Integrating Care For Older People

This book explains how to promote and prolong “healthy ageing,” which constitutes maintaining daily functioning and well-being until the end of life. In this context, the editor of the book and the international team of authors, all of whom are experts on the various aspects of ageing, demonstrate the value of this new approach in clinical practice. The systematic integration of a functional assessment, if not a complete and comprehensive geriatric assessment, is fundamental in daily clinical practice. Identifying risk factors at midlife will help to promote health at any age. Moreover, randomized control trials are making it increasingly clear that interventions could help ageing and elderly adults enjoy their remaining years without disability. Indeed, wellbeing will also increase, allowing elderly adults to stay independent until a very advanced age. The book also shows how considerable societal benefits can be easily forecast when more lifetime is spent without disability, followed by a dignified end of life. This book will be of interest to all medical doctors, general practitioners and organ specialists as well as geriatricians who want to have a complete overview of what healthy ageing means.

Highly Commended in the Public Health category of the 2003 BMA Medical Book Competition. 'The book is also helpfully laid out. `Signposts' in right hand margins link issues discussed in different parts of the book. Each chapter has a short summary of contents at the start, an overview at the end and `headline points'- short bullet points designed to reinforce key messages in the reader's mind. The end of each chapter also includes references and further suggested reading... This book will repay study by anyone involved in planning or delivering services for older people- particularly those working to try to implement `joined up' services. From this perspective, the book is genuinely inspirational. It shows how much can be achieved by working in this way and -more importantly- how it was done.' - Journal of Interprofessional Care 'This is an important book... It needs to be read and understood by everyone involved in caring, but especially by those with the power to influence change- which is increasingly purchasers and senior managers. It also provides a valuable guide to a large literature and has useful examples of questionnaires, data collection forms and clinical vignettes.' - International Journal of Geriatric Psychiatry 'This book is unique and brilliant at the same time. It shows the limits of what any given healthcare professional can accomplish and the amazing, seemingly impossible feats that an effective team caring for older persons can accomplish. The commentary on leadership in healthcare and the ways in which healthcare teams evolve and work is excellent. It is not in the least dry, but rather invigorating as one sees the concepts, values, and visions manifest in clever solutions to problems... It weaves in the history of geriatrics seamlessly. The enthusiastic anticipation in the excellent foreword is amply justified. The concepts here are universal... Every medical library should possess this remarkable book.' - Doody's Reviews The authors of this book share their practical experience of implementing a multi-agency approach to the support of older people. They show how systems thinking can help with the complexity of developing a model of care that co-ordinates medical, social and community services. They offer insight into the effective use of on-going assessment, evaluation, costing and information technology, with examples. They demonstrate how they achieved a `one-stop' rapid response to emergencies and a multi-level approach to risk management. They also show how enabling the older person to become an equal partner in decision-making, both as an individual user and as a citizen, reduces dependency, and can prevent current problems such as overlap and duplication of service and inappropriate admission to hospital and residential care. They offer models of consultation and guidance on running participative groups. This resource meets the growing need for material on multi-agency practice and is an invaluable tool for all those working across organisational and professional boundaries to deliver an integrated care system for older people.

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.

This handbook gives profound insight into the main ideas and concepts of integrated care. It offers a managed care perspective with a focus on patient orientation, efficiency, and quality by applying widely recognized management approaches to the field of health care. The handbook also provides international best practices and shows how integrated care does work throughout various health systems. The delivery of health and social care is characterised by fragmentation and complexity in most health systems throughout the world. Therefore, much of the recent international discussion in the field of health policy and health management has focused on the topic of integrated care. “Integrated” acknowledges the complexity of patients ́ needs and aims to meet it by taking into account both health and social care aspects. Changing and improving processes in a coordinated way is at the heart of this approach.

This report synthesises evidence from seven case studies covering Australia, Canada, the Netherlands, New Zealand, Sweden, the United Kingdom and the United States. It considers similarities and differences of programmes that are successfully delivering integrated care, and identifies lessons for policy-makers and service providers to help them address the challenges ahead.

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.