Table 4 - uploaded by Dan Venables
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Source publication
Current policy in England emphasises the importance of caring for highly dependent older people for as long as possible at home. It is therefore crucial that day care services are effective and widely available.
To compare the type and standard of care provided for older people with dementia in day centre and day hospital settings.
A cross-sectiona...
Context in source publication
Context 1
... hospitals scored significantly higher than the day centres in terms of factors that might encourage reha- bilitation (mean difference ¼ 2.7 [95% CI ¼ 1.7-3.7]; p < 0.001) (Table 4). Occupational therapy, reality orientation boards, snoezelen or sensory rooms, phy- siotherapy ( p < 0.001), speech therapy ( p < 0.01) and reminiscence rooms ( p < 0.05) were more likely to be found in day hospitals. ...
Citations
... In recent years, day surgery has grown rapidly and has become a major surgical pattern in In Britain, the United States, and Canada. [12][13][14][15] Ophthalmic surgeries require short operative time and are usually performed on patients in good conditions, contributing to the application of ophthalmic day surgeries. [2] There are 7 steps in the surgery process: outpatient consultation, pre-operative examination, surgery appointment, admission, surgery, discharge, and follow-up. ...
Purpose
We aim to discuss the construction, operation, and prospects of ophthalmic day-care wards in general hospitals and to provide a reference for the management of ophthalmic day-care wards.
Methods
Nursing staff with clinical experience were arranged to participate in the construction of ophthalmic day-care ward, including the ward layout, staff training, and management. WeChat groups were set up to promote health awareness. Clinical information was collected from patients who had ophthalmic day surgeries at our hospital between January and December 2021. All patients had standard medical procedures for admission, treatment, and health education. The incidence of adverse events, age distribution, disease types, and reasons for canceling surgeries were analyzed to evaluate the operation of ophthalmic day-care wards.
Results
A total of 4,830 patients were admitted between January and December 2021. Cataract accounted for the largest proportion of disease types (89.4%). 61.45% of patients were aged between 61 and 80. No medical adverse events, such as information error, iatrogenic injury, equipment failure, and medication error occurred.
Conclusion
The keys to a well-functioning ophthalmic day ward are 1. management by nursing staff with adequate clinical experience; 2. emphasis on health awareness; 3. pre-operative preparation and assessment 4, standard medical procedures for admission, treatment, and health education. Day-care wards are high-quality and low-cost, which will benefit ophthalmic patients and be a useful addition to the medical field.
... (Salter, 1992: 20) Following a 1994 Audit Commission report, which had called for day centre providers to define their role (Powell et al., 2000), by the beginning of the 21st century, statutory day centres were coming under increased scrutiny and criticism. Although day centres had been formally constituted for more than 50 years, there was little evidence of any formal evaluation (Morley, 1974;PricewaterhouseCoopers, 2007) and no national standards had been developed (Reilly et al., 2006). The emergence of day centres without specific guidance was not surprising given the burst of activity in terms of welfare services in the Attlee government of the late 1940s (Johns, 2011), but a set of minimum standards in Northern Ireland were finally drafted in 2012 (Department of Health, Social Services and Public Safety Northern Ireland (DHSSPSNI), 2012). ...
... Criticisms of day centres are rife in the literature, with their being described as being poorly co-ordinated and unprofessional (Nies et al., 1991;Reilly et al., 2006), segregating (PricewatershouseCoopers, 2007;Karpf, 2014), inaccessible (Clark, 2001;McLeod et al., 2008), paternalistic (Roulstone and Morgan, 2009;Duffy, 2010;Age UK, 2011), infantilising (Ritchie, 2003;Tse and Howie, 2005), unstimulating (Manthorpe and Moriarty, 2014) and undesirable (Weeks and Roberto, 2002;Heenan, 2006). Older people are conscious of these concerns and have reported hesitation about attending, though often feel happy with the service and how they are treated after a few visits (Powell et al., 2000;Ritchie, 2003;Lund and Engelsrud, 2008;Caiels et al., 2010). ...
The social needs of frail or isolated older people are sometimes aided by referrals to day centres in the United Kingdom. Since the late 1940s, day centres have had a role to play promoting socialisation in later life. Additionally, attendance at day centres is often open ended, with participants only leaving due to moving to a nursing home or dying. In this study, the views of those attending time-limited day centre programmes in seven day centres in Northern Ireland have been sought in relation to their thoughts about the service as well as how they feel when it ends. Seventeen participants completed diaries for the programme duration and/or engaged in an interview process. Participants reflected on the social and educational benefits of attending but also recognised impositions in the centres that impinged upon individual choices and also the length of time they could remain. This study reveals that, in order to maintain socialisation, time-limited programmes must have clear follow-on strategies for participants. Additionally, respondents' experiences reflect that a paternalistic model of care delivery remains in place that, whilst restrictive, reveals that access to the service is more specialised and not universal. Nevertheless, should day centres wish to remain relevant, it is important that service users are fully consulted about their desires and choices within the setting.
