Analysis of a territorial approach to the delivery of nursing home care services based on historical data

2006 ◽  
Vol 30 (4) ◽  
pp. 283-291 ◽  
Author(s):  
N. Lahrichi ◽  
S. D. Lapierre ◽  
A. Hertz ◽  
A. Talib ◽  
L. Bouvier
Pflege ◽  
2002 ◽  
Vol 15 (1) ◽  
pp. 16-23 ◽  
Author(s):  
Jochen Laible ◽  
Herbert Mayer ◽  
Georges C.M. Evers

Mit dieser Arbeit wurden durch ein deskriptiv-exploratives Querschnittsdesign erstmalig verlässliche Daten zur Prävalenz des Ulcus cruris in der häuslichen Pflege erhoben. Eine randomisierte Stichprobe von 520 häuslichen Pflegediensten in Nordrhein-Westfalen wurde im März 2000 angeschrieben und mittels standardisiertem Fragebogen zu ihren Patienten mit Ulcus cruris befragt. Ermittelt wurden neben der Trägerschaft der Einrichtungen und deren geographische Ansiedlung auch die demographischen Daten der Betroffenen sowie die Dauer und die Ursachen der Ulcera. Auf einer Grundlage der Angaben von 161 Pflegediensten mit insgesamt 12156 Patienten und 326 Betroffenen konnte eine Gesamtprävalenz von 2,68% (± 0.29%) für das Ulcus cruris in der häuslichen Pflege errechnet werden. Das Alter der 326 Betroffenen beträgt im Durchschnitt 77,5 Jahre. Frauen sind mehr als doppelt so häufig betroffen wie Männer, was jedoch im Wesentlichen auf eine höhere Lebenserwartung der Frauen zurückzuführen ist. Fast ein Viertel der Ulcera sind unbekannter Genese. Dieses Ergebnis dürfte ein großes Problem für die häusliche Pflege darstellen, da die Anwendung von Kompressionsverbänden oder -strümpfen für den Behandlungserfolg beim Ulcus cruris von entscheidender Bedeutung und von den ursächlichen Faktoren abhängig ist. Die ausgesprochene Chronizität der Ulcus-Erkrankung bestätigt sich auch in dieser Untersuchung. Durchschnittlich zehn Monate beträgt die Dauer für das aktuelle Ulcus cruris. Für die Betroffenen sind jedoch jahre- oder gar jahrzehntelange Heilungsverläufe keine Seltenheit. In fast 80% der Fälle erfolgt die Wundversorgung einmal täglich durch die häuslichen Pflegedienste.


2020 ◽  
Vol 11 (2) ◽  
pp. 216
Author(s):  
Razak Abdullah ◽  
Rosyidah Arafat ◽  
Syahrul Syahrul

