ABSTRACT
OBJECTIVES: To investigate why nursing home care had been recommended for elderly people who were assessed subsequently as being of low dependency. DESIGN: Examination of community care assessment documentation for low dependency residents to assess reasons for recommending nursing home care; comparison of these with data from a subsequent SCRUGs (Scottish Care Resource Utilisation Groups) assessment. SETTING AND SUBJECTS: Three hundred and four residents within eight private nursing homes in Glasgow. RESULTS: Twenty six percent of the residents were described as being of low dependency. Of these, 44% had dementia and 6% personal care needs alone; 29% had medical problems which required nursing input, but not necessarily to a level requiring nursing home care. Information in the community care assessment often described a higher level of need than that identified subsequently. From the information given in the medical component of the community care assessment it was often unclear why the decision to recommend nursing home care was made. CONCLUSION: Admission to nursing homes may be encouraged by over-emphasiZing care requirements, by placing emphasis on safety rather than independence and by inadequate recording of information. Elderly people who cannot remain at home need improved assessment procedures, better understanding of their needs and a wider range of accommodation options.
Subject(s)
Activities of Daily Living/classification , Geriatric Assessment/classification , Nursing Homes/statistics & numerical data , Private Sector/statistics & numerical data , Urban Population , Aged , Aged, 80 and over , Female , Health Services Misuse , Health Services Research , Humans , Male , Middle Aged , Needs Assessment , Scotland , State Medicine , Utilization ReviewABSTRACT
A retrospective cohort review survey assessed hepatitis B immunisation uptake in at-risk infants over 4 years and a GP questionnaire identified the problems of poor communication and uncertainty of responsibility for immunisation as barriers to successful implementation of the immunisation programme. Incorporating appointments for hepatitis B immunisation within the national child immunisation recall system would help improve uptake but, in the meantime, a manual appointment system could be incorporated within existing child immunisation systems.