“We don’t have the infrastructure to support them at home”: How health system inadequacies impact on long-term care admissions of people with dementia

Donnelly, Nora-Ann; Humphries, Niamh; Hickey, Anne; Doyle, Frank

doi:10.1016/j.healthpol.2017.09.020

Cited by 14 publications

(16 citation statements)

References 35 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

Section: Resultsmentioning

confidence: 99%

“…67 This could be due to service organisation factors, for example, not being able to access a psychiatrist unless the person with dementia is admitted, 45 or economic factors, with insufficient funds and staffing in outpatient services. 52 Professional carers reported feeling frustrated by limitations on their ability to avoid emergency situations in dementia. 55 There were not always the staff available to control extreme behavioural symptoms.…”

Section: Open Accessmentioning

confidence: 99%

“…Lack of support meant that hospitalisation resulting in the person with dementia discharged to residential care was experienced as a relief for stressed carers, who had felt guilty about making this decision on their own. 52 Carers reported finding it hard to speak to GPs and community services about potential crisis situations. 53 There were also barriers identified by professionals, with reports from care facility and emergency department staff of carers directly contradicting instructions in advance care plans, ordering more burdensome interventions.…”

Section: Open Accessmentioning

confidence: 99%

See 2 more Smart Citations

Urgent care for patients with dementia: a scoping review of associated factors and stakeholder experiences

et al. 2020

View full text Add to dashboard Cite

ObjectivesPeople with dementia are more vulnerable to complications in urgent health situations due to older age, increased comorbidity, higher dependency on others and cognitive impairment. This review explored the factors associated with urgent care use in dementia and the experiences of people with dementia, informal carers and professionals.DesignScoping review. The search strategy and data synthesis were informed by people with dementia and carers.Data sourcesSearches of CINAHL, Embase, Medline, PsycINFO, PubMed were conducted alongside handsearches of relevant journals and the grey literature through 15 January 2019.Eligibility criteriaEmpirical studies including all research designs, and other published literature exploring factors associated with urgent care use in prehospital and emergency room settings for people with dementia were included. Two authors independently screened studies for inclusion.Data extraction and synthesisData were extracted using charting techniques and findings were synthesised according to content and themes.ResultsOf 2967 records identified, 54 studies were included in the review. Specific factors that influenced use of urgent care included: (1) common age-related conditions occurring alongside dementia, (2) dementia as a diagnosis increasing or decreasing urgent care use, (3) informal and professional carers, (4) patient characteristics such as older age or behavioural symptoms and (5) the presence or absence of community support services. Included studies reported three crucial components of urgent care situations: (1) knowledge of the patient and dementia as a condition, (2) inadequate non-emergency health and social care support and (3) informal carer education and stress.ConclusionsThe scoping review highlighted a wider variety of sometimes competing factors that were associated with urgent care situations. Improved and increased community support for non-urgent situations, such as integrated care, caregiver education and dementia specialists, will both mitigate avoidable urgent care use and improve the experience of those in crisis.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Open Accessmentioning

confidence: 99%

Section: Open Accessmentioning

confidence: 99%

See 1 more Smart Citation

Urgent care for patients with dementia: a scoping review of associated factors and stakeholder experiences

et al. 2020

View full text Add to dashboard Cite

show abstract

“…They can include; carer, family, friend, community members (Bowen et al, 2011;Ledgerd et al, 2016;Liken, 2001;Toot, Hoe, et al, 2013), general practitioner (Bruce, 2002), medical services, law enforcement agencies (Galvin et al, 2010;Ledgerd et al, 2016;Toot, Hoe, et al, 2013), specialist crisis intervention teams, and support workers for people with dementia or unpaid/paid carers (Bruce, 2002;Johnson et al, 2013;Ledgerd et al, 2016;Meiland et al, 2014;Toot, Hoe, et al, 2013). The factors that influence decision making and action include the availability of; hospital, respite, specialist and community services (Donnelly, 2017;Ledgerd et al, 2016;Toot, Hoe, et al, 2013), equipment and technology (Ledgerd et al, 2016;Toot, Hoe, et al, 2013), flexible and easily accessible services (Ledgerd et al, 2016;Toot, Hoe, et al, 2013), carer support services (Ledgerd et al, 2016;Toot, Hoe, et al, 2013) and carer knowledge and skill (Bruce, 2002;Sadak et al, 2017).…”

