WHO’s global survey on assistive technologies

WHO has launched a global survey to gather views on the most necessary and useful assistive technologies such as hearing aids and wheel chairs. The survey will feed into the first ever WHO mandated list of essential assistive technologies, similar to the WHO Essential Medicines List. These practical tools – some low, some higher technologies – are becoming increasingly necessary to the many people in high- and middle-income countries who are living longer due to better healthcare. Similar devices are used by people with disabilities, allowing them to live more autonomously and participate in their communities. This list will represent a tool for governments to plan and focus efforts to help populations acquire the 50 priority products, thereby improving the everyday lives of the elderly and people with disabilities. The survey may be taken via a link on this WHO page.

The Right Medicine: Improving Care in Care Homes.

The increase of polypharmacy together with the population aging is making care homes a central point to develop health care programmes, specially related to medicines management and integration of different health care proffessionals.

The Royal Pharmaceutical Society has recently published a report addressing the main issues of medicine use in care homes. The needs identified by the authors include developing better communication systems, reducing falls in care homes, decreasing inappropriate use of psychotropic medicines, improving coordinated end of life care and lowering waste of medicines at home.

The report includes some recommendations such as giving pharmacists a major role in care homes medicine management, strengthening coordination between physicians and pharmacists or developing programmes of regular medicines review and staff training in integrated teams with other practitioners.

Delivering integrated care for older people with frailty

The conference was focused on the ways in which integrated care can be delivered for older people with frailty, looking at interactions between acute, primary, community and social care services, older people living with complex co-morbidities and ways in which older people with frailty can be supported to maintain their health and wellbeing.

Presentations are available in this link: Delivering integrated care for older people with frailty 

Introducing home care services in Bulgaria

The introduction of home care services was proposed as a patient-oriented solution for ensuring appropriate service provision closer to home; a pilot approach allowed the gradual rollout and testing of an existing home care model being implemented abroad, which was adapted to meet the Bulgarian context; efforts to introduce home care included creating new roles and responsibilities for the health workforce and developing information and communication resources; establishing the necessary health system conditions, including the development of a supportive legal framework, is an important area of focus for advancing the sustainability and scale of the current transformations.

Establishing a Gerontology Coordination Centre to improve care for the elderly in Monaco

The Ministry of Health and Social Affairs opened the Gerontology Coordination Centre as a dedicated resource to support and provide services to elderly people aged 60 years and over; Monaco's small geographic and population size lent itself to a centralized approach. The initiative created a hub for the coordination of multiple aspects of health and social care for the elderly; services offered by the Centre are holistic, integrated, tailored to individual needs and place strong emphasis on supporting patients’ independence. Comprehensive geriatric assessments evaluating physical, mental and social needs are now available to all people aged 60 years and over; data collection performed by the Centre provides information on emerging needs within the elderly population, enabling data-driven policy responses.

Pioneering integrated organizational models for improving elderly people’s care in Ängelholm, Sweden

A new integrated care organization (Hälsostaden) was established to merge primary and hospital care with elderly and social care. Hälsostaden is jointly managed by its regional and municipal government and employs 600 professionals across health and social sectors; early investments in stakeholder relationships and trust building were essential for securing the future of the initiative and developing a foundation based on teamwork; finding the uniting objective of improving care for elderly people enabled stakeholders to move forward with planning; contextualizing the initiative within emerging political priorities helped generate political support and secure the necessary legal frameworks; identifying individual organizational strengths and pooling resources minimized required investments and supported in-house initiatives.

Health and social care in aging population: an integrated care institution for the elderly in Greece

The purpose of this article was to describe the nature of the services actually offered to the elderly in Greece by an institution of integrated care, as opposed to those that should be offered according to the relevant law, and to investigate the factors influencian the supply of those services. 

Interrupted time series analyses on the effect on integrated care among the older population

Current health and social care systems in most European countries, are highly fragmented into specialist services, and poorly designed to provide health and social care for patients with multiple health problems and social needs. As some groups of patients might have greater difficulties navigating in a fragmented and divided system than others, current system also risks increasing inequalities in access and use of health and social care services. The aim of this study is to investigate if a comprehensive integrated care system perform better than ‘standard care’ in regards to emergency department visits, hospitalization for ambulatory care sensitive conditions (ACSC), costs and re-admissions as well as increase equity in health care among older people.

Are Clients Satisfied with Integrated Care? Enhancing Client Feedback on Discharge from a Domiciliary Based Multidisciplinary Integrated Care Service

The Integrated Care Programme for Older People has supported the development of integrated care services at pioneer sites in Ireland, each developed to meet local needs. Patient Reported Experience Measures (PREMs) have been used to evaluate user experience in intermediate care in the United Kingdom. This project aimed to evaluate client experience of a domiciliary based, multidisciplinary, integrated care service.

