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Lauren Swan,1,2 N Frances Horgan,3 Chie Wei Fan,4 Austin Warters,5 Maria O’Sullivan1 1Department of Clinical Medicine, Trinity College Dublin (TCD), Dublin, Ireland; 2North Dublin Homecare Ltd, Dublin, Ireland; 3School of Physiotherapy, RCSI University of Medicine and Health Sciences, Dublin, Ireland; 4Department of Geriatric Medicine, Mater Misericordiae University Hospital, Dublin, Ireland; 5Older Person Services CHO9, Health Service Executive (HSE), Dublin, IrelandCorrespondence: Lauren Swan, Email swanla@tcd.ieIntroduction: Socioeconomic disadvantage is associated with multiple adverse health outcomes in ageing. Whether this negative impact persists in populations of more advanced age and dependency is less clear. We aimed to determine the association between residential area deprivation and pre-specified health characteristics among community-dwelling dependent older adults.Methods: We conducted a cross-sectional analysis of data from 1591 community-dwelling adults aged 65 years and older of mean age 83.9 ± 7.1 years and in receipt of state home support in Ireland. The HP Pobal Deprivation Index was used to categorize residential areas by socioeconomic deprivation. Health variables analysed included physical dependency (Barthel Index), polypharmacy (≥ 5 medications), previous acute hospital admission, cognitive impairment, and mental health diagnoses. Associations between residential area deprivation and prespecified health outcomes were explored in multivariable logistic regression analysis.Results: In socioeconomically disadvantaged areas, high physical dependency was twice that observed in affluent areas (16.2% vs 6.9%, p = 0.009). Similarly, acute hospitalization, as the trigger for increased dependency, was more common in deprived settings (41.6% v 29.1%, p < 0.001). Polypharmacy was common in this population (67.6%), but significantly higher in deprived vs affluent settings (74.7% v 64.5%, p = 0.030). The findings persisted in multivariable analys

Lauren Swan,1,2 N Frances Horgan,3 Vanda Cummins,4 Elissa Burton,5 Rose Galvin,6 Dawn A Skelton,7,8 Bex Townley,8 Frank Doyle,9 Samira B Jabakhanji,10 Jan Sorensen,10 Debbie Rooney,2 Lisa Murphy,2 Austin Warters,11 Maria O’Sullivan1 1Department of Clinical Medicine, Trinity College Dublin, Dublin, Ireland; 2North Dublin Home Care (NDHC), Dublin, Ireland; 3School of Physiotherapy, RCSI University of Medicine and Health Sciences, Dublin, Ireland; 4Primary Care Physiotherapy Services CHO9, Health Service Executive (HSE), Dublin, Ireland; 5Curtin School of Allied Health, Curtin University, Perth, Australia; 6School of Allied Health, Ageing Research Centre, University of Limerick (UL), Limerick, Ireland; 7School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, Scotland; 8Later Life Training, Killin, UK; 9Department of Health Psychology, RCSI University of Medicine and Health Sciences, Dublin, Ireland; 10Healthcare Outcomes Research Centre (HORC), RCSI University of Medicine and Health Sciences, Dublin, Ireland; 11Older Person Services CHO9, Health Service Executive (HSE), Dublin, IrelandCorrespondence: Maria O’Sullivan, Email maria.osullivan@tcd.ieIntroduction: In Ireland, over 55,000 older adults are supported in their community by formal home support, amounting to an estimated 23 million care hours annually. There is a growing need to move beyond care, to more proactive approaches to maintain physical function. In a feasibility study, we delivered the “Care to Move” (CTM) program through existing home support services. This qualitative study aimed to explore the experience and perceptions of Health Care Assistants (HCAs), who were trained in and delivered the CTM program.Methods: We conducted semi-structured telephone interviews with 22 HCAs [mean age 49.0 ± 10.7 years and female 21/22] involved in the delivery of the program with older adults [n = 35, mean age 82.8 (7.8) years]. Interview transcrip