Section: What Happens During Crisismentioning

confidence: 99%

What happens before, during and after crisis for someone with dementia living at home: A systematic review

Hopkinson¹,

King²,

Mullins

et al. 2020

Dementia

View full text Add to dashboard Cite

BackgroundPeople living with dementia often experience crisis. Home treatment of crisis is an alternative to hospital admission that can have better outcomes. This systematic review is about people with dementia living at home and in crisis. It identifies modifiable factors in the crisis process that may facilitate crisis resolution. MethodsThe protocol is registered on PROSPERO. A systematic search of MEDLINE, EMBASE, CINAHL, AHMED, PsycINFO, Cochrane Library, and references of retrieved publications, identified empirical research in English language and date range 1/2000 to 2/2019. Two researchers independently screened abstracts, selected publications and extracted data using a framework based on published guidelines. This is a report of the analysis and narrative synthesis. ResultsThe search identified 2,755 titles and abstracts, 76 were selected for full-text examination and 13 agreed for inclusion. The included studies evidence that:For a person with dementia, crisis is a process that begins with a problem judged to put them or others at risk of harm. It leads to decision and action to treat this risk, thus resolve the crisis. Such crisis can be predicted or unpredicted and progress quickly or slowly.Medical treatment, community resources, and psychosocial support of personal resources, decision making, relationships, and social networks, are all modifiable factors that can treat the risk of harm during crisis. Carers' and professionals' knowledge and skills in dementia care are likely to play a key role in crisis resolution in the home. ConclusionThere has been limited investigation of the process and management of crisis at home for people living with dementia. The results of this review provide a foundation for future research. There is no consensus on critical components of home treatment to facilitate crisis resolution. However, education in dementia care for carers and professionals is likely to prove essential to successful home treatment.

show abstract

“…Seamless integration into insurance systems and hospital records with Elderly Health Electronic Records). (Carretero, 2015;Carretero et al, 2012;Deen, 2015;Donnelly, Humphries, Hickey, & Doyle, 2017;Kluzer, Redecker, & Centeno, 2010;Pang et al, 2015;Qidwai, 2011) Cost: The Cost of technology is the price imposed on the families or the center of the HCS to design, purchase, implement, operate, maintain, and support ICT services for receiving welfare, medical, and nursing support services. (Alhuwail, Koru, & Nahm, 2016;Al-Qurishi et al, 2015;Applebaum & Phillips, 2015;Kok, Berden, & Sadiraj, 2015;Koru, Alhuwail, Topaz, Norcio, & Etta Mills, 2016) Quality and integrated data: The quality and integrity of data collected from devices and tools that the elderly people, their families, or care center can receive to access support services including registration of the electronic health records.…”

Section: Technologymentioning

confidence: 99%

Using active information and communication technology for elderly homecare services: A scoping review

Chelongar

Ajami

2020

Home Health Care Services Quarterly

View full text Add to dashboard Cite

Nowadays, as life expectancy grows, the healthcare industry faces growing challenges related to corresponding increases in chronic diseases. Home care services (HCS) are the solution to this growing problem. It's a general premise that information and communication technology (ICT) can address these health issues and enhances HCS. The scope of our study was the active managerial and supervisory roles of these technologies within HCS. The study aimed to extract, accumulate, and classify the challenges of using active ICT for elderly HCS. We employed the keywords, their synonyms, and their combinations into the searching areas of title, keywords, and abstract. More than 300 resources were collected, and found those 33 articles of those 33 articles were eligible for our study. Later, a team of experts provided their opinions on our gatherings, which were collected individually. According to the expert team's opinions, researchers classified challenges into; technology, human factors, and management.

show abstract

“We don’t have the infrastructure to support them at home”: How health system inadequacies impact on long-term care admissions of people with dementia

Cited by 14 publications

References 35 publications

Urgent care for patients with dementia: a scoping review of associated factors and stakeholder experiences

Urgent care for patients with dementia: a scoping review of associated factors and stakeholder experiences

What happens before, during and after crisis for someone with dementia living at home: A systematic review

Using active information and communication technology for elderly homecare services: A scoping review

Contact Info

Product

Resources

About