Latar Belakang : Proses menua merupakan proses alami yang diikuti dengan terjadinya peurunan kondisi fisik, psikologis dan sosial yang saling berkaitan satu sama lain .Kondisi penurunan tersebut mempengaruhi kemampuan lanjut usia dalam melakukan aktifitas sehari – hari/ Activity daily livings yang memerlukan perhatian dan bantuan keluarga sehingga mengakibatkan permintaan untuk perawatan di rumah meningkat dengan cepat. Perawatan Home care menjadi arena perawtaan professional dan informal. Review ini bertujuan untuk mengetahui bagaimana pelayanan home care pada lanjut usia.Metode : Dalam mengumpulkan artikel menggunakan beberapa database Pubmed, Science Direct, Wiley, dan Google Scholar dengan strategi pencarian menggunakan metode PICO (population, intervention, comparison and outcome dengan batasan publikasi artikel dari tahun 2009-2019.Hasil : Hasil temuan diperoleh beberapa point yaitu perlunya perawat melakukan Analisis kehidupan lansia sebelum memberikan pelayanan home care, pelayanan tepat waktu, Ukuran pengalaman aspek interpersonal perawatan karena itu dapat menjadi indikator yang berguna dari hasil kualitas hidup, pentingnya partisipasi lanjut usia, berbagi sejarah dengan perawat dan lansia, terjaminnya privasi lansia, pemenuhan standar kebutuhan lansia, selanjutnya ada factor komunikasi, pembangunan hubungan perawat dan lanjut usia, kepercayaan, keamanan, perawat harus pandai dalam menilai kekahawatiran rasa depresi yang disembunyikan oleh lansia, dan siap dalam menerima perbadaan pandangan dalam hal perawatan home care dengan lansia. Kata kunci :  Home care, Lanjut Usia Abstract Background: The aging process is a natural process that is followed by a decline in physical, psychological and social conditions that are interrelated with each other. The condition of the decline affects the ability of the elderly in carrying out daily activities / Activity daily livings that require attention and assistance from family so resulting in a rapidly increasing demand for home care. Care Home care is an arena for professional and informal care. This review aims to determine the experience of nurses in providing home care services for the elderly.Method: Data was obtained from google scholar website database, Since direct and Proquest, and obtained 5 articles. The five articles were then carried out by the journal research critics using the appropriate CASP tools namely 5 articles with the Critical Appraisal of Qualitative Study.Results: The findings obtained by several points, namely Analysis of the lives of the elderly before giving home care services, timely services, measures of experience of interpersonal aspects of care because it can be a useful indicator of quality of life outcomes, the importance of elderly participation, sharing history with nurses and the elderly, ensuring privacy, fulfilling the standards of elderly needs, then there are factors of communication, building relationships between nurses and the elderly, trustworthiness, security, nurses must be clever in assessing the concerns of depression that are hidden by the elderly, and ready to accept improvements in terms of nursing home care with the elderly . Keywords: Experience, Nurse, Home care, Elderly


2022 ◽  
Author(s):  
Finaba Berete ◽  
Stefaan Demarest ◽  
Rana Charafeddine ◽  
Karin Ridder ◽  
Johan Vanoverloop ◽  
...  

Abstract BackgroundThis study examines the risk factors associated with nursing home admission (NHA) in Belgium to contribute to a better planning of the future demand for nursing home (NH) services and health care resources.MethodsIndividual level linkage of the 2013 Belgian health interview survey data and health insurance data (2012 to 2018) was done. Only non-institutionalized participants, aged ≥65 years at the time of the survey were included in this study (n=1930). Participants were followed until NHA, death or end of study period, i.e., December 31, 2018. The risk of NHA was calculated using a competing risk analysis.ResultsOver the follow-up period (median 5.29 years), 226 individuals were admitted to a NH and 268 died without admission to a NH. The overall cumulative risk of NHA was 1.4%, 5.7% and 13.1% at, respectively 1 year, 3 years and the end of follow-up. After multivariable adjustment, higher age, low educational attainment, belonging to low income household, living alone, use of home care services and a number of need factor (e.g., history of falls, suffering from urinary incontinence, depression or Alzheimer disease, etc.) were significantly associated with a higher risk of NHA, while female, individuals with multimorbidity and increased contacts with health care providers were significantly associated with a decreased risk of NHA. Subjective health and limitations are both significant determinants of NHA, but subjective health is an effect modifier on the effect of limitations and vice versa.ConclusionsOur findings pinpoint important predictors of NHA in older adults, and offer possibilities of prevention to avoid or delay NHA for this population. The strong impact of need factors on the risk of NHA may indicate equitable access to NHA (i.e., those in need for support have access to NH). Practical implications include prevention of falls and appropriate and timely management of physical chronic conditions and neurodegenerative disorders. Focus should also be on people living alone to provide the appropriate social support and/or home care services. Further investigation of predictors of NHA should include contextual factors such as the availability of nursing-home beds, hospital beds, physicians and waiting lists for NHA.


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.


