Info Long-Term Care

2010 Alzheimer’s Disease Progress Report: A Deeper Understanding

2012-01-20T08:23:00.003-06:00

The National Institute on Aging (NIA), part of the Federal Government’s National Institutes of Health (NIH) at the U.S. Department of Health and Human Services, has primary responsibility for basic, clinical, behavioral, and social research in Alzheimer’s disease, aimed at finding ways to treat and, ultimately, prevent this disease. The Institute’s Alzheimer’s disease research program is integral to its mission, which is to enhance the health and well-being of older people. This 2010 Progress Report on Alzheimer’s Disease summarizes recent Alzheimer’s research conducted or supported by the NIA and other components of NIH,
http://www.nia.nih.gov/alzheimers/publication/2010-alzheimers-disease-progress-report-deeper-understanding

Seniors in Focus

2012-01-18T15:31:00.001-06:00

The January issue of Land, a feature of the Canadian Institute of Health Information website, has a special article focusing on two important reports on seniors and health care in Canada, including the report:
Health Care in Canada, 2011: A Focus on Seniors and Aging
To read the article, go to:
http://www.cihi.ca/land/Article/In+Focus/default

New articles in the geriatric literature

2012-01-18T15:21:00.001-06:00

Don't forget to check out the Selected New Articles in the Geriatric Literature feature on this blog just to the right of this post. These articles are selected from dozens of recent alerts from major geriatric and long term care journals.

Aging in Place: A State Survey of Livability Policies and Practices

2012-01-16T09:16:00.001-06:00

Nearly 90 percent of people over the age of 65 want to stay in their home for as long as possible. However, for older adults to age in place, their physical and service environment must be able to accommodate their needs.

NCSL partnered with the AARP Public Policy Institute to examine promising state land use, transportation, and housing policies that may enable aging in place. These policies include integrating land use, housing and transportation; efficiently delivering services in the home; providing more transportation choices; and improving affordable, accessible housing to prevent social isolation.

Aging in Place – In Brief: A two page summary of the report’s major findings
Full Report - Aging in Place: A State Survey of Livability Policies and Practices

Assessment of nursing home residents in Europe: the Services and Health for Elderly in Long TERm care (SHELTER) study.

2012-01-16T09:13:00.000-06:00

Graziano Onder, Iain Carpenter, Harriett Finne-Soveri, Jacob Gindin, Dinnus Frijters, Jean-Claude Henrard,Thorsten Nikolaus, Eva Topinkova, Matteo Tosato, Rosa Liperoti, Francesco Landi and Roberto Bernabei

BMC Health Services Research 2012, 12:5 doi:10.1186/1472-6963-12-5Published: 9 January 2012

Background:

Aims of the present study are the following: 1. to describe the rationale and methodology of the Services and Health for Elderly in Long TERm care (SHELTER) study, a project funded by the European Union, aimed at implementing the interRAI instrument for Long Term Care Facilities (interRAI LTCF) as a tool to assess and gather uniform information about nursing home (NH) residents across different health systems in European countries; 2. to present the results about the test-retest and inter-rater reliability of the interRAI LTCF instrument translated into the languages of participating countries; 3 to illustrate the characteristics of NH residents at study entry.

Method:

A 12 months prospective cohort study was conducted in 57 NH in 7 EU countries (Czech Republic, England, Finland, France, Germany, Italy, The Netherlands) and 1 non EU country (Israel). Weighted kappa coefficients were used to evaluate the reliability of interRAI LTCF items.

Results:

Mean age of 4156 residents entering the study was 83.4+/-9.4 years, 73% were female. ADL disability and cognitive impairment was observed in 81.3% and 68.0% of residents, respectively. Clinical complexity of residents was confirmed by a high prevalence of behavioral symptoms (27.5% of residents), falls (18.6%), pressure ulcers (10.4%), pain (36.0%) and urinary incontinence (73.5%). Overall, 197 of the 198 the items tested met or exceeded standard cut-offs for acceptable test-retest and inter-rater reliability after translation into the target languages.

Conclusion:

The interRAI LTCF appears to be a reliable instrument. It enables the creation of databases that can be used to govern the provision of long-term care across different health systems in Europe, to answer relevant research and policy questions and to compare characteristics of NH residents across countries, languages and cultures.

The complete article is available as a provisional PDF. The fully formatted PDF and HTML versions are in production.

Complaints in for-profit, non-profit and public nursing homes in two Canadian provinces

2012-01-04T12:21:00.004-06:00

"Background: Nursing homes provide long-term housing, support and nursing care to frail elders who are no longer able to function independently. Although studies conducted in the United States have demonstrated an association between for-profit ownership and inferior quality, relatively few Canadian studies have made performance comparisons with reference to type of ownership. Complaints are one proxy measure of performance in the nursing home setting. The goal of the study is to determine whether there is an association between facility ownership and the frequency of nursing home complaints.

Methods: Publicly available data on complaints, regulatory measures, facility ownership and size for 604 facilities in Ontario over 1 year (2007/08) and 62 facilities in British Columbia (Fraser Health region) over 4 years (2004–2008) was analyzed. All analyses were carried out at the facility level.

Interpretation: Compared with for-profit chain facilities, non-profit, charitable and public facilities had significantly lower rates of complaints in Ontario. Likewise, in British Columbia’s Fraser Health region, non-profit owned facilities had significantly lower rates of complaints compared with for-profit owned facilities."

Click here to read the full article

By Us For Us

2011-12-19T15:27:00.002-06:00

The By Us For Us© Guides from the Murray Alzheimer Research and Education Program, University of Waterloo website, are a series of guides researched, designed and created by a group of persons with dementia and/or their partners in care. The guides are designed to equip persons with dementia with the necessary tools to enhance their well being and manage daily challenges.

The series consists of three types of guides:
· For Persons with Dementia
· Written by persons with dementia and family partners (Partnership)
· For Family Partners (Partners in Care)

Two new guides are now available:
· Living and Celebrating Life Through Leisure (Person with Dementia)
· Before/Early Diagnosis: (Partners in Care)

Other By Us For US© guides include:
· Living and Transforming with Grief and Loss (Partnership)
· Memory Workout (Persons with Dementia)
· Managing Triggers (Persons with Dementia)
· Enhancing Communication (Persons with Dementia)
· Enhancing Wellness (Persons with Dementia

The series is available in PDF format or may be ordered from the Murray Alzheimer Research and Education Program, University of Waterloo: http://marep.uwaterloo.ca/products/MAREP-OrderForm-AllTools-ChequePymt.pdf

http://marep.uwaterloo.ca/products/bufu.html

Recommended Treatment Strategies for Clinicians Managing Older Patients with HIV

2011-12-19T15:22:00.005-06:00

As a result of effective ARV (Antiretroviral ) treatments , the Centers for Disease Control (CDC) predicts that by mid-decade nearly half of the expected 1.5 million Americans living with HIV will be 50 or older. The interaction of aging and HIV contributes to injury to multiple organs resulting into the transformation of HIV infection into a complex chronic disease. Over the last few years several organizations, including the Academy of HIV Medicine, the American Geriatrics Society, and the AIDS Community Research Initiative have collaborated to address the clinical management of older persons with AIDS

Produced by the HIV and Aging Consensus Project, this document consists of strategies formulated beginning in 2009 from clinicians caring for older HIV infected persons, and recognizes that in this rapidly evolving field new evidence may bolster or refute treatment strategies described.

http://www.aahivm.org/hivandagingforum

Supporting People with Intellectual Disabilities Who Challenge or are Ageing: A Rapid Review of the Evidence

2011-12-19T15:20:00.005-06:00

A significant care need for service commissioners and providers of services for people with intellectual disabilities (ID) is presented by people with behaviours that challenge and/or have mental health problems, and ageing people with an ID. In addition family caregivers of both these populations can face many obstacles in their caring roles if adequate supports are not in place to help them.

This rapid review was undertaken using a framework adapted from the NHS Centre for Reviews and Dissemination (CRD, 2009) and the Rapid Review Methodology (NHS, Wales 2006).

The aims of the review are as follows.

Aims and review questions – behaviours that challenge
In relation to people who challenge the aim was to search for, evaluate and prioritise studies or other robust literature that have focussed on the following main review question.
What services and support do people with ID who display behaviours that challenge and their caregivers require to meet their needs?

Citation: Slevin, E. Taggart, L. McConkey, R. Cousins, W. Truesdale-Kennedy, M. Dowling, L. (2011) A rapid review of literature relating to support for people with intellectual disabilities and their family carers when the person has: behaviours that challenge and/or mental health problems; or they are advancing in age, Belfast, Northern Ireland: University of Ulster.

http://www.publichealth.hscni.net/sites/default/files/Intellectual%20Disability.pdf

Many Degrees of Policy Freedom: The Federal Government’s Role in Care for Seniors

2011-11-29T09:25:00.001-06:00

Published in November, 2011 as part of the Institute for Research on Public Policy, IRPP Study Series this study by Harvey Lazar explore the imblance between the demand and supply of care for seniors.

He argues that although researchers have been warning of the aging of Canada’s population for decades, governments do not yet have an overarching policy strategy to deal with the profound, long-term socio-economic implications of this demographic shift, or its more immediate impact. He examines how the imbalance will grow and the need to re-evaluate the federal government’s policy role.

http://www.irpp.org/pubs/IRPPstudy/IRPP_Study_no24.pdf

Osteoporosis Long Term Care Website

2011-11-21T13:51:00.001-06:00

This site was created as part of the Ontario Osteoporosis Strategy in collaboration with Osteoporosis Canada and other partners to provide meaningful and useful information as well as the latest research and best care practices to improve the bone health of older adults.

The site will share the stories of care providers, people and places who work to improve the bone health of older adults in long-term care homes and their communities.
http://osteoporosislongtermcare.ca/

Canadian Geriatrics Journal Online

2011-11-16T09:10:00.001-06:00

Volume 14 of the Canadian Geriatrics Journal is now available online.

Published four times a year, The Canadian Geriatrics Journal (CGJ) is a peer-reviewed publication focused on innovative aging research aimed at improving the health and the care provided to older persons residing in Canada and abroad. While submissions from researchers outside Canada are welcome, they are committed to encouraging aging research by Canadians. The CGJ is targeted to family physicians with training or an interest in the care of older persons, specialists in geriatric medicine, geriatric psychiatrists, and members of other health disciplines with a focus on gerontology.

The CSJ has also chosen to implement the Creative Commons Attribution Non-Commercial No-Derivative license (http://creativecommons.org/licenses/by-nc-nd/2.5/ca/), which permits unrestricted non-commercial use and distribution, provided the original work is properly cited.

Articles published under this Open Access model are made freely available online immediately upon publication, as part of a long-term archive, without subscription access restrictions. CGJ readers are entitled to use, reproduce, distribute or display these articles provided that:

the original authorship is properly and fully attributed;
the journal and publisher (Canadian Geriatrics Society) are attributed as the original place of publication with the correct citation details provided;
no articles are reproduced for commercial use without the prior consent of the Canadian Geriatrics Society and payment of the appropriate fee

Mental Health Commission of Canada Guidelines for Comprehensive Mental Health Services for Older Adults in Canada

2011-11-16T08:43:00.001-06:00

On October 12, 2011, the Mental Health Commission of Canada (MHCC) released the Guidelines for Comprehensive Mental Health Services for Older Adults in Canada.

Coauthored with the Canadian Coalition for Senior's Mental Health, and developed with input from seniors, families, service planners, and service providers from across the country, the Guidelines were designed to support individuals and groups working to ensure that the diverse mental health needs of Canadian seniors are met in the coming decades.

The full document has been organized into three sections, including evidence-based recommendations highlighted in grey boxes:

Part I: Framing the Context – Key Factors to Consider in Planning a Comprehensive Integrated Mental Health System for Seniors sets the context and explores the key factors that should be considered when planning a mental health service system for older adults, including guiding values and principles that underpin the recommendations and content of this document.

Part II: An Integrated Model for Mental Health Services in Late Life focuses on the services required to support adults in later life, including models for mental health services in later life and descriptions of the functions of each resource, and staffing benchmarks for specialized seniors’ mental health services.

Part III: Facilitators of a Comprehensive Mental Health Service System discusses the mechanisms that facilitate a comprehensive mental health service system, including recommendations about cultural safety, diversity, the role of caregivers and service delivery models.