... The majority of the studies that examined dementia care were conducted in the US ( Ready et al., 2004;Carroll et al., 2005), Japan ( Miyamoto et al., 2002;Suwa 2002;Hosaka and Sugiyama, 2003;Fukushima et al., 2005), Korea (Kim et al., 2002), Australia and New Zealand (Shanley, 2006), UK ( Upton and Reed, 2005;Hoe et al., 2005;Hoskins et al., 2005;Reilly et al., 2006) and the rest of Europe, including Italy ( Balla et al., 2007), the Netherlands ( Droes et al., 2004a;Droes et al., 2004b), Germany (Zank and Schacke 2002;Zank and Frank 2002), Denmark (Vogel, 2006), Sweden ( Ericson et al., 2001, Andren andElmstahl 2005;Mavall and Thorslund, 2007), France ( Thomas et al., 2002;Gramain et al., 2004). In Canada, a landmark study of dementia was conducted by the Canadian Study on Health and Aging (CSHA) working group in the early 1990's. ...
Little research has been conducted on examining the relationship between caring interventions such as adult day programs (ADPs) and the quality of life (QOL) of individuals with Alzheimer’s disease. Our study objective was to investigate the merits of attending ADPs on the QOL of these individuals. We hypothesized that individuals with Alzheimer’s disease who attended ADP had higher QOL than those who did not. We also hypothesized that individuals with Alzheimer’s disease who attended ADP enjoyed comparable QOL as their non-diseased counterparts. To explore these issues, we piloted a cross-sectional study in Durham, Ontario, Canada. We recruited 130 participants at five ADPs and at six caregiver support groups in the region. Among them, there were 73 disease-free ADP clients, 28 ADP clients with Alzheimer’s disease and 29 individuals with Alzheimer’s disease who did not attend ADPs. Study procedures involved primary data collection using assisted self-report questionnaires and a 13-item quality-of-life scale. This current paper provided a detailed description of the study process. We also provided results that showed overall QOL scores for individuals with Alzheimer’s disease who attended ADP were comparable to those without the disease (2.7 vs. 2.9, p=0.1), whereas the scores were much lower for individuals with Alzheimer’s disease who did not attend ADP than those who attended ADP (1.9 vs. 2.7, p=0.0001). Individuals who attended ADP consistently provided higher ratings than those who did not attend ADP. Based on our findings, we concluded that attending ADPs may be partially responsible for the observed differences in QOL.
... DCs represent day care facilities which provide vulnerable older adults living in the community with assistance in the activities of daily living, social support, physical exercise and occupational therapy (Reilly et al. 2006). DCs address a wide range of needs including the prevention of physical and functional deterioration and the promotion of companionship and social stimulation. ...
... DCs address a wide range of needs including the prevention of physical and functional deterioration and the promotion of companionship and social stimulation. Actually, the majority of DC attendants are older people with cognitive impairment, as shown by a recent survey conducted in the North West of England, in which 72% of DC attendees had been diagnosed with dementia (Reilly et al. 2006). It is therefore not surprising that in assessing the effectiveness of DC services, the outcomes taken into account mainly refer to older adults with dementia and their caregivers: an improvement in the mood of the elders, a reduction or a delay in their admission to hospital and to long-term facilities, a lesser caregiver distress (Engedal 1989;Gitlin et al. 2006;Smits et al. 2007). ...
... Cross-sectional study comparing subjects attending a DC (the ''attendants'' group) with those not attending a DC (the ''non-attendants'' group). We decided to quantify DC attendance on a weekly basis, in line with a recent study (Reilly et al. 2006), i.e., as the number of days of attendance per week in the past month, with once a week being the lowest possible attendance in our country. This seems to be a reasonable choice in our specific setting: the older persons in Milan generally attend DCs on specific days of the week which usually do not change over time. ...
Late-life depression is associated with disabled functioning and a poor quality of life (QOL). The aim of this cross-sectional
study was to find out whether the attendance of a day care centre (DC) was associated with QOL in community-dwelling older
adults suffering from a depressive disorder without dementia. The study enrolled 149 depressed older adults aged 70 or older,
who consecutively underwent a comprehensive geriatric assessment from April to July 2008 at the Geriatric Medicine Unit of
the Fondazione Ospedale Maggiore Policlinico in Milan, Italy. QOL was evaluated by means of the European Quality of Life Visual
Analogue Scale (EuroQol VAS). DC attendance was quantified as number of days of attendance per week in the past month. Participants
attending a DC at least once a week (n=17) had a higher mean EuroQol VAS score than non-attendants (n=132) (mean±SD 58.8±19 vs. 45.3±22.5; P=0.019). In multiple linear regression analysis a higher weekly attendance of DCs was related to a better quality of life
according to the EuroQol VAS score (unstandardized coefficient 3.048, 95% CI 0.063–6.033, P=0.045) after correction for age, sex, balance and gait abilities, comorbidity, pharmacotherapy, living alone, and severity
of depression. Therefore, in older outpatients suffering from a depressive disorder without dementia the attendance of a DC
was an independent correlate of the QOL. A randomized controlled longitudinal study will be necessary to determine whether
attending a DC is really effective on the QOL in the management of late-life depression.
