intervention Group ◽  
Community Dwelling ◽  
Delivery Model ◽  
Care Services ◽  
Care Delivery Model ◽  
Community Dwelling Older Adults

Abstract The effectiveness of sufficient care coordination for high-need community-dwelling older adults has not been discussed. This study aimed to examine the effectiveness of a newly-developed care delivery model for high-need community-dwelling older adults. A cluster randomized controlled trial with repeated measures design was employed. A total of 145 high-need older adults participated in the study and were randomly assigned to either the intervention group or comparison group. A categorized list of care services based on the types of high-need older adults as the intervention allowed care coordinators to make adequate care service linkages. The intervention period ranged over 6 months with regulated home visits and assesssments. Functional ability, quality of life, depressive symptoms, and healthcare and social service utilizations were measured at baseline, and at 3 and 6 months into the intervention. The participants’ satisfaction with care delivery was measured at the end of 6-month intervention. Results showed that the intervention group had a better functional ability, a higher quality of life, reduced depressive symptoms, and more efficient healthcare and social service utilizations than the comparison group at both the 3-month and 6-month intervals (all p &lt; .05). By the end of the 6-month study, the intervention group were more satisfied with the care service linkages than the comparison group (p &lt; .05). The positive effects of providing a categorized list of care services for care coordinators to make service linkages have been evidenced by the outcomes. The promising findings supported a further longer-term implementation of the care delivery model.

Aging Brain Care

2017 ◽  
Author(s):  
Catherine A. Alder ◽  
Mary Guerriero Austrom ◽  
Michael A. LaMantia ◽  
Malaz A. Boustani
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Care Delivery ◽  
Health Care Delivery System ◽  
Care Plan ◽  
Aging Brain ◽  
Multiple Chronic Conditions ◽  
Late Life Depression ◽  
Medical Provider ◽  
Holistic View

While fragmented care is a problem across the entire health care delivery system, it is especially problematic for vulnerable older adults with dementia and late-life depression. Most older adults have multiple chronic conditions. Cognitive impairment and mood disorders complicate the management of these comorbid conditions by interfering with the patient’s ability to monitor and report symptoms and comply with the care plan. To reduce fragmentation and promote integrated care, each medical provider must adopt a more holistic view of health care, recognizing the importance of communication and collaboration among all providers and the potential impact of any one action on the patient’s overall health. The Aging Brain Care (ABC) model provides a structure for integrating evidence-based interventions for dementia and depression into the primary care environment. By extending the delivery of care beyond the clinic, ABC offers patient-centered services aimed at coordinating care across multiple providers, settings, and community resources.

scholarly journals How to treat the frail elderly: The challenge of multimorbidity and polypharmacy

2013 ◽  
Vol 7 (9-10) ◽  
pp. 183 ◽  
Author(s):  
Cara Tannenbaum
Keyword(s):  
Older Adults ◽  
Urinary Tract ◽  
Lower Urinary Tract Symptoms ◽  
Frail Elderly ◽  
Lower Urinary Tract ◽  
Treatment Choices ◽  
Frail Older Adults ◽  
Urinary Tract Symptoms ◽  
Pharmacologic Management ◽  
Lower Urinary

The pharmacologic management of lower urinary tract symptoms in frail older adults is complicated by two key considerations: the increased likelihood of comorbidities and the increased likelihood of polypharmacy. This brief review summarizes how these factors may impact treatment choices in this population.

Development of a Care Delivery Model for High-Need Older Adults in the Community

2019 ◽  
Vol 68 (5) ◽  
pp. 390-397 ◽  
Author(s):  
Hui-Fen Hsu ◽  
Kuei-Min Chen ◽  
Yu-Ming Chen ◽  
Chiang-Ching Chang ◽  
Meng-Chin Chen ◽  
...  
Keyword(s):  
Older Adults ◽  
Care Delivery ◽  
Delivery Model ◽  
Care Delivery Model

scholarly journals Care for frail older adults in the community: an integrative review

2020 ◽  
Vol 23 (6) ◽  
Author(s):  
Gislaine Alves de Souza ◽  
Karla Cristina Giacomin ◽  
Josélia Oliveira Araújo Firmo
Keyword(s):  
Older Adults ◽  
Interpersonal Relationships ◽  
Web Of Science ◽  
Care Delivery ◽  
Scientific Evidence ◽  
Integrative Review ◽  
Care Providers ◽  
Inclusion Criteria ◽  
Frail Older Adults ◽  
Review Study

Abstract Objective: to identify scientific evidence regarding the care of frail older adults in the community, from the perspective of the older adults themselves. Method: a descriptive, integrative review study was performed. The search for articles was carried out in the Medline, Lilacs, Web of Science, Scopus and SciELO databases. The inclusion criteria were complete available articles; published between 2014 and 2019; written in Portuguese, English, Spanish or French; which had older adults as participants. Results: four categories of analysis emerged from the results: frailty from the perspective of frail older adults; priorities from the perspective of the older adults; the older adults’ perspectives on care by services; and interpersonal relationships in the care of frail older adults. The perception of the older adults has specific characteristics, has maintaining their independence as a focus of care, signals the need to maintain interpersonal relationships, improve communication, and for actions of health education and people-centered services. Conclusion: these points demand the attention of care providers and policy services to improve care delivery and provide actions that are welcomed by this public.

Development of an Exercise Program for the Frail Elderly

2001 ◽  
Vol 9 (4) ◽  
pp. 452-465 ◽  
Author(s):  
Marijke J.M. Chin A Paw ◽  
Nynke de Jong ◽  
Martin Stevens ◽  
Petrus Bult ◽  
Evert G. Schouten
Keyword(s):  
Older Adults ◽  
Frail Elderly ◽  
Motor Behavior ◽  
Exercise Program ◽  
Community Dwelling ◽  
Daily Activities ◽  
Preliminary Evaluation ◽  
Elderly Adults ◽  
Frail Older Adults ◽  
And Performance

The article describes the design and preliminary evaluation of a 17-week, twice-weekly, comprehensive, progressive exercise program for frail elderly adults. The main objective was to maintain or improve mobility and performance of daily activities essential for independent functioning. Strength, speed, endurance, flexibility, and coordination were trained by walking, kneeling, and chair stands, performed in the context of motor behavior such as games and daily activities. The acceptability of the exercise program was evaluated in a population of community-dwelling, frail older adults (mean age 77.6 ± 5.4 years). Eighty-one percent completed the program. Program appreciation and attendance were high. Seventy-three percent reported wanting to continue participating if possible—although most only once a week. At follow-up (1–1.5 years afterward) 30% were still participating in an exercise program. The exercise program was enjoyed and accepted by a population of frail, previously sedentary elderly adults. Widespread implementation of this program could increase physical activity among frail older adults.

A Multicenter Survey of Older Adults in Subacute Care on Their Current Driving Efficacy and Their Intention to Resume Driving After Discharge

2018 ◽  
Vol 26 (3) ◽  
pp. 21-25
Author(s):  
Sina Aghaie ◽  
Myriam Kline ◽  
Irina Dashkova ◽  
Karishma Patel ◽  
James Lolis ◽  
...  
Keyword(s):  
Older Adults ◽  
Subacute Care ◽  
Multicenter Survey
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