The Management of the Older Person with a Long-Term Condition

Author(s):  
Maggi Banning
Keyword(s):  
2021 ◽  
pp. archdischild-2020-320655
Author(s):  
Lorna K Fraser ◽  
Fliss EM Murtagh ◽  
Jan Aldridge ◽  
Trevor Sheldon ◽  
Simon Gilbody ◽  
...  

ObjectiveThis study aimed to quantify the incidence rates of common mental and physical health conditions in mothers of children with a life-limiting condition.MethodsComparative national longitudinal cohort study using linked primary and secondary care data from the Clinical Practice Research Datalink in England. Maternal–child dyads were identified in these data. Maternal physical and mental health outcomes were identified in the primary and secondary care datasets using previously developed diagnostic coding frameworks. Incidence rates of the outcomes were modelled using Poisson regression, adjusting for deprivation, ethnicity and age and accounting for time at risk.ResultsA total of 35 683 mothers; 8950 had a child with a life-limiting condition, 8868 had a child with a chronic condition and 17 865 had a child with no long-term condition.The adjusted incidence rates of all of the physical and mental health conditions were significantly higher in the mothers of children with a life-limiting condition when compared with those mothers with a child with no long-term condition (eg, depression: incidence rate ratio (IRR) 1.21, 95% CI 1.13 to 1.30; cardiovascular disease: IRR 1.73, 95% CI 1.27 to 2.36; death in mothers: IRR 1.59, 95% CI 1.16 to 2.18).ConclusionThis study clearly demonstrates the higher incidence rates of common and serious physical and mental health problems and death in mothers of children with a life-limiting condition. Further research is required to understand how best to support these mothers, but healthcare providers should consider how they can target this population to provide preventative and treatment services.


2018 ◽  
Vol 39 (8) ◽  
pp. 898-901
Author(s):  
Robert Applebaum ◽  
Shahla Mehdizadeh ◽  
Diane Berish

The long-term services system has changed substantially since the mid-1970s, when the landmark book Last Home for the Aged argued that the move to the nursing home was the last move an older person would make until death. Using detailed nursing home utilization data from the Minimum Data Set, this study tracks three cohorts of first-time nursing home admissions in Ohio from 1994 through 2014. Each cohort was followed for a 3-year period. Study results report dramatic reductions in nursing home length of stay between the 1994 and 2011 cohorts. Reduction in length of stay has important implications for nursing home practice and quality monitoring. The article argues that administrative and regulatory practices have not kept pace with the dramatic changes in how nursing homes are now being used in the long-term services system.


2019 ◽  
Vol 35 (1) ◽  
pp. 70-86 ◽  
Author(s):  
Stephen Hughes ◽  
Sophie Lewis ◽  
Karen Willis ◽  
Anne Rogers ◽  
Sally Wyke ◽  
...  

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S138-S138
Author(s):  
Oscar Riberio ◽  
Laetitia Teixeira ◽  
Lia Araujo ◽  
Constança Paúl

Abstract The caregiver support ratio (CSR) has been defined as the number of potential caregivers aged between 45 and 64 (the most common caregiving age range) for each person aged 80 and over (subgroup of older adults most at risk of needing long term services and support). In 2010, for the USA, this number was calculated to be 7 to 1, a ratio that was projected to shrink to 4 to 1 in 2030, and to 3 to 1 in 2015 according to the AARP Public Policy Institute. In this study we used data from CENSUS HUB to calculate the CSR in Europe considering a total of 27 countries. Main results revealed that a group of Mediterranean countries (Italy, Greece, Spain and Portugal), along with France, Belgium and Sweden have the lowest CSR (5 to 1); on the other hand, the countries with the highest CSR are Slovakia (9 to 1), and Ireland, Poland, Cyprus and Malta (8 to 1). In average, for the 27 countries, the estimated number of caregivers per frail older person today is 6 to 1. These findings reveal important differences between countries and may inform EU policy decisions regarding long-term care (LTC). Given that informal care forms a cornerstone of all LTC systems in Europe, and that this continent faces a rapidly increasing number of people in very advanced age with extended years of disability living at home, estimating the CSR for the next decades is of crucial importance.


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