A progressive form of long-term care of old people with reduced self-sufficiency is home care. It is an alternative of in-patient care and provides services in the client's home. It combines the advantages of lower cost with the possibility to remain in the domestic environment and keep up social contacts. The most important factors which will substantially increase the need of home care are demographic development, the declining availability of potential care providers and possibilities of the family to ensure care, economic pressure and clients' preference. The present state of home care provision does not meet the demands of society nor individual demands of clients. It is important to create a new model of home care which will form an integral part of the social and health care policy of the state. The author discusses in particular the main principles of this care based on principles of state regulated pluralism.

• MeSH
• lidé MeSH
• senioři MeSH
• služby domácí péče trendy   MeSH
• zdravotní služby pro seniory trendy   MeSH
• Check Tag
• lidé MeSH
• senioři MeSH
• Publikační typ
• anglický abstrakt MeSH
• časopisecké články MeSH

BACKGROUND: Most people in a state of illness or reduced self-sufficiency wish to remain in their home environment. Their physiological needs, and their psychological, social, and environmental needs, must be fully met when providing care in their home environment. The aim of this study is to provide an overview of the self-perceived needs of older people living with illness or reduced self-sufficiency and receiving professional home care. METHODS: A scoping review of articles published between 2009 and 2018 was conducted by searching six databases and Google Scholar. Inductive thematic analysis was used to analyze data from the articles retrieved. RESULTS: 15 articles were included in the analysis. Inductive thematic analysis identified six themes: coping with illness; autonomy; relationship with professionals; quality, safe and secure care; role in society; environment. CONCLUSION/DISCUSSION: Older home care patients living with chronic illness and reduced self-sufficiency are able to express their needs and wishes. Care must, therefore, be planned in line with recipients' needs and wishes, which requires a holistic approach.

• Klíčová slova
• Care provision, Home care, Needs, Wishes,
• MeSH
• adaptace psychologická MeSH
• chronická nemoc MeSH
• lidé MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• služby domácí péče * MeSH
• Check Tag
• lidé MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• Publikační typ
• časopisecké články MeSH
• Scoping Review MeSH

People living with Parkinson's disease (PwP) experience a wide range of motor and non-motor symptoms associated with increasing complexity of care delivery. A multispecialty approach has been presented as an intuitive solution for tailored and comprehensive care delivery. Nevertheless, past trials of both multidisciplinary or interdisciplinary care models in PD suggested no measurable change to a small benefit in quality of life (QoL) and failed to show economic sustainability. We propose a home-based community-centred integrated care (iCARE-PD) for PwP as a pragmatic solution to harness the potential of existing care resources using an integrated care strategy, enable self-management support and implement technology-enabled care. The iCARE-PD model is based on Freeman's concept of continuity of care and the expanded Chronic Care Model for organization of care strategies. A home-based community-centred integrated care has immediate implications for clinical practice, with potential benefits in rural areas or lower-income countries, by enhancing access to care with optimized costs. There is a need to establish which and how interventions may be used as an instrument of care in each local deployment of the iCARE-PD model. We put forward a multidisciplinary framework to generate the evidence supportive of its implementation as the standard of care in the future and delineate the core strategies to secure the implementation of this care approach across different health care systems to ensure feasibility and economic sustainability. We envision this model becoming a paradigm of personalized care transferable to people with atypical forms of neurodegenerative parkinsonism.