The Guideline webpage includes the Guidelines in PDF format as well as an interactive version.
http://www.mentalhealthcommission.ca/English/Pages/MHCC_Seniors_Guidelines.aspx

Older Women's Health Report

2011-11-09T10:58:00.001-06:00

On October 27, 2011, the POWER Study (Project for an Ontario Women's Health Evidence-Based Report), released the “Older Women’s Health Report”. The “Older Women’s Health Report” was created from the results of the larger study, published in two volumes, which will serve as an evidence-based tool for policy makers, providers, and consumers in their efforts to improve health and reduce health inequities among Ontario women. The study reports on the overall health of women and men in Ontario, their access to health care services, and how these are related to the social determinants of health and the leading causes of illness and death.

The following findings are discussed in more detail in the “Older Women’s Health Report”:
· Women are disproportionately represented in the older population, particularly among those who reside in long-term care and have unique needs.
· Older women were more likely than men to report disability and chronic pain.
· Much of the observed disability among older adults is due to chronic conditions.
· There were high rates of potentially avoidable hospital admissions for common chronic conditions (heart failure, COPD, diabetes) among older women and men. These rates increased with age and were highest among those aged 80 and older.
· Among those receiving home care, there are opportunities to improve care for both women and men.
· Among residents of long-term care, there were few gender differences on reported quality indicators after risk-adjustment.
· We need to prepare the diverse health care workforce to meet the needs of the aging population

Both the full “Older Women’s Report” and the Highlights document can be downloaded from: http://www.powerstudy.ca/the-power-report/the-power-report-volume-2/older-womens-health-report

Citation for the report: Rochon PA, Bronskill SE, Gruneir A, Liu B, Johns A, Lo AT, Bierman AS. Older Women's Health In: Bierman AS, editor. Project for an Ontario Women's Health Evidence-Based Report: Toronto; 2011.

Alzheimer's Disease Family Caregiver Study Fact Sheet

2011-11-09T09:43:00.000-06:00

This new survey released by the National Family Caregivers Association (NFCA) and Forest Laboratories, Inc. reveals what family caregivers fear most: first, their loved one's general health and physical decline, and second, the fear that Alzheimer's will take away their loved one's ability to communicate. Communication decline with their loved ones is not just a fear but a major source of stress, and also interferes with their ability to fulfill responsibilities/obligations as a caregiver.

Despite the stress associated with communicating, most caregivers surveyed adopted new ways to communicate with the person they care for (71 percent) and feel they have become better communicators themselves (76 percent). The most common alternative methods include observing facial expressions (84 percent) and body language (79 percent) and using pictures/photos (66 percent).

It is estimated that 5.4 million Americans have Alzheimer's disease and are being cared for by nearly 15 million unpaid caregivers -- including family, friends, partners and neighbors. Often the equivalent of a full-time job, 80 percent of at-home care for people with Alzheimer's or another dementia is provided by family caregivers.

Fact Sheet Download (286K PDF)
Tips to Communicate with Loved One (247K PDF)

World Alzheimer Report: The Benefits of Early Diagnosis and Intervention

2011-11-02T13:14:00.001-05:00

This is the third of the Alzheimer's Disease International's World's Alzheimer Report. Alzheimer's Disease International works for an improved quality of life for people with dementia and their carers around the world, and believes that policy and practice should be based on the best available evidence.

This year’s World Alzheimer Report 2011 provides the findings of an independent research group which collated and reviewed all of the available evidence relating to early diagnosis and early intervention.

Key questions include:

Is it possible to promote earlier diagnosis of dementia, and how might this be achieved?
What are the overall benefits or disadvantages of earlier diagnosis and intervention for
people with dementia and their carers?
What treatments or interventions are effective in the early stages of dementia?
Is there evidence that some interventions are more effective when applied early in the
disease course?
Can earlier diagnosis and intervention reduce health and social care costs?

The insights provided here will be of interest to policymakers and planners and give additional stimulus to existing national programs while encouraging other countries to give much more attention to closing the treatment gap.

Financial Implications of the Green House Model

2011-11-02T11:19:00.000-05:00

Published in Seniors Housing and Care Journal, 2011, V. 19(1), this article by Robert Jenkens, MSRED; Terri Sult, MBA; Newell Lessell, MBA; David Hammer, MS; Anna Ortigara, RN, MS, FAAN examines the initial and long-term financial viability of THE GREEN HOUSE® model. Developed by Dr. William Thomas and rooted in the tradition of the Eden Alternative, The GREEN HOUSE®model is intended to de-institutionalize long-term care by eliminating large nursing facilities and creating habilitative, social settings. Existing research establishes that the GREEN HOUSE® model nursing home care provides significant and sustained satisfaction and clinical improvements when compared to traditional nursing homes. Recent research on the financial implications of the Model, although inconclusive, have pointed to some mutually reinforcing findings to recommend the model as a strong option for organizations to explore as they seek to address current and future challenges in their nursing home operations and markets.
http://thegreenhouseproject.org/wp-content/uploads/2011/09/NIC_2011_SHCJ_GreenHouseArticle.pdf

To learn more about the GREEN HOUSE® model, check out the web site at: http://thegreenhouseproject.org

Population Aging and the Evolving Care Needs of Older Canadians An Overview of the Policy Challenges

2011-10-31T09:12:00.001-05:00

IRPP Study, no. 21, October 2011

As the first members of Canada’s baby boom generation turn 65, the official age of retirement, this study by gerontologist Neena Chappell provides a timely overview of the main health and social policy challenges presented by population aging in three areas: informal care, formal care, and prevention.

There is much argument and debate among experts as to whether Canada’s existing public programs will be sustainable with the increases in the number of seniors and their higher than average use of health and social services.

Chappell first looks at the evolving care needs, and shows that in the coming years, more seniors will depend on fewer individuals to provide the care they need.

Developing policies that support the needs of informal caregivers is important. In addition, there is a need for formal long-term home care as lower fertility rates, increasing rates of divorce, remarriage and blended families may affect the provision of care by family members. The assumption that medical care is the most appropriate means to ensure the health of an aging population needs to be re-examined.

This paper was published by the IRPP. Founded in 1972, the Institute for research on Public Policy is an independent, national, bilingual, nonprofit organization. The IRPP seeks to improve public policy in Canada by generating research, providing insight and sparking debate on current and emerging policy issues facing Canadians and their governments.

http://www.irpp.org/pubs/IRPPstudy/IRPP_Study_no21.pdf

Market Survey of Long-Term Care Costs The 2011 MetLife Market Survey of Nursing Home, Assisted Living, Adult Day Services, and Home Care Costs October 2011

2011-10-27T13:29:00.000-05:00

In 2002, the MetLife Mature Market Institute pioneered the collection of national market survey data on nursing home, assisted living, and home care costs. Since then, these market survey data have been updated and released on an annual basis. In 2007, cost information on adult day services (ADS) was included for the first time.

This market survey, conducted in conjunction with LifePlans, Inc., contains daily private-pay rates for private and semi-private rooms in licensed nursing homes, monthly base rates for assisted living communities, hourly rates for home health aides from licensed agencies and agency-provided homemaker companion services, and daily rates for adult day services across the United States. Geographic areas reported are for state Metropolitan Statistical Areas (MSA), and a randomly selected sample of service providers or facilities not already identified in the MSAs (“Rest of State” areas). Costs for this survey were calculated for each service provider in an area and were aggregated across all providers to compute a statewide average cost

http://www.metlife.com/assets/cao/mmi/publications/studies/2011/mmi-market-survey-nursing-home-assisted-living-adult-day-services-costs.pdf

The Baby Boomers: A profile of Manitoba’s new generation of seniors

2011-10-19T20:42:00.000-05:00

From the University of Manitoba Centre on Aging Summer 2011 newsletter:

Much discussion has arisen around the bulge in the current population referred to as the “baby boomers.” Baby boomers are those individuals born between 1946 and 1964; 2011 marks the year that the first of the baby boomers turn 65 years of age.

Questions of social concern have naturally arisen, such as how to deal with the financial strain of burgeoning healthcare needs and how best to anticipate changes in the job-market as a large portion of the population consider retirement.

This report has been compiled to help create a picture of the baby-boomers today and by doing so, better understand what they, as a group, may be like in years to come.

The report focuses on Manitobans between the ages of 45 and 64. In some sections, comparisons are made between those 45 to 54 years of age and those 55 to 64 years of age and in a few cases those aged 65 and over. The 2010 Profile of Manitoba’s Seniors provides detailed information on individuals in Manitoba aged 65 and over.

Download the report from www.umanitoba.ca/centres/aging

Not a one way street: Research into older people's experiences of support based on mutuality and reciprocity

2011-10-19T15:02:00.000-05:00

This paper explores alternative approaches and key messages from the first two stages of an action research project - Not A One Way Street - set up through the UK Better Life Programme at the Joseph Rowntree Foundation (http://www.jrf.org.uk/work/workarea/better-life).

Not A One Way Street is a collaborative research project designed to identify, examine and better understand the various ways in which older people with high support needs take up active roles within different arrangements based on ‘mutuality and reciprocity’ and is one of several projects exploring alternative approaches to planning, funding and providing long term care for older people with these needs.

The research is being undertaken by the National Development Team for Inclusion (NDTi) and Community Catalysts. These organizations share a concern that older people with high support needs are too often seen as a burden and a drain on resources rather than as individuals with gifts, skills, assets and contributions.

These initial findings will be of interest to those involved in commissioning and providing services and support (across all public services and sectors); policy makers and implementers who are developing plans and services that directly impact on older people.

http://www.jrf.org.uk/sites/files/jrf/supporting-older-people-full_0.pdf

Go4Life

2011-10-19T15:00:00.000-05:00

from NIA NEWS, October 19, 2011

Being physically active is vital to maintaining health and independence as we age, and a new federal campaign for people 50 and older will help them to get active and keep going. Introduced today by the National Institutes of Health (NIH), the Go4Life campaign encourages sedentary older adults to reap health benefits by making physical activity part of their daily lives. Only 25 percent of people aged 65-74 say they engage in regular physical activity.

Go4Life’s participating organizations will incorporate campaign resources into their own health and wellness activities, disseminating Go4Life web links and materials to their members, employees, and customers. Many partners will directly sponsor events or community activities aimed at engaging older adults in exercise and physical activity as the campaign moves forward.

The campaign was conceived, and is being led, by the National Institute on Aging (NIA), the component of NIH devoted to research on aging. The NIA will work with the Go4Life community on events and will highlight participating organizations and their activities on the campaign website.

The research-based resources of Go4Life center on a colorful, interactive website (www.nia.nih.gov/Go4Life) providing information and motivation for exercise for individuals, families and friends, organizations, and health care professionals. The site features specific exercises, success stories, and free materials to motivate growing numbers of older people to start exercising and keep going. It even offers online virtual coaches to help motivate Go4Life participants. Many Go4Life materials are available in Spanish at http://go4life.niapublications.org/resources/spanish#espanol.

To develop Go4Life, NIA brought together some of the nation’s leading experts on aging, exercise, and motivation. Over two years, the task force reviewed the research and worked with the institute to develop a book, “Exercise & Physical Activity: Your Everyday Guide from the National Institute on Aging.” The campaign is based on the book.

For further information on the public and private support of the Go4Life initiative, please visit www.nia.nih.gov/Go4Life.

Adult Abuse and Neglect Prevention Training

2011-09-29T14:57:00.000-05:00

The 12-module curriculum — developed collaboratively by PHI, BEAM (Bringing Eden Alternative to Michigan), and Michigan State University -– is available as a free download at the PHI Training and Organizational Development Services website.

Each module is 60 minutes, and focuses on developing skills to prevent abuse and neglect, as well as other communications and relational skills. These modules:

Use adult learner-centered approaches that actively engage participants in learning;
Are easy to use by educators for in-services in a wide variety of long-term care settings; and
Can be used as stand-alone training, though they are ideally taught consecutively to effectively address abuse and neglect.

