The Costs of Caring for People with Dementia and Related Cognitive Impairments

The National Council on Ageing and Older People has undertaken a programme of research into dementia in Ireland. An Action Plan for Dementia provided a framework for the provision and planning of services for people with dementia in Ireland The Costs of Caring for People with Dementia and Related Cognitive Impairments is a complementary report to the Action Plan but with a more quantitative focus. The role of carers is one that is often taken for granted and is seen by many as a free resource. Dr Oâ?TShea explores what caring for a person with dementia entails in terms of the carers time, finances and stress. Evaluating the cost of caring for a person with dementia is the main focus of this study Download the Report here

Disability Act 2005: Sectoral Plan for the Department of Health and Children and the Health Services

Department of Health and Children Sectoral Plan in respect of health and personal social services provision for people with disabilities, as provided for in the Disability Act 2005. Read the Report (PDF, 448kb)

The Quality of Life of Older People with a Disability in Ireland

The Quality of Life of Older People with a Disability in Ireland For many years the National Council on Ageing and Older People (NCAOP) has advocated the importance of meaningful consultation with older people in order to inform public policy and facilitate the development of services to meet their needs. This research study was commissioned to present a picture of quality of life in older age for people with a disability in Ireland and was grounded in consultation with them. It is the first such study to be undertaken here. Click here to download PDF 1.9mb

Improving outcomes for people with skin tumours including melanoma (update)

The management of low-risk basal cell carcinomas in the community.In February 2006, the National Institute for Health and Clinical Excellence (NICE) published service guidance on skin cancer, ‘Improving outcomes for people with skin tumours including melanoma’ (NICE guidance on cancer services). Many of the recommendations in this guidance were converted into peer review measures published in the ‘Manual for cancer services 2008: skin measures..

Substance use behaviours of young people with a moderate learning disability: a longitudinal analysis.

Substance use behaviors of young people attending a special school are reported over a 4-year period from the age of 12-16 years. The article investigated these behaviors by surveying a cohort of young people with a statement for moderate learning disabilities annually during the last 4 years of compulsory schooling. The findings show that these young people consistently reported lower levels of tobacco, alcohol, and cannabis use compared with those attending mainstream school. No other illicit drug use was reported. The potential implications of these findings are discussed in relation to the context and timing of targeted substance education and prevention initiatives for young people with moderate learning disability attending a special school.This resource was contributed by The National Documentation Centre on Drug Use.

The meaning of dependence and independence of older people with a disability in Ireland

The paper presents the findings of a research study carried out in Ireland in 2006 (Murphy et al., 2007) which explored the meaning of dependence and independence for older people with a disability. The research adopted a grounded theory approach; purposive sampling was used initially with some relational sampling towards the latter interviews. The sample was comprised of 143 older people with one of six disabilities: stroke (n=20), arthritis (20), depression (20), sensory disability (20), a learning disability (24), and dementia (18). All participants lived at home, some participants required high levels of help in activities of living while others were mostly independent. An interview schedule was used to guide interviews, all of which were tape recorded and transcribed. Data was collected on levels of dependence and independence using the Katz scale. Participants recorded high levels of independence in relation to transferring (93%), toileting (92%), dressing (87%), continence (87%) and feeding (98%). The main area of dependence where participants required assistance from others was with bathing (77%). The constant comparative technique was used to analyze qualitative data. The findings of the study would suggest that participants personal definition of their independence or dependence shifted relative to others and/or improvement or worsening of their capacity People were aware of the difference between independence and dependence, but these two concepts were not always perceived as opposites. It was possible to be independent and dependent at the same time. People valued being able to do things for themselves, accepted help when necessary but wanted to reciprocate when possible. Participants used varied coping strategies to regain and retain control of their lives. Strategies to promote older peoples independence and self esteem will be explored in this paper.