Elissa Burton,1,2 N Frances Horgan,3 Vanda Cummins,3,4 Austin Warters,5 Lauren Swan,6,7 Maria O’Sullivan,7 Dawn A Skelton,8,9 Bex Townley,9 Frank Doyle,10 Samira B Jabakhanji,11 Jan Sorensen,11 Debbie Rooney,6 Lisa Murphy,6 Rose Galvin12 1Curtin School of Allied Health, Curtin University, Perth, Western Australia, Australia; 2enAble Institute, Curtin University, Perth, Western Australia, Australia; 3School of Physiotherapy, RCSI University of Medicine and Health Sciences, Dublin, Ireland; 4Primary Care Physiotherapy Services CHO9, Health Service Executive (HSE), Dublin, Ireland; 5Older Person Services CHO9, Health Service Executive (HSE), Dublin, Ireland; 6North Dublin Home Care (NDHC), Dublin, Ireland; 7Department of Clinical Medicine, Trinity College Dublin (TCD), Dublin, Ireland; 8School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, Scotland; 9Later Life Training Ltd, Killin, Scotland; 10Department of Health Psychology, RCSI University of Medicine and Health Sciences, Dublin, Ireland; 11Healthcare Outcomes Research Centre (HORC), RCSI University of Medicine and Health Sciences, Dublin, Ireland; 12School of Allied Health, Ageing Research Centre, Health Research Institute, University of Limerick (UL), Limerick, IrelandCorrespondence: Elissa Burton, Curtin School of Allied Health, Curtin University, GPO Box U1987, Bentley, Western Australia, 6845, Australia, Tel +61 8 9266 4926, Fax +61 8 9266 3699, Email E.Burton@curtin.edu.auPurpose: Physical activity has been shown to improve older adults’ functional capacity, independence, and quality of life. In a feasibility study, we embedded a movement approach within older adults existing home care services through “Care to Move” (CTM). The aim of this qualitative study is to explore older adults’ experiences of CTM within their home care support services and to identify the strengths and barriers of engaging in CTM from the perspective of the older recipient.Materials and Methods: We conduc

Lauren Swan,1 Austin Warters,2 Maria O’Sullivan1 1Department of Clinical Medicine, School of Medicine, Trinity College Dublin (TCD), Dublin, 8, Ireland; 2Older Person Services, Dublin North City and County Community Health Organisation, Health Service Executive (HSE), Dublin, 9, IrelandCorrespondence: Maria O’Sullivan Email maria.osullivan@tcd.ieIntroduction: Maintaining skeletal muscle function throughout life is a crucial component of successful aging. Disadvantaged socioeconomic position (SEP) is associated with adverse health outcomes, but has not been extensively studied for the muscle disease sarcopenia. We aimed to determine the prevalence of probable sarcopenia, a precursor to sarcopenia diagnosis, based on the European Working Group on Sarcopenia in Older People 2 (EWGSOP2) guidelines overall, and according to SEP.Methods: This cross-sectional study comprised 3342 community-dwelling older adults [mean age (SD) 68.9 ± 6.3 years] from Wave 1 of the Irish Longitudinal Study on Ageing. Probable sarcopenia was identified using gender-specific cut-off values for handgrip strength as recommended by EWGSOP2. SEP was defined by educational attainment. Multivariate regression analysis was employed to determine associations between probable sarcopenia and pre-defined risk factors.Results: Overall, 23.4% of the population had probable sarcopenia and was significantly higher in the subset with low compared with high SEP (28.9% vs 18.1%, p< 0.001). Consistent with this, multivariate logistic regression analysis showed that disadvantaged SEP was a significant determinant of probable sarcopenia [OR, CI 1.48 (1.17, 1.87) p< 0.001]. Other known risk factors, namely, increased age, low physical activity, comorbidity, and osteoarthritis were significantly associated with an increased likelihood of probable sarcopenia, while overweight/obesity appeared to be protective.Conclusion: Disadvantaged SEP was an independent determinant of p

Improvements in neonatal and paediatric care mean that many children with complex care needs (CCNs) now survive into adulthood. This cohort of children places great challenges on health and social care delivery in the community: they require dynamic and responsive health and social care over a long period of time; they require organisational and delivery coordination functions; and health issues such as minor illnesses, normally presented to primary care, must be addressed in the context of the complex health issues. Their clinical presentation may challenge local care management. The project explored the interface between primary care and specialised health services and found that it is not easily navigated by children with CCNs and their families across the European Union and the European Economic Area countries. We described the referral-discharge interface, the management of a child with CCNs at the acute-community interface, social care, nursing preparedness for practice and the experiences of the child and family in all Models of Child Health Appraised countries. We investigated data integration and the presence of validated standards of care, including governance and co-creation of care. A separate enquiry was conducted into how care is accessed for children with enduring mental health disorders. This included the level of parental involvement and the presence of multidisciplinary teams in their care. For all children with CCNs, we found wide variation in access to, and governance of, care. Effective communication between the child, family and health services remains challenging, often with fragmentation of care delivery across the health and social care sector and limited service availability.