Long-term care provision, hospital bed blocking, and discharge destination for hip fracture and stroke patients

Abstract Socioeconomic status (SES) is generating considerable interest in terms of health of individuals, but how it is associated with long-term care has not been established yet. We study the relationship between SES and long-term care provision to parents among the Japanese adults using JSTAR. We use the following six measures of SES for the analysis: income, asset, expenditure, living condition, housing condition and education. We find a greater probability of care provision to parents among those in higher SES categories for some SES measures, compared to the lowest category. However, after considering the survival probability of parents, the relationship is reversed and the probability of care provision is found to be greater among lower SES individuals. The association is more pronounced among males. The association is likely to be partly mediated by care needs of parents. These results suggest a higher burden of care disproportionately falls in low SES individuals.

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Exploring the impact of austerity-driven policy reforms on the quality of the long-term care provision for older people in Belgium and the Netherlands

Journal of Aging Studies ◽

10.1016/j.jaging.2016.05.003 ◽

2016 ◽

Vol 38 ◽

pp. 92-104 ◽

Cited By ~ 12

Author(s):

David Janssen ◽

Wesley Jongen ◽

Peter Schröder-Bäck

Keyword(s):

The Netherlands ◽

Older People ◽

Long Term Care ◽

Care Provision ◽

Policy Reforms ◽

Term Care ◽

The Impact

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Old-Age Care Provision in Spain in the Context of a New System of Long-Term Care and a Lingering Economic Crisis

Journal of Population Ageing ◽

10.1007/s12062-018-9232-8 ◽

2018 ◽

Vol 13 (1) ◽

pp. 41-62 ◽

Cited By ~ 1

Author(s):

Jeroen Spijker ◽

Pilar Zueras

Keyword(s):

Old Age ◽

Economic Crisis ◽

Long Term Care ◽

Care Provision ◽

Term Care ◽

New System

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Transition processes and pathways across Austrian long-term care provision. Lessons to be learnt in a European context

International Journal of Integrated Care ◽

10.5334/ijic.428 ◽

2009 ◽

Vol 9 (6) ◽

Author(s):

Georg Ruppe

Keyword(s):

Long Term Care ◽

Care Provision ◽

Term Care ◽

Transition Processes ◽

European Context

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Abstract W P340: Emergency Department Nurses Collaborate With Long Term Care Facilities for Stroke Patients

Stroke ◽

10.1161/str.46.suppl_1.wp340 ◽

2015 ◽

Vol 46 (suppl_1) ◽

Author(s):

Jamie L Strom

Keyword(s):

Emergency Department ◽

Long Term Care ◽

Stroke Patients ◽

Term Care ◽

Stroke Treatment ◽

Emergency Department Nurses ◽

Senior Services ◽

To Receive ◽

Education Initiative

Background and Purpose: Stroke treatment is often delayed before patients reach the emergency department (ED). Some patients arrive in time to receive medication that can reverse new stroke symptoms. Some are not as fortunate. They are either admitted to the palliative unit, or discharged only to live with their new disabilities possibly for the rest of their lives. In 2013, nurses observed many long term care (LTC) patients were not getting to the ED in time to receive tPA (tissue plasminogen activator), a medication used to reverse stroke symptoms. The purpose of this process improvement was to increase the number of LTC patients with stroke symptoms arriving in the ED within the tPA window. Methods: To determine how many patients from nursing homes were missing the tPA window, data from the ED’s records was abstracted from the month of June 2013. The sample size was all patients who presented with possible stroke symptoms, and who were also from LTC facilities. Surprisingly, 100% of LTC patients presenting with stroke symptoms missed the tPA window. With the support of ED leadership, we decided to raise awareness about the tPA window in the LTC facilities. No evidence existed from ED’s related to LTC patients and the tPA window. Approximately 1,000 unused stroke pamphlets were collected. A PowerPoint presentation based on AHA guidelines was used. A lecture occurred at the community’s senior services meeting, and many LTC administrators were willing to adopt this education initiative at their facilities. ED staff became involved and helped conduct the in-services. In exchange for their volunteering, they received credit to help with career ladders at their hospital. Results: The number of possible stroke patients from LTC facilities getting to the ED within eight hours of the last time seen normal (LTSN) has increased from 0% in June 2013, to 25% in March 2014. Conclusions: Stroke education teams of ED nurses showed improvement in LTC patients arriving in the ED within the tPA window. In conclusion, it is encouraged that other ED staff volunteer to teach in LTC facilities in their own communities, in assisting their stroke patients as well.

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Familiarisation and Regional Variation in Long-Term Care Provision

Rescaling Social Policies: Towards Multilevel Governance in Europe ◽

10.4324/9781315244433-8 ◽

2017 ◽

pp. 277-312

Author(s):

Rahel Strohmeier Navarro Smith

Keyword(s):

Regional Variation ◽

Long Term Care ◽

Care Provision ◽

Term Care

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Economic development and long-term care provision by families, markets and the state

The Journal of the Economics of Ageing ◽

10.1016/j.jeoa.2019.100210 ◽

2020 ◽

Vol 15 ◽

pp. 100210 ◽

Cited By ~ 2

Author(s):

Akira Yakita

Keyword(s):

Economic Development ◽

Long Term Care ◽

The State ◽

Care Provision ◽

Term Care

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Palliative care provision in long-term care facilities differs across Europe: Results of a cross-sectional study in six European countries (PACE)

Palliative Medicine ◽

10.1177/0269216319861229 ◽

2019 ◽

Vol 33 (9) ◽

pp. 1176-1188 ◽

Cited By ~ 4

Author(s):

Maud ten Koppel ◽

Bregje D Onwuteaka-Philipsen ◽

Lieve Van den Block ◽

Luc Deliens ◽

Giovanni Gambassi ◽

...

Keyword(s):

Palliative Care ◽

Advance Care Planning ◽

Long Term Care ◽

Care Planning ◽

Care Provision ◽

Cross Sectional ◽

Term Care ◽

Care Facilities ◽

Advance Care

Background: While the need for palliative care in long-term care facilities is growing, it is unknown whether palliative care in this setting is sufficiently developed. Aim: To describe and compare in six European countries palliative care provision in long-term care facilities and to assess associations between patient, facility and advance care planning factors and receipt and timing of palliative care. Design: Cross-sectional after-death survey regarding care provided to long-term care residents in Belgium, England, Finland, Italy, the Netherlands and Poland. Generalized estimating equations were used for analyses. Setting/participants: Nurses or care assistants who are most involved in care for the resident. Results: We included 1298 residents in 300 facilities, of whom a majority received palliative care in most countries (England: 72.6%–Belgium: 77.9%), except in Poland (14.0%) and Italy (32.1%). Palliative care typically started within 2 weeks before death and was often provided by the treating physician (England: 75%–the Netherlands: 98.8%). A palliative care specialist was frequently involved in Belgium and Poland (57.1% and 86.7%). Residents with cancer, dementia or a contact person in their record more often received palliative care, and it started earlier for residents with whom the nurse had spoken about treatments or the preferred course of care at the end of life. Conclusion: The late initiation of palliative care (especially when advance care planning is lacking) and palliative care for residents without cancer, dementia or closely involved relatives deserve attention in all countries. Diversity in palliative care organization might be related to different levels of its development.

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