Inequalities in Old Age: The impact of the recession on older people in Ireland, North and South CARDI Grants

Inequalities in Old Age: the impact of the recession on older people in Ireland, North and SouthAbout the research:This research, led by Professor Paddy Hillyard, Emeritus Professor Queen’s University Belfast, was carried out with funding from CARDI’s Grants Programme Call 2. The purpose of the study was to analyse the impact of the recession on older people in Northern Ireland (NI) and the Republic of Ireland (ROI) and the extent to which inequalities within the older population have been affected by the economic crisis.Research Brief:This brief, authored by CARDI staff, is based on the findings of the research project and also contains additional information of interest.Research Team:Professor Paddy Hillyard, Emeritus Professor Queen’s University Belfast - lead researcher;Dr Francesca Lundstr̦m, Research Consultant;Dr Demi Patsios, Policy Research Consultant;Sarah Machniewski, Researcher;David Taylor, Chartered Accountant and Management Consultant;Dr Maureen Lyons, Research Manager, School of Social Justice, UCD.Methodology and availability of data:Several methods were used in the research, including:�� a review of relevant literature;����a detailed analysis of many databases relevant to older people’s incomes and lives;��building a model to assess the impact of the recession on older people;surveys of financial advisers in voluntary, private and public sectors;��six focus groups, three each in NI and RoI.Availability of data:Despite the huge amount of information which is officially collected and published in NI and RoI, very little is directly comparable. ��The development of a mechanism to encourage the production of more comparable data North and South would be very beneficial.��For example, this study identified a basket of 25 factors that can be used to compare the living standards of older people in NI and RoI and to monitor changes in future yearsTo access the full report please click on the following link:Inequalities in Old Age: the impact of the recession on older people in Ireland, North and SouthPlease find the presentation from the launch below:Inequalities, Pensions and the Recession by Prof Paddy Hillyard, Queen’s University Belfast and Dr Demi Patsios, Policy Research Consultant, Dr Francesca Lundstr̦m, Research Consultant.��������

The development of professional guidelines for the eye examination of people with dementia

Recently published guidelines��in the UK��relating to sight tests among people with dementia go some of the way to addressing the specific needs of this group. However, there is still a long way to go in terms of improving the provision of eye care services and optimising the visual health of this group.A��study, published by the Thomas Pocklington Trust,��which examines this subject - The development of professional guidelines for the eye examination of people with dementia - was presented at the first ever national “Dementia and Sight Loss conference” in London (1st December) - a forum where 100 dementia and sight loss professionals met to discuss ways to tackle the challenge of concurrent dementia and sight loss. The study, by researchers at the University of Bradford Schools of Optometry and Health Studies, reviewed procedures for sight tests and eye examinations among those with dementia. It found that policy and practice were hampered by a serious lack of basic research into concurrent dementia and sight loss and prompted recommendations which could lead to improved procedures, tools and techniques.Recommendations prompted by the study outline seven steps towards improving policy and practice:Conduct a systematic study of the availability and uptake of sight tests among people with dementia. Set up a website for people with dementia and their carers with information on how dementia affects eye health, and the importance of eye examinations. Develop education and training for optometrists and care home staff. Compile a list of optometrists experienced in providing eye care for people with dementia. Develop a template for recording the results of eye examinations in people with dementia – something which can be endorsed by professional bodies and made available to care homes. Measure the effectiveness of eye care, such as sight tests and cataract removals, on the quality of life of people with dementia. Research clinical testing methods so that guidelines can be strengthened. Measuring contrast sensitivity, for example, in someone with dementia could be vital as an inability to judge contrasts can make daily tasks impossible.To access the discussion paper please follow this link: The development of professional guidelines for the eye examination of people with dementia ��

End of life care standards for people with dementia

End of life care standards for people with dementiaThis project, funded under Call 1 of CARDI’s Grants Programme and led by Dr Suzanne Cahill, School of Social Work and Social Policy, Trinity College Dublin, highlights the need for guaranteed standards of care for older people with dementia at the end of their lives.The research recommends the introduction of standards as a matter of urgency because of the huge increases in the number of people affected, and the number likely to be affected in the future. It is estimated that the number of people with dementia in the Republic of Ireland will rise from 44,000 to 104,000 by 2036 and in Northern Ireland from 16,000 to 47,000 in 2051.The research draws attention to the importance of agreeing new standards in Ireland, North and South, by proposing guidelines to develop policies and practices that can reflect the best available throughout the world.Research Team:•������ Dr Suzanne Cahill, School of Social Work and Social Policy, Trinity College Dublin•������ Ms Daphne Doran, Quality Initiatives, Belfast•������ Dr Max Watson, University of Ulster and Northern Ireland HospiceResearch briefingFull report��

