Goal attainment scaling with older people in general practice: A feasibility study.

Background: The impact of health problems on daily life and consequent treatment goals differ from person to person, particularly for older people with multiple health problems. Personalized care in general practice can help address these health problems, but evaluation of its effects remains difficult. In rehabilitation, a common approach to the evaluation of personalized care is Goal Attainment Scaling.

Perceived doctor-patient relationship and satisfaction with general practitioner care in older persons in residential homes.

Objective: Understanding patient satisfaction from the perspective of older adults is important to improve quality of their care. Since patient and care variables which can be influenced are of specific interest, this study examines the relation between patient satisfaction and the perceived doctor-patient relationship in older persons and their general practitioners (GPs).

Design: Cross-sectional survey.

A Structured Process Description of a Pragmatic Implementation Project: Improving Integrated Care for Older Persons in Residential Care Homes.

Evaluation of the implementation of integrated care can differ from trial-based research due to complexity. Therefore, we examined whether a theory-based method for process description of implementation can contribute to improvement of evidence-based care. MOVIT, a Dutch project aimed at implementing integrated care for older vulnerable persons in residential care homes, was used as a case study.

Satisfaction in Older Persons and General Practitioners during the Implementation of Integrated Care.

Background: Integrated care for older persons with complex care needs is widely advocated. Particularly professionals and policy makers have positive expectations. Care outcome results are ambiguous.

[A treatment plan as method and compass].

For elderly people with complex care needs, working with a treatment plan is a method for offering personalized, proactive, integrated care. The treatment plan works as a 'compass' because it indicates the key points to focus on in the care for the elderly person. It can take personal wishes and preferences into account, improve the person's ability to cope independently and involve family and caregivers in the process.

[Do not screen all elderly for cognitive impairment].

Early and routine screening of older people for cognitive impairment is widely advocated as it is thought to support proactive interventions and improve treatment results. However, scientific evidence to support this strategy is lacking. The recent systematic review of screening instruments and interventions discussed in this commentary shows that the widely implemented Mini-mental state examination questionnaire (MMSE) is indeed adequate to confirm the diagnosis of dementia, and to a lesser extent also mild cognitive impairment.

Assessment of appropriateness of screening community-dwelling older people to prevent functional decline.

Objectives: To identify appropriate screening conditions, stratified according to age and vulnerability, to prevent functional decline in older people.

Design: A RAND/University of California at Los Angeles appropriateness method.

Setting: The Netherlands.

[Working together responsibly in primary care--from ideal to reality].

In January 2010, the Royal Dutch Medical Association (KNMG) will publish the guideline 'Sharing responsibilities when cooperating in cure and care'. However, in practice the situation is a long way off from the ideal outlined in the guideline. The ideal situation for a patient in need of complex care would be to have coordination and case management in the hands of one person, but in practice, several care providers are involved.