Caring For Older People In The Community

Family caregiving affects millions of Americans every day, in all walks of life. At least 17.7 million individuals in the United States are caregivers of an older adult with a health or functional limitation. The nation's family caregivers provide the lion's share of long-term care for our older adult population. They are also central to older adults' access to and receipt of health care and community-based social services. Yet the need to recognize and support caregivers is among the least appreciated challenges facing the aging U.S. population. Families Caring for an Aging America examines the prevalence and nature of family caregiving of older adults and the available evidence on the effectiveness of programs, supports, and other interventions designed to support family caregivers. This report also assesses and recommends policies to address the needs of family caregivers and to minimize the barriers that they encounter in trying to meet the needs of older adults.

The WHO Falls Prevention for Active Ageing model provides an action plan for making progress in reducing the prevalence of falls in the older adult population. By building on the three pillars of falls prevention, the model proposes specific strategies for: 1. Building awareness of the importance of falls prevention and treatment; 2. Improving the assessment of individual, environmental, and societal factors that increase the likelihood of falls; and 3. For facilitating the design and implementation of culturally appropriate, evidence-based interventions that will significantly reduce the number of falls among older persons. The model provides strategies and solutions that will require the engagement of multiple sectors of society. It is dependent on and consistent with the vision articulated in the WHO Active Ageing Policy Framework. Although not all of the awareness, assessment, and intervention strategies identified in the model apply equally well in all regions of the world, there are significant evidence-based strategies that can be effectively implemented in all regions and cultures. The degree to which progress will be made depends on to the success in integrating falls prevention strategies into the overall health and social care agendas globally. In order to do this effectively, it is necessary to identify and implement culturally appropriate, evidence-based policies and procedures. This requires multi-sectoral, collaborations, strong commitment to public and professional education, interaction based on evidence drawn from a variety of traditional, complementary, and alternative sources. Although the understanding of the evidence-base is growing, there is much that is not yet understood. Thus, there is an urgent need for continued research in all areas of falls prevention and treatment in order to better understand the scope of the problem worldwide. In particular, more evidence of the cost-effectiveness of interconnections is needed to develop strategies that are most likely to be effective in specific setting and population sub-groups.

"Nurses play a vital role in improving the safety and quality of patient car -- not only in the hospital or ambulatory treatment facility, but also of community-based care and the care performed by family members. Nurses need know what proven techniques and interventions they can use to enhance patient outcomes. To address this need, the Agency for Healthcare Research and Quality (AHRQ), with additional funding from the Robert Wood Johnson Foundation, has prepared this comprehensive, 1,400-page, handbook for nurses on patient safety and quality -- Patient Safety and Quality: An Evidence-Based Handbook for Nurses. (AHRQ Publication No. 08-0043)." - online AHRQ blurb, http://www.ahrq.gov/qual/nurseshdbk/

Caring for older people encompasses complex physical, social and psychological needs, and poses many diverse challenges for nurses. Caring for Older People in the Community provides nurses with an up to date practical resource that explores these challenges. Throughout the book the use of reflection points and scenarios enable the reader to reflect on current issues and consider how underpinning theory supports practice. Each chapter is evidence based and fully referenced, with full contact details of charities. This book will appeal to health and social care practitioners working in community settings, and will help nurses meet the challenge of nursing and the ageing population with empathy and understanding of diverse needs

Social isolation and loneliness are serious yet underappreciated public health risks that affect a significant portion of the older adult population. Approximately one-quarter of community-dwelling Americans aged 65 and older are considered to be socially isolated, and a significant proportion of adults in the United States report feeling lonely. People who are 50 years of age or older are more likely to experience many of the risk factors that can cause or exacerbate social isolation or loneliness, such as living alone, the loss of family or friends, chronic illness, and sensory impairments. Over a life course, social isolation and loneliness may be episodic or chronic, depending upon an individual's circumstances and perceptions. A substantial body of evidence demonstrates that social isolation presents a major risk for premature mortality, comparable to other risk factors such as high blood pressure, smoking, or obesity. As older adults are particularly high-volume and high-frequency users of the health care system, there is an opportunity for health care professionals to identify, prevent, and mitigate the adverse health impacts of social isolation and loneliness in older adults. Social Isolation and Loneliness in Older Adults summarizes the evidence base and explores how social isolation and loneliness affect health and quality of life in adults aged 50 and older, particularly among low income, underserved, and vulnerable populations. This report makes recommendations specifically for clinical settings of health care to identify those who suffer the resultant negative health impacts of social isolation and loneliness and target interventions to improve their social conditions. Social Isolation and Loneliness in Older Adults considers clinical tools and methodologies, better education and training for the health care workforce, and dissemination and implementation that will be important for translating research into practice, especially as the evidence base for effective interventions continues to flourish.

As the first of the nation's 78 million baby boomers begin reaching age 65 in 2011, they will face a health care workforce that is too small and woefully unprepared to meet their specific health needs. Retooling for an Aging America calls for bold initiatives starting immediately to train all health care providers in the basics of geriatric care and to prepare family members and other informal caregivers, who currently receive little or no training in how to tend to their aging loved ones. The book also recommends that Medicare, Medicaid, and other health plans pay higher rates to boost recruitment and retention of geriatric specialists and care aides. Educators and health professional groups can use Retooling for an Aging America to institute or increase formal education and training in geriatrics. Consumer groups can use the book to advocate for improving the care for older adults. Health care professional and occupational groups can use it to improve the quality of health care jobs.

Providing a concise review of the demographic context underpinning the development of community care for older people, and a critical review of community care in post-war Britain, this textbook discuss the current data and research regarding service provision and the costs and effectiveness of such services. The author integrates available data about the use of different types of service, and considers the implications of the 1993 policy and demographic change on the provision of community care in the future, comparing data relating to Britain with that of other developed countries, especially in Europe.

This accessible textbook compares ways in which basic components of community care are funded, organised and provided by governmental and non-governmental agencies, allowing practitioners and policy-makers to learn from the experiences of their counterparts in Europe and North America.