Background The number of older people with unmet care and support needs is increasing substantially due to the challenges facing the formal and informal care system in the United Kingdom. Addressing these unmet needs is becoming one of the urgent public health priorities. In order to develop effective solutions to address some of these needs, it is important first to understand the care and support needs of older people. Methods A scoping review was conducted, using the Arksey and O’Malley original and enhanced framework, to understand the care and support needs of older people, focusing on those living at home with chronic conditions in the UK. The search was conducted using five electronic data bases, grey literature and reference list checks. The WHO International Classification of Functioning, Disability and Health (ICF) framework was used to analyse and categorise the literature findings. Results Forty studies were included in the final analysis- 32 from academic literature and 8 from grey literature. The review highlighted that older adults faced a range of physical, social and psychological challenges due to living with chronic conditions and required care and support in three main areas: 1) social activities and relationships; 2) psychological health; and 3) activities related to mobility, self-care and domestic life. The review also highlighted that many older people demonstrated a desire to cope with their illness and maintain independence, however, environmental factors interfered with these efforts including: 1) lack of professional advice on self-care strategies; 2) poor communication and coordination of services; and 3) lack of information on services such as care pathways. A gap in the knowledge was also identified about the care and support needs of two groups within the older population: 1) older workers; and 2) older carers. Conclusions The review highlighted that older people living with chronic conditions have unmet care needs related to their physical and psychological health, social life, as well as the environment in which they live and interact. Findings of this review also emphasized the importance of developing care models and support services based around the needs of older people. Electronic supplementary material The online version of this article (10.1186/s12877-019-1189-9) contains supplementary material, which is available to authorized users.
The aim of this qualitative evidence synthesis is to identify and assess existing evidence on barriers to and facilitators of older people's usage of mHealth. Existing literature identified many factors that affect people's experiences and perceptions of mHealth, which are in turn influenced by their personal circumstances and biography. The following themes were identified using the thematic synthesis approach: (a) perception of usefulness, (b) user requirements, (c) self-efficacy, (d) sense of self and control, (e) privacy and confidentiality, and (f) cost. MHealth devices and services are complex interventions that have to be integrated into an older person's life in order to facilitate effective use. Developers, providers, and policymakers should make sure that older people are included in decisions about technology use and, further, should question whether the current promotion of technology as a panacea for societal and budgetary problems is rooted in a realistic assessment of their use in practice.
The number of people who combine work and unpaid care is increasing rapidly as more people need care, public and private care systems are progressively under pressure and more people are required to work for longer. Without adequate support, these working carers may experience detrimental effects on their well‐being. To adequately support working carers, it is important to first understand the challenges they face. A scoping review was carried out, using Arksey and O’Malley's framework, to map the challenges of combining work and care and solutions described in the literature to address these challenges. The search included academic and grey literature between 2008 and 2018 and was conducted in April 2018, using electronic academic databases and reference list checks. Ninety‐two publications were mapped, and the content analysed thematically. A conceptual framework was derived from the analysis which identified primary challenges (C1), directly resulting from combining work and care, primary solutions (S1) aiming to address these, secondary challenges (C2) resulting from solutions and secondary solutions (S2) aiming to address secondary challenges. Primary challenges were: (a) high and/or competing demands; (b) psychosocial/‐emotional stressors; (c) distance; (d) carer's health; (e) returning to work; and (f) financial pressure. This framework serves to help those aiming to support working carers to better understand the challenges they face and those developing solutions for the challenges of combining work and care to consider potential consequences or barriers. Gaps in the literature have been identified and discussed.
Reference 1. Abdi, et al. Understanding the care and support needs of older people: a scoping review and categorisation using the WHO international classification of functioning, disability and health framework (ICF).
Prior to the ongoing COVID-19 pandemic, around 16% of the European working-age population had provided unpaid care to a frail, sick or disabled family member, friend or neighbour (Eurofound, 2015)-a number which has since increased dramatically (Carers UK, 2020;Power, 2020; United Nations, 2020). This unpaid care work is of substantial economic value; for example, Buckner and Yeandle (2015) estimated that unpaid care saves the UK economy roughly the same amount as total annual public spending on their National Health Service (~£132 billion). More than half of the European carer population currently combine unpaid care with paid work, meaning that about 15% of all people in paid work are so-called "working carers" (Carers UK, 2019; Eurofound, 2015). Even before the COVID-19 pandemic, this number was expected to increase as more people require care, fewer formal services are available or affordable due to public funding constraints, and more people are needed in the job market for longer to support an ageing society-especially women who provide
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