Health and Care of an Ageing Population: Alignment of Health and Social Systems to Address the Need

2021 ◽  
pp. 097206342199499
Author(s):  
Sangay Thinley
Keyword(s):  
Health Care ◽  
Older People ◽  
Long Term Care ◽  
Health Care Systems ◽  
Population Ageing ◽  
Demographic Shift ◽  
Term Care ◽  
The Social ◽  
Care Systems

Population ageing is both an achievement and challenge, an achievement as longevity is the result of successful prevention and control of diseases, decreasing fertility rates and overall socio-economic development. It is at the same time a challenge as the increasing number of older people and the resultant demographic shift are accompanied by the need to adjust and scale up the social and health care systems. The challenges are of particular relevance to the developing world where the demographic shift is occurring much faster. Comprehensive efforts based on country contexts are required in the following areas: (a) older persons and development, (b) health and well-being and (c) enabling and supportive environments to address population ageing needs. This article, however, focuses only on three most crucial issues, that is, livelihood, health care systems and care of the older dependent people. Measures to sustain the livelihood of older people, to align the health systems to provide care and to develop long-term care systems are highlighted. Person-centred care, integration and functional capacity are advocated. Further, ageing in place or living in one’s own home, community or a place with the closest fit with the person’s needs and preferences is considered very important for healthy ageing. In terms of enhancing livelihood, major policy changes and reforms to improve the social security systems and expanding coverage as well as increasing the amounts to minimum subsistence levels are highlighted. Another area which needs to be strengthened is the tradition of existing family support systems. The health systems alignment required are reflected for each health system building block, and focuses mainly on (a) developing and ensuring access to services that provide older-person-centred care; (b) shifting the clinical focus from disease to intrinsic capacity; and (c) developing or reorienting the health workforce to provide care as per alignment. Long-term care systems would best meet the needs of dependent older people if families, communities, civil society organisations and private sector are equally involved while governments play leadership roles in setting up and monitoring quality.

scholarly journals Using Health Care Resources Wisely After the COVID-19 Pandemic: Recommendations to Reduce Low-Value Care

2021 ◽  
Vol 1 (5) ◽  
Author(s):  
Sinwan Basharat ◽  
Karen Born
Keyword(s):  
Health Care ◽  
Long Term Care ◽  
Health Care Systems ◽  
Care Quality ◽  
Choosing Wisely ◽  
Limited Resources ◽  
Term Care ◽  
Health Care Resources ◽  
Care Systems

Low-value tests, treatments, and procedures are an important health care quality problem in Canada and across the world because they provide little clinical benefit, may be harmful for patients, and waste limited resources. Due to the COVID-19 pandemic, health care systems face increased challenges of limited resources, reduced capacity, and a growing backlog of surgeries and other procedures. The pandemic has compelled health care professionals to make challenging decisions to prioritize health care services while coping with increased demand. As Canada emerges from the pandemic and health care systems rebuild and begin to address the backlog of delayed or cancelled services, there is an imperative to introduce lasting changes to reduce low-value care and ensure high-quality care is available to everyone. To help inform efforts for using health care resources wisely and to support decision-making, CADTH and Choosing Wisely Canada convened a 10-member multi-disciplinary panel of clinicians, patient representatives, and health policy experts to review areas of low-value care that can be reduced or limited. This panel reviewed, deliberated, and prioritized 19 recommendations of the more than 400 Choosing Wisely Canada recommendations, the implementation of which can help ensure high-value care after the pandemic. Examples of the 19 recommendations include: Avoiding unnecessary transfers for patients in long-term care to hospitals unless there is an urgent medical need. Limiting blood tests and imaging unless required to answer a specific clinical question or guide treatment. Not transfusing red blood cells for hemodynamically stable patients in the intensive care unit. Not delaying palliative care for patients with serious illness because they are pursuing disease-directed treatment. Moreover, the panel’s discussion highlighted how the selected recommendations can advance key priorities, including improving health equity and access to care, appropriately using limited resources, emphasizing patient-focused care, and addressing challenges the pandemic has presented for long-term care.

Habituation Theory and Environment-Aging Research: Ennui to Joie De Vivre?

1989 ◽  
Vol 29 (4) ◽  
pp. 241-257 ◽  
Author(s):  
Carolyn Norris-Baker ◽  
Rick J. Scheidt
Keyword(s):  
Older People ◽  
Psychological Control ◽  
Long Term Care ◽  
Aging Research ◽  
Term Care ◽  
Targeted Interventions ◽  
Situational Characteristics ◽  
The Social ◽  
The Impact

Robert Kastenbaum posits that functional aging results in the overadaptation to our own routines and expectations, producing “hyperhabituation,” mental stagnation, and novaphobic response orientations. This article examines the promise and implications of this notion for two areas of environment-aging research: psychological control and environmental comprehension. Possible causal and mediating links between control and habituation are considered, as well as the impact of habituation on environmental perception, cognition, and appraisal. Personal and situational characteristics of older people likely to be at risk for habituated responses are suggested. The article also speculates about individually- and environmentally-targeted interventions which might prevent and/or ameliorate tendencies toward hyperhabituated responses among older people who reside in highly ritualized and constant environments such as long-term care institutions. Interventions subject to future evaluations include modifications for the social, physical, and policy milieux and desensitization of novaphobic responses.

