ABSTRACT: While Magnet is a commitment to excellence and thus recognition, the accountable care organization (ACO) focus is to quality and reimbursement. Each can be built on a model of shared characteristics that in the end will prove a source of success for the creation of an organization that is ...

Over the past three decades, diagnosis related groups (DRG) have revolutionized hospital funding by successfully focusing hospitals attention on the 'production' process. However, using DRG for funding acute hospitals does little to create incentives outside of the hospital, or coordinate health care across providers and settings. With many health care ...

Making healthcare provision more sustainable against a backdrop where 'even the sceptics are admitting the Earth will face cataclysmic change if the economy and environment are not re-aligned', maintaining safe, sustainable care environments while experiencing 'a reform programme so big that you can see it from space', and the importance ...

Saskatchewan has embarked on a journey to transform the quality of its healthcare. Through our experiences, we have learned many lessons that could be useful to the development of a pan-Canadian system of measurement aimed at bettering care. However, measurement in isolation is insufficient to achieve improved healthcare. The system ...

Aims and objectives  To determine the opinion of primary care doctors regarding the cardiovascular risk tables, their degree of use in clinical practice and the specific difficulties encountered when using them. Method  Transversal descriptive study. Location  Primary Care, Madrid, Spain. Participants  Primary care doctors from four of Madrid's sanitary areas. ...

Aim  To explore the feasibility and acceptability of implementing a personal care planning approach for diabetes care in general practice. Methods  A four-stage care planning process was introduced for diabetes annual review, involving patients (1) being made aware of the new process, (2) attending an appointment to gather clinical data, ...

To describe primary care management of knee pain, in relation to National Institute for Health and Clinical Excellence (NICE) OA guidelines, and examine variation in management by patient characteristics. Subjects were 755 adults aged ≥50 years who responded to baseline and 3-year surveys and had consulted primary care for knee ...

Meeting the information needs of family caregivers in a timely and appropriate way is a key concern of home care. The present study aimed to explore the following two areas: (a) the priority information needs and sources of family caregivers of home elderly patients and (b) the differences in information ...

Summary Background  Cellulitis is responsible for over 400 000 bed days per year in the English National Health Service (NHS) at the cost of £96 million. Objectives  An audit following transfer of care of lower limb cellulitis managed in secondary care from general physicians to dermatologists. Methods  Review of patient details ...

Elderly care includes complex interactions between formal services, informal care, morbidity and disabilities. Studies of the incremental effects of formal and informal care are rare and thus the objective was to describe the longitudinal patterns in formal and informal care given to non-demented and demented persons living in a rural ...

The purpose of this article is to describe our experience in implementing a primary care-based dementia and depression care program focused on providing collaborative care for dementia and late-life depression. Capitalizing on the substantial interest in the US on the patient-centered medical home concept, the Aging Brain Care Medical Home ...

People caring for family members who have dementia often experience considerable levels of anxiety and depression. However, relatively little is known about the awareness of carer distress among people with dementia. This study investigated whether or not people with dementia are aware of the level of distress experienced by their ...

This systematic review aimed to establish best practice in relation to thickened fluids for people with dementia living in residential aged care facilities. This review considered all types of studies that examined the prescription and administration of thickened fluids to people with dementia in residential aged care facilities. English-language articles ...

If early intervention in dementia care is to be enhanced, it is important to have a critical debate over how this should be realized. In this paper, we offer a synthesis of two approaches to care: mental health recovery and person-centred care, and apply them to early-stage dementia care. 'Person-centred ...

This systematic review investigated the prescription, administration and effectiveness of oral liquid nutritional supplements (OLNS) for people with dementia in residential aged care facilities (RACF). A comprehensive search of relevant databases, hand searching and cross-referencing found 15 relevant articles from a total of 2910 possible results. Articles which met the ...

Early development of advance care plans is an ethical and supportive intervention providers can offer patients and families facing a dementia diagnosis.

Objectives. To investigate how well recognized the association between rheumatoid arthritis (RA) and excess cardiovascular (CV) risk is within primary care and the current assessment strategies being employed by general practitioners (GPs). Methods. Questionnaires were sent to all 376 GPs in the Worcestershire Primary Care Trust. Results. Thirty-two per cent of GPs identified ...