Before you start: How to Use Training Materials (pdf 270KB)

Module 1: Person-Centered Care

Provides an overview of the principles of person-centered care as a foundation for abuse prevention and quality care for clients.
Module 1: Person-Centered Care (zip 1.31MB)

Module 2: Identifying Potential Signs of Abuse & Neglect
Focuses on the identification of abuse and neglect by exploring the physical signs, emotional responses, and verbal comments an abused person might display.
Module 2: Identifying Potential Signs of Abuse & Neglect (zip 1.45MB)

Module 3: Abuse & Neglect – Defining & Reporting
Discusses the importance of reporting suspected abuse, neglect, or misappropriation, and the appropriate steps for filing a report. Participants develop a working definition of abuse and neglect beyond the legal definition with the goal of early detection of abusive situations.
Module 3: Abuse and Neglect – Defining & Reporting (zip 907KB)

Module 4: Stress Triggers & Trigger Busters – Life Influences
Identifying the everyday stressors of life that, if not managed appropriately, can lead a caregiver to abuse or neglect. Participants learn healthy, simple ways for self care, which ultimately improve the quality of care for the adult clients.
Module 4: Stress Triggers & Trigger Busters – Life Influences (zip 1.03MB)

Module 5: Stress Triggers & Trigger Busters – Job Challenges
Provides a forum for identifying work-related stressors that can lead a caregiver to abuse or neglect. Participants brainstorm productive means for individuals to counteract these stressors in healthy ways and create a better work environment.
Module 5: Stress Triggers & Trigger Busters – Job Challenges (zip 726KB)

Module 6: Stress Triggers & Trigger Busters – Client Behaviors

Explores challenging client behaviors and the impact these behaviors have on caregiver stress. A key component of this module is the identification of potential reasons for client behaviors and the role of caregivers in creating a person-centered environment.
Module 6: Stress Triggers & Trigger Busters – Client Behaviors (zip 1.03MB)

Module 7: Stress Trigger Signals

Identifies the physical, mental, and social stress trigger signals that occur when a person is nearing a trigger point: the point at which abuse and neglect may occur. Participants learn their individual trigger signals as well as healthy means to reduce the impact of these stressors.
Module 7: Stress Trigger Signals (zip 1.37MB)

Module 8: Active Listening
Introduces the skill of active listening as a means of promoting person-centered care, creating an abuse-free environment, and developing quality care and relationships for the clients and DAS. During this interactive session, participants learn basic listening skills that benefit both home and work environments.
Module 8: Active Listening (zip 727KB)

Module 9: De-escalation – Conflict Resolution
Empowers DAS with practical means of identifying the factors often contributing to conflict as well as four simple steps to effectively resolve conflicts with co-workers or competent clients.
Module 9: De-escalation – Conflict Resolution (zip 1.33MB)

Module 10: De-escalation – Client Behaviors
Provides the DAS with an understanding of how clients with cognitive loss communicate. The module also includes effective communication strategies and practical steps to de-escalate a client with cognitive loss during a time of distress or agitation.
Module 10: De-escalation – Client Behaviors (zip 820KB)

Module 11: When Abuse Happens
Addresses the responsibilities of direct access staff when abuse does occur. By incorporating information provided in previous modules such as identifying and reporting abuse, person-centered care, and active listening, participants walk through the step-by-step process of identifying an abusive situation, responding to the client, and reporting the incident.
Module 11: When Abuse Happens (zip 879KB)

Module 12: Active Communication – Learning Circle
Identifies the benefits of incorporating learning circles (a practical group communication method) into the fabric of any organization as a means of promoting healthy relationships and problem solving.
Module 12: Active Communication – Learning Circle (zip 877KB)

Sharing Best Practices: Transition Management in Ontario Home First Implementation Guide & Toolkit

2011-09-28T14:48:00.001-05:00

Home First is an evidence-based, person-centred, transition management philosophy focused on keeping patients – specifically high needs seniors - safe in their homes for as long as possible with community supports. If/when acute hospital care is required, Home First aims to support patients to return home on discharge prior to assessment for and/or admission to a Long Term Care (LTC) home or other appropriate care setting. Under Home First, transferring patients from hospital to a LTC home is considered only after all other community options are considered.

Home First was first introduced in Ontario by the Mississauga Halton (MH) Local Health Integration Network in 2008 to address significant patient flow issues within hospitals that were resulting in increased numbers of individuals designated as ALC (alternate level of care).

Because of the variation of practices across the province and the early stages of implementation that many of the LHINs are at, the benefit of developing this Implementation Guide & Toolkit (herein referred to as the guide) as a “how-to” manual for LHINs was identified.

The purpose and focus of this guide is on the transition management of patients from institutional care to the home setting. It is meant to act as a manual for the LHINs in implementing Home First and reflects the diversity of approaches across all LHINs. Given the unique local circumstances within each LHIN, this guide does not endorse or recommend one specific model or approach to Home First; rather, LHINs have the ability to adopt the tools described in this guide at their discretion. Specifically, the purpose of this guide is to:

• Promote a provincial philosophy of Home First
• Be a resource guide for LHINs to implement Home First
• Outline common risks and challenges associated with Home First and strategies to address them
• Provide a set of provincial performance metrics to be used across all LHINs to measure the progress and success of Home First
• Provide a set of tools and templates for LHINs to use in rolling out Home First

http://tinyurl.com/6datbdl

A Guide to Promoting Emotional Health and Preventing Suicide in Senior Living Communities

2011-09-12T14:26:00.004-05:00

A Guide to Promoting Emotional Health and Preventing Suicide in Senior Living Communities is written for administrators and managers of departments of nursing, social work, pastoral care, wellness, and staff development in senior living communities.

Senior living communities include nursing homes, assisted living facilities, independent living facilities, and continuing care retirement communities. Too often, staff in senior living communities do not think about suicide prevention until a suicide attempt or death occurs.

This Guide will help you be proactive by implementing policies, protocols, programs, and activities that will improve all residents’ quality of life, while also helping protect vulnerable members of the community from suicide and related emotional health problems.

The Guide contains the following components:

Getting Started: Includes background information on suicide and suicide prevention, directions for using the Guide, a Sample Policy, and a Facility Assessment Checklist
Goals and Action Steps: Includes sections addressing each of the three essential approaches to suicide prevention in a senior living community:
Section 1. Whole Population Approach: Discusses strategies to promote the emotional health of all residents, regardless of their risk for suicide
Section 2. At-Risk Approach: Discusses how to identify and assist residents who are at a particularly high risk for suicide and related emotional health problems
Section 3. Crisis Response Approach: Focuses on what senior living communities should do after suicide deaths and attempts
Each section has background information, goals relevant to the approach, and action steps your staff can take to meet those goals.
Tools for Implementing Action Steps: Includes worksheets, fact sheets, and program descriptions to help you create and implement the policies, protocols, programs, and activities discussed in the Goals and Action Steps component of the Guide
References

Women and Dementia: Not forgotten

2011-09-12T09:13:00.000-05:00

This report from the International Longevity Center UK aims to bring together the current evidence on dementia and women, identifying key issues and highlighting areas which merit further public policy, medical or clinical research or intervention.

The report is presented in the form of an evidence review, composed from a
literature review of a range of quantitative and qualitative data including: academic, clinical and
research papers and grey literature.

By approaching dementia through the prism of sex and gender, the report attempts to
understand the complexities of the interaction between biology and socially constructed roles.

http://www.ilcuk.org.uk/files/pdf_pdf_191.pdf

Young People in Nursing Homes

2011-09-01T09:09:00.001-05:00

Published by Monash University in August, 2011, the objective of this white paper is to summarize the research and policy context related to the issue of young people in nursing homes in Australia.

This discussion paper aims to:
• summarize research regarding the social inclusion of young people in nursing homes
• provide background on the policy and practical challenges regarding young people in
nursing homes

http://www.summerfoundation.org.au/attachments/151_White%20Paper%20Young%20People%20in%20Nursing%20Homes-lo.pdf

Older People in Care Homes: Sex, sexuality and intimate relationships

2011-09-01T09:03:00.001-05:00

Published in August, 2011 from the Royal College of Nursing (UK), this guidance has been developed to help nurses and care staff work effectively with issues of sexuality, intimate relationships and sex, particularly for older people living in care homes.

Its goal is to facilitate learning, support best practice, and serve as a resource to help nurses and care staff address the needs of older service users in a professional, sensitive, legal and practical way.

Alongside raising awareness of issues which can impact on the sexuality, intimate relationships and sexual
activity of older care home residents, the document contains:

legal and professional frameworks within which nursing and caring practice takes place
considerations for policies that address sexuality and sexual health needs in care homes
guidance on principles of good practice, including care environments, organisational systems and care
practices
ideas on how to identify barriers to expression of sexuality and work towards removing these in
practice
suggestions on how to broach issues concerning sexuality, intimate relationships and sex
guidance on dealing with situations where sexuality is seen as a problem
suggestions on how staff can develop their own confidence and competence in dealing with
sexuality issuescase examples,which can be used to highlight issues for discussion.

http://www.rcn.org.uk/__data/assets/pdf_file/0011/399323/004136.pdf

Senior Women

2011-08-03T10:39:00.001-05:00

Senior Women is a chapter in Statistics Canada, Women in Canada: A gender based statistical report, 2011. The chapter provides an overview of senior women in the population, analysed in a historical context where appropriate. It examines their socio-demographic characteristics, including life expectancy, diversity, family and living arrangements, health and well-being, labour force participation and income. The chapter is also available in PDF.

http://www.statcan.gc.ca/pub/89-503-x/2010001/article/11441-eng.htm

The last taboo: a guide to dementia, sexuality, intimacy and sexual behaviour in care homes

2011-07-29T08:33:00.001-05:00

From the International Longevity Centre UK, this new guide, provides care home workers and managers with information and practical advice about the complex, controversial and sensitive issue of sexuality and intimacy in care homes.

The guide not only provides essential information on this aspect of dementia
care but offers practical advice to support current work-based
practices. Set out in an accessible and easy-to-read format, this
guide includes case studies, questions, suggestions and a self assessment
quiz to promote easy learning. It also provides a possible pathway for care home managers to develop a guiding policy on sexual expression in dementia.

To download a full copy of the guide go to: http://www.ilcuk.org.uk/record.jsp?type=publication&ID=95

Dementia Commissioning Pack

2011-07-21T09:03:00.000-05:00

A new resource to support clinical commissioning groups in designing and purchasing high quality dementia services was launched today by Department of Health (Great Britain) Care Services Minister Paul Burstow.

The dementia commissioning pack provides a set of tools and templates for health and local authority commissioners, helping them to design services that are suited to local needs and are cost effective.

It supports planning across the whole spectrum of dementia, from early diagnosis to end of life care, together with guidance on how to reduce the inappropriate use of antipsychotic medication.
The pack was developed in consultation with a range of health and social care experts, including people with dementia and their carers. It aims to:

Improve quality of services for people with dementia by placing patient outcomes and patient choice at the heart of the commissioning process
Drive efficiency by reducing unwarranted variation in services
Reduce bureaucracy for commissioners by providing tailored documents and templates, bringing together the different aspects of commissioning (clinical, financial, commercial, contractual and procurement)

Initiatives on Health Aging in Canada

2011-07-15T13:17:00.003-05:00

The purpose of this report from the Canadian Agency for Drugs and Technology in Health is to provide a general overview of regional health authority and other local level frameworks, initiatives, programs, and/or strategies developed to support healthy aging. The focus of this report is on strategies related to social connected-ness, physical activity, healthy eating, falls prevention, and tobacco control specifically tailored to the senior population.

http://www.cadth.ca/media/pdf/Initiatives_on_Healthy_Aging_in_Canada_es-17_e.pdf

Cultural Diversity and Hospice Care

2011-07-15T09:41:00.003-05:00

Hospice Foundation of America has developed "Addressing Cultural Diversity in Hospice Care," a free online webinar that looks at how, and why, different cultures may, or may not, utilize hospice. This tutorial aims to prepare and equip hospice organizations, and its providers and volunteers, with strategies and information to meet the needs of culturally diverse patients and loved ones.

HFA's new program, plus additional resources and Fact Sheets, is available at no charge. Free Continuing Education credits are available for a wide range of professionals. This program is part of HFA's Hospice Information Center, an extensive online library that also includes programs such as Understanding Hospice, Family Caregiving, and Coping with Cancer at the End of Life. The programming provides hospices and other community organizations the opportunity to educate staff and volunteers about the basics of hospice care, caregiving, and grief, and links are provided to guide viewers to more information on a variety of subjects. Other resources are available for consumers, to help family and friends learn about hospice and how it can help people cope with some of life's most challenging situations, in a format that is accessible and understandable. Resources are also available in Spanish and Chinese.
from Hospice and Caregiving Blog by Krista Renenger.

Adaptive Equipment to Prevent Falls in Older Adults

2011-07-04T09:04:00.001-05:00

Each month, E‐NEWS from the University of Iowa Geriatric Education Center delivers abstracts from current multidisciplinary healthcare journal articles related to a specific geriatric topic.

