Occupational therapy at home may benefit people with dementia and their carers
Multiple occupational therapy sessions, provided in a person with dementia’s own home, improve their ability to carry out daily activities, compared withusual care. Improvements are also seen in behavioural and psychological symptoms and their quality of life. In addition, carers report feeling less distress, and a better quality of life.
This study was a systematic review of trials where an average of eight one-hour sessions of occupational therapy was compared with usual care or minimal...
‘Care navigation’ is being widely adopted in primary care, but in varying ways
Clinical Commissioning Groups (CCGs) in England are implementing care navigation in primary care to help people with non-medical issues to access alternative services. This ‘social prescribing’, facilitated by nominated care navigators, also aims to reduce the pressure on general practice, and forms part of the NHS Long Term Plan.
This NIHR-funded study shows that the role is fulfilled in different ways by people with a wide variety of job titles. This may make it harder for patient...
Closer links between police and health services can improve experiences for people in mental health crisis
Tighter working partnerships between health professionals and police services are likely to improve the care of people who come into contact with police during mental health crises.
People experiencing severe mental health episodes can present with extreme and unpredictable behaviour posing a danger to themselves and members of the public. Police are often the first to respond in these challenging situations.
New models are emerging of mental health staff working with police. This NIHR-funded ...
Psychological therapies may improve parenting skills in parents of children with chronic illness
Psychological therapies appear to show promise in helping improve self-reported parenting behaviour of parents of children and adolescents with cancer, chronic pain, diabetes or traumatic brain injury.
Cognitive behavioural therapy (CBT) and problem-solving therapy (PST) appear particularly valuable in supporting this. Psychological therapies also seemed beneficial in improving the mental health of parents who have children with cancer and chronic pain, but not in studies of children with diabe...
Ways of integrating care that better coordinate services may benefit patients
New integrated care models can increase patient satisfaction, perceived quality of care and improve access to services. It is less clear whether there may be effects on hospital admissions, appointments or healthcare costs. Strong leadership and patient engagement are among factors influencing successful implementation.
The NHS is undergoing reconfiguration to better coordinate services around patients. This NIHR-funded review looked at the international literature to understand how new care mo...
Structured training improves skills of wheelchair users
Structured wheelchair skills training increases wheelchair users’ skills when compared with no training, standard care or education controls. The training, as developed in Canada, is more effective for new wheelchair users than experienced users. It includes difficult everyday challenges from wheeling through gravel to negotiating high curbs.
Links have been found previously between wheelchair skills capacity (reflecting what the user can do) and: independent mobility, reduced reliance on...
Case managers improve outcomes for people with dementia and their carers
Using a case manager to coordinate health and social care improves the challenging behaviour of people with dementia and reduces the burden on caregivers. Quality of life of caregivers improves the most when case managers have a professional background in nursing.
This NIHR-funded review compared the effectiveness of standard community treatment and interventions with case managers overseeing the interventions for people living with dementia. It considered evidence from 14 trials in a number of...
Multi-morbidity predicted to increase in the UK over the next 20 years
Two-thirds of adults aged over 65 are expected to be living with multiple health conditions (multi-morbidity) by 2035. Seventeen percent would be living with four or more diseases, double the number in 2015. One-third of these people would have a mental illness like dementia or depression.
Increased life expectancy by around three years for both men and women means people will spend longer living with multi-morbidity.
This study, partly supported by NIHR, ran a computer model using data on ove...
Additional therapy helps social recovery from first episode psychosis
Social recovery therapy increases structured activity, such as work, education or sport, by eight hours per week for people with severe social withdrawal following a first episode of psychosis. This cognitive behavioural type of treatment was added to other early interventions and might be particularly useful for those lacking motivation or living with other conditions that prevent them engaging with mental health services.
This NIHR-funded trial included 154 young adults with first episode of ...
Social exclusion heightens risk of death across many health conditions
Socially excluded men have a mortality rate that is nearly eight times higher than the average for other men, and it is almost 12 times higher for excluded women. These health inequities in outcomes exist across a wide range of health conditions, particularly in infectious diseases and mental health. These findings suggest the need for a joined-up approach across sectors to support inclusive services and policies.
Populations who experience social exclusion included in the NIHR-supported study ...