scholarly journals A Study on the Elderly’s Subjective Perception Types on Long-Term Care Service -Q Methodological Analysis by the Elderly Using Home Care Services-

2010 ◽  
Vol null (50) ◽  
pp. 27-48
Author(s):  
Bok-Ki Shin ◽  
이재환
2021 ◽  
pp. 084456212110443
Author(s):  
Brittany Barber ◽  
Lori Weeks ◽  
Lexie Steeves-Dorey ◽  
Wendy McVeigh ◽  
Susan Stevens ◽  
...  

Background An increasing proportion of older adults experience avoidable hospitalizations, and some are potentially entering long-term care homes earlier and often unnecessarily. Older adults often lack adequate support to transition from hospital to home, without access to appropriate health services when they are needed in the community and resources to live safely at home. Purpose This study collaborated with an existing enhanced home care program called Home Again in Nova Scotia, to identify factors that contribute to older adult patients being assessed as requiring long-term care when they could potentially return home with enhanced supports. Methods Using a case study design, this study examined in-depth experiences of multiple stakeholders, from December 2019 to February 2020, through analysis of nine interviews for three focal patient cases including older adult patients, their family or friend caregivers, and healthcare professionals. Results Findings indicate home care services for older adults are being sought too late, after hospital readmission, or a rapid decline in health status when family caregivers are already experiencing caregiver burnout. Limitations in home care services led to barriers preventing family caregivers from continuing to care for older adults at home. Conclusions This study contributes knowledge about gaps within home care and transitional care services, highlighting the importance of investing in additional home care services for rehabilitation and prevention of rapidly deteriorating health.


Author(s):  
Frank J. Elgar ◽  
Graham Worrall ◽  
John C. Knight

ABSTRACTAs the demand for home care services increases, health care agencies should be able to predict the intake capacity of community-based long-term care (CBLTC) programs. Two hundred and thirty-seven clients entering a CBLTC program were assessed for activities of daily living (ADL) and cognitive and affective functioning and were then followed to monitor attrition and reasons why clients left the program. Compromised ADL functioning at baseline increased likelihood of death and institutionalization by 2 per cent each year. Over a 10-year period, reduced cognitive functioning at baseline increased the risk of death by 9 per cent and decreased the likelihood of leaving the program due to improvement by 18 per cent. Reduced affective functioning at baseline increased the risk of institutionalization during the course of the study by 3 per cent. Routine functional assessments with the elderly may help in the management of similar home care programs.


1994 ◽  
Vol 20 (1-2) ◽  
pp. 59-77
Author(s):  
Eleanor D. Kinney ◽  
Jay A. Freedman ◽  
Cynthia A. Loveland Cook

Community-based, long-term care has become an increasingly popular and needed service for the aged and disabled populations in recent years. These services witnessed a major expansion in 1981 when Congress created the Home and Community-Based Waiver authority for the Medicaid program. Currently, all states offer some complement of community-based, long-term care services to their elderly and disabled populations and nearly all states have Medicaid Home and Community-Based Services waivers which extend these services to their Medicaid eligible clients.An ever increasing proportion of the population is in need of community-based, long-term care services. Between nine and eleven million Americans of all ages are chronically disabled and require some help with tasks of daily living. In 1990, thirty percent of the elderly with at least one impaired activity of daily living used a community-based, long-term care service. Not surprisingly, expenditures for community-based, long-term care have increased.


2021 ◽  
Author(s):  
Brittany Barber ◽  
Lori Weeks ◽  
Lexie Steeves-Dorey ◽  
Wendy McVeigh ◽  
Susan Stevens ◽  
...  

Abstract Background: An increasing proportion of older adults experience avoidable hospitalizations, and some are potentially entering long-term care homes earlier and often unnecessarily. Within Canada, approximately 10 percent of newly admitted long-term care residents could have potentially been cared for at home. Without adequate support from health care services to transition older adults from hospital to home, they often lack access to appropriate services when they are needed in the community thus making them more vulnerable to avoidable hospital visits, rapid deterioration of health, and earlier and unnecessary placement into residential long-term care. The purpose of this study was to collaborate with an existing enhanced home care program called Home Again in Halifax, Nova Scotia, to identify factors that contribute to older adult patients being assessed as requiring long-term care when they could potentially return home with enhanced supports. Methods: Through a retrospective case study design, we analyzed nine interviews for three focal patient cases including older adult patients, their family or friend caregivers, and healthcare professionals. Results: Findings indicate home care services for older adults are being sought too late, after hospital re-admission, or a rapid decline in health status when family caregivers are already experiencing caregiver burnout. Limitations in home care services ultimately led to barriers preventing family caregivers from continuing to care for older adults at home, such as absence of overnight services, a lack of information about home care services, and a lack of knowledge to navigate resources available. Conclusion: This study contributes knowledge about gaps within home care and transitional care services, highlighting the significance of investing in additional home care services for rehabilitation and the prevention of rapidly deteriorating health when older adults are discharged home after their first hospital visit. By understanding experiences and challenges of patients, family or friend caregivers, and healthcare professionals, we identified ways to reduce healthcare costs and improve the delivery and quality of home care services to better support older adult patients and their family or friend caregivers and to ensure hospitalized older adults are not unnecessarily admitted to nursing homes.


