BMJ analysis notes in overstretched UK primary care system, acid test is likely to be whether GPs find that a focus on frailty helps to reduce, rather than increase, professional burden in dealing with their most complex patients, while also benefiting their older frail patients.
This guideline covers the care and support of adults receiving social care in their own homes, residential care and community settings | National Institute for Health and Care Excellence (NICE)
This NICE guideline aims to help people understand what care they can expect in residential and community settings, and to improve their experience by supporting them to make decisions about their care.
The guideline has been developed by a committee of people who use services, and carers and professionals. It has used information from a review of research evidence about people’s experiences of care and support, and from expert witnesses. The committee also gave consideration to the potential resource impact of the recommendations. The recommendations are considered to be aspirational but achievable.
The return on investment tool pulls together evidence on the effectiveness and associated costs for interventions aimed at preventing falls in older people living in the community. The flexible Excel sheet allows for results to be tailored to the local situation based on the knowledge of the user. All interventions are aimed at those aged 65 and over.
The tool comes with an accompanying report, which details how the tool was constructed and presents the main results.
The second report summarises the findings from a literature review carried out to identify cost-effective interventions.
Local authorities and Clinical Commissioning Groups (CCGs) can use results from the tool to protect and improve the health of their local populations when making commissioning decisions.
Enhanced health in care homes: learning from experiences so far | The King’s Fund
This report draws on published literature about joining up and co-ordinating care homes and health services. It also draws on interviews with a range of providers, local authorities and CCGs. It aims to help care homes and NHS providers (including GPs), local authorities and CCGs who are thinking through how to join up and co-ordinate services locally and how to manage the complexities involved.
The report makes recommendations for extending enhanced health in care homes to all areas, supporting and developing leaders, and ensuring that people living in care homes can access high-quality health care.
Comprehensive geriatric assessment may increase the likelihood that frail older people can be discharged to independent living | Cochrane Database of Systematic Reviews | via National Institute for Health Research
Older people who received comprehensive geriatric assessment when in hospital were slightly more likely to be living in their own homes one year later. Sixty percent were discharged to independent living compared with 56% receiving standard ward care. People who had received this proper assessment were also 20% less likely to be in a nursing home after three months or more.
Comprehensive geriatric assessment is a careful review by a multidisciplinary specialist team of people’s medical, functional, mental and social capabilities. It aims to improve recovery and enable people to maintain function and independence.
This updated Cochrane review covered 29 trials compares this assessment with routine care for people over 65, excluding those with stroke and orthopaedic conditions. It may save NHS resources, but the quality of evidence was too low to assess this reliably.
Hazra N C, Rudisill C, Gulliford M C. Determinants of health care costs in the senior elderly: age, comorbidity, impairment, or proximity to death? Eur J Health Econ. 2017. [Epub ahead of print].
Ageing on its own does not drive healthcare costs. Instead, this research found that the increasing number of health conditions and age-related impairments along with the proximity to death are more strongly linked to healthcare costs than age alone.
This UK study investigated healthcare costs in people over 80 years old. Costs increased to the mid-90s before declining again. Proximity to death was the strongest predictor of cost, which was higher for people aged 80-84: £10,027 per year versus £7,021 per year for those over 100. Multiple illnesses also had a strong influence, with each additional health complaint progressively increasing costs.
This suggests that to provide person-centred and efficient healthcare services for all, planning should take account of the number and types of conditions rather than age alone.
National Institute for Health Research (NIHR) Themed Review: Advancing Care: Research with care homes
There are more than twice as many people living in care homes in England and Wales, than there are people staying in hospital. Yet we know far more about effective treatments in hospital and less about what works most effectively to improve care for older people in care homes. Research in care homes is a relatively new and emerging field.
Advancing Care provides an overview of recent NIHR research on improving the health and care of care home residents. It highlights current research taking place now and explores new approaches being developed in this important area.
The reviewbrings together NIHR research on three themes relating to the care of older people in care homes: Living well – maintaining good health and quality of life, ageing well – managing long term conditions associated with ageing, and dying well – ensuring a good quality end of life. It features:
23 published studies
21 ongoing studies
Quotes from care home owners, managers, staff and researchers