Rôles et vécus des pharmaciens d’officine dans les soins palliatifsàdomicile en France Role and Experience ofCommunity Pharmacists in Home Palliative Care in France

The need for home palliative care is increasing in allWestern countries.Community pharmacists are local professionals whose role in end-of-life care at home remains poorly understood.The aim of this study is to understand how community pharmacists see their role in end-of-life home care in France,and to analyze their experiences of this care.An online questionnaire was distributed to community pharmacists working in France between December 2022 and March 2023.Of the 136 respondents to the questionnaire,87%had accompanied at least one patient at the end of life in the 3 months preceding the survey.Therapeutic education(88%of respondents),psychological support for caregivers(85%of respondents),securing treatment(82%of respondents)and monitoring therapeutic compliance(80%of respondents)are the behaviors validated by the greatest number of participants.The majority of professionals surveyed had a positive overall experience of managing patients at the end of life.These results pave the way for pharmacists to better support end-of-life patients at home.

The Study of Supply and Demand about Shanghai Community Home Care Service

As the Chinese traditional culture is depend on the family, community home care service is increasingly becoming the first choice of the elderly aged. At present, Shanghai is facing serious aging phenomenon, the contradiction between supply and demand has become more and more intensified. This paper will analyze the status of supply and demand about Shanghai community endowment services, and then identify the existing problems and reasons for the accordance in supply and demand on the base of analysis. Ultimately, this paper will raise suggestions about promoting the matching between supply and demand of Shanghai community home care service.

A Home for the Aged in a Rural Community

Both in their mid-70s, Shan Baorui and his wife are now living at a model home for the aged in north China.The couple lives in a single room with heating in winter and an indoor toilet. Outside is a garden-like compound with flowers colorfully bright in the refresh- ing breeze.

The research of the community-home elderly long-term care service system

With the rapid development of the aging of the population, the demand of long-term care services in the elderly is growing. Because of family miniaturization, core, and currently limited social accumulation are difficult to meet the demand of the elderly in long-term care.Community provides the elderly long-term care services, and provides the elderly all kinds of household helping services. They just make up for the inadequacy of the family and society.And how to make the community elderly long-term care services become more suitable for the needs of the elderly at home, provide better service for the elderly, are our current problems to be solved.

Changes and Development of Home and Community Based Elderly Care Service Policies in China

This paper analyzes the current situation of the development of home and community based elderly care service in China,points out the existing problems,and puts forward improvement measures,aiming to deepen the understanding of HCBS and promote the theoretical research and practice of community home-based elderly care service.

The Experiences of the Elderly and Caregivers in Respect of Caring for the Elderly in Windhoek and Rehoboth Namibia: An Exploratory and Descriptive Study

In many instances, care for the elderly, especially in long-term care institutions, is provided under minimal supervision by caregivers who are lay people. This can lead to poor quality care or neglect of the elderly. The research question was: “How competent are lay caregivers for the elderly in old age homes, who often lack the opportunity for training to improve their knowledge and skills, in delivering care to the elderly? The aims of the study were to explore and describe the experiences of both the caregivers and the elderly in respect of caring for the elderly in old age homes. The objectives of the study were to explore and describe the experiences of the caregivers and the elderly with respect to caring for the elderly and in respect of nursing care they received. A qualitative, explorative, descriptive, contextual and phenomenology design was used to perform this study. In the situational analysis, the experiences and needs of the caregivers were described. Themes in terms of interpersonal relationships that could be positive or negative regarding the elderly were identified. These included lack of regular in-service training sessions for caregivers. Likewise, sub-themes like communication, support and caring for elderly people were revealed. Inadequate knowledge of caregivers in caring procedures, a shortage of staff, equipment and absence of policies which should support and guide the work of caregivers impacts negatively on the care of the elderly. From the experiences of the elderly and caregivers, the competencies under scrutiny emerged and were measured qualitatively by the perceptions of the elderly, in respect of the caring they were exposed to.

