The interRAI HC Assessment System has been designed to be a user-friendly, reliable, person-centered system that informs and guides comprehensive planning of care and services for elderly and disabled persons in community-based settings around the world. It focuses on the person's functioning and quality of life by assessing needs, strengths, and preferences. It also facilitates referrals when appropriate. When used on multiple occasions, it provides the basis for an outcome-based assessment of the person's response to care or services. The interRAI HC Assessment System can be used to assess persons with chronic needs for care, as well as with post-acute care needs (e.g., after hospitalization or in a hospital-at-home situation).
The interRAI Acute Care (AC) assessment is a key component of the interRAI Hospital Assessment Systems. It is designed for use among all adult patients who are admitted for an overnight stay in hospital. The interRAI AC is designed to form part of the general nursing admission assessment that is offered to all adult patients on arrival at an inpatient unit. The interRAI AC is to be used alongside other nursing assessment information that usually includes biometric (for example, pulse and blood pressure) and administrative information. The interRAI AC comprises two forms: the Admission Form is completed when the patient arrives at the inpatient unit, and the Discharge Form is completed on the day of discharge.
For every person over the age of 65 in today's European Union there are four people of working age but by 2050 there will only be two. Demand for long-term care of which home care forms a significant part will inevitably increase in the decades to come. Despite the importance of the issue however up-to-date and comparative information on home care in Europe is lacking. This book attempts to fill some of that gap by examining current European policy on home care services and strategies. Home care in Europe probes a wide range of topics including the links between social services and health-care.
"The interRAI Mental Health system is designed to support care planning, outcome measurement, quality improvement and case mix based funding applications. The target population for MH is all adults aged 18 and over in in-patient psychiatric settings, including acute, chronic, forensic and geriatric psychiatry"--Provided by publisher.
The U.S. population of older adults is predicted to grow rapidly as "baby boomers" (those born between 1946 and 1964) begin to reach 65 years of age. Simultaneously, advancements in medical care and improved awareness of healthy lifestyles have led to longer life expectancies. The Census Bureau projects that the population of Americans 65 years of age and older will rise from approximately 40 million in 2010 to 55 million in 2020, a 36 percent increase. Furthermore, older adults are choosing to live independently in the community setting rather than residing in an institutional environment. Furthermore, the types of services needed by this population are shifting due to changes in their health issues. Older adults have historically been viewed as underweight and frail; however, over the past decade there has been an increase in the number of obese older persons. Obesity in older adults is not only associated with medical comorbidities such as diabetes; it is also a major risk factor for functional decline and homebound status. The baby boomers have a greater prevalence of obesity than any of their historic counterparts, and projections forecast an aging population with even greater chronic disease burden and disability. In light of the increasing numbers of older adults choosing to live independently rather than in nursing homes, and the important role nutrition can play in healthy aging, the Institute of Medicine (IOM) convened a public workshop to illuminate issues related to community-based delivery of nutrition services for older adults and to identify nutrition interventions and model programs. Nutrition and Healthy Aging in the Community summarizes the presentations and discussions prepared from the workshop transcript and slides. This report examines nutrition-related issues of concern experienced by older adults in the community including nutrition screening, food insecurity, sarcopenic obesity, dietary patterns for older adults, and economic issues. This report explores transitional care as individuals move from acute, subacute, or chronic care settings to the community, and provides models of transitional care in the community. This report also provides examples of successful intervention models in the community setting, and covers the discussion of research gaps in knowledge about nutrition interventions and services for older adults in the community.
This publication explores some of the key issues, ranging from interpreting the evidence base to assessing the policy context for, and approaches to, chronic disease management across Europe. Drawing on 12 detailed country reports (available in a second, online volume), the study provides insights into the range of care models and the people involved in delivering these; payment mechanisms and service user access; and challenges faced by countries in the implementation and evaluation of these novel approaches.