This month’s E‐NEWS focuses on Adaptive Equipment to Prevent Falls in Older Adults.
http://www.healthcare.uiowa.edu/igec/publications/e-news/assets/E-News_07_2011.pdf

A Total Indifference to Our Dignity: Older People's Understanding of Elder Abuse

2011-06-29T08:56:00.001-05:00

Funded by the Centre for Ageing Research and Development in Ireland and published by Age Action Ireland, the aim of this research was to shed light on how older people understand elder abuse. It also sought to identify what older adults consider to be the main threats to their personal safety and well-being in their communities and what services and supports they think are useful to address cases of abuse

The design of the study was participatory, qualitative, multi-disciplinary and had a cross-border dimension. The reason for taking this approach was that by its nature elder abuse dis-empowers older people, it was therefore important that the research methodology supported empowerment. Hence older people were involved at both ends of the continuum, as research informants (through focus group participation) and as peer-researchers. Following training in research methods, specifically in facilitating focus groups and data analysis, four lay people aged 60 years and over became part of the research team as ‘peer-researchers’.

Findings show that the current definitions of elder abuse, which centre on the actions or inactions of a person or persons where there is an expectation of trust, ignore wider societal issues like the withdrawal of respect and recognition. This serves to place older people in vulnerable positions. Standard typologies of abuse were recognised by participants, although sexual abuse was not commonly mentioned except when prompted. However, what also emerged was a new concept of ‘personhood abuse’. This refers to societal attitudes; how these affect a person’s confidence, autonomy and agency resulting in an inability to say no or to stand up for oneself against abusive acts, words and pressures possibly from fear of negative repercussions such as withdrawal of contact and/or care.

Many ways were identified to support older people and reduce the opportunity for abusive actions to occur. They centred on community-based and peer supports through ‘having someone to talk to’ and being aware of their rights. Continued involvement in community based activity which keeps people active and participating in society, such as community transport and clubs, supported people’s access to amenities and opportunities for engagement and were identified as ways to prevent abuse from happening. Enhanced status, resources and support therefore need to be given to these types of community activities to prevent abuse occurring in the first place. These types of supports can enable older people to share their concerns in an everyday setting and to gain informal support and confidence; seeking more formal interventions when necessary.

http://www.cardi.ie/userfiles/A%20Total%20Indifference%20to%20our%20Dignity%20-%20Older%20People%27s%20Undersantandings%20of%20Elder%20abuse%20%28June%202011%29.pdf

New PHI Publication Series Documents Innovations That Improve Quality of Care and Jobs

2011-06-29T08:49:00.000-05:00

From the PHI Blog:

Long-term care providers across the nation are investing in their direct-care workers as part of their efforts to improve the quality of care and quality of life for elders and people with disabilities. Their innovative approaches to transforming their industry are showcased in a new PHI series of case studies and best practices.

The series offers concrete examples of how long-term care employers — nursing homes, home care organizations, and residential long-term care facilities — are achieving their visions of relationship-centered care, in which consumers and the caregivers closest to them have greater control over everyday decision making.

Case Studies

The Business of Caregiving, a series of eight in-depth case studies, focuses on overarching management philosophies that have led to better-quality jobs for direct-care workers and better-quality care for consumers.

Among the practices highlighted are The PHI Coaching Approach^SM, which builds communication and problem-solving skills and provides a strong foundation for relationship-centered caregiving; accessible and affordable education and career advancement opportunities; peer mentor programs; and participatory management styles, including self-managed teams.

Several of the nursing facilities featured report that investing in frontline staff is essential to their efforts to implement changes such as consistent assignment, self-managed households, and individualized care.
Several of the case studies, which are available online, also include a multimedia component, such as podcasts, photo slideshows, video clips, and downloadable charts.

Best Practices

The series’ 20 “best practice” profiles highlight specific approaches to reducing turnover, promoting job satisfaction, and implementing relationship-centered care. These profiles are intended to offer enough detail to encourage other long-term care providers to adapt the practices within their own organizations.
Each of the best practices provides details on:

Practice implementation
Outcomes of the new initiatives
Lessons learned — both challenges and successes
Background on the organization and contact information to learn more

Sectoral Workforce Development

PHI was funded by the Hitachi Foundation because of its industry role as a sectoral workforce development organization. PHI is the only national organization focused solely on improving jobs for direct-care workers as a strategy for strengthening long-term care businesses and improving care for elders and people with disabilities.
PHI’s sectoral strategy is described in a new paper, entitled “Improving Jobs and Care: a National Sector Strategy.” Authored by PHI President Steven Dawson, the paper provides workforce development practitioners with a deeper understanding of how PHI has succeeded in influencing the fields of long-term care and workforce development — and the challenges and opportunities going forward.
The paper was presented in late May at the “Building Ladders and Raising the Floor Conference,” sponsored by PHI and Jobs for the Future in Washington, DC.

* * *

PHI (www.PHInational.org) is a national organization that works to improve the lives of people who need home or residential care — and of the direct-care workers who provide that care. PHI’s work is grounded in the philosophy that quality jobs for direct-care workers will lead to quality care for long-term care consumers.

Safe Practices in Patient Care

2011-06-29T08:46:00.001-05:00

Safe Practices in Patient Care is a serial publication dedicated to helping nurses caring for the critically and chronically ill to minimize medical errors by presenting clinically and evidenced-based safe practices. Safe Practices is also an accredited home-study program and is underwritten by an educational grant from Covidien Nursing Care.

Past issues include:

Enteral Nutrition and Hydration in Long-term Care
by Peggi Guenter, PhD, RN, CNSN

Safe Practices in Long-term Wound Care
By Catherine T. Milne, APRN, MSN, BC, CWOCN

Aspiration Pneumonia due to Enteral Tube Feeding.
by Carol McGinnis RN, MS, CNSN

Early Enteral Nutrition Following Cardiovascular Surgery.

New: Overcoming Challeges to CAUTI Prevention Online Program.

A Guide to the Management of Psychotic Disorders and Neuropsychiatric Symptoms of Dementia in Older Adults

2011-06-28T09:19:00.001-05:00

This guide has been developed to assist healthcare providers in managing psychotic symptoms and disorders in older adults. It is based on two publications of the American Geriatrics Society (AGS) (www.americangeriatrics.org), and the 2010 edition of The Geriatrics Review Syllabus and the 2011 edition of Geriatrics At Your Fingertips.

A web-based version is available here: http://dementia.americangeriatrics.org/GeriPsych_index.php

AGS Discussion Boards on Facebook

2011-06-28T09:09:00.000-05:00

The American Geriatrics Society’s Facebook page now includes a section where members and non-members alike can post discussion topics and comment on issues related to geriatric care.

Go to facebook.com/AmericanGeriatricsSociety to find the new Discussions section in the left hand tool bar.

Optimising treatment and care for people for people with behavioural and psychological symptoms of dementia

2011-06-10T15:19:00.000-05:00

This best practice guide has been designed to support health and social care professionals to determine the best treatment and care for people experiencing behavioural and psychological symptoms of dementia (BPSD). behavioural and psychological symptoms of dementia

Alzheimer's Society has worked with the Department of Health to develop a best practice guide for health and social care professionals. The guide provides information, advice and resources for treatment and person-centred care for people with dementia.

To help us to make this resource as useful and effective as possible the best practice guide is now available as a consultation document. All health and social care professionals are invited to provide feedback through their online form before Monday 3 July 2011.

The final version will be released later in 2011.

Common Core Principles for Supporting People with Dementia: A guide to training the social care and health workforce

2011-06-09T15:08:00.003-05:00

This guide, commissioned by the UK Department of Health as part of the implementation of the National Dementia Strategy: Living Well with Dementia (Department of Health 2009), presents eight Common Core Principles for Supporting People with Dementia.

They can be used to enable workforce development for any member of staff working in health or social care with people at any stage of dementia, from the earliest signs to the fully diagnosed condition. The common core principles are relevant to every setting and provide a basis for a general understanding of the condition. They aim to build workers’ confidence in adapting their actions and communication in order to respond appropriately to the person with dementia. Signposting to resources and further reading has been included at the end of the guide.

Although the guide is written primarily for the health and social care sectors, the principles and supporting information will also be of interest to those working in any situation where people interact with those with dementia. The principles can be applied to any customer-focused provision, with equal relevance to those working in settings such as shops and banks, as well as public sector settings such as library, education and housing services.

The principles have been written on the assumption that the workforce supporting people in the later stages of dementia will have received specialist training and support.

http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/documents/digitalasset/dh_127447.pdf

The MetLife Study of Elder Financial Abuse: Crimes of Occasion, Desperation, and Predation Against America's Elder

2011-06-08T13:42:00.001-05:00

In 2009, the MetLife Mature Market Institute, in collaboration with the National Committee for the Prevention of Elder Abuse (NCPEA), and the Center for Gerontology at Virginia Tech, released a groundbreaking study to on the extent and implications of elder financial abuse.

The study, Broken Trust: Elders, Family, and Finances, was designed to provide accessible and well-researched information on the problem of elder financial abuse, and consisted of a review of the scholarly and professional literature and an in-depth analysis of news article.

In 2010, to further examine the impact of elder financial abuse on the lives of seniors, the MetLife Mature Market Institute partnered with leading researchers, in consultation with NCPEA. The research team expanded its analysis of research published in the scholarly literature and gathered additional articles from the U.S. Administration on Aging’s National Center on Elder Abuse newsfeed. In addition, several individuals whose stories appeared in the 2008 newsfeeds were contacted and asked to share subsequent information about their situations. The MetLife Study of Elder Financial Abuse: Crimes of Occasion, Desperation, and Predation Against America’s Elders adds to the knowledge of the widening problem of elder financial abuse.

Geriatric Research News ‘special edition’ dedicated to falls and falls prevention research

2011-06-08T13:26:00.001-05:00

The latest edition of the Simon Fraser Geriatric Research Centre News is devoted to falls and falls prevention research.

Falls are a major cause of injury amongst seniors, often having a devastating effect on their mobility and independence.

To address this, the CIHR-funded (Technology for Injury Prevention) TIPS program comprises an interdisciplinary group of researchers based at SFU and UBC to examine the causes of falls in long-term care and to develop innovative interventions to reduce the incidence and negative effects.

Older People Leaving Hospital

2011-06-08T13:14:00.000-05:00

Older people leaving hospital: a statistical overview of the Transition Care Program in 2008-09 presents key statistics on the characteristics and services provided to older people who are eligible for residential aged care directly after discharge from hospital. The program aims to improve recipients' independence and functioning. At 30 June 2009 there were 2,228 places providing transitional care to older people leaving hospital. During 2008-09, around 12,600 individuals received just over 14,000 episodes of transition care.

http://www.metlife.com/assets/cao/mmi/publications/studies/2011/mmi-elder-financial-abuse.pdf

Palliative care for older people: better practices

2011-06-06T09:25:00.000-05:00

Populations around the world are ageing and more people are living with the effects of serious chronic illness towards the end of life.

This publication from the World Health Organization provides examples of better palliative care practices, from or relevant to the WHO European Region.

While some examples remain to be fully evaluated, they will nevertheless help policy-makers, decision-makers, planners and multidisciplinary professionals to plan and support the most appropriate and effective services for the care and quality of life of older people.

http://www.euro.who.int/__data/assets/pdf_file/0017/143153/e95052.pdf

Quality management by result-oriented indicators: Towards benchmarking in residential care for older people, Policy Brief, June, 2011

2011-06-01T15:20:00.000-05:00

Policy Briefs are a publication series providing a synthesis of topics of research and policy advice from researchers at the European Centre for Social Welfare Policy and Research.

The project ‘Quality Management by Result-oriented Indicators – Towards Benchmarking in Residential Care for Older People’ had the following objectives:

• To collect, sift and validate result-oriented quality indicators at the personal care home organizational level, based on experiences in selected member states. Apart from the quality of (nursing) care, a special focus was given to resident‘quality of life’. Economic performance, leadership issues and the social context complemented the domains used to frame indicators that serve to define, measure and assess overall quality in care homes.

• To investigate and gain experience in methods on how to work with and train care home managers to work with result-oriented indicators and deal with challenges.

This Policy Brief provides information about the project team’s approaches and project results. The project results were discussed with more than 130 experts from different fields (providers, regulators, policy-making, client organisations, etc.) during the Final Conference in Brussels from 3-4 November 2010. Highlights from the discussion are presented in the second part of this Policy Brief.

http://www.euro.centre.org/data/1306242771_99752.pdf

New Publications from the Hartford Institute for Geriatric Nursing

2011-05-26T12:21:00.000-05:00

The following new publications are highlighted in the Hartford Institute for Geriatric Nursing (HIGN) Report, Volume 1/Issue 5/May 2011. To subscribe, go to the HIGN home page.