Two-thirds of all residents in nursing homes in Germany suffer from some type of dementia. We investigated whether or not dementia patients receiving special (segregated or partially segregated) care exhibited a better quality of life than their counterparts residing in traditional nursing homes. In a cross-sectional study in 28 special ...

The purpose of this review is to critically evaluate the available evidence from the published scientific literature on dementia care and service provision in rural and remote settings from the perspective of formal/paid caregiving, in order to assess the current state of knowledge, identify policy and practice implications, and make ...

OBJECTIVE: Care for demented people is very resource demanding, the prevalence is increasing and there is so far no cure.Cost of illness (CoI) studies are important by identifying the distribution of costs between different payers of care. The European Union (EU) funded the European Collaboration on Dementia (Eurocode) as part ...

Memory clinics have been promoted as opportunities for improving dementia diagnosis and care. This article describes the implementation of an interdisciplinary memory clinic within primary care in Ontario, Canada, that aims to provide timely access to comprehensive assessment and care and to improve referring physicians' knowledge of the management of ...

The study examined the ability of trained General Practitioners (GPs) to carry out guideline based diagnostics and therapy of dementia. The article reports the GP-related findings. 100 GPs took part in the prospective multi-centre study. 34 GPs started self-guided medical dementia care after attending a special training. The control group ...

Literature suggests that quality of life (QOL), quality of care (QOC) and Behavioural and Psychological Symptoms of Dementia (BPSD) can be improved by relatively simple and inexpensive person-centred approaches to nursing care practices (PCC) and modifications to physical environment (PCE). Most research on this topic is observational and few randomised ...

This Australian study explored management for older people with dementia in an acute hospital setting. As the population ages, increasing numbers of older people with dementia are placed into an acute care hospital to manage a condition other than dementia. These people require special care that takes into account the ...

How should suspected pneumonia be treated in patients with advanced dementia?

To determine the acceptability of dementia screening in two populations of older adults in different primary care settings. Cross-sectional study of consecutive patients presenting for primary care appointments in the Duke University Health System (n = 152) or Durham VA Medical Center (n = 193) were evaluated face to face using the Dementia Screening ...

Psychosocial interventions in long-term care have the potential to improve the quality of care and quality of life of persons with dementia. Our aim is to explore the evidence and consensus on psychosocial interventions for persons with dementia in long-term care. This study comprises an appraisal of research reviews and ...

Canadians with dementia have access to Medicare, a universal, single payer healthcare program. Implementation of Medicare is through the provinces and territories, giving variation in the level of care available. At present, there is no national strategy for dementia, although a recent report from the Alzheimer Society of Canada is ...

The need for healthcare practitioners to respect the dignity of older people is widely recognised in England, where it has been given attention by politicians, professionals and health service regulators. This article aims to provide examples of how such ambitions may be used in practice development. This article reports the ...

To outline the importance of understanding quality of life (QOL) in people with dementia living in long-term care. To consider several key research questions and some of the challenges and impact of neglecting knowledge transfer. There is a gap between the knowledge in the broad dementia research literature and transfer ...

To review contemporary literature on quality of life for people with dementia. One of the consequences of population ageing is the predicted increase in the incidence of dementia. While we can as yet do little to affect the course of the disease, health care professionals are well-placed to intervene to ...

The study was designed to assess how a day care programme once a week, for seven weeks, with group collaboration and social and cultural activities was experienced by clients. The aim was to provide some insight into how older adults with mild cognitive impairment perceive and experience day care. As ...

The goal of this project was to develop a portable, Internet-based multimedia education program (IBME) to provide a more efficient training resource for direct care workers (DCWs) who care for nursing home residents suffering from late-stage dementia. Thirty-four DCWs from 8 nursing homes in 8 states completed 5 posttest open-ended ...

Neuropsychiatric symptoms (NPS) occur frequently in residents of long-term care institutions. The aim of this study was to review the literature systematically on the course of NPS in residents with dementia in long-term care institutions. A systematic literature search was conducted using Medline, PsychInfo, Embase and Cinahl. Search terms included ...

