What works in maintaining older people with higher level needs at home? : Outcomes from a literature review with a UK focus

Stewart, Ailsa and MacIntyre, Gillian (2011) What works in maintaining older people with higher level needs at home? : Outcomes from a literature review with a UK focus. In: ENSACT conference, 2009-04-22 - 2009-04-26. (Unpublished)

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Abstract

It is widely acknowledged that the majority of people wish to remain at home throughout their life rather than be admitted to institutional care. Government policy has actively supported the transition from institutional care to community care over a number of years. This paper aims to bring together the evidence from a number of sources that evaluates interventions for older people with higher level needs to remain at home with a particular focus on Scotland and the UK more broadly. A combination of database, manual and citation searches was used to identify key studies and grey literature. The principal types of grey literature of relevance to the study including policy documents, expert opinion pieces and unpublished primary research were identified via a Research Advisory Group and individual interviews with key informants. In addition contact was made with home care managers across Scotland to identify unpublished locally commissioned work. Findings have been identified around a range of key interventions including prevention of admission and supported discharge models as well as the emerging fields of telehealth/telecare and home care re-ablement. This review found a potential divergence between what existing research tells us works and the direction of policy in supporting older people at home in the UK. As the impact of the current spending review and the proposed cuts to funding for state services, including those to older people, becomes clearer, it is crucial that resources are targeted at models and interventions which support effective outcomes for older people rather than those which can purely provide evidence of savings. This paper aims to discuss how the existing evidence can be used to support evidenced based policy development which will help older people with higher level needs remain at home and achieve effective outcomes.

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