Try this: Assessment of Fear of Falling in Older Adults: The Falls Efficacy Scale-International (FES-I)
The Falls Efficacy Scale-International (FES-I) is a short, easy to administer tool that measures the level of concern about falling during social and physical activities inside and outside the home whether or not the person actually does the activity. The level of concern is measured on a four point Likert scale (1=not at all concerned to 4=very concerned) (Yardley et al., 2005). The FES-I was developed in a collaborative effort with members of the Prevention of Falls Network Europe (ProFaNE), European Committee focused on fall prevention and the psychology of falling. The group tested the FES-I using different samples in different countries and translated the tool into several languages.

A Bill of Rights for Hospitalized Older Adults
Acute-care hospitals have few structures, programs, or staff prepared to address the special needs of older adults. To help correct this issue, the Hartford Institute for Geriatric Nursing and the Coalition of Geriatric Nursing Organizations (CGNO) proposed language for a Bill of Rights for Hospitalized Older Adults. The Bill of Rights proceeds from general value statements to the specific knowledge, skills, and actions necessary to provide quality care to older adult patients.

"Clinical Rotations in Nursing Home" Module
The Hartford Institute, with funding from the Jewish Foundation for Education of Women (JFEW), has created a new web-based module to help nursing faculty improve how they structure and conduct student clinical rotations in nursing homes. Mathy Mezey, EdD, RN, FAAN, is the Principal Investigator for the effort. Designed for baccalaureate and graduate level, the module will be widely disseminated to nursing school faculty and the national nursing community.

How U.S. Older Adults Provide Care for Their Aging Parents, Adult Children, and Friends

2011-05-25T08:23:00.000-05:00

Most research on the gender gap in unpaid caregiving in the United States has focused on young families. During the childrearing years, women provide the bulk of child care, although the time men spend caring for their children has increased in recent years.

As part of Population Research Bureau's 2010-2011 Policy Seminar series, Suzanne Bianchi, a University of California Los Angeles sociology professor, examined new research on caregiving in later life—a time when men and women may spend their time in similar ways as they enter their retirement years. The study, conducted with Joan Kahn and Brittany McGill of the University of Maryland, explored whether retirement and marital status made a difference in how men and women helped others. Specifically, they set out to learn whether men replaced paid work with time spent helping others after retirement and whether divorced people spent less time caring for kin, reflecting weakened family ties.

The 45-minute webcast presents the results of the study.

http://www.prb.org/Journalists/Webcasts/2011/us-aging-family-care-policy-seminar.aspx

Mental Health and Addictions Issues for Older Adults: Opening the Doors to a Strategic Framework

2011-05-25T08:18:00.001-05:00

Published in March, 2010 by the Canadian Mental Health Association (CMHA), Ontario, a not-for-profit, charitable organization whose vision is “mentally healthy people in a healthy society.” As a core responsibility, CMHA, Ontario develops and provides public policy advice that promotes mental health and improves the lives of people living with mental illness.

The aim of this paper is to concentrate attention on older adults with mental health and addictions issues and underscore the necessity for a framework that is specifically focused on this group. The aging population in Ontario, the increasing prevalence of mental ill-health in this demographic and the associated human, health and social costs provide compelling reasons to establish a framework that prevents mental ill health, provides for early identification and early intervention if illness presents, and supports seniors so they can live in their homes, in communities of their choice.

http://www.ontario.cmha.ca/submissions.asp?cID=519019

Help Wanted? Providing and Paying for Long-Term Care

2011-05-24T09:45:00.001-05:00

This new report from the Organisation for Economic Co-operation and Development (OECD) provides a comparative analysis of the common challenges and diverse solutions OECD countries are adopting to respond to the growing demand for long-term care services, particularly its implications for financing and labour markets.

Chapter 1 and 2 examine the growing demand for long-term care in the context of ageing societies, discuss demographic projections and their implications for long term care labour markets and expenditure

Chapter 3 and 4 discuss the role of family carers, the impact of caring on carers’mental health, poverty and labour market participation, as well as policies to support family carers.

Chapters 7 and 8 analyse, respectively, public and private coverage schemes for long-term care in OECD countries, while Chapter 9 discusses financing policies to improve access while keeping cost under
control.

Chapter 10 reviews options to improve value for money from long-term care services, and to manage more efficiently the interface between health and care.

The webpage for the report provides country data for OECD countries.

www.oecd.org/health/longtermcare/helpwanted

Dementia among aged care residents: first information from the Aged Care Funding Instrument

2011-05-24T09:26:00.001-05:00

The Aged Care Funding Instrument (ACFI) is a new tool to appraise the care needs of permanent residents in residential aged care facilities in Australian Government subsidized aged care.

The ACFI appraisal was used to identify more than 104,400 permanent residents in 2008-09 who had a diagnosis of dementia. This equates to 53% of all residents with an ACFI appraisal in this financial year. Seventy per cent of residents with a dementia diagnosis were female reflecting their overall proportion in residential care. Approximately 79% of all residents with dementia were aged 70 years and over.

The report analyses data extracted from the Australian Department of Health and Ageing’s Aged and Community Care Management Information System (ACCMIS). This Management System holds administrative data on approved services to care recipients and residents and payment of funding to approved providers of community and residential care. This report outlines the demographic characteristics and care requirements of permanent residents with a diagnosis of dementia and other residents in Australian Government subsidised residential aged care facilities in 2008–09, as identified by information from the Aged Care Funding Instrument (ACFI). The report is structured as follows:
• Chapter 2 describes the background and purpose of the ACFI, how it is used and the information it collects.
• Chapter 3 examines how dementia is defined and described in the ACFI and what diagnostic sources are used.
• Chapter 4 discusses the characteristics and care needs of aged care residents with a diagnosis of dementia. It also includes data on the comorbidities of residents with a diagnosis of dementia and the completed length of stay of residents with a diagnosis of dementia compared with other residents.
2
• Chapter 5 presents some characteristics of residential aged care facilities that provide care to people with a diagnosis of dementia and information on the average amount of Australian Government subsidy (excluding supplements) provided to care for these people, as compared to other residents.

The information within the report provides a resource for program planners and funders and identifying needs for residential aged care, both now and in the future.

http://www.aihw.gov.au/publication-detail/?id=10737419025&tab=2

Better with Age: A Regional Roundtable Series on Health Systems Planning for the Aging Population

2011-05-24T09:19:00.000-05:00

This month's issue of Healthcare Quarterly, 14(2) 2011: 14-15 reports on the Canadian Health Services Research Foundation's (CHSRF) roundtable series Better with Age: Health Systems Planning for the Aging Population, held in six locations across Canada in fall 2010:

October 7, 2010 – Calgary, Alberta (British Columbia, Alberta and northern region)
October 15, 2010 – Winnipeg, Manitoba (Saskatchewan and Manitoba)
October 20, 2010 – Ottawa, Ontario (national roundtable)
October 27, 2010 – Halifax, Nova Scotia (Atlantic region and northern region)
November 4, 2010 – Toronto, Ontario (Ontario)
November 10, 2010 – Montreal, Quebec (Quebec)

http://www.longwoods.com/content/22375

Evidence-Based Toolkit: Program Summaries and Implementation Guide

2011-05-11T11:38:00.002-05:00

The Evidence-Based Toolkit (Toolkit) is a compendium of selected programs that address the seven leading preventable chronic conditions among older adults, according to the Centers for Disease Control and Prevention: arthritis, cancer, depression, diabetes, falls, heart disease, and obesity.

The toolkit was published by the Brookdale Demonstration Initiative in Healthy Urban Aging Project, a 3-year project to: a) assess health and social well-being among older adults attending senior centers; b) design and implement evidence-based practices; and c) evaluate effectiveness and cost-effectiveness. The goal of the project is to provide reliable data for public policy makers seeking to address health and social concerns of older adults that can enhance and empower healthy aging in place in NYC’s neighborhoods.

Thirty-five evidence-based program are included in the Toolkit. These programs were found to effectively produce significant health outcomes and have been rigorously studied and documented in peer-reviewed scholarly literature, and could be feasibly be implemented in community settings.

The Toolkit is comprised of three (3) components:

Programs Summaries and Implementation Guide
Condition Specific Instruments
Cross-Cutting Instruments

http://www.brookdale.org/pdf_docs/DFTA%20Brookdale%20Toolkit.pdf

Improving Care Search Centre

2011-05-09T08:28:00.000-05:00

The Improving Care Search Centre, created by the Canadian Patient Safety Institute, is a publicly available web-based search centre, provides an easy method for searching information on patient safety and quality improvement generated by organizations from across the country and around the world.

The site includes news on patients safety, information from the CPSI Twitter feed, CSPI publications, and a webcast.

http://www.improvingcaresearchcentre.com

Because this is the rainy day: a discussion paper on home care and informal caregiving for seniors with chronic health conditions

2011-04-21T14:50:00.000-05:00

Released in February, 2011, by The Change Foundation, an independent policy think tank, intent on changing the health-care debate, health-care practice and the health-care experience in Ontario.

Can we provide good care at home for seniors with chronic health conditions? If so, at what cost? And to whom?

To explore these questions, The Change Foundation commissioned leading home-care expert Dr. John Hirdes, (Professor, University of Waterloo and Scientific Director, Homewood Research Institute), to examine data on Ontario seniors with chronic conditions to help us understand how they use home-care services, what their health-care needs are as they move from hospital to home and/or community care, and what the implications are for their caregivers.

Dr. Hirdes and his research team delved into rich, detailed data about home-care use in Ontario from 2004 to 2008. The picture that emerges illustrates the need for action to address three objectives:

to better align home-care services to seniors’ needs;
to realign resources from acute to community care; and
to use home care more strategically to provide seniors and their informal caregivers with care and support tailored to their needs as well as to help solve health system problems.

http://www.changefoundation.ca/docs/ElderlyInformal.pdf

Non-pharmacological Interventions for Behavioral Symptoms of Dementia

2011-04-19T09:44:00.001-05:00

In 2004, the U.S. Office of the Assistant Deputy Under Secretary for Health for Policy and Planning estimated that the total number of Veterans with dementia would be as high as 563,758 in FY 2010. The VHA Office of Geriatrics and Extended Care (OGEC) in Patient Care Services has primary responsibility for coordination and direction of VHA dementia initiatives. OGEC convened an interdisciplinary Dementia Steering Committee (DSC) in December 2006, with the goal of making recommendations on comprehensive, coordinated care for Veterans with dementia.

The DSC requested VA HSR&D's Evidence-based Synthesis Program (ESP) to review evidence on selected topics, in order to assist with DSC planning efforts. This evidence review addresses the following questions:

How do non-pharmacological treatments of behavioral symptoms compare in effectiveness with each other, with pharmacological approaches, and with no treatment?
How do non-pharmacological treatments of behavioral symptoms compare in safety with each other, with pharmacological approaches, and with no treatment?
How do non-pharmacological treatments of behavioral symptoms compare in cost with each other, with pharmacological approaches, and with no treatment?

http://www.hsrd.research.va.gov/publications/esp/dementia_nonpharm.cfm

The National Institute on Aging/Alzheimer’s Association Diagnostic Guidelines for Alzheimer’s Disease

2011-04-19T09:22:00.000-05:00

For the first time in 27 years, clinical diagnostic criteria for Alzheimer’s disease dementia have been revised, and research guidelines for earlier stages of the disease have been characterized to reflect a deeper understanding of the disorder.

The National Institute on Aging/Alzheimer’s Association Diagnostic Guidelines for Alzheimer’s Disease outline some new approaches for clinicians and provide scientists with more advanced guidelines for moving forward with research on diagnosis and treatments. They mark a major change in how experts think about and study Alzheimer’s disease. Development of the new guidelines was led by the National Institutes of Health and the Alzheimer’s Association.

The original criteria were the first to address the disease and described only later stages, when symptoms of dementia are already evident. The updated guidelines announced today cover the full spectrum of the disease as it gradually changes over many years. They describe the earliest preclinical stages of the disease, mild cognitive impairment, and dementia due to Alzheimer’s pathology. Importantly, the guidelines now address the use of imaging and biomarkers in blood and spinal fluid that may help determine whether changes in the brain and those in body fluids are due to Alzheimer’s disease. Biomarkers are increasingly employed in the research setting to detect onset of the disease and to track progression, but cannot yet be used routinely in clinical diagnosis without further testing and validation.