KeywordsDay care centres-Depression-Older outpatients-Quality of life-Social participation
... Personen in Leitungsfunktion setzen andere Schwerpunkte bei ihren Qualitätsvorstellungen. Es handelt sich zwar auch um Aspekte der Prozessqualität, allerdings wird die Bedeutung des gerontopsychiatrischen Assessments und die Absprache mit den Angehörigen zur Festlegung der Therapieziele betont. Diese Qualitätskriterien aus Anbietersicht stimmen mit den Ergebnis− sen einer Befragung an gerontopsychiatrischen Tageskliniken in Großbritannien überein [18], in der zusätzlich zu den hier ge− nannten Qualitätskriterien ausreichend demenzgeschultes Per− sonal gefordert wurde, um die Selbstständigkeit der Patienten fördern zu können. Auffällig ist, dass weniger als die Hälfte der Befragten geronto− psychiatrische Tageskliniken kannten. ...
Anliegen Analyse von Prädiktoren der Inanspruchnahme gerontopsychiatrischer Tageskliniken und von Qualitätswünschen pflegender Angehöriger von Demenzpatienten. Methode Von 404 Angehörigen wurden quantitative und qualitative Daten erhoben und regressions- bzw. inhaltsanalytisch ausgewertet. Ergänzend wurden Leitungspersonen in Tageskliniken interviewt. Ergebnisse Einziger signifikanter Inanspruchnahmeprädiktor ist der Bedarf der Angehörigen an tagesklinischer Unterstützung. Die häufigsten Qualitätswünsche beziehen sich auf die Personalqualifikation und die Inhalte der Intervention. Schlussfolgerung Um die Inanspruchnahme gerontopsychiatrischer Tageskliniken zu steigern, müssen die Angehörigen der Erkrankten von den Vorteilen, die sich daraus für sie ergeben, überzeugt werden.
... While DCM involves a detailed recording of the process of care, other indicators of person-centred care have tended to focus on the structure of care. For example, Reilly et al. (2006) included a policy of no uniforms for staff as one component of person-centred care. There is a tension between developing indicators that are workable in practice whilst being sufficiently detailed to capture the nuances of person-centred care. ...
... The present study represents a considered attempt to explore the meanings of person-centred care and to translate this abstract concept into practical tools. While a number of indicators, or benchmarks, for person-centred care have previously been developed, these have tended to focus on the structure rather than the process of care, and have relied heavily on professional perspectives (Baker and Edwards, 2002;Reilly et al., 2006). The present study included the perspectives of all stakeholders both in identifying the components of person-centred care and in evaluating the tools developed. ...
... However, it is necessary to be cautious in the interpretation of health care involvement since other factors unrelated to the implementation of the SAP may have contributed to the variation in health personnel involvement in the assessments and care plans as documented in this study. First, it should also be borne in mind that differences that exist between authorities in the provision of health care services may also depend to some degree on supply factors, for example not all authorities in the study had a day hospital facility available, a picture that has been replicated on a wider scale (Reilly et al., 2006). Second, it is possible that in respect of the social care of older people, health care staff, and nurses in particular, may be moving into a predominantly more acute assessment role and away from involvement in long-term care. ...
National Evaluation of the Single Assessment Process: Stage II Vol 1
Purpose
The growing range and complexity of community care services require robust approaches to ensuring quality.
Method
This review collated studies on the use of standards in regulating community health and social care using Social Care Online, MEDLINE and CINAHL databases. Studies were appraised by two reviewers and synthesized by study themes.
Results
Sixteen studies were synthesized under three themes:
• standards in quality assurance and quality improvement;
• effectiveness of standards; and
• design of regulatory standards.
Standards facilitate providers in self-regulation and enable regulators to support and monitor improvement. Effectiveness of standards depends on their language and interpretation, and on organizational factors. There was little evidence of scales within quality standards.
Discussion
There is continuing debate about self-regulation versus external regulation. Social care service regulation requires more research.
Conclusion
Regulatory organizations should take note of wider initiatives toward evidence-based practice in the design of quality standards.
Le Plan Alzheimer 2008/2012 avait comme but d’améliorer le soutien apporté aux patients âgés et à leurs familles. Objectif : Décrire la typologie des patients, pris en charge dans un hôpital gériatrique de jour de suivi, entre 2008 et 2012. Méthodes : Programme de médicalisation des systèmes d’information centré sur le nombre de maladies associées et plusieurs indicateurs spécifiques. Résultats : Le nombre de patients a augmenté entre 2008 (109) et 2009 (293) puis est resté stable (environ 300). Les différences entre 2008 et les années suivantes ont été statistiquement significatives pour le nombre de maladies associées (p < 0,001) et le nombre de jours / patients (p < 0,01), mais pas pour la période 2009-2012. Conclusion : Les variations des indicateurs semblent être liées au développement des nouvelles structures et à un changement dans l’organisation des réseaux gérontologiques.