Tensions and polarities in the autonomy of family carers in the context of the COVID-19 pandemic in France

2022 ◽  
Author(s):  
Olivier Giraud ◽  
Anne Petiau ◽  
Abdia Touahria-Gaillard ◽  
Barbara Rist ◽  
Arnaud Trenta
Keyword(s):  
Older People ◽  
Social Service ◽  
Long Term Care ◽  
Health Protection ◽  
Family Carers ◽  
Frail Older People ◽  
Term Care ◽  
Care Systems ◽  
The Impact

This article analyses the impact of the COVID-19 lockdown on ‘monetised’ family carers’ understanding of their own autonomy in a long-term care relation at home. The reduction or suspension of medico-social service deteriorated the situation of family carers of frail older people or people with disability. We develop and apply an analytical grid of 15 interviews of monetised family carers about the reorganisation of care systems and their situation as carers. We identify three types of understandings of autonomy among family carers in the context of the COVID-19 pandemic: preventive autonomy; health protection autonomy; and supported autonomy.

Public-Private Partnership in Health and Long-Term Care

2018 ◽  
pp. 103-124
Author(s):  
Wing Tung Ho ◽  
Ben Yuk Fai Fong
Keyword(s):  
Hong Kong ◽  
Long Term Care ◽  
Health Care Systems ◽  
Public Private Partnership ◽  
Term Care ◽  
Related Services ◽  
Private Partnership ◽  
Aging Populations ◽  
Care Systems

An exponential growth in elderly population reflects a proportional increase in recourses that are unaffordable and unsustainable to the economy. This rapid demand for health services and long-term care not only leads to non-financial implication like shortage of manpower and long waiting time, but this also creates a large burden on health and related services in the public sector. Involving the private sector to provide better and more efficient facilities and services and to encourage innovation will enhance productivity, speed up project and service delivery, and increase opportunities for investment in health. This chapter examines existing problems within health care systems in aging populations such as Hong Kong, explores the advantages and challenges of Public Private Partnership (PPP), identifies successful factors in establishing PPPs models, reviews the PPP projects in Hong Kong and elsewhere and recommends methods in promoting PPP in health and long-term care as sustainable solutions.

Long-term care as contested acoustical space: Exploring resident relationships and identities in sound

2019 ◽  
Vol 27 (1) ◽  
pp. 61-73 ◽  
Author(s):  
Megan E Graham
Keyword(s):  
Health Care ◽  
Social Space ◽  
Long Term Care ◽  
Care Facility ◽  
Well Being ◽  
Social Significance ◽  
Term Care ◽  
Similar Treatment ◽  
The Social

As the global population ages, residential care facilities are challenged to create positive living environments for people in later life. Health care acoustics are increasingly recognized as a key design factor in the experience of well-being for long-term care residents; however, acoustics are being conceptualized predominantly within the medical model. Just as the modern hospital battles disease with technology, sterility and efficiency, health care acoustics are receiving similar treatment. Materialist efforts towards acoustical separation evoke images of containment, quarantine and control, as if sound was something to be isolated. Sound becomes part of the contested space of long-term care that exists in tension between hospital and home. The move towards acoustical separation denies the social significance of sound in residents’ lives. Sound does not displace care; it emplaces care and the social relationships therein. Drawing upon ethnographic fieldwork in a Canadian long-term care facility, this article will use a phenomenological lens to explore how relationships are shaped in sound among residents living in long-term care. Ethnographic vignettes illustrate how the free flow of music through the care unit incited collective engagement among residents, reduced barriers to sharing social space and constructed new social identity. The article concludes that residents’ relationships are shaped within the acoustical milieu of the care unit and that to impose acoustical separation between residents’ living spaces may further isolate residents who are already at risk of loneliness.

scholarly journals Forms of Providing and Financing Long-Term Care in OECD Countries

2017 ◽  
Vol 17 (2) ◽  
pp. 159-178 ◽  
Author(s):  
Renáta Halásková ◽  
Pavel Bednář ◽  
Martina Halásková
Keyword(s):  
Cluster Analysis ◽  
Long Term Care ◽  
Formal System ◽  
Principal Component ◽  
Oecd Countries ◽  
Population Ageing ◽  
Term Care ◽  
Care Systems ◽  
Provision Of Care

Abstract Long-term care is being prioritised due to population ageing, and hand in hand with the development of professional provision of long-term care, public expendi-tures will be increasing. Mainly countries with a sharp increase in the number of people aged 80+ will have to address the sustainability of long-term care systems and the pro-curement of relevant services. This paper aims to evaluate the forms of provision and financing of long-term care in selected OECD countries. Provision and funding of long-term care in terms of a formal system are assessed based on selected criteria using analytical methods (principal component analysis and TwoStep cluster analysis). Results of the evaluation carried out in 2008 and 2013 by means of the selected indicators of long-term care, using TwoStep cluster analysis, confirmed both similar as well as different approaches to the provision and financing of long-term care in the analysed countries. The most marked differences in the provision of care based on indicators LTC recipients aged 65+ and LTC recipients in institutions as a percentage of total LTC recipients were found between the first cluster (Australia and Korea with the highest share of LTC recipients) and the second cluster (Czech Republic, Estonia, with the lowest share of LTC recipients). In financing of long-term care (LTC expenditures on institutions as a percentage of total LTC expenditures), the most significant differences were observed between the first (Australia, Korea, with the largest share of LTC expenditures on institutions) and third cluster (mainly Nordic countries, with the lowest share of LTC expenditures on institutions of total LTC expenditures).

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