The new guidelines appear online April 19, 2011 in Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association. They were developed by expert panels convened last year by the National Institute on Aging (NIA), part of the NIH, and the Alzheimer’s Association. Preliminary recommendations were announced at the Association’s International Conference on Alzheimer’s Disease in July 2010, followed by a comment period.

Evidence-Based Policy Prescription for an Aging Population: HealthcarePapers

2011-04-05T09:14:00.000-05:00

Vol. 11 No. 1 2011 of the journal Healthcare Papers, focuses on Canadian perspectives on aging policy.

The Table of Contents can be found at the link below:

http://www.longwoods.com/publications/healthcarepapers/22233

Please note: for copies of the articles in this issue, contact your local health library.

Everyone Rides: Transportation Access for Culturally and Ethnically Diverse Elders

2011-04-05T08:55:00.000-05:00

This booklet from the National Center on Safe Transportation is a starting point for discussion of the challenges involved in addressing the mobility needs of diverse elders and contains recommendations for action developed by a national coalition convened by the NCST.

http://seniortransportation.easterseals.com/site/DocServer/Everyone_Rides.pdf?docID=113443

Strengthening Communication & Problem Solving

2011-04-05T08:47:00.004-05:00

Strengthening Communication & Problem-Solving Competencies for CNAs consists of six one-hour in-service training sessions for facility-based Certified Nursing Assistants (CNAs).

The goal is to help CNAs provide better care for residents in long-term care facilities, by developing core competencies of communications and problem-solving skills that will provide them with concrete tools to respond to resident’s needs and preferences.

Introduction for Instructors

The “Introduction for Instructors” is a guide for delivering the curricula and should be used by instructors in preparing for the training. Each unit includes two files (1) curriculum (2) handouts.

Unit 1. Introduction to Resident-Centered Care and Active Listening

Unit 2. Active Listening: Paraphrasing

Unit 3. Active Listening: Asking Open-Ended Questions

Unit 4. Managing Emotions: Pulling Back

Unit 5. The Exploring Options Approach to Problem-Solving

Unit 6. Giving Constructive Feedback

This curriculum was developed for The SCAN Foundation as part of a series of continuing education curricula for California’s direct-care workforce. The geriatric-focused curricula, which are based on adult learning principles, will support the workforce by enhancing and developing knowledge and skills to provide care.

To download the curriculum free of charge, visit The SCAN Foundation’s site. Once you’ve registered your email and information, click on “Strengthening Communication and Problem-Solving Competencies for CNAs” or any of the other curricula provided as part of this series.

http://phinational.org/training/resources/phi-curricula/strengthening-communication/

Generation alzheimer's: the Defining Disease of the Baby Boomers

2011-04-05T08:40:00.000-05:00

This year, the first baby boomers turn 65. While Alzheimer’s is not normal aging, age is the greatest risk factor for the disease.

This report from the Alzheimer's Association conveys the burden of Alzheimer's and dementia on individuals, families, government and the nation's healthcare system.

THE GREEN HOUSE® Project Consumer Toolkit: Bringing the Green House Model to Your Community

2011-04-05T08:32:00.000-05:00

The Green House Model is a de-institutionalization effort that lets people who need help with daily living skills live in a home in the community. Green House combines small homes with the full range of personal care and medical services expected in high-quality nursing homes. Green House creates an intentional community to support the most positive elderhood and work life possible.

This new toolkit introduces the Green House Model, provides a FAQ, and suggestions for getting started in exploring this model in your community.

http://thegreenhouseproject.com/Documents/The%20Green%20House%20Project_Toolkit.pdf

Enhancing Use of Clinical Preventive Services Among Older Adults – Closing the Gap

2011-03-25T08:24:00.000-05:00

This report, from the Centers for Disease Control (U.S.) focuses on the use of potentially lifesaving preventive services by the growing population of adults aged 65 years and older. By presenting and interpreting available state and national self-reported survey data, the Report aims to raise awareness among public health and aging services professionals, policy makers, the media, and researchers of critical gaps and opportunities for increasing the use of clinical preventive services, particularly among those who are currently underserved.

The Report is divided into four sections:

• Featured Preventive Services looks at eight services for which sufficient data at the state or national level exist: two vaccinations that protect against influenza and pneumococcal disease; five screenings for early detection of breast cancer, colorectal cancer, diabetes,
• Additional Preventive Services briefly discusses seven other services recommended for older adults: alcohol misuse screening and counseling, aspirin use, blood pressure screening, cervical cancer screening, depression screening, obesity screening and counseling, and zoster vaccination.
•Making a Difference addresses the implications of the survey data and offers examples of recent interventions that have successfully increased use of clinical preventive services in diverse communities.
• References are provided for those who wish to delve further.

http://www.cdc.gov/Features/PreventiveServices/Clinical_Preventive_Services_Closing_the_Gap_Report.pdf

Understanding the returns from cardiovascular and stroke research: The Policy Report

2011-03-21T08:04:00.001-05:00

This project, from the Rand Corporation, explores the impacts arising from cardiovascular and stroke research funded 15-20 years ago and attempts to draw out aspects of the research, researcher or environment that are associated with high or low impact.

The project is a case study-based review of 29 cardiovascular and stroke research grants, funded in Australia, Canada and UK between 1989 and 1993. The case studies focused on the individual grants but considered the development of the investigators and ideas involved in the research projects from initiation to the present day. Grants were selected through a stratified random selection approach that aimed to include both high- and low-impact grants. The key messages are as follows: 1) The cases reveal that a large and diverse range of impacts arose from the 29 grants studied. 2) There are variations between the impacts derived from basic biomedical and clinical research. 3) There is no correlation between knowledge production and wider impacts 4) The majority of economic impacts identified come from a minority of projects. 5) We identified factors that appear to be associated with high and low impact.

This report presents the key observations of the study and an overview of the methods involved. It has been written for funders of biomedical and health research and health services, health researchers, and policy makers in those fields. It will also be of interest to those involved in research and impact evaluation.

http://www.rand.org/pubs/monographs/MG1079.html

I Wanna Wash My Hands

2011-03-17T14:00:00.000-05:00

Youtube video from Ontario's Brant Healthcare System

The development of end of life care standards for people with end stage dementia (2011)

2011-03-14T09:12:00.001-05:00

The aim of this study was to contribute to improving quality of life for people with end stage dementia living in residential care settings by investigating the experiences of elderly spouses whose relatives had recently died with end-stage dementia in nursing homes in both Northern Ireland (NI) and the Republic of Ireland (RoI).

In addition, from the data collected, guidelines will be drafted for delivery of quality care in end stage dementia in long stay residential institutions. The drafted guidelines will then be circulated to a multi-disciplinary group of health service professionals across Ireland (four health service professionals in NI and four in RoI) and their views on the guidelines sought.

http://www.cardi.ie/userfiles/End%20of%20life%20standards%20final%20report.pdf

A New Care Paradigm Slashes Hospital Use and Nursing Home Stays for the Elderly and the Physically and Mentally Disabled

2011-03-09T08:21:00.000-06:00

From Commonwealth Fund, Publications in Brief, March 8, 2011, Summary Writer: Sarah Klein
Notes: Health Affairs, March 2011 30(3): 408–11, available at http://content.healthaffairs.org/content/30/3/412.extract.

The Issue
Patients with complex medical, social, and behavioral health needs require high-quality, personalized, round-the-clock care to improve health and self-management of chronic illnesses. Intensive services can reduce hospitalizations and nursing home placements.

The Innovation
Commonwealth Care Alliance, a nonprofit health system in Massachusetts that offers medical and social services to older people and the physically and mentally disabled, provides individualized primary care, behavioral health, and support services to its patients using multidisciplinary teams that are headed by nurse practitioners. The teams have broad leeway to order services—including transportation—without prior approval from the plan. The cost of providing additional support services is offset by reduced hospitalizations and nursing home placements.

Results
The model sharply reduced hospitalizations among elderly patients. The number of hospital days per 1,000 members in 2007 was equal to 55 percent of hospital days for comparable patients who were cared for in a fee-for-service payment environment. For disabled patients, monthly medical costs were $3,061 in 2008 compared with $5,210 for Medicaid fee-for-service patients. The health system scored in the 90th percentile or above on Healthcare Effectiveness Data and Information Set (HEDIS) measures of diabetes care, monitoring of patients on long-term medication, and access to preventive care services.

Citation
"A New Care Paradigm Slashes Hospital Use and Nursing Home Stays for the Elderly and the Physically and Mentally Disabled," Health Affairs, March 2011 30(3):412–15.

The 'GRACE' Model: In-Home Assessments Lead to Better Care for Dual Eligibles

2011-03-09T08:13:00.003-06:00

From the Commonwealth Fund, Publications in Brief, March 8, 2011, Summary Writer: Sarah Klein
Health Affairs, March 2011 30(3):431–34, available at http://content.healthaffairs.org/content/30/3/431.extract.

The Issue
Fragmentation of care is common among Medicare beneficiaries, half of whom receive treatment for five or more chronic conditions each year. Comprehensive, coordinated care—particularly during transitions in care—has the potential to improve health outcomes and lower the cost of care.
The Innovation

Geriatric Resources for Assessment and Care of Elders (GRACE) conducts in-home assessments using a team with nurse practitioner and a social worker to develop individualized care plans for low-income seniors, many of whom are eligible for Medicare and Medicaid and most of whom have multiple chronic conditions. The team, which is responsible for coordinating patient care on an ongoing basis, collaborates with a broader group of providers including a geriatrician, a pharmacist, a physical therapist, and a mental health worker. A Web-based care management tracking system supports coordination and continuity of care among the health care professionals and sites of care.
Results

The two-year intervention—developed by Wishard Health Services in Indiana—saved $1,500 per enrolled high-risk patient by the second year. For patients at the highest risk of hospitalization, GRACE reduced hospital admission rates by 12 percent and 44 percent in the first and second years of the program. GRACE patients also reported higher quality of life compared with the control group.

Citation

"The 'GRACE' Model: In-Home Assessments Lead to Better Care for Dual Eligibles," Health Affairs, March 2011 30(3):431–34.

Just Ask Just Tell

2011-03-07T11:21:00.002-06:00

..is a Patient Communication Tool Kit developed by the Geriatrics Interprofessional Practice Interorganization Collaboration (GiiC) initiative of the Regional Geriatric Program of Toronto and the Regional Geriatric Program central.

"Just Ask Just Tell: Better sharing between you and your doctor and health professionals" consists of 7 easy to use tools:
- Who I am
- Getting information
- Taking my medications
- About my medications
- Appointments
- Home care providers
- Home from hospital

Available in pocket card, ½ page & amp; full page sizing with How to Use Instruction and Background Information Guide.

• Just Ask Just Tell - How to Use the Tools [PDF 1.0MB]

• Just Ask Just Tell - Background Information [PDF 280KB]

• Just Ask Just Tell - Going Home from Hospital - full page [DOC 220KB]

• Just Ask Just Tell - Going Home from Hospital - half page [DOC 340KB]

• Just Ask Just Tell - Going Home from Hospital - pocket card [PDF 210KB]

• Just Ask Just Tell - Who's Coming to My Home - full page [DOC 230KB]

• Just Ask Just Tell - Who's Coming to My Home - half page [DOC 360KB]

• Just Ask Just Tell - Who's Coming to My Home - pocket card [PDF 270KB]

• Just Ask Just Tell - Appointments - full page [DOC 200KB]

• Just Ask Just Tell - Appointments - half page [DOC 310KB]

• Just Ask Just Tell - Appointments - pocket card [PDF 220KB]

• Just Ask Just Tell - About My Medications - full page [DOC 230KB]

• Just Ask Just Tell - About My Medications - half page [DOC 350KB]

• Just Ask Just Tell - About My Medications - pocket card [PDF 230KB]

• Just Ask Just Tell - Taking My Medications - full page [DOC 220KB]

• Just Ask Just Tell - Taking My Medications - half page [DOC 340KB]

• Just Ask Just Tell - Taking My Medications - pocket card [PDF 220KB]

• Just Ask Just Tell - Getting Information - full page [DOC 110KB]

• Just Ask Just Tell - Getting Information - half page [DOC 340KB]

• Just Ask Just Tell - Getting Information - pocket card [PDF 230KB]

• Just Ask Just Tell - Who I Am - full page [DOC 220KB]

• Just Ask Just Tell - Who I Am - half page [DOC 340KB]

• Just Ask Just Tell - Who I Am - pocket card [PDF 210KB]

• Engaging Patients in Health Care Encounters - Tool Development (Slide Presentation) [PDF 1.4MB]

Senior Friendly Care in Toronto Central LHIN Hospital

2011-03-07T11:18:00.000-06:00

Prepared for the Toronto Central Local Health Integration Network by the Regional Geriatric Program of Toronto The background document, survey and summary report were commissioned by the Toronto Central LHIN to support its Integrated Health Service Plan 2010-2013 priorities, including a commitment to reduce the risk of functional decline for seniors while in acute care.

