Background and Purpose-A pilot evaluation of an occupational therapy intervention to improve self-care independence for residents with stroke-related disability living in care homes was the basis of this study. Methods-A cluster randomized controlled trial with care home as the unit of randomization was undertaken in Oxfordshire, UK. Twelve homes (118 residents) were randomly allocated to either intervention (6 homes, 63 residents) or control (6 homes, 55 residents). Occupational therapy was provided to individuals but included carer education. The control group received usual care. Assessments were made at baseline, postintervention (3 months) and at 6-months to estimate change using the Barthel Activity of Daily Living Index (BI) scores, "poor global outcome", (defined as deterioration in BI score, or death) and the Rivermead Mobility Index. Results-At 3 months BI score in survivors had increased by 0.6 (SD 3.9) in the intervention group and decreased by 0.9 (2.2) in the control group; a difference of 1.5 (95% CI allowing for cluster design, Ϫ0.5 to 3.5). At 6 months the difference was 1.9 (Ϫ0.7 to 4.4). Global poor outcome was less common in the intervention group. At 3 months, 20/63 (32%) were worse/dead in the intervention group compared with 31/55 (56%) in the control group, difference Ϫ25% (Ϫ51% to 1%). At 6 months the difference was similar, Ϫ26% (Ϫ48% to Ϫ3%). Between-group changes in Rivermead Mobility Index scores were not significantly different. Conclusion-Residents who received an occupational therapy intervention were less likely to deteriorate in their ability to perform activities of daily living.
Immobility, inactivity and the lack of social interaction are associated with poor physical and mental health. The main aim of this study was to examine the type and frequency of activities and social interactions with took place in a care home for older people. Residents within the communal area of a care home were observed over a period of 16 hours at 10-minute intervals by two psychologists. Residents' positions, activities and interactions were recorded. The majority of observations (97%) found residents sitting and not engaged in activity (60.7%). Only 10.7% of observations involved social interaction of residents either with each other or with a carer. The results demonstrate a very low level of daily activity and interaction in the care home setting. The risks of immobility and inactivity related complications such as pressure sores, muscle weakness, depression and anxiety are high.
The UK's national population structure, in line with most Western societies, is ageing rapidly. The combination of falling fertility and increasing longevity is having an impact on family structures and resultant relationships, with the emergence of long vertical multi-generational families replacing the former laterally extended family forms. This is occurring at a time when UK government policy is placing increasing reliance on families to provide health and social care and support for the growing number of frail older people. While there has been extensive research on family care within the majority white population, there is less understanding of the elder family care provision for the UK's growing older ethnic population. This paper discusses the changing demographics, new government policy on promoting independent living and its implications for family care provision, and reviews our current understanding of family care and support for older people within the UK’s varied ethnic minority families.
Our objective was to investigate the impact of increased asthma awareness among primary care physicians on the asthma control and satisfaction of their patients. Physicians attended an asthma education session with emphasis on patient-physician partnership followed by 4 month monitored follow-up of patients aged 5-44 years with mild to moderate asthma. Findings were compared with a group of patients whose physician attended the session but did not participate in the follow-up and two other control groups. The study included pediatricians and general practitioners of Maccabi Healthcare Services and their patients. Asthma symptoms were rated by patients and physicians. Data on drug prescription and use were derived from the Maccabi central database. Patient response and satisfaction and physician satisfaction were evaluated by telephone interviews. Mean asthma symptom score improved from 2.0 to 1.1 in the study group of patients (p < 0.001). The use of reliever drugs decreased concomitantly with a rise in controller drugs in all patients. An improvement in asthma status was reported by 64% of the study patients and 39% of non-participating patients (p = 0.007). Fifty-eight percent of the patients rated their competence to deal with asthma as high before the intervention compared to 62% of the participating and 55% of the non-participating patients after the intervention (p = 0.002). Most physicians claimed that simply increasing their awareness on asthma led to beneficial results in their patients. Physician education followed by monitored follow-up enhanced asthma control and patient satisfaction. Nevertheless, physician education alone appears to have a significant isolated impact on asthma control.
Aims A review by an international charity for older people, Help the Aged, suggested that older people living in care homes in the UK do not receive the appropriate levels of access to health professionals. The authors aimed to establish the access to and use of services provided by allied health professions to care homes in Oxfordshire and Warwickshire. Methods A postal survey with telephone follow up of the use of and access to allied health-care services in 121 Oxfordshire and Warwickshire care homes was conducted using an established questionnaire. Findings The majority of homes reported using a chiropodist (91%), an optician (86%), hearing services (63%) and a physiotherapist (65%). Less than half of the homes reported using an occupational therapist (41%), a dietician (44%) or a speech and language therapist (39%). A third used an alternative therapist (35%) and a similar number (35%) a social activities organizer. There was inconsistency in the sources of funding and the reasons for referral, particularly regarding occupational therapy and the provision of aids and adaptations. Conclusions The expertise of allied health-care professions available in UK hospital and domiciliary National Health Service (NHS) settings is not evident or accessible in the care home setting unless funded privately. When taking into account the high levels of impairments in these settings, access would appear to be contrary to the UK National Service Framework for Older People, which suggests that the NHS will provide a universal service for all based on clinical need, not ability to pay.
A recent study suggested that older people in care homes do not receive appropriate levels of access to health professionals. This study aimed to establish the access to and use of services provided by allied health professions to care homes in Oxfordshire and Warwickshire.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.