• Klíčová slova
• Caregiver, Home care, Integrated care, Parkinson's disease, Technology-enabled care,
• MeSH
• integrované poskytování zdravotní péče organizace a řízení   MeSH
• lidé MeSH
• organizační modely * MeSH
• Parkinsonova nemoc terapie   MeSH
• self-management * MeSH
• služby domácí péče organizace a řízení   MeSH
• veřejné zdravotnické služby organizace a řízení   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH

BACKGROUND: Due to the rapid ageing of the population, there is increasing demand for long-term care in the people's home environment. Such care aims to allow the people to stay at home and avoid hospitalisation or other institutional care. In home health care, care must be provided at the highest possible quality, with the focus on the people's needs and experiences. OBJECTIVES: This study explores the experiences and needs of frail older people receiving home health care. DESIGN AND METHODS: An exploratory descriptive qualitative approach was chosen. Audio-taped semi-structured interviews were conducted with fifteen older people receiving home health care. A content analysis was used to analyse the data collected. RESULTS: The content analysis identified one main theme, three categories and seven subcategories related to frail older people's needs and experiences of home health care. The main theme was quality of care. The first category, Safe and Secure Care, consisted of three subcategories: Education and Experience of Nurses, Information, and Continuity of Care in terms of personnel continuity and regular care. The second category, Autonomy, contained two subcategories: Decision-making and Self-sufficiency. The last category, Relationship with Professionals, consisted of two subcategories: Personality of Nurse and Partnerships. CONCLUSION: Older people are able to express their satisfaction or dissatisfaction with home health care. The results of this study revealed that the quality of care is crucial for frail older people. IMPLICATION FOR PRACTICE: The provision of home health care is inherently highly specific; home care nurses should work to provide the highest possible quality of care. In particular, nurses should focus on ensuring that the care they provide is safe, effective, timely, efficient and person-centred.

• Klíčová slova
• experiences, home health care, needs, older people, quality of care,
• MeSH
• domácí životní podmínky MeSH
• křehký senior * MeSH
• kvalitativní výzkum MeSH
• lidé MeSH
• senioři MeSH
• služby domácí péče * MeSH
• spokojenost pacientů MeSH
• zdravotnické služby - potřeby a požadavky MeSH
• Check Tag
• lidé MeSH
• senioři MeSH
• Publikační typ
• časopisecké články MeSH

In the Czech Republic comprehensive home care encompasses many services. The overall focus is on providing a mosaic of care to help maintain each patient's quality of life.

• MeSH
• komplexní zdravotní péče organizace a řízení   normy   MeSH
• kvalita zdravotní péče MeSH
• lidská práva MeSH
• odborná způsobilost MeSH
• služby domácí péče organizace a řízení   normy   MeSH
• služby preventivní péče organizace a řízení   MeSH
• vzdělávání pacientů jako téma organizace a řízení   MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Česká republika MeSH

BACKGROUND AND AIMS: The increase in the proportion of elderly people and a consequent increase in the demand for care have caused healthcare systems to become overloaded. This paper describes the use of Home Care Quality Indicators (HCQIs), derived from the Minimum Data Set for Home Care, for monitoring quality of care. Research questions were, "Do HCQI scores vary between home care organizations in different countries?" and "Are one or more country-specific sites consistently scoring better on most or all HCQIs"? METHODS: a cross-sectional observational study of 65+ randomly selected clients of home care organizations in urban areas in 11 European countries who had been receiving home care for at least two weeks. Data were collected with the MDS-HC. The scoring of 16 prevalent quality indicators for home care, adjusted for population differences, was calculated with baseline data. RESULTS: Population size at baseline was 4,007 clients. Among home care clients in Europe, "rehabilitation potential in Activities of Daily Living and no therapies" (average 75.9%) and "inadequate pain control" were the most common quality problems. The prevalence between populations studied in various countries varied substantially. No country-specific site consistently scored worst or best. CONCLUSIONS: HCQIs derived from the MDS-HC detect variance in quality scores between home care in the 11 partner countries. The highest prevalence of unwanted outcomes were most often found in the Czech Republic, Italy and Germany. Although further research is necessary, we believe that HCQIs may be of great value for quality improvement in home care.