2014 ◽  
Vol 36 (2) ◽  
pp. 400-419 ◽  
Author(s):  
HÅKAN JÖNSON

ABSTRACTThe aim of this article is to investigate different ways in which nursing home scandals in Sweden have been framed, to discuss the relations between these existing frameworks, and to identify ways of describing the problem that are absent in the current debates. Data for the study consisted of media articles, television documentaries and internet debates, expert reports and court hearings, and interviews with representatives of organisations dealing with the issue of mistreatment in care services for older people. An analytical tool developed within social movement research was used to identify three ‘debates’ on such mistreatment in Sweden, where competing ways of framing the problem have been used: (a) a debate where staff are cast as either perpetrators or victims, (b) a debate on privatisation and profit as the motive for neglect of care recipients, and (c) a debate on deserving and non-deserving recipients of socially provided care centred around populist claims. The analysis highlights a need to introduce an alternative frame for interpretation where mistreatment in care for older people is regarded as involving scandalous cases of ageism. This anti-ageism frame would provide older people with a lead role in the drama – not just as victims but as stakeholders in relation to the problem.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hilda Bø Lyng ◽  
Eline Ree ◽  
Torunn Wibe ◽  
Siri Wiig

Abstract Background The Covid-19 pandemic introduced a global crisis for the healthcare systems. Research has paid particular attention to hospitals and intensive care units. However, nursing homes and home care services in charge of a highly vulnerable group of patients have also been forced to adapt and transform to ensure the safety of patients and staff; yet they have not received enough research attention. This paper aims to explore how leaders in nursing homes and home care services used innovative solutions to handle the Covid-19 pandemic to ensure resilient performance during times of disruption and major challenges. Methods A qualitative exploratory case study was used to understand the research question. The selected case was a large city municipality in Norway. This specific municipality was heavily affected by the Covid-19 pandemic; therefore, information from this municipality allowed us to gather rich information. Data were collected from documents, semi-structured interviews, and a survey. At the first interview phase, informants included 13 leaders, Head of nursing home (1 participant), Head of Sec. (4 participants), Quality manager (4 participants), Head of nursing home ward (3 participants), and a Professional development nurse (1 participant), at 13 different nursing homes and home care services. At the second phase, an online survey was distributed at 16 different nursing homes and home care services to expand our understanding of the phenomenon from other leaders within the case municipality. Twenty-two leaders responded to the survey. The full dataset was analysed in accordance with inductive thematic analysis methodology. Results The empirical results from the analysis provide a new understanding of how nursing homes and home care leaders used innovative solutions to maintain appropriate care for infected and non-infected patients at their sites. The results showed that innovative solutions could be separated into technology for communication and remote care, practice innovations, service innovations, and physical innovations. Conclusion This study offers a new understanding of the influence of crisis-driven innovation for resilience in healthcare during the Covid-19 pandemic. Nursing home and home care leaders implemented several innovative solutions to ensure resilient performance during the first 6–9 months of the pandemic. In terms of resilience, different innovative solutions can be divided based on their influence into situational, structural, and systemic resilience. A framework for bridging innovative solutions and their influence on resilience in healthcare is outlined in the paper.


2016 ◽  
Vol 2016 ◽  
pp. 1-8 ◽  
Author(s):  
Kjell H. Halvorsen ◽  
Cecilie Johannessen Landmark ◽  
Anne Gerd Granas

Introduction. Antiepileptic drugs (AEDs) are used to treat different conditions in elderly patients and are among the drug classes most susceptible to be involved in drug-drug interactions (DDI). The aim of the study was to describe and compare use of AEDs between home care service and nursing home patients, as these patients are not included in nationwide databases of drug utilization. In the combined population, we investigate DDI of AEDs with other central nervous system- (CNS-) active drugs and DDIs involving AEDs in general. Materials and Methods. Point-prevalence study of Norwegian patients in home care services and nursing homes in 2009. At the patient level, we screened for different DDIs involving AEDs. Results. In total, 882 patients (7.8%) of 11,254 patients used AEDs and number of users did not differ between home care services and nursing homes (8.2% versus 7.7%). In the combined population, we identified 436 potential DDIs in 45% of the patients. Conclusions. In a large population of elