scholarly journals Managerial Strategies for Long-Term Care Organization Professionals: COVID-19 Pandemic Impacts

2020 ◽  
Vol 12 (22) ◽  
pp. 9682
Author(s):  
Ana Dias ◽  
Annibal Scavarda ◽  
Augusto Reis ◽  
Haydee Silveira ◽  
Nelson Ebecken
Keyword(s):  
Empirical Research ◽  
Rio De Janeiro ◽  
Long Term Care ◽  
Statistical Significance ◽  
Theoretical Research ◽  
Categorical Variables ◽  
Care Organization ◽  
Term Care ◽  
Janeiro City

This paper aims to analyze the strategies that healthcare professionals have adopted during the coronavirus pandemic (COVID-19) in long-term care organizations in Rio de Janeiro city, Brazil, by investigating their competencies—mainly managerial ones. To reach its goals, this paper performs empirical research and theoretical research. For the empirical research, the plans of professionals during COVID-19 pandemic in long-term care organizations are observed, and a questionnaire is applied to analyze observed data integrity. The data are analyzed through the Python and IBM SPSS Statistic programming languages, and descriptive analyses use descriptive statistic proportions, rates, minimum, maximum, mean, median, standard deviation, and coefficient of variation (CV). A non-parametric approach performs repeated measure comparisons using Wilcoxon’s test, while the McNemmar test is used to repeat the categorical variables. Statistical significance is assumed at the 5% level. For the theoretical research, a literature review is developed using scientific databases. The results show that for the searched period, the number of deaths and the number of people infected by COVID-19 in these organizations are low when compared to general statistics of Rio de Janeiro city. This paper concludes that these strategical adoptions have brought significant benefits to long-term care organizations, and it might motivate researchers to develop future studies related to long-term care organizations, helping to fill the literature gap on the subject.

scholarly journals The price of privilege: helping mom die at home

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 863-863
Author(s):  
Renee Beard
Keyword(s):  
Home Care ◽  
Social Services ◽  
Long Term Care ◽  
Organizational Factors ◽  
Care Organization ◽  
Term Care ◽  
Long Term Care Insurance ◽  
At Home

Abstract Americans overwhelmingly wish to age in place and many explicitly want to die at home. Yet, the anemic welfare state means that only the most fortunate among us are able to achieve that goal. A disproportionate burden of care falls squarely to families, which are smaller and more geographically spread out than ever before. Carers too often wind up in environments that are far from conducive, namely being older and perhaps frail themselves or younger and perhaps with small children of their own. Drawing on an autoethnographic study of my mother’s final years and a case study analysis of one innovative home care agency, this project examines the individual and organizational factors that allow one family to grant their family member’s wish to die at home. Grounded theory methods revealed facilitators including presence of a home-based long term care insurance policy, geographic mobility, and access to a democratically-oriented home care organization. Barriers, of course, include lack of access to long term care insurance and a daughter who lives in a progressive state with a waiver for Home and Community Based Services. While the privilege of access underscores the social determinants of aging, this case study reveals some important features that suggest how senior social services could be. Even for the “ideal type” presented here, the many trials and tribulations of aiding a loved one to die at home relate to the untenable nature of doing it all in a context whereby social services are fragmented and driven by financial incentives.

scholarly journals Proposal for an instrument for the admission of the elderly to long-term care facilities: elaboration and validation

2019 ◽  
Vol 22 (3) ◽  
Author(s):  
Eloá Sanches Martins Corrêa ◽  
Maria Paula Pizzaia Arrabaça ◽  
Mirian Ueda Yamaguchi ◽  
Marcelo Picinin Bernuci
Keyword(s):  
Long Term Care ◽  
Scientific Evidence ◽  
Statistical Significance ◽  
The Elderly ◽  
Relevant Information ◽  
Second Phase ◽  
Term Care ◽  
Consensus Score ◽  
Care Facilities

Abstract Objective: To elaborate and validate an instrument for the admission of the elderly to long-term care facilities. Method: A methodological study was performed, divided into two phases, the first of which was the elaboration of the instrument based on a literature review of research published in journals indexed in SciELO and in databases such as Medline, LILACS, IBECS, Embase and books related to gerontology, defining theoretical dimensionality through relevant information to support individualized and integral care for the elderly. The second phase of the study involved validation by nine experts from a multidisciplinary field. Six criteria were used to validate the construct, for which the experts chose one of the following options: adequate, inadequate or requires greater adequacy and also, when necessary, added suggestions. The decision to maintain, reformulate or exclude items was based on the Percentage of Consensus (PC) among the experts, for which consensus of more than 80% was adopted as the value of statistical significance. Results: The scientific evidence base for the construction of the instrument consisted of anamnesis and physical examination domains, segmented in ten and four sections, respectively. Half of the sections achieved a score above that proposed, four of which received a maximum consensus score in all criteria. Conclusion: The instrument was developed and proved to be consistent for applicability by different professionals in the area, with the aim of promoting geriatric care focused on the health of the institutionalized patient.

scholarly journals Intersections of ageism and gender stigma: Exploring long-term care employees' attitudes towards aging

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 951-951
Author(s):  
Tarah Loy-Ashe ◽  
Brent Hawkins
Keyword(s):  
Long Term Care ◽  
Single Case ◽  
Statistical Significance ◽  
Direct Care ◽  
Positive Interactions ◽  
Term Care ◽  
On Line ◽  
Quantitative Results ◽  
And Gender

Abstract The purpose of this mixed methods, single case study was to explore long-term care (LTC) employees’ attitudes towards age and gender. The intersection of Rosemary Garland-Thomson’s theory of feminist disability (2001) and Hailee Gibbons’ compulsory youthfulness theory (2016) provided the conceptual framework for this project. The sample consisted of 60 LTC direct care employees, all employed at the same organization, who completed an on-line survey during the COVID-19 pandemic. The survey consisted of demographic questions and the Fraboni Scale of Ageism. Twenty-one of these employees participated in a 30-45 minute phone interview. Cultural artifacts were also collected. All data were collected during the COVID-19 pandemic. Although quantitative results showed no statistical significance, qualitative results suggest that employees do exhibit some ageist attitudes towards the residents for whom they care. Despite evidence that most employees felt a deep connection with residents, they detached themselves from the aging process. The theoretical framework lends hand in explaining how both ableism and ageism appeared to contribute to this detachment. Findings indicated employees’ interactions and attitudes towards residents were influenced by themes compassionate ageism, ableism, and identity, which resulted in meta theme caregiver validation and reward. Employees received validation and altruistic reward from positive interactions with what they perceived to be “ideal” residents; those who fit the stereotype of a nursing home resident, such as older, pleasant, and dependent. The perceived “ideal” residents varied by gender. Generally, female residents were expected to be more independent and at times viewed negatively when requesting assistance.

Reablement in a small municipality, a survival analysis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Kjartan Sarheim Anthun ◽  
Monica Lillefjell ◽  
Kirsti Sarheim Anthun
Keyword(s):  
Survival Analysis ◽  
Home Care ◽  
Long Term Care ◽  
Statistical Significance ◽  
Lower Mortality ◽  
Administrative Database ◽  
Term Care ◽  
Level Of Functioning ◽  
Care Services

Abstract Background Reablement is a municipal service given to patients at home. The purpose of the service is to assist recovery after hospital discharges or other sudden changes in a patient’s functional level. The service is often provided by a team of nurses, physiotherapists, and occupational therapists. The purpose of this paper is to compare users of this service to users who receive traditional home care services. Outcomes to be measured are risk of long-term care and mortality. Methods All users of health and care services in a Norwegian municipality were eligible for inclusion. Data was extracted from the local user administrative database. Users were divided in two groups: those who received reablement and those home care users who did not receive reablement service. Propensity score matching was used to match users based on age, sex, and level of functioning in activities of daily living (ADL). Survival analysis was deployed to test if the reablement users had different risk of becoming long-term care users, and whether the mortality rate differed for this group. Results 153 reablement users were included in the study. These were matched to 153 non-reablement home care users. The groups had similar distributions of age, sex, and level of functioning when starting their service trajectories. Regressions showed that reablement users had lower risk of using long-term care services in the study period (time at risk up to 4 years), and lower mortality. However, none of these estimates were statistically significant. Conclusions The study indicates that the reablement users in one municipality had lower use of long -term care and lower mortality when properly estimated, but numbers were too small for statistical significance to be found.

scholarly journals Multiple Correspondence Analysis is a Useful Tool to Visualize Complex Categorical Correlated Data

2017 ◽  
Vol 1 (1) ◽  
Author(s):  
Jacqueline Quail ◽  
Meric Osman ◽  
Gary Teare
Keyword(s):  
Correspondence Analysis ◽  
Long Term Care ◽  
Multiple Correspondence Analysis ◽  
Categorical Variables ◽  
Comorbid Condition ◽  
Comorbid Conditions ◽  
Term Care ◽  
Icd 10 ◽  
The Relationship

ABSTRACT ObjectivesWe sought to identify the most expensive hospitalized individuals in the Canadian province of Saskatchewan in fiscal year 2012/13, and determine the primary cause of their high use of health services. Our aim was to identify health problems that can be prevented or better managed in a non-hospital health care setting. Comorbid conditions are an important and confounding covariate in this population and so we used multiple correspondence analysis (MCA) to investigate the association of these conditions with each other and the most responsible diagnosis for each hospitalization. MCA is a multivariable descriptive statistical technique that displays the relationship between categorical variables in 2-dimensional graphical form. ApproachWe identified the most expensive 5% of people hospitalized between 01APR2012 and 31MAR2013. Hospital costs accounted for the majority of costs, but physician, drug, long-term care, and home care costs were added. Comorbid conditions in any of the 25 hospital diagnostic fields were identified and grouped into categories based upon ICD-10-CA subcategories. For example, category 1 was ICD-10-CA codes F10-F19: Mental and behavioural disorders due to psychoactive drug use, while category 2 was ICD-10-CA codes F20-F29: Schizophrenia, schizotypal, and delusional disorders. SAS™ v9.3 was used to conduct MCA and generate graphs displaying the correlation between each comorbid condition category, where the distance of each dot from the other represents the strength of the association between the disease categories (i.e., diseases that are correlated cluster together.) The frequency of each category of comorbid condition was represented by the size of the dots on the graph (e.g., the more people with the disease, the larger the dot.) Categories of comorbid conditions were redefined based upon data findings and clinical expertise. ResultsThree patient groups emerged as being amenable to intervention and thus cost savings, specifically (1) individuals of advanced age who are no longer able to live at home and are hospitalized while waiting for a bed in a long-term care facility, (2) individuals with a mental health and/or addiction problem, and (3) individuals who experienced medical harm during their time in hospital. ConclusionMCA is a valuable graphical tool that is easy to learn and, in conjunction with other statistical techniques, can be used to elucidate the relationship between complex correlated categorical variables.

scholarly journals Assessing apathy in long-term care residents with dementia: Who should be the rater?

Dementia ◽  
2017 ◽  
Vol 18 (6) ◽  
pp. 2220-2229
Author(s):  
Ying-Ling Jao ◽  
Kristine Williams ◽  
Jacqueline Mogle ◽  
Liza Behrens ◽  
Caroline McDermott
Keyword(s):  
Long Term Care ◽  
Pearson Correlation ◽  
Statistical Significance ◽  
Nursing Assistants ◽  
Future Research ◽  
Certified Nursing Assistants ◽  
Term Care ◽  
Licensed Practical Nurses ◽  
Practical Nurses

