Care management for older people with mental health problems: from evidence to practice

Abstract

Aim: To explore the implications of providing intensive care management in a typical old age mental health service in North West England. Methods:The time spent by core groups of specialist mental health and social services staff on a range of activities deemed central to the provision of intensive care management was explored by means of a diary exercise. The difference between what is actually being done and what evidence suggests is needed was examined.Results: More than 1500 hours of activity were appraised. Assessment and care managementrelated tasks accounted for more than 40% and 30% of social work and nursing staff's time, respectively. However, several fundamental features of intensive care management were lacking, including health staff's adoption of the care manager role, arrangements to facilitate appropriate information sharing and sufficient time for practitioners to provide the necessary careful assessment of needs, liaison with other agencies, and close and regular contact with the elderly person and their care network.

Exploring patterns of care coordination within services for older people

“…Reflecting this, subsequent research has suggested that components of intensive care management, essential to support people at home, were rarely in place in local authorities in England. 50…”

“…49 Effective systems for screening, prioritising and gatekeeping access to care coordination services permit the identification of service users with complex needs. 50 These features have been specified in policy guidance over many years in England [51][52][53] and were identified as precursors to intensive care management. 50 Three measures of differentiation have been explored in this study.…”

“…50 These features have been specified in policy guidance over many years in England [51][52][53] and were identified as precursors to intensive care management. 50 Three measures of differentiation have been explored in this study. Firstly, whether or not eligibility for entry into care coordination services was additional to those for universally available services.…”

Occupational therapy roles and responsibilities: Development of a standardised measure of time use for staff working with adults in community settings

“…In this activities were categorised according to three themes: direct care, indirect care and team or service development as described in Table 3. The fourth category contained residual activities not captured in any of the principal themes (Challis et al, 2007(Challis et al, , 2012Jacobs et al, 2006Jacobs et al, , 2013Tucker et al, 2008;Weinberg et al, 2003). The schedule comprised a list of activities and a diary grid (Monday to Friday, 8 a.m. to 7 p.m.) divided into 30-minute intervals.…”

“…Roles not already classified (Challis et al, 2007(Challis et al, , 2012Jacobs et al, 2006Jacobs et al, , 2013Tucker et al, 2008;Weinberg et al, 2003).…”