The Research of Social Organizations Participating in the Urban Community Aged Care＇ s Problems--Base on the City of Shanghai in China

With the deepening of China＇s aging population, the conmmnity aged care gradually become endowment new options. Social organization for its own characteristics, play an important role in participating in community aged care. But the extent to which the current social organizations to participate in the community aged care is still very low, the reason is mainly affected by the community aged care access mechanism. Article in the Shanghai community, for example, starhng fiom the present situation of the current social organizations to participate in the community aged care, analysis of the problems arising fi-om the social organizations in the community aged care, probe into its reasons in access mechanism, put forward the corresponding countermeasures and Suggestions, encourage social organizations play an effective role in the community aged care.

Lessons learned from the hospital to home community care program in Singapore and the supporting AI multiple readmissions prediction model

In a prior practice and policy article published in Healthcare Science,we introduced the deployed application of an artificial intelligence(AI)model to predict longer‐term inpatient readmissions to guide community care interventions for patients with complex conditions in the context of Singapore's Hospital to Home(H2H)program that has been operating since 2017.In this follow on practice and policy article,we further elaborate on Singapore's H2H program and care model,and its supporting AI model for multiple readmission prediction,in the following ways:(1)by providing updates on the AI and supporting information systems,(2)by reporting on customer engagement and related service delivery outcomes including staff‐related time savings and patient benefits in terms of bed days saved,(3)by sharing lessons learned with respect to(i)analytics challenges encountered due to the high degree of heterogeneity and resulting variability of the data set associated with the population of program participants,(ii)balancing competing needs for simpler and stable predictive models versus continuing to further enhance models and add yet more predictive variables,and(iii)the complications of continuing to make model changes when the AI part of the system is highly interlinked with supporting clinical information systems,(4)by highlighting how this H2H effort supported broader Covid‐19 response efforts across Singapore's public healthcare system,and finally(5)by commenting on how the experiences and related capabilities acquired from running this H2H program and related community care model and supporting AI prediction model are expected to contribute to the next wave of Singapore's public healthcare efforts from 2023 onwards.For the convenience of the reader,some content that introduces the H2H program and the multiple readmissions AI prediction model that previously appeared in the prior Healthcare Science publication is repeated at the beginning of this article.

Evidence of Care of the Aged in Ghanaian Communities—A Scoping Review

Sub-Saharan Africa population is increasing in age with little acknowledgement on the consequences of the issues of ageing. Aim: To explore and describe evidence in published literature on care given to the aged at home and how they prepare for their ageing. Method: The study applied the Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA) framework for systematic literature reviews using the population, intervention, comparison and outcome (PICO) method to track the eligibility of research questions. This method was the most appropriate for use in exploring the current position in available literature for that of Ghana. The research was performed using five electronic databases from January to July 2017 taking into consideration the set inclusion and exclusion criteria. Only studies written in English were considered and a total of 18 articles met the study criteria. Reviewers extracted primary studies comprising quantitative, qualitative and critical reviews. Result: The literature review showed shortcomings in care for the aged at home. From the search, six core themes were generated: neglect of aged care;aged care for the younger generation;aged living arrangements;government neglect;preparedness;and care of the aged in Ghana. Conclusion: This review offered significant insight into care for the aged in their homes. The inclusive nature of the rigorous approach used provided a good understanding of underlying issues on the needs of the aged. Challenges for future are broadened in scope for more research and effective awareness for interventional projects, services on care given to the aged.

A family nurse-led intervention for reducing health services’utilization in individuals with chronic diseases:The ADVICE pilot study

Objectives:Intensive health services'utilization is common in older individuals affected by chronic diseases.This study assessed whether a structured family nurse-led educational intervention would be effective in reducing health services'use(readmissions and/or emergency service access)among older people affected by chronic conditions.Methods:This is a non-randomized before-after pilot study.A sample of 78 patients was recruited from two general practices in Italy and 70 among them were followed for 8 months.Standard home care was provided during the first four months'period(months 1-4),followed by the educational intervention until the end of the study(months 5-8).The intervention,based on the teach-back method,consisted of by-weekly 60-min home sessions targeting aspects of the disease and its treatment,potential complications,medication adherence,and health behaviours.Rates of health services'use were collected immediately before(T0),and after the interventions(T1).Differences in utilization rates were examined by the McNemar's test.Potential factors associated with the risk of health services'use were explored with a Cox proportional hazard regression model.Results:The sample(n=78)was predominantly female(n=50,64.1%),and had a mean age of 76.2(SD=4.8)years.Diabetes mellitus was the most frequent disease(n=27,34.6%).McNemar's test indicated a significant reduction in health services'use at T1(McNemar χ^(2)==28.03,P<0.001).Cox regressions indicated that time and patient education,as well as their interaction,were the only variables positively associated with the probability of health services'use.Conclusion:A teach-back intervention led by a family nurse practitioner has the potential to reduce health services'use in older patients with chronic diseases.