• MeSH
• činnosti denního života MeSH
• kliniky pro terapii bolesti MeSH
• kvalita zdravotní péče normy   MeSH
• lidé MeSH
• průřezové studie MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• služby domácí péče normy   MeSH
• ukazatele kvality zdravotní péče normy   MeSH
• Check Tag
• lidé MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• Publikační typ
• časopisecké články MeSH
• multicentrická studie MeSH
• práce podpořená grantem MeSH
• srovnávací studie MeSH
• Geografické názvy
• Česká republika MeSH
• Itálie MeSH
• Německo MeSH

BACKGROUND: Evaluating the quality of care provided to older individuals is a key step to ensure that needs are being met and to target interventions to improve care. To this aim, interRAI's second-generation home care quality indicators (HCQIs) were developed in 2013. This study assesses the quality of home care services in six European countries using these HCQIs as well as the two derived summary scales. METHODS: Data for this study were derived from the Aged in Home Care (AdHOC) study - a cohort study that examined different models of community care in European countries. The current study selected a sub-sample of the AdHOC cohort from six countries whose follow-up data were complete (Czech Republic, Denmark, Finland, Germany, Italy and the Netherlands). Data were collected from the interRAI Home Care instrument (RAI-HC) between 2000 and 2002. The 23 HCQIs of interest were determined according to previously established methodology, including risk adjustment. Two summary measures, the Clinical Balance Scale and Independence Quality Scale were also determined using established methodology. RESULTS: A total of 1,354 individuals from the AdHOC study were included in these analyses. Of the 23 HCQIs that were measured, the highest proportion of individuals experienced declines in Instrumental Activities of Daily Living (IADLs) (48.4 %). Of the clinical quality indicators, mood decline was the most prevalent (30.0 %), while no flu vaccination and being alone and distressed were the most prevalent procedural and social quality indicators, respectively (33.4 and 12.8 %). Scores on the two summary scales varied by country, but were concentrated around the median mark. CONCLUSIONS: The interRAI HCQIs can be used to determine the quality of home care services in Europe and identify areas for improvement. Our results suggest functional declines may prove the most beneficial targets for interventions.

• MeSH
• činnosti denního života MeSH
• etnicita MeSH
• geriatrické hodnocení metody   statistika a číselné údaje   MeSH
• kohortové studie MeSH
• kvalita života * MeSH
• lidé MeSH
• organizační modely MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• služby domácí péče * organizace a řízení   normy   statistika a číselné údaje   MeSH
• stárnutí * fyziologie   psychologie   MeSH
• ukazatele kvality zdravotní péče normy   MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Geografické názvy
• Česká republika MeSH
• Dánsko MeSH
• Finsko MeSH
• Itálie MeSH
• Německo MeSH
• Nizozemsko MeSH

OBJECTIVE: The study aimed to determine the clinical effectiveness of honey dressings in the management of non-healing wounds in elderly persons receiving home care. MATERIAL AND METHODS: Design: a prospective interventional study. The sample comprised 40 Czech home care clients (aged over 65 years) with non-healing wounds who were randomly assigned to two groups. Wounds were treated with honey (intervention group) or conventional (controls) dressings. Each wound was studied for three months. A detailed description of a wound (location, size, wound bed, edges, amount of exudate, odor, adjacent skin) were recorded. Wounds were assessed with the Wound Healing Continuum and pain intensity with the Visual Analog Scale. RESULTS: Over the 3-month period, 16 (80%) individuals in the intervention group had their wounds completely healed, as compared with only six (30%) controls. There was no statistically significant difference in wound size between the groups on Day 1 (p = 0.1801). Ninety days later, the difference in wound size between the groups was statistically significant (p = 0.0041). There was a statistically significant difference in pain intensity between the two groups (p = 0.0007), with higher pain scores being indicated by controls. CONCLUSION: The study results showed that the application of honey dressings to non-healing wounds resulted in faster healing, wound size reduction and lower pain intensity.