The interRAI ChYMH-DD is intended to be used with children and youth with developmental disabilities in mental health settings to support comprehensive care planning, outcome measurement, quality indicators, and case mix classification to estimate relative resource intensity. It employs specific observation periods in order to provide reliable and valid measures of clinical characteristics that reflect the child's or youth's strengths, preferences, and needs. In keeping with other interRAI instruments, the basic time frame for assessment was set at 3 days unless otherwise indicated. Triggers for numerous Collaborative Action Plans to support care planning decisions are also embedded in the instrument. There are two versions of the ChYMH-DD assessment form. Typically, the In-patient form would be used for a child or youth who currently resides in a residential facility or psychiatric facility/unit, and the Community-Based form for a child or youth who resides in a community setting.
This book offers mental health clinicians a comprehensive guide to assessing and managing suicide risk. Suicide has now come to be understood as a multidimensionally determined outcome, which stems from the complex interaction of biological, genetic, psychological, sociological and environmental factors. Based on recent evidence and an extensive literature review, the book provides straightforward, essential information that can easily be applied in a wide variety of disciplines.
Pressure ulcers are defined by the National Pressure Ulcer Advisory Panel (NPUAP) as “localized injury to the skin and/or underlying tissue usually over a bony prominence, as a result of pressure, or pressure in combination with shear and/or friction.” A number of risk factors are associated with increased risk of pressure ulcer development, including older age, black race, lower body weight, physical or cognitive impairment, poor nutritional status, incontinence, and specific medical comorbidities that affect circulation such as diabetes or peripheral vascular disease. Pressure ulcers are often associated with pain and can contribute to decreased function or lead to complications such as infection. In some cases, pressure ulcers may be difficult to successfully treat despite surgical and other invasive treatments. In the inpatient setting, pressure ulcers are associated with increased length of hospitalization and delayed return to function. In addition, the presence of pressure ulcers is associated with poorer general prognosis and may contribute to mortality risk. Recommended prevention strategies for pressure ulcers generally involve use of risk assessment tools to identify people at higher risk for developing ulcers in conjunction with interventions for preventing ulcers. A variety of diverse interventions are available for the prevention of pressure ulcers. Categories of preventive interventions include support surfaces (including mattresses, integrated bed systems, overlays, and cushions), repositioning, skin care (including lotions, dressings, and management of incontinence), and nutritional support. Each of these broad categories encompasses a variety of interventions. The purpose of this report is to review the comparative clinical utility and diagnostic accuracy of risk-assessment instruments for evaluating risk of pressure ulcers and to evaluate the benefits and harms of preventive interventions for pressure ulcers in different settings and patient populations. The following Key Questions are the focus of this report: KQ1. For adults in various settings, is the use of any risk-assessment tool effective in reducing the incidence or severity of pressure ulcers compared with other risk-assessment tools, clinical judgment alone, and/or usual care? KQ1a. Do the effectiveness and comparative effectiveness of risk-assessment tools differ according to setting? KeQ1b. Do the effectiveness and comparative effectiveness of risk-assessment tools differ according to patient characteristics and other known risk factors for pressure ulcers, such as nutritional status or incontinence? KQ2. How do various risk-assessment tools compare with one another in their ability to predict the incidence of pressure ulcers? KQ2a. Does the predictive validity of various risk-assessment tools differ according to setting? KQ2b. Does the predictive validity of various risk-assessment tools differ according to patient characteristics? KQ3. In patients at increased risk of developing pressure ulcers, what are the effectiveness and comparative effectiveness of preventive interventions in reducing the incidence or severity of pressure ulcers? KQ3a. Do the effectiveness and comparative effectiveness of preventive interventions differ according to risk level as determined by different risk-assessment methods and/or by particular risk factors? KQ3b. Do the effectiveness and comparative effectiveness of preventive interventions differ according to setting? KQ3c. Do the effectiveness and comparative effectiveness of preventive interventions differ according to patient characteristics? KQ4. What are the harms of interventions for the prevention of pressure ulcers? KQ4a. Do the harms of preventive interventions differ according to the type of intervention? KQ4b. Do the harms of preventive interventions differ according to setting? KQ4c. Do the harms of preventive interventions differ according to patient characteristics?