2021 ◽  
Vol 12 (1) ◽  
pp. 155-180
Author(s):  
Laila Tingvold ◽  
Oddvar Førland

Introduction: Increased voluntary work in long-term care (LTC) is encouraged in white papers in Norway as well as in many other western states. This is due to the growth in the number of service recipients and a subsequent economic burden for the state. Voluntary work in nursing homes and home care services take place in different spatial contexts, but little attention has been paid to how the different contexts may potentially influence the possibilities for voluntary work. The aim of this study is to obtain new knowledge of the significance of context in recruitment of volunteers in LTC. Method: A cross-sectional study was conducted among leaders in nursing homes and home services in 50 municipalities across all regions of Norway. Descriptive analysis was used. Results: According to the leaders, home care services had less voluntary work than nursing homes. Respondents from home care scored “poor flow of information” and “low interest in the municipality” as major hinderances, more so than respondents from nursing homes did. Discussion: Nursing homes typically have many residents under one roof following a similar schedule. Thus, volunteer-run activities are held more easily at set times and incorporated into the daily life of the institutions. On the other hand, home dwellers in home care stay in a more individualised setting with more autonomy and can opt out of activities that nursing home residents would normally join. Skill acquisition, networking and socializing are common motivations for volunteering, and a nursing home setting may be an easier context to obtain this. The governmental endeavour for increased voluntary work in LTC can be seen as an effort to meet expected rises in public expenditure. However, the realism can be debated due to substantial challenges on the future potential of volunteerism in LTC, especially in the home care context.


10.2196/22316 ◽  
2021 ◽  
Vol 23 (8) ◽  
pp. e22316
Author(s):  
Hanne Marie Rostad ◽  
Randi Stokke

Background Welfare technologies are often described as a solution to the increasing pressure on primary health care services. However, despite initiating welfare technology projects in the health care sector and different government incentives, research indicates that it is difficult to integrate welfare technology innovations in a complex and varying setting, such as long-term care. Objective We aim to describe the types of welfare technology and the extent to which welfare technology is provided in long-term care (ie, nursing homes and home care services); examine whether the extent of welfare technology provision differs on the basis of municipal characteristics (ie, population size, centrality, the proportion of older inhabitants, and income); and identify how local governments (ie, municipalities) describe their efforts toward integrating welfare technologies in long-term care. Methods Quantitative and qualitative data about welfare technology from a larger cross-sectional survey about the provision of long-term care services in Norwegian municipalities were combined with registry data. Representatives of 422 Norwegian municipalities were invited to participate in the survey. Frequencies were used to describe the distribution of the types and extent of welfare technologies, whereas the Fisher exact test and Kruskal-Wallis one-way analysis of variance were used to determine the association between the extent of welfare technology and municipal characteristics. Free-form text data were analyzed using thematic analysis. Results A total of 277 municipalities were surveyed. Technology for safety was the most widespread type of welfare technology, whereas technology for social contact was the least prevalent. Two-thirds of the sample (183/277, 66.1%) in nursing home and (197/277, 71.1%) in home care services reported providing one or two different types of welfare technology. There was a statistically significant association between the extent of welfare technology and population size (in both nursing homes and home care services: P=.01), centrality (nursing homes: P=.01; home care services: P<.001), and municipal income (nursing homes: P=.02; home care services: P<.001). The extent of welfare technology was not associated with the proportion of older adults. The municipalities described being in a piloting phase and committing to future investment in welfare technology. Monetary resources were allocated, competency development among staff was initiated, and the municipalities were concerned about establishing collaborations within and between municipalities. Home care services seem to have a more person-centered approach in their efforts toward integrating welfare technologies, whereas nursing homes seem to have a more technology-centered approach. Conclusions Many municipalities provide welfare technologies; however, their extent is limited and varies according to municipal characteristics. Municipal practices still seem dominated by piloting, and welfare technologies are not fully integrated into long-term care services. Innovation with welfare technology appears top-down and is influenced by national policy but also reflects creating a window of opportunity through the organization of municipal efforts toward integrating welfare technology through, for example, collaborations and committing personnel and financial resources.


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