Addressing safety risks in integrated care programs for older people living at home: a scoping review

Many older people live at home, often with complex and chronic health and social care needs. Integrated care programs are increasingly being implemented as a way to better address these needs. To support older people living at home, it is also essential to maintain their safety. Integrated care programs have the potential to address a wide range of risks and problems that could undermine older people’s ability to live independently at home. The aim of this scoping review is to provide insight into how integrated care programs address safety risks faced by older people living at home - an area that is rather underexplored.

Impact Assessment of an Innovative Integrated Care Model for Older Complex Patients with Multimorbidity: The CareWell Project

In aging populations, multimorbidity (two or more chronic diseases in the same person) is very common. Patients with multimorbidity have complex health and social needs, are at risk of being admitted to the hospital or residential care home and require a wide range of interventions.

To satisfy the needs of these patients and their families, new innovative integrated care models are needed. To be effective, they should have primary care as the cornerstone of care, effective integration between care levels, empower patient and carers/families, and should be patient-centered. The use of information and communication technology (ICT) platforms could facilitate and improve communication promoting patient empowerment and home support. This innovative interoperability should increase effectiveness, efficiency, and equity.

The aim of the CareWell project was to implement and to assess the effectiveness of an integrated care program based on the coordination between health providers, home-based care, and patient empowerment, supported ...

Impact of the CareWell integrated care model for older patients with multimorbidity: a quasi-experimental controlled study in the Basque Country

Older patients with multimorbidity have complex health and social care needs, associated with elevated use of health care resources. The CareWell program for older patients with multimorbidity, is based on the coordination between health providers, home-based care and patient empowerment, supported by information and communication technology tools. The implementation of CareWell integrated care model changed the profile of health resource utilization, strengthening the key role of primary care and reducing the number of emergency visits and hospitalizations

Who Cares? Attracting and Retaining Care Workers for the Elderly

This report presents the most up-to-date and comprehensive cross-country assessment of long-term care (LTC) workers, the tasks they perform and the policies to address shortages in OECD countries. It highlights the importance of improving working conditions in the sector and making care work more attractive and shows that there is space to increase productivity by enhancing the use of technology, providing a better use of skills and investing in prevention.

Health care for chronic neurological patients after COVID-19

Covid-19 has hit the world population hard. Its effects continue to arise at the community and individual level. However, recovered patients, who had a relatively long stay in the ICU due to the complications of the disease, present and will present very diverse sequelae: post-traumatic stress, transient cognitive alterations and neurological alterations. This article-commentary shows how the health system should reformulate certain priorities for the care of the neurological sequelae of the pandemic at the individual level.

Effective implementation approaches for healthy ageing interventions for older people: A rapid review

Given the advanced demographic transition in the world, seeking healthy aging is an imperative task. In this review, strategies that favor a better quality of life for the elderly are shown, including the interaction of different levels of care (intra and extra system). All of this results in better global health indicators for the elderly population, which in turn translates into less need for care by the system.

Health workforce planning under conditions of uncertainty: identifying supportive integrated care policies using scenario analysis

Integrated care presents health workforce planners with significant uncertainty. This results from:

• (1) these workforces are likely in the future to be different from the present.
• (2) integrated care's variable definitions.
• (3) workforce policy and planning is not familiar with addressing such challenges.

One means to deal with uncertainty is scenario analysis. In this study shows some aspects of integration-supportive workforce governance and planning policies that were derived from the application of scenario analysis.Through a mixed methods design that applies content analysis, scenario construction and the policy Delphi method, it's analized a set of New Zealand's older persons health sector workforce scenarios. Developed from data gathered from workforce documents and studies, the scenarios were evaluated by a suitably qualified panel, and derived policy statements were assessed for desirability and feasibility.

Telemedicine for housebound older persons during the Covid-19 pandemic

Hollander and Brendan highlighted the benefit to decision-making that may be drawn from the use of automated screening algorithms in prioritizing patient care to better allocate resources during the Coronavirus disease 2019 (Covid-19) pandemic.  A strategy to screen older community dwellers at risk for home confinement-related adverse consequences must, therefore, be adopted based on an efficient and effective forward triage framework. In older community dwellers, assessing frailty is a definite cornerstone of triage, as it provides insight into the degree of vulnerability in their health status and their risk for adverse consequences. 

The Centre of Excellence on Longevity of McGill University (Quebec, Canada) designed, in late March 2020, a short assessment known as “Evaluation SOcio-GERiatrique” (ESOGER) for Montreal’s housebound community-dwelling older adults. It acts as the first step in connecting older community dwellers who are housebound during the ...