• Klíčová slova
• Elderly, Home care, Honey dressing, Non-healing wound,
• MeSH
• biologické krytí normy   statistika a číselné údaje   MeSH
• časové faktory MeSH
• geriatrie přístrojové vybavení   metody   MeSH
• hojení ran účinky léků   fyziologie   MeSH
• lidé MeSH
• med * MeSH
• prospektivní studie MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• služby domácí péče normy   statistika a číselné údaje   MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Československo MeSH

It is important for older and disabled people who live alone to be able to cope with the daily challenges of living at home. In order to support independent living, the Smart Home Care (SHC) concept offers the possibility of providing comfortable control of operational and technical functions using a mobile robot for operating and assisting activities to support independent living for elderly and disabled people. This article presents a unique proposal for the implementation of interoperability between a mobile robot and KNX technology in a home environment within SHC automation to determine the presence of people and occupancy of occupied spaces in SHC using measured operational and technical variables (to determine the quality of the indoor environment), such as temperature, relative humidity, light intensity, and CO2 concentration, and to locate occupancy in SHC spaces using magnetic contacts monitoring the opening/closing of windows and doors by indirectly monitoring occupancy without the use of cameras. In this article, a novel method using nonlinear autoregressive Neural Networks (NN) with exogenous inputs and nonlinear autoregressive is used to predict the CO2 concentration waveform to transmit the information from KNX technology to mobile robots for monitoring and determining the occupancy of people in SHC with better than 98% accuracy.

• Klíčová slova
• KNX technology, Smart Home Care, localization, mobile robot, occupancy, presence,
• MeSH
• lidé MeSH
• oxid uhličitý MeSH
• robotika * metody   MeSH
• samostatný způsob života MeSH
• senioři MeSH
• služby domácí péče * MeSH
• technologie MeSH
• Check Tag
• lidé MeSH
• senioři MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• oxid uhličitý MeSH

AIM: Drugs may interact with geriatric syndromes by playing a role in the continuation, recurrence or worsening of these conditions. Aim of this study is to assess the prevalence of interactions between drugs and three common geriatric syndromes (delirium, falls and urinary incontinence) among older adults in nursing home and home care in Europe. METHODS: We performed a cross-sectional multicenter study among 4023 nursing home residents participating in the Services and Health for Elderly in Long-TERm care (Shelter) project and 1469 home care patients participating in the Identifying best practices for care-dependent elderly by Benchmarking Costs and outcomes of community care (IBenC) project. Exposure to interactions between drugs and geriatric syndromes was assessed by 2015 Beers criteria. RESULTS: 790/4023 (19.6%) residents in the Shelter Project and 179/1469 (12.2%) home care patients in the IBenC Project presented with one or more drug interactions with geriatric syndromes. In the Shelter project, 288/373 (77.2%) residents experiencing a fall, 429/659 (65.1%) presenting with delirium and 180/2765 (6.5%) with urinary incontinence were on one or more interacting drugs. In the IBenC project, 78/172 (45.3%) participants experiencing a fall, 80/182 (44.0%) presenting with delirium and 36/504 (7.1%) with urinary incontinence were on one or more interacting drugs. CONCLUSION: Drug-geriatric syndromes interactions are common in long-term care patients. Future studies and interventions aimed at improving pharmacological prescription in the long-term care setting should assess not only drug-drug and drug-disease interactions, but also interactions involving geriatric syndromes.

• Klíčová slova
• Delirium, Drugs, Falls, Geriatric Syndromes, Interactions, Tailored therapy,
• MeSH
• delirium epidemiologie   MeSH
• dlouhodobá péče statistika a číselné údaje   MeSH
• geriatrické hodnocení metody   MeSH
• inkontinence moči epidemiologie   MeSH
• lidé MeSH
• pečovatelské domovy statistika a číselné údaje   MeSH
• prevalence MeSH
• průřezové studie MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• služby domácí péče statistika a číselné údaje   MeSH
• syndrom MeSH
• úrazy pádem statistika a číselné údaje   MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Evropa epidemiologie   MeSH