The documents describes the case for change and introduces a Senior Friendly Hospital Framework. The goal is to inform senior leaders in hospitals on how to modify the way care is organised and provided to older patients. Additionally, it is intended to emphasize the multiple dimensions of organizational change essential to achieve improved health outcomes for seniors. The Toronto Central LHIN will be stewards and leaders in this systemic alignment of needs and resources by supporting partner hospitals in adopting the Senior Friendly Hospital Framework and integrating measurable objectives into the hospital service accountability agreements.

Documents

• senior friendly care backgrounder july 2010_final [PDF 480KB]

• self assessment template senior friendly care july 2010 [DOC 180KB]

• A Summary of Senior Friendly Care in Toronto Central LHIN Hospitals [PDF 1.1MB]

Guideline on the Assessment and Treatment of Delirium in Older Adults at the End of Life

2011-03-07T11:15:00.000-06:00

Delirium is a common and serious condition encountered in older persons. Compared to similarly aged individuals, older hospitalized persons who are delirious have a worse prognosis. They have prolonged lengths of hospital stay, worse functional outcomes, higher institutionalization rates, increased risk for cognitive decline and higher mortality rates (Leentjens & van der Mast, 2005; Rockwood, 2001). In many cases, delirium is not recognized or is misdiagnosed as another condition such as dementia or depression.

The occurrence of delirium is not inevitable.With funding from the Public Health Agency of Canada Population Health Fund, CCSMH was able to collaborate with experts in the fields of geriatrics and delirium to develop evidence-based recommendations on the assessment and treatment of delirium in older adults. From 2007-2010, pilot projects were launched to disseminate information and implement recommendations from the guidelines. http://ccsmh.ca/pdf/guidelines/NatlGuideline_DeliriumEOLC.pdf

All documents can be downloaded at no charge. If you prefer a hard copy of the material, or need multiple copies for your team or class, contact Kimberly Wilson, Executive Director, kwilson@baycrest.org (416-785-2500 ext. 6331).

Population Aging and the Continuum of Older Adult Care in Manitoba

2011-03-07T09:32:00.000-06:00

Older adults (people 65+ years old) are the main users of home care services and nursing homes (called personal care homes, or PCHs, in Manitoba), and the number of older adults living in Manitoba will soon increase considerably. Most Canadian provinces have expanded their care options for older adults, and Manitoba initiated an Aging in Place program in 2004. As one part of this program, supportive housing was created as an alternate to PCH use so that some people can continue living in the community.

To date however, Manitoba has not developed a tool that differentiates supportive housing users from PCH users. This tool is important to ensure that people receive the right type of care based on their needs. Also, a new strategy is required to more clearly define PCH residents’ needs so that providers can develop better care plans for these individuals. Knowledge from this tool can also be used to help understand the capacity of supportive housing to offset PCH use, now and in the future.

This research was conducted at the Manitoba Centre for Health Policy (MCHP), Faculty of Medicine, University of Manitoba, and provides evidence about the continuum of home care, supportive housing, and PCH care in Manitoba. Using a combination of clinical data from the Winnipeg Regional Health Authority (WRHA) and health care use data from the Population Health Research Data Repository (Repository) housed at MCHP, the objectives of this research were to:

develop a tool for placing people into either supportive housing or PCH care and a second tool to
more clearly describe PCH residents’ needs.
use this new evidence to estimate the capacity for supportive housing to offset current and future
PCH use.

Profile of Older Americans 2010

2011-03-07T08:21:00.000-06:00

The web based publication Profile of Older Americans: 2010 is now available online.

This annual summary of the latest statistics on the older population covers 15 topical areas including population, income and poverty, living arrangements, education, and health.

To access this publication, please go to http://www.aoa.gov/AoARoot/Aging_Statistics/Profile/index.aspx

End-of-life care standards for people with dementia

2011-02-25T11:55:00.001-06:00

From the CARDI (Centre for Ageing Research and Development in Ireland) Grants Program Research Brief, January 2100, this This briefing is based on the findings of a research project by Cahill et al. (2010), funded under CARDI’s Grants Programme, to identify key issues in end-of-life care for dementia and to produce a set of guidelines for end-of-life care for residents with dementia in care homes in Ireland, North and South.

The authors argue that a set of guidelines to assist nursing homes in developing policies and practices in end-of-life care for residents with dementia may provide a useful basis for comparison with international best practice. The guidelines developed by the authors of the research project may also help individual institutions to
review their practice and delivery of care to this particularly vulnerable group of residents.

http://www.cardi.ie/publications/endoflifecarestandardsforpeoplewithdementia

Canadian Dementia Resource and Knowledge Exchange

2011-02-25T11:33:00.001-06:00

The Canadian Dementia Resource and Knowledge Exchange (CDRAKE) is a free, virtual network that brings together practitioners in dementia care to:
o Support the learning needs of people seeking practice change
o Facilitate quick and easy access to the best knowledge for continuous quality improvement
o Stimulate, support and share innovations
o Build and strengthen collaborative partnerships between stakeholders
o Foster direct links between knowledge users and producers

The site features news, a resource exchange, a question and answer exchange, and communities of practice.

http://www.dementiaknowledgebroker.ca/

Can older drivers be nudged? How the public and private sectors can influence older drivers’ self-regulation

2011-02-25T11:06:00.000-06:00

This report, published February 2011 from the International Longevity Centre, considers how interventions, or ‘nudges’, based around insights from behavioural economics and psychology can be used to assist older
drivers in coping with the ageing process.

Today’s older people are driving further and more often than previous cohorts. Clearly, cars are vital for mobility. Maintaining mobility in later life helps to delay the physical and mental decline associated with ageing, and is crucial for maintaining access to services, social connectivity, and fulfilling the various
routines of daily life. In being available at any hour, and providing door-to-door transport, cars offer benefits that would be impossible for public transport to fully replace. While there is no evidence that older drivers per se are less safe behind the wheel, there are questions regarding the road safety of older drivers.
Physiological (including visual) and cognitive decline is certainly part of the ageing process, and may therefore impact on driving unless the right support systems are in place.

http://www.racfoundation.org/assets/rac_foundation/content/downloadables/older_drivers_nudge-main_report-berry.pdf

End-of-Life Recommendations for Leaders

2011-02-15T08:33:00.000-06:00

A new Institute for Healthcare Improvement (IHI) article in the January/February 2011 issue of Healthcare Executive presents six leadership actions to more effectively honor patient preferences at the end of life.

In End-of-Life Care: 6 Leadership Actions IHI Vice President Andrea Kabcenell and IHI Senior Fellow Jim Conway offer recommendations based on the American College of Healthcare Executives' recently revised Decisions Near the End of Life Ethical Policy Statement, the work of IHI, and the findings of the Expert Panel on End-of-Life Care in the Commonwealth of Massachusetts.

Support. Stay. Save. Care and support for people with dementia in their own homes

2011-02-09T08:25:00.001-06:00

This report, published by the Alzheimer's Society (UK), provides evidence from over 2,000 carers, people with dementia and home care workers on the aspirations, experiences and outcomes of providing dementia care in the community in England, Wales and Northern Ireland. The evidence and recommendations are for commissioners and service providers and are intended to support good practice in meeting the
needs of people with dementia living in their own homes

http://alzheimers.org.uk/site/scripts/download_info.php?fileID=1030

Seniors and the Health Care System: What Is the Impact of Multiple Chronic Conditions?

2011-02-02T16:06:00.000-06:00

CIHI’s study Seniors and the Health Care System: What Is the Impact of Multiple Chronic Conditions? examines how seniors not living in institutions access health services and what kind of care they receive. According to the study, three out of four Canadians age 65 and older reported having at least one chronic condition, while one in four seniors reported having three or more.
Among the study’s key findings:

The 24% of seniors who reported living with three or more chronic conditions were responsible for 40% of health care use among Canadian seniors.
Seniors with three or more chronic conditions reported using three times as many health care services as Canadians age 65 and older with no chronic conditions. Those with three or more chronic conditions also reported more than twice the rate of visits to a family doctor as seniors with only one chronic condition.
Similar patterns of health care use existed among adults age 45 to 64; those with three or more chronic conditions made six times as many health care visits as those with no reported conditions.
Seniors with three or more chronic conditions made three times as many visits to emergency departments as seniors with no reported chronic conditions.

For a press release and link to the full report go to:
http://www.cihi.ca/CIHI-ext-portal/internet/en/Document/types+of+care/primary+health/RELEASE_27JAN11

Canadian Falls Prevention Curriculum E-learning Course

2011-01-25T15:55:00.000-06:00

Registration is now open for the next offering of the Canadian Falls Prevention Curriculum (CFPC) ELearning course through the University of Victoria.

This facilitated CFPC ELLearning course will run from February 11th to March 11th, 2011, and the fee is 175 canadian dollars plus HST.

If you work with older adults in long term care, acute care, home care or in the community, this four week ELearning course will help you acquire the knowledge and skills needed to apply an evidence-based approach to the prevention of falls and fall-related injuries.

Through online, instructor-facilitated learning modules you will: - study online, 4 to 8 hours per week through instructor-facilitated learning modules - learn how to design, implement and evaluate a falls prevention program.

Upon course completion you should be able to: - define the scope and nature of the problem of falls - provide fall risk identification and assessment - provide a selection of prevention interventions reflecting evidence-based strategies - understand social policy and context - provide application of a program planning model - evaluate the effectiveness of a fall prevention program Sarah Elliott Fall Prevention Assistant BC Injury Research and Prevention Unit. Phone: (604) 875-2000 ext. 6981 Fax: (604) 875-3569

Oral Care Skill Webinars

2011-01-24T10:58:00.001-06:00

The Ontario Senior’s Health Research Transfer Network’s (SHRTN) Oral Health Community of Practice supported by the Regional Geriatric Program Central and Halton Region .is offering a series of webinars that started in November 2010 and will continue through to late Spring 2011 on topics related to oral care skills for care providers of frail and dependent older adults.

These webinars are FREE, max 30 min in length, and are available to health care and oral care providers, educators, managers.

All webinars will be archived on the web for future viewing/downloading.

To Register, go to and complete the online form at https://www.surveymonkey.com/s/WebinarsOralHealth

For more information contact:
Terry Kirkpatrick at tekirkp@sympatico.ca or 613‐762‐7752
Mary‐Lou van der Horst at dhm9@xplornet.com or 905‐541‐0656

Senior Friendly Care in Toronto

2011-01-21T10:36:00.000-06:00

Prepared for the Toronto Central Local Health Integration Network by the Regional Geriatric Program of Toronto

The background document, survey and summary report were commissioned by the Toronto Central LHIN to support its Integrated Health Service Plan 2010-2013 priorities, including a commitment to reduce the risk of functional decline for seniors while in acute care.

The documents describes the case for change and introduces a Senior Friendly Hospital Framework. The goal is to inform senior leaders in hospitals on how to modify the way care is organised and provided to older patients. Additionally, it is intended to emphasize the multiple dimensions of organizational change essential to achieve improved health outcomes for seniors. T

Documents include:
• senior friendly care backgrounder july 2010_final
• self assessment template senior friendly care july 2010
• A Summary of Senior Friendly Care in Toronto Central LHIN Hospitals

How can local authorities with less money support better outcomes for older people?

2011-01-20T10:42:00.001-06:00

From the Joseph Rowntree Foundation, written by the UK Centre on Policy on Ageing, this "Solutions" document provides examples of imaginative, affordable and effective ways of supporting older people’s health, well-being, social engagement and independence.

The projects demonstrate the importance of:

involving people who use support and services in shaping them;
investing in collective solutions, small grants or seed-funding for self-help groups, and developing local markets to provide the support people want and value;
greater emphasis on the assistance that older people need and choose, and their experiences rather than on conventional social care and/or services;
developing place-based approaches that reflect the whole of people's lives, and delivering value for money, for example by including transport, leisure, and fire and rescue services to co-ordinate support.

http://www.jrf.org.uk/sites/files/jrf/authorities-supporting-older-people-summary.pdf

Dementia Risk Assesment Tool

2011-01-17T10:26:00.001-06:00

This online dementia risk assessment was developed by experts at The Copper Ridge Institute, affiliated with The Johns Hopkins University School of Medicine.