An exploratory study of the wealth of older people in Ireland ��� North and South

In 2012, CARDI was asked by The Office of the First Minister and Deputy First Minister in Northern Ireland to carry out a series of research projects on ageing in Ireland, North and South. This study, An exploratory study of the wealth of older people in Ireland – North and South, was led by Professor Paddy Hillyard, Queen's University Belfast. It had the following objectives: Examine what information is available on the wealth of older people on the island of Ireland. Describe the type and level of housing, property and other assets. Provide comparable estimates of the wealth of older people in Northern Ireland (NI) and the Republic of Ireland (ROI). Draw out the policy implications of the research. Stimulate a wider discussion about wealth and inequalities. Key findings: In NI the total personal wealth was estimated at just under �100 billion. People aged 50 and under were estimated to have 35% of the total wealth, while people aged 50 and over had 65%. Existing data does not allow for a similar comparison in ROI. People aged 65+ in NI have a median disposable weekly income of �280 compared to �494 for those aged 25-49, �452 for those aged 50-64 and �251 for those aged 16-24. In ROI, people aged 65+ have a median disposable weekly income of €446 compared to €790 for those aged 25-49, €654 for those aged 50-64 and €418 for those aged 16-24. In NI, people aged 65+ have the highest rate of home ownership (63%) and the lowest level of outstanding mortgage (3%) of any age group. They also have the highest level of savings (�4,000 on average) but the lowest level of value of household goods (a median of �525). In ROI, 87% of people over 65 own their house outright and 2% own their house with a mortgage. The average value of savings held by this age group is €5,519. In ROI the total value of owner-occupied housing stock was estimated to be €280 billion, of which 54% was held by those under 50. In NI people over 50 had �42.5 billion (60%) of owner-occupied housing assets while those under 50 had �28.2 billion (40%).

Phase 2 Parent/Carer Questionnaire: Review of Allied Health Professions��' (AHP) support for children/young people with a statement of special educational needs

We want to know what you think about the AHP services for your child. We will also seek views of AHPs and teachers who work with your children and we will use them all to inform our decisions. This phase of the review is focusing on current AHP services for children/young people with a statement of special educational needs enrolled in mainstream schools and learning support centres/units attached to a mainstream school.

The development of the Quality Indicator for Rehabilitative Care (QuIRC): a measure of best practice for facilities for people with longer term mental health problems

BACKGROUND: Despite the progress over recent decades in developing community mental health services internationally, many people still receive treatment and care in institutional settings. Those most likely to reside longest in these facilities have the most complex mental health problems and are at most risk of potential abuses of care and exploitation. This study aimed to develop an international, standardised toolkit to assess the quality of care in longer term hospital and community based mental health units, including the degree to which human rights, social inclusion and autonomy are promoted. METHOD: The domains of care included in the toolkit were identified from a systematic literature review, international expert Delphi exercise, and review of care standards in ten European countries. The draft toolkit comprised 154 questions for unit managers. Inter-rater reliability was tested in 202 units across ten countries at different stages of deinstitutionalisation and development of community mental health services. Exploratory factor analysis was used to corroborate the allocation of items to domains. Feedback from those using the toolkit was collected about its usefulness and ease of completion. RESULTS: The toolkit had excellent inter-rater reliability and few items with narrow spread of response. Unit managers found the content highly relevant and were able to complete it in around 90 minutes. Minimal refinement was required and the final version comprised 145 questions assessing seven domains of care. CONCLUSIONS: Triangulation of qualitative and quantitative evidence directed the development of a robust and comprehensive international quality assessment toolkit for units in highly variable socioeconomic and political contexts

Factors influencing interprofessional practices of physiotherapists working in private settings with people with low back pain: a qualitative study