Comparison of Integrated Care of the Elderly in Iran with Other Selected Countries, a Comparative Study

The current situation of the population of Iran is such that at present the population has changed from the explosive situation of the child population to the increase of the elderly population. The aim of this study was to compare the integrated care of the elderly in Iran with other selected countries.

Integrated Care in Europe: Keys, Challenges and Best Practices

Elderly people, dependency and vulnerability in the coronavirus pandemic: an emergency for a social and health integration

The current SARS-CoV-2 pandemic (COVID-19) is affecting elderly people worldwide with greater incidence and severity. In Spain, 68% of all coronavirus hospitalizations correspond to those over 60 years of age. This work aims to highlight the evidence about the measures to be implemented through current and future guidelines. The need to prepare for action by implementing international protocols stand out. There is a trend towards biopsychosocial care of elderly people in all settings where they are, adapting care and personalizing decisions on hospital admissions, palliative care, among other criteria, to years adjusted to quality of life, as well as alternatives for monitoring and treatment of COVID-19 pathology and others existing in this population group. Measures to reduce the transmission of the virus through hygiene and social distancing are necessary, attending to biopsychosocial health of the elderly isolated. Intersectoral communication is proposed as innovative alternatives, and the use of technological tools ...

Barriers and Facilitators in the Uptake of Integrated Care Pathways for Older Patients by Healthcare Professionals: A Qualitative Analysis of the French National “Health Pathway of Seniors for Preserved Autonomy” Pilot Program

Integrated care is a particularly promising approach in geriatrics – a field in which the medical, psychological and social issues are often complex. The uptake of integrated care by healthcare professionals is essential but varies markedly.

The objective of the present study of healthcare professionals was to identify barriers to and facilitators of commitment to integrated care for seniors.

Care for caregivers- a mission for primary care

The number of elderly people living in the community who are limited in daily activities is increasing worldwide. This generates prolonged care, which usually falls on one family member, the family caregiver. Caregivers are prone to develop psychosocial and physical symptoms. As a result, the World Health Organization (WHO) issued a clear directive to assess and support these caregivers. The main goals of this study were to assess primary care physicians’ (PCP) awareness to caregivers’ health risks and the extent that they recommended preventive measures to maintain the health of the caregivers. Although a high percentage of physicians were aware and concerned about caregivers’ health, their preventive care activities were relatively passive. PCPs should take a more active and preventive role for maintaining caregivers’ health.

Primary care and the older person with complex needs: reflections on the implementation of a primary–secondary model of integrated care

The demand and complexity of the health needs of older people is growing. Traditionally siloed, condition-centric care is no longer appropriate. It is costly to the Australian health system and life-threatening to the individual. In parallel to demographic change is increasing global awareness of the impact of social, behavioural, and environmental factors on health outcomes. Although significant when not addressed, the amenable nature of many personal contextual factors is an opportunity to improve health and quality of life. A move away from reactive, episodic models of health care delivery towards patient focussed integrated care is required to meet the changing demands of an aging population. This forum article provides a reflection on the current state of integration for older people with complex needs through the lens of a local community facing model: OPEN ARCH. Australia still has some way to go to establishing system level enablers for an integrated approach ...

Program of All-inclusive Care for the Elderly (PACE): an innovative model of integrated geriatric care and financing

The Program of All-inclusive Care for the Elderly (PACE) is a long-term care delivery and financing innovation. A major goal of PACE is prevention of unnecessary use of hospital and nursing home care.

Integrating Health and Care for Older People in China: What Has Been Accomplished? What is Next?

In China, in addition to its rapid ageing process and large older population, the incidence of chronic disease and disability in the elderly is astonishingly high. Among the 267 million people aged 60 and over in 2021, there were about 190 million people with at least one chronic disease and 40 million living with disability [1]. This has created a huge challenge for the world’s most populous country which is also a middle-income economy in caring for its senior citizens. In response to the complex needs of the elderly and drawing from international experience, China has adopted an active ageing and healthy ageing strategy, and integrating health and care has increasingly been a policy priority for coping with population ageing in the past decade. Progress has been made while challenges remain. The experiences and lessons of China might be referential for the other middle income countries in integrating health ...

Components and Outcomes in Under-and Postgraduate Medical Education to Prepare for the Delivery of Integrated Care for the Elderly: A Scoping Review

The ageing society requires physicians who can deliver integrated care, but it is unclear how they should be prepared for doing so. This scoping review aims to create an overview of educational programmes that prepare (future) physicians to deliver integrated care while addressing components and outcomes of the interventions.