Analysis of home care-based multi-level old-age service system

With the deepening of China＇s aging, China＇s social pension problem more obvious each day, and gradually become the focus of attention of the whole society. On the one hand, China entered the aging society, old-age needs to grow exponentially. The sixth national census shows that in our country, the population aged 60 and 13.26% of the total population over the total number of 179 million, 65 years and older the proportion of 8.87% of the total population, the absolute number of nearly 120 million. Hundreds of millions of older age groups will produce a growing demand for care services, which is the original old-age service system and the whole economic and social development is a huge pressure. On the other hand, with the economic and social transformation, the traditional model of family pension has been unable to adapt to the profound changes in modem employment, family structure, the concept of retirement, since most parts of China, ＂old before getting ricE＂ the situation, how to solve the elderly the pension problem is related to the overall situation of China＇s economic and social development, related to the overall situation of building a harmonious society in China. Under current national conditions, the emphasis on the development of a single individual body to meet the growing demand for pension service is not realistic, we must mobilize the enthusiasm of all aspects of the element, multi-service integration of resources subject to their commitment to a different responsibilities and tasks provide a full range of care services according to different types, different levels of the actual needs of the older age groups. On the aging problem is that the whole community to face, you need to multi-government body, families, communities, institutions combine effectively starting from the actual needs of the elderly population, according to the financial assistance, life care, spiritual consolation three set the specific needs of services, through a government-led, home-based care services, community care services for the core and supplementary services for institutions focused on pension and other means to provide a full range of pension services.

Associations of social participation, demographic, socioeconomic and disease factors with nutritional risk in a group of older Hong Kong adults

Aims: To identify the impact of social participation, socio-demographic, socio-economic and disease factors on nutritional risk among older persons in Hong Kong. Background: Few published work has investigated the relative risks of social participation, demographic, socioeconomic and disease factors with malnutrition in community-living older people, this study is to investigate the associations of these risk factors on the nutritional status in better nutrition support for the old age group. Design: A crosssectional study. Methods: It was a secondary analysis of a database in a mobile community centre between January 2008 and December 2009. One thousand seven hundred and thirty one participants aged between 54 and 103 were collected. With 319 full Mini Nutritional Assessment (MNA) completed, the participants’ demographic, socio-economic data, diseases, and nutritional status were analyzed with relative risk and 95% confidence interval level to identify the factors that make them vulnerable to nutritional risk. Results: The prevalence of malnutrition in the community-dwelling old was 3.95% and 83.7% of the sample was at risk of malnutrition. Living on allowances, young old who was socially engaged and good relationship with family members were at less risk to malnutrition. Conclusions: Special attention should be taken to these groups as they are prone to develop malnutrition.

Stigma and Discrimination against People Living with HIV and AIDS in Malawi

A study was conducted to explore stigma and discrimination among people living with HIV and AIDS who were on home based care in the Lilongwe district of Malawi. The study design was descriptive through sectional and utilized qualitative data collection and analysis method. Fifteen people living with HIV and AIDS, aged between 15 and 60 years were purposively sampled from three organizations, which were: Light House, National Association for people living with HIV and AIDS in Malawi and Lilongwe Diocese. Qualitative data were collected using an open ended interview guide during in-depth face to face interviews with the participants. The data were analysed using ATLAS. ti 5.0. Results show that all the participants were facing stigma and discrimination because they were living with HIV and AIDS. Distant relatives were the main source of stigma and discrimination followed by friends and church members. Most participants indicated that they felt they were discriminated because HIV infection is associated with bad behaviours such as prostitution or promiscuity. However some of them complained that they contracted the virus from their married partners and hence they did not deserve to be stigmatized or discriminated against. Results show that there is a need for creation of awareness among community members on the transmission of HIV and the need for home based care for the chronically ill people living with HIV and AIDS.