This assessment will help provide guidance as to whether you, or someone you know, may have higher risk for having dementia and should speak further to a physician.

http://www.alzcast.org/memorysurvey/

Use of Advance Directives in Long-term Care Populations

2011-01-11T08:54:00.000-06:00

An advance directive (AD) allows a patient to communicate health care preferences in the event that he or she is no longer able to make these decisions (1). Many view advance care planning (ACP)—a process that includes discussing values and goals of care among the patient, family, and physician, and determining or executing treatment directives—as a way to help ensure that wishes about end-of-life care are honored (2). Ideally, ADs are part of the ACP process. Research indicates that the preference for having an AD can be influenced by individual attitudes, cultural beliefs, health conditions, and trust in health care professionals. This report, from the National Center for Health Statistics (U.S.), presents the latest national data on ADs in three long-term care populations—those receiving home health care or hospice care and those residing in nursing homes.

http://www.cdc.gov/nchs/data/databriefs/db54.pdf

The Impact of a Regulatory Intervention on Resident-Centered Nursing Home Care: Rhode Island’s Individualized Care Pilot

2010-12-22T08:07:00.002-06:00

Overview

In an effort to use the annual nursing home survey process to promote resident-centered care practices, the Rhode Island Department of Health implemented the Individualized Care Pilot from November 1, 2007, to April 30, 2008.

The initiative promoted resident-centered care primarily through activities integrated with the annual recertification inspection. In addition to enhancing existing survey processes, the pilot incorporated a visit from the state Quality Improvement Organization into the survey process itself.

This study assessed the impact of that pilot on resident-centered care practices. Online surveys were sent to administrators at all Rhode Island nursing homes pre- and post-pilot. Based on reports from participating homes, the pilot helped nursing home administrators understand, consider, and implement resident-centered care. The findings paint a promising picture about the potential to spur provider change through a multipronged approach centered on the regulatory process.

BP Blogger Myth-Busting Newsletter for LTC: STroke 2

2010-12-14T14:07:00.000-06:00

The latest issue of the BP Blogger Myth-busting Newsletter for LTC on Stroke is now available.

This newsletter is a collaborative effort of the Ontario Stroke Network Community & LTC Specialists and the Regional Geriatric Program-Central (Hamilton).

For back issues on 22 topics, go to www.rgpc.ca or www.shrtn.on.ca

Anxiety Disorders

2010-12-10T14:45:00.002-06:00

The newest addition to the NIHSeniorHealth website looks at Anxiety Disorders.

Anxiety disorders are characterized by persistent, excessive and disabling fear and worry and get progressively worse if left untreated. It is estimated that anxiety disorders affect between 3 and 14 percent of older adults in a given year.

Visitors to the website can learn about the risk factors, symptoms and treatments for generalized anxiety disorder, social phobia, panic disorder, post-traumatic stress disorder (PTSD), obsessive compulsive disorder (OCD) and specific phobias such as fear of flying or fear of public speaking. Anxiety disorders can severely affect a person’s life, and they are often overlooked in older adults.

This easy-to-use, senior friendly website features basic health and wellness information for older adults from the National Institutes of Health.

http://nihseniorhealth.gov/anxietydisorders/aboutanxietydisorders/02.html

Profiles of State Innnovation: Roadmap for Managing Long-Term Care Supports and Services

2010-12-02T15:51:00.001-06:00

In November, 2010, the Center for Health Care Strategies (CHCS) published its third report in a series on innovative strategies for providing long-term services and supports to low-income people with Medicaid.
Profiles of State Innovation: Roadmap for Managing Long-Term Supports and Services identifies the best practices in the nation for delivering effective long-term services and supports under Medicaid managed-care programs.

The SCAN Foundation, CHCS conducted an environmental scan to identify state best practices for rebalancing programs to provide innovative alternatives to nursing homes including, expanding the pool of personal care workers to increase the numbers of beneficiaries in home and community settings; take advantage of initiatives that help people move out of nursing homes and into the community; and analyze relevant data to track quality of care metrics that reflect the vision of the long-term care program .

Health and Well-being of Canadian Seniors

2010-12-01T15:28:00.001-06:00

The Chief Public Health Officer's Report on The State of Public Health in Canada 2010 (released October 2010) contains a chapter on the Health and Well-Being of Canadian seniors. This is an excellent summary and overview with statistics of the current health and well-being of the Canadian population aged 65 years and older, including patterns of ill health and disability within this age group. It focuses on physical and mental health as well as economic and social well-being.

Topics include:

· Demographics of the senior population
· Physical health
· Life expectancy
· Mortality
· Chronic conditions and infectious disease
· Mobility and functional health
· Falls and related injuries
· Underweight and obesity
· Health Behaviours
· Physical Activity
· Health Eating and Nutrition
· Smoking
· Alohol Abuse
· Medication use
· Mental Health
· Alzheimer’s and Dementia
· Depression
· Delirium
· Economic and Social Well-being

http://www.phac-aspc.gc.ca/cphorsphc-respcacsp/2010/fr-rc/cphorsphc-respcacsp-06-eng.php

The private cost of long-term care in Canada : where you live matters (2010)

2010-11-15T09:00:00.001-06:00

Published in October, 2010 in the SEDAP research series, this paper explores the Canadian economic experience access to long-term care health care. The authors found that the private cost of long-term care differs greatly across the country, and within provinces, with substantial variation, depending on income level, marital status, and, in Quebec alone, on assets owned. A non-married person with average income would pay more than twice as much in the Atlantic provinces as in Quebec, while a couple with one in care would pay almost four times as much in Newfoundland as in Alberta

The Program for Research on Social and Economic Dimensions of an Aging Population (SEDAP) is an
interdisciplinary research program centred at McMaster University with co-investigators at seventeen other
universities in Canada and abroad. The SEDAP Research Paper series provides a vehicle for distributing
the results of studies undertaken by those associated with the program.

http://socserv.mcmaster.ca/sedap/p/sedap277.pdf

Implementing and Disseminating an Evidence-Based Program to Prevent Falls in Older Adults, Texas, 2007-2009

2010-11-08T08:58:00.000-06:00

From Prevention in Chronic Disease Dis 2010;7(6), this paper addresses the growing issue of falls as a public health problem, and describes a statewide effort in Texas to implement and disseminate A Matter of Balance/Volunteer Lay Leader model, an evidence-based fall prevention program.

http://www.cdc.gov/pcd/issues/2010/nov/09_ 0224.htm

Growing Older: Adding Life to Years

2010-11-03T13:34:00.003-05:00

The Chief Public Health Officer's Report on the State of Public Heath in Canada, 2010: Growing Older - Adding Life to Years is now public and available on the Public Health Agency of Canada website: ht! tp://www.phac-aspc.gc.ca/cphorsphc-respcacsp/index-eng.php

Emotional Experience Improves With Age: Evidence Based on Over 10 Years of Experience Sampling

2010-10-28T14:24:00.000-05:00

A new Stanford University study shows that as we grow older, we tend to become more emotionally stable, and that translates into longer, more productive lives that offer more benefits than problems,

Read full story in Stanford Report
Download PDF of Psychology and Aging article

Improving Patient Safety in Nursing Homes

2010-10-27T13:49:00.002-05:00

This document from the Agency for Health Research and Quality (AHRQ) contains references to Web sites that provide practical resources nursing homes can use to implement changes to improve patient safety culture and patient safety. This resource list is not exhaustive, but is provided to give initial guidance to nursing homes looking for information about patient safety initiatives. This document will be updated periodically.

General resources are listed first, in alphabetical order, followed by resources organized by the dimensions assessed in the Agency for Healthcare Research and Quality (AHRQ) Nursing Home Survey on Patient Safety Culture (available at http://www.ahrq.gov/qual/patientsafetyculture).

Resources by Dimension:

Dimension 1. Overall Perceptions of Resident Safety
Dimension 2. Feedback;Communication About Incidents
Dimension 3. Supervisor Expectations and Actions Promoting Resident Safety
Dimension 4. Management Support for Resident Safety
Dimension 5. Organizational Learning
Dimension 6. Training; Skills
Dimension 7. Compliance with Procedures
Dimension 8. Teamwork
Dimension 9. Handoffs
Dimension 10. Communication Openness
Dimension 11. Nonpunitive Response to Mistakes
Dimension 12. Staffing

http://www.ahrq.gov/qual/nhsurvey10/nhimpptsaf.htm

A New Tool for Delivering Culturally-Competent Geriatric Care

2010-10-19T10:10:00.001-05:00

By the middle of this century, one out of every three older Americans will be from a diverse group of minority populations.

The eCampus geriatrics portal. is an educational website that offers a range of tools and resources to help health-care professionals provide culturally-competent geriatric care.

The site is divided into three areas:

Culture Med: is a collection of five ethnogeriatrics modules that include instructional strategies and a student evaluation guide. Topics include an introduction, an overview of patterns of health risks and mortality.
Ethno Med: provides detailed information on specific ethnicities, as well as instructional and student evaluation strategies.
Tools and Resources: includes video teaching tools and slide show presentations.

Measuring the Quality of Long-Term Care

2010-10-19T09:57:00.004-05:00

At at least 70% of the over 65s will require some long-term care (LTC) services during their lives, and pojections suggest that over the next twenty years the total cost of LTC will rise by 110%. Ensuring the quality of the long term care services and learning from current experience will continue to be of great importance.

The current issue of Eurohealth (v. 16(2), 2010 published by LSE Health, London School of Economics and Political Science, examines approaches to measuring quality in seven countries:

US: Vincent Mor discusses the advancement of public reporting of provider performance as a means of introducing quality based competition.

Germany: Andreas Büscher describes Germany's program of publishing overall quality scores for LTC facilities for the general public, and in order to develop expert standards and quality indicators.

Finland: Harriet Finne-Soveri and colleagues review nine years experience using the US originated Resident Assessment Instrument benchmarking system.

Austria: Birgit Trukeschitz describes the introduction, not only of a national quality certificate for care homes, but also a tool to be used in respect of quality of home-based care provided by nursing staff.

England: Juliette Malley takes a critical look at the impact of quality measures, and their usefulness as independent, reliable measures of quality.

National Resource Center on LGBT Aging Launched

2010-10-13T08:36:00.000-05:00

The National Resource Center on LGBT Aging is the US's only technical assistance resource center aimed at improving the quality of services and supports offered to lesbian, gay, bisexual and transgender (LGBT) older adults. Established in 2010 through a federal grant from the U.S. Department of Health and Human Services, the National Resource Center on LGBT Aging provides training, technical assistance and educational resources to aging providers, LGBT organizations and LGBT older adults. The center is led by Services & Advocacy for GLBT Elders (SAGE) in partnership with 10 leading organizations from around the country.
The National Resource Center on LGBT Aging was officially launched in October 2010, unveiling a web site that will serve as a comprehensive clearinghouse of information for aging providers, LGBT organizations and LGBT older adults. Over time, SAGE and our 10 organizational partners will provide more and more training and develop even more tools and resources for aging providers, LGBT organizations and LGBT older adults.

http://www.lgbtagingcenter.org/

Defining Dining: It's About Me

2010-10-06T11:34:00.000-05:00

“Defining Dining: It’s About Me” is this year’s theme of the National Consumer Voice for Quality Long Term Care Residents' Rights Week. Resident’s Rights Week is celebrated by the National Consumer Voice in the first full week in October each year to honor residents living in all long-term care facilities, including nursing homes, sub acute units, assisted living, board and care and retirement communities. This offers an opportunity for every facility to focus on and celebrate awareness of dignity, respect and the value of each individual resident.

The site contains a number of useful staff training resources for enhancing the dining experience of residents, including a Powerpoint presentation for staff education, a presentation guide and a poster of dining enhancement ideas.
http://www.theconsumervoice.org/resident/nursinghome/residents-rights

Aging Well in Communities: A Toolkit for Planning, Engagement & Action

2010-10-06T09:56:00.000-05:00

The Center for Civic Partnerships has created Aging Well in Communities: A Toolkit for Planning, Engagement & Action. The Center for Civic Partnerships' mission is to provide leadership and management support to build healthier communities and more effective nonprofit organizations.The Center for Civic Partnerships is a center of the Public Health Institute.

The toolkit includes:

A community planning overview, which presents key elements of an aging well planning process
Step-by-step guides for three important data-gathering activities:
Case studies that show how seven communities are addressing the needs of an aging population
A resource list of web sites and organizations offering valuable information on aging-related issues