Background Apathy is prominent in persons with dementia and apathy assessment is challenging. It remains unclear who should conduct apathy assessments in long-term care settings for residents with moderate to advanced dementia. The Apathy Evaluation Scale (AES) is a widely used instrument and its use for long-term care residents with dementia needs to be further established. This study explored the relationship among apathy assessments conducted by family and clinical caregivers using the original AES (AES-18) and the nursing home version (AES-10). Methods This study used a cross-sectional, descriptive design and enrolled 15 quartets of participants recruited from long-term care settings. Each quartet consisted of one resident with dementia, one family member, one certified nursing assistant, and one licensed practical nurse or activity staff. Family, certified nursing assistants, and licensed practical nurses/activity staff rated the resident’s apathy level on the AES independently. Bivariate Pearson correlation coefficients were used for analysis. Results The results revealed that ratings conducted by certified nursing assistants and licensed practical nurses/activity staff were moderately correlated for the AES-18 and the result approached statistical significance (r = 0.47, p = .08). None of the other AES ratings among family, certified nursing assistants, and licensed practical nurses/activity staff were significantly correlated. Discussion Family and clinical caregivers were incongruent on their AES ratings of apathy. It remains undetermined which rater provides the most valid AES rating for residents with dementia. Findings from this study further highlight challenges in rating apathy in this population. Future research is needed to determine best practices for accurate apathy assessment for residents with dementia in long-term care.

Les soins de longue durée aux personnes âgées: Choix d'un système clinico-administratif dans le contexte d'un réseau de soins intégrés

2004 ◽  
Vol 23 (1) ◽  
pp. 35-45
Author(s):  
Nicole Dubuc ◽  
Réjean Hébert ◽  
Johanne Desrosiers ◽  
Martin Buteau
Keyword(s):  
Long Term Care ◽  
Elderly Person ◽  
Individual Characteristics ◽  
Care Organization ◽  
Term Care ◽  
Care Systems ◽  
Casemix System ◽  
Similar Resource ◽  
Dependent Elderly

ABSTRACTFor the past 10 years, in long-term care systems, we have witnessed the accelerated deployment of casemix management systems. A casemix is formed by clusters, defined by individual characteristics that explain similar resource use. However, certain questions regarding the development of these systems must be raised. Moreover, none of these systems was developed in the context of an integrated care organization that can track the progress of a dependent elderly person through every kind of care arrangement available—from own home, through intermediate facility, to long-term care institution. This article emphasizes the necessity of being well informed about the features of existing systems, in order to choose or develop the system that best answers the goals of a particular health care system. Finally, it underlines important elements that should be considered in each step of the development of a casemix system in this context.

scholarly journals ORGANIZATION OF MEDICAL AND SOCIAL CARE FOR THE ELDERLY AND SENILE POPULATION IN THE WORLD. ANALYTICAL REVIEW

2021 ◽  
Vol 67 (1) ◽  
pp. 8-8
Author(s):  
A.Sh. Senenko ◽  
◽  
T.V. Kaigorodova ◽  
A.B. Garmaeva ◽  
◽  
...  
Keyword(s):  
Content Analysis ◽  
Long Term Care ◽  
Social Care ◽  
The Elderly ◽  
World Health ◽  
Care Organization ◽  
Term Care ◽  
The World ◽  
Analytical Review

Significance. Population aging is considered one of the characteristic features of the modern demographic processes. This is both a forecast for the future and a basis for setting goals for health systems. Thus, the 2008 analytical review of the WHO Regional Office for Europe says that the long-established type of the fragmented care needs to be replaced by a comprehensive and coordinated type of care [1]. It is logical that this phenomenon affects not only health care, but goals of the social services as well, and economic indicators in general. In this regard, many countries have been undertaking efforts to implement or improve long-term care. Purpose. To evaluate medical and social care organization for the elderly and senile population in the world on the basis of the content analysis. Material and methods. Content analysis of the World Health Organization documents on medical and social care organization for the elderly and senile population. A total of 212 documents have been analyzed, 54 out of them have been selected for the analysis including 38 WHO materials and 16 scientific publications on the topic. Selection criteria - the documents should contain sufficient information on medical and social care organization for the elderly and senile population. Results. Analysis of the selected documents and publications has identified an urgent need to develop a comprehensive system of medical and social care delivery for the elderly as a separate group of the population with its peculiar characteristics of the course of diseases, comorbidity, and the need for long-term care.

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