The growing number of dementia patients leads to both policy, economic and health organization constraints. Many healthcare systems have developed case management programs in order to optimize dementia patients and caregivers care and services delivery. Nevertheless, to what extend case management programs can lead to an improvement of care and ...

Informal care is a significant component of the societal resource use and costs in dementia care. Thus it is fundamental that assessments of informal care are valid. Thus the aim was to analyse the validity of time estimates with the Resource Utilization in Dementia (RUD) instrument. Prospective observational study. Community ...

The main aim of this paper is to give an overview on the quality of life, health care utilisation and costs of dementia in Hungary. A cross-sectional non-population based study of 88 consecutive dementia patients and their caregivers was conducted in three GP practices and one outpatient setting in 2008. ...

Processes of demographic change are leading to decreasing human resources in professional as well as lay care; this decrease necessitates new concepts of care, especially for the growing number of people with dementia (p.w.d.). Since the amendment to the German Care Insurance Law (2002), family carers have been entitled to ...

Diseaser emergencies are occurring with seemingly increased frequency. The likelihood that gerontological nurse will be involved in a disaster scenario, regardless of practices setting, is real. Instead of recoiling from this likelihood, the best approach is preparedness. In this article we examine what constitutes a disaster and how it differs ...

Innovative approaches to the widespread delivery of evidence-based dementia care are needed. The aims of this study were to determine whether a telephone screening method could efficiently identify individuals in the community in need of care for dementia and to develop a multidimensional needs assessment tool for identifying the type ...

Falls are the most frequently reported adverse events in inpatient settings. We conducted a retrospective case-control study of inpatient falls within aged care wards in a tertiary hospital to investigate the associated characteristics of elderly patients suffering from falls and fall-related characteristics. Consecutive retrospective cross-sectional design spanned July 2006 to ...

To write a narrative review of the role of primary care physicians in the long-term care of people with dementia living at home, with a focus on psychosocial interventions, the provision of information and carer support, behavioural and psychological symptoms and case management. The systematic review carried out for the ...

This article aims to describe the content of person-centred care as described by people with dementia, family members and staff in residential aged care. Person-centred care is increasingly being regarded as synonymous with best quality aged care; however, studies exploring stakeholders' experiences of person-centred care are few. A qualitative explorative ...

to present a critical comparative review of published tools measuring the person-centeredness of care for older people and people with dementia. included tools were identified by searches of PubMed, Cinahl, the Bradford Dementia Group database, and authors' files. The terms "Person-centered," "Patient-centered" and "individualized" (US and UK spelling), were paired ...

This paper discusses whether current UK social policy promotes the human rights of people with dementia living in England. The author focuses on the role of recent legal reforms and key developments in social care policy--notably the Mental Capacity Act 2005 and the 2009 National Dementia Strategy--in facilitating their human ...

The prevalence of dementia is reaching epidemic proportions globally, but there remain a number of issues that prevent people with dementia, their families and caregivers, from taking control of their condition. In 2008, Alzheimer's Disease International (ADI) launched a Global Alzheimer's Disease Charter, which comprises six principles that underscore the ...

This article describes a symposium about the clinical challenges of providing care to persons with dementia and their families. The plenary session addressed the bereavement process in the general older adult population, neurocognitive processes that alter the grief process in persons with dementia, and therapeutic approaches to support grieving persons ...

The sociophysical home environment is an integral component of everyday coping, self-identity, and well-being for individuals with dementia; however, residential discontinuity is a common experience for many of these individuals. This article examined the meanings, functions, and experiences associated with living at home for individuals with dementia at the critical ...

We implemented a 12-week drama-based educational intervention to introduce to dementia practitioners person-centred care that emphasizes the notion of embodied selfhood (defined as non-verbal self-expression). Person-centred dementia care guidelines emphasize the assessment of individual needs, and where appropriate, the use of non-pharmacological interventions before resorting to pharmacological management. However, dementia ...

Person-centred care has been linked with quality of care but difficulties remain in person-centred care being implemented in care practice. This study explores the use of life story work to enhance person-centred care with people with dementia. The study investigates how life story work is: understood and developed in practice; ...