Purpose: Collaboration and interprofessional practices are highly valued in health systems everywhere, partly based on the rationale that they improve outcomes of care for people with complex health problems, such as low back pain. Research in the area of low back pain also supports the involvement of different health professionals in the interventions for people who present this condition. The aim of this studywas to identify factors influencing the interprofessional practices of physiotherapists working in private settings with people with low back pain. Relevance: Physiotherapists, like other health professionals, are encouraged to engage in interprofessional practices in their dailywork. However, to date, very little is known of their interprofessional practices, especially in private settings. Understanding physiotherapists' interprofessional practices and their influencing factors will notably advance knowledge relating to the organisation of physiotherapy services for people with low back pain. Participants: Participants in this study were 13 physiotherapists including 10 women and 3 men, having between 3 and 22 years of professional experience, and working in one of 10 regions of the Province of Quebec (Canada). In order to obtain maximal variation in the perspectives, participants were selected using a recruitment matrix including three criteria: duration of professional experience, work location, and physical proximity with other professionals. Methods: Thiswas a descriptive qualitative study using faceto- face semi-structured interviews as the main method of data collection. An interview guide was developed based on an evidence-derived frame of reference. Each interview lasted between 55 and 95 minutes and was transcribed verbatim. Analysis: Qualitative analyses took the form of content analysis, encompassing data coding and general thematic regrouping. NVivo version 8 was used to assist data organisation and analysis. Results: Multiple factors influencing the interprofessional practices of physiotherapists were identified. The main factors include the consulting person's health condition, the extent of knowledge on health professionals' roles and fields of practice, the proximity and availability of professional resources, as well as daily work schedules. Conclusions: Our findings highlight the influence of multiple factors on physiotherapists' interprofessional practices, including professional practice and organisational issues. However, further research on the interprofessional practices of physiotherapists is still required. Research priorities targeting the views of other health professionals, as well as those of services users, would enhance our comprehension of interprofessional practices of physiotherapists. Implications: This study provides new insights that improve our understanding of the interprofessional practices of physiotherapists working in private settings with people with low back pain, more specifically on the factors influencing these practices. Based on our findings, implementing changes such as improving current and future health professionals' knowledge of the fields and roles of other health professionals through training may contribute to positively influencing interprofessional practices. Keywords: Interprofessional practices; Private practice; Low back pain Funding acknowledgements: This research was supported in part by a B.E. Schnurr Memorial Fund Research Grant administered by the Physiotherapy Foundation of Canada, as well as from a clinical research partnership in physiotherapy between the Quebec Rehabilitation Research Network (REPAR) and the Ordre professionnel de la physiothérapie du Québec (OPPQ). KP received doctoral-level scholarships from the Canadian Institutes of Health Research (CIHR) and the Institut de recherche Robert-Sauvé en santé et en sécurité du travail (IRSST). CE Dionne is a FRSQ senior Research Scholar. Ethics approval: This project was approved by the ethics research committee of the Institut de réadaptation en déficience physique de Québec.

The Americans with Disabilities Act Employer/Employee Rights & Responsibilities, May 2001

This publication was designed with the belief that the ADA addresses both employers and employees to achieve a viable workforce and productive society. The law was intended to reflect the balance between the employer and the employee with a disability. This booklet contains information on Title I of the ADA but should not be considered legal advice. Title I is directly related to the employment provisions of the law. Both employers and employees have responsibilities and rights under the ADA and this booklet addresses the balance of rights and responsibilities under the law. This law was designed to remove the barriers that prevent qualified persons from enjoying equal employment opportunities solely because of a disability. It demonstrates America recognizing the vitality and abilities of all people to contribute in our society, particularly in the area of employment. This is civil rights law. It prohibits discrimination against persons with disabilities and encourages the recognition of citizens with disabilities as full participants in American life. It recognizes that these members of the American work force are an excellent resource for employers.

Improving Transition Outcomes-An Innovative State Alignment Grant for Improving Transition Outcome for Youth with Disabilities Through the Use of Intermediaries, 2004

Iowa Vocational Rehabilitation Services, a Division of the State of Iowa Department of Education, in partnership with six other state agencies, applied for and was awarded funding for “Improving Transition Outcomes for Youth with Disabilities Through the Use of intermediaries.” This Innovative State Alignment Grant is funded by the Department of Labor, Office of Disability Employment Policy. For clarity and brevity, the Iowa team chose to use “Improving Transition Outcomes” as the project name, thus providing the acronym ITO. Grant funding began October 1, 2003 with the possibility of renewal for five years.