Community Based Integrated Care For Older Adults

Community-based integrated care (CBIC) is designed to keep older adults where they want to be – at home and out of hospitals and nursing homes. The Program of All-Inclusive Care for the Elderly (PACE) is an example of successful CBIC, established in 1985 as an innovative solution to pervasive issue: how to provide integrated care to a high-risk population of older adults that promotes community living (not a nursing home) in a cost-effective manner. This unique guide provides readers with a concise yet informative base of understanding of PACE as well as a “deep dive” into the components and job roles that will serve as a reference for existing PACE providers and will inform those who are considering the possibility of developing a new PACE program. Chapters are organized into five thematic sections. Part one presents both domestic and international perspectives on CBIC, with part two delving deeper into the US PACE model, including its history, policy evolution and effectiveness. Specifics regarding the organization and management of PACE and the essential roles and positions comprise parts three and four, respectively, from leadership and the involvement of the state to the roles of the social worker, nurse, nutritionist, rehabilitation specialist, and more. Care planning, coordination and end of life care round out part five. In addition to geriatricians and other clinical practitioners involved with the care of older patients, Community-Based Integrated Care for Older Adults is also a resource for scholars, policy makers and the general public who are interested in innovations in long-term care that provide older adults with alternatives to nursing homes.

We live in a rapidly aging world, in which people who are age 60 and older outnumber children under the age of five. This book reveals large and growing gaps in care for older adults in countries at all income levels and shows how to leverage reforms for improving health outcomes for older adults and create healthier, more prosperous communities. Aimed at policy makers and other health and development stakeholders who want to promote healthier aging, Silver Opportunity compiles the latest evidence on care needs and gaps for aging populations. It argues that primary health care should be the cornerstone of integrated service delivery for older people, but primary health care systems must first build their capacity to respond to older people’s health needs. It presents an original framework for policy action to advance primary health care†“centered, integrated senior care; documents the experiences of pioneering countries in delivering community-based care to older people; and provides recommendations for decision-makers. The framework presents four policy levers with which to improve health care for seniors—financing, innovation, regulation, and evaluation and measurement—or FIRE. Finally, the book posits that by acting now, countries can leverage population aging to accelerate progress toward health equity and universal health coverage.

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.

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.

This book describes geriatrics practice models that are used to guide the care of older adults, allowing seniors to remain at home, prevent functional disability and preserve quality of life. The models include specific interventions which are performed by health care workers to address the needs of older persons and their caregivers. These models respect patient values, consider patient safety and appreciate psychosocial needs as well. Divided into six parts that discuss hospital-based models of care, transitions from hospital to home, outpatient-based models of care and emergency department models of care, this text addresses the needs of vulnerable patients and the community. Geriatric Models of Care is an excellent resource for health care leaders who must translate these programs to address the needs of the patients in their communities.

The WHO World report on ageing and health is not for the book shelf it is a living breathing testament to all older people who have fought for their voice to be heard at all levels of government across disciplines and sectors. - Mr Bjarne Hastrup President International Federation on Ageing and CEO DaneAge This report outlines a framework for action to foster Healthy Ageing built around the new concept of functional ability. This will require a transformation of health systems away from disease based curative models and towards the provision of older-person-centred and integrated care. It will require the development sometimes from nothing of comprehensive systems of long term care. It will require a coordinated response from many other sectors and multiple levels of government. And it will need to draw on better ways of measuring and monitoring the health and functioning of older populations. These actions are likely to be a sound investment in society's future. A future that gives older people the freedom to live lives that previous generations might never have imagined. The World report on ageing and health responds to these challenges by recommending equally profound changes in the way health policies for ageing populations are formulated and services are provided. As the foundation for its recommendations the report looks at what the latest evidence has to say about the ageing process noting that many common perceptions and assumptions about older people are based on outdated stereotypes. The report's recommendations are anchored in the evidence comprehensive and forward-looking yet eminently practical. Throughout examples of experiences from different countries are used to illustrate how specific problems can be addressed through innovation solutions. Topics explored range from strategies to deliver comprehensive and person-centred services to older populations to policies that enable older people to live in comfort and safety to ways to correct the problems and injustices inherent in current systems for long-term care.

In today’s world, healthy aging and a fulfilling lifestyle are important to older members of society, with many opting to remain as independent and mobile as possible for as long as possible. However, elderly individuals tend to have a variety of functional limitations that can increase the likelihood of debilitating falls and injuries. Assessments of functionality are very often only performed following an accident, which implies a hindsight bias because results do not necessarily reflect pre-accidental performance capacities. Furthermore, these belated measures do little to reduce the likelihood of new falls. As such, it is imperative that personalized preventative approaches are taken to prevent falls. Integrated Care and Fall Prevention in Active and Healthy Aging contains state-of-the-art research and practices related to integrated care, fall prevention, and aging throughout areas ranging from medical to social aspects of care, health economy, standards, pathways and information scopes, practices and guidelines, technology, etc. Covering topics such as active care and healthy aging, it is ideal for doctors, gerontologists, nursing home and long-care facility staff, scientists, researchers, students, academicians, and practitioners working in care pathways involving good practices of fall prevention in home care and community care settings.

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.