The Impact Of Homelessness On Health

New report warns that that the rising number of older homeless will create significant extra pressures for councils | Local Government Association

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The Local Government Association (LGA) says that older homelessness is a growing hidden phenomenon that needs greater understanding.  Latest figures show that between April and June this year, councils accepted 620 people aged over 60 as homeless – at a rate of nearly 10 a day. This is up from the 270 accepted between October and December 2009, which was the lowest number since records began in 2005.

The LGA, which represents more than 370 councils in England and Wales, is warning that based on existing trends, this is set to double by 2025.

The LGA is calling for government to address the undersupply in specialist housing for older people, and an adaption to the implementation of welfare reforms to reduce the risk of homelessness. It says councils need to be able to borrow to invest in new council housing to increase supply, boost home ownership and reduce homelessness.

Full report: The Impact of Homelessness on Health: A guide for Local Authorities

 

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Living longer, healthier lives – working towards integrated, people-centred care for older persons

As the world marks International Day of Older Persons on 1 October, WHO will launch new guidelines on integrated care for older people (ICOPE) to support the work of Member States towards creating more integrated, person-centred health and long-term care for people at all ages.

The guidelines, which will launch during a high-level meeting in Geneva, Switzerland on 2 October 2017, offer evidence-based guidance to health-care providers on the appropriate approaches at the community level to detect and manage important declines in physical and mental capacities, and to deliver interventions in support of caregivers. These standards can act as the basis for national guidelines and for the inclusion of older people’s health care in primary care programmes, using a person-centred and integrated approach.

Change in loneliness after intervention with cochlear implants or hearing aids

The aim of the study was to investigate the impact of hearing aid (HA) and cochlear implant (CI) use on loneliness in adults| The Laryngoscope

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Image source: Joonas Tikkanen – Flickr // CC BY-ND 2.0

One hundred and thirteen adults, aged ≥ 50 years, with postlingual hearing loss and receiving routine clinical care at a tertiary academic medical center, were evaluated with the University of California at Los Angeles Loneliness Scale before and 6 and 12 months after intervention with HAs or CIs. Change in score was assessed using linear mixed effect models adjusted for age; gender; education; and history of hypertension, diabetes, and smoking.

Treatment of hearing loss with CIs results in a significant reduction in loneliness symptoms. This improvement was not observed with HAs. We observed differential effects of treatment depending on the baseline loneliness score, with the greatest improvements observed in individuals with the most loneliness symptoms at baseline.

Full reference: Contrera, K.J. et al. (2017) Change in loneliness after intervention with cochlear implants or hearing aids. The Laryngoscope. Vol. 127 (Issue 8) pp. 1885–1889

Physical inactivity levels in adults aged 40 to 60 in England

Public Health England has released data on brisk walking levels and physical inactivity in people aged between 40 and 60 in England from 2015 to 2016.

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Data released by Public Health England (PHE) has shown that the amount of activity people do starts to tail off from the age of 40. PHE estimates 40% of 40- to 60-year-olds take a brisk 10-minute walk less frequently than once a month.

The analyses were carried out by PHE using data from Sport England’s Active Lives Survey, which is designed to measure participation in sport and physical activity in England.

PHE  say just 10 minutes a day could have a major impact, reducing the risk of early death by 15%. To help, the government agency is promoting a free app – Active 10 – which can monitor the amount of brisk walking an individual does and provide tips on how to incorporate more into the daily routine.

In addition, the PHE framework ‘Everybody active, every day’ has been updated. This framework aims to make active lifestyles a reality for all, with 4 areas for action which will:

  • change the social ‘norm’ to make physical activity the expectation
  • develop expertise and leadership within professionals and volunteers
  • create environments to support active lives
  • identify and up-scale successful programmes nationwide

Full document:
Everybody active, every day: an evidence-based approach to physical activity

Related: BBC News: Middle-aged told to walk faster

The Guardian: 6 million middle-aged people take no exercise

Substance misuse in older people

Action is needed to deal with growing levels of substance misuse in people aged over 50, claims BMJ editorial 

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Researchers in the UK and Australia said the number of people aged over 50 who were experiencing problems from substance misuse was growing rapidly and the numbers receiving treatment were expected to treble in the US and double in Europe by 2020.

In both the UK and Australia, dangerous levels of drinking are declining, except among people aged 50 years and older, they said. One of the authors warns that the issue goes beyond drinking, citing illicit drugs such as cannabis, and commonly prescribed medications such as opioid painkillers as also being an issue.

Full  editorial:  Rao, R. & Roche, A.  Substance misuse in older people: Baby boomers are the population at highest risk  BMJ 2017;358:j3885

Related : Baby boomers’ drink and drug misuse needs urgent action, warn experts | The Guardian

Impact of inadequate health literacy on patient satisfaction, healthcare utilization, and expenditures

Inadequate health literacy (HL) is associated with impaired healthcare choices leading to poor quality-of-care | Geriatric Nursing

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Our primary purpose was to estimate the prevalence of inadequate HL among two populations of AARP®Medicare Supplement insureds: sicker and healthier populations; to identify characteristics of inadequate HL; and to describe the impact on patient satisfaction, preventive services, healthcare utilization, and expenditures. Surveys were mailed to insureds in 10 states. Multivariate regression models were used to identify characteristics and adjust outcomes. Among respondents (N = 7334), 23% and 16% of sicker and healthier insureds, respectively, indicated inadequate HL. Characteristics of inadequate HL included male gender, older age, more comorbidities, and lower education. Inadequate HL was associated with lower patient satisfaction, lower preventive service compliance, higher healthcare utilization and expenditures. Inadequate HL is more common among older adults in poorer health, further compromising their health outcomes; thus they may benefit from expanded educational or additional care coordination interventions.

Full reference: MacLeod, S. et al. (2017) The impact of inadequate health literacy on patient satisfaction, healthcare utilization, and expenditures among older adults. Geriatric Nursing. Volume 38 (Issue 4) pp. 334–341

The care of older people in care homes

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 review brings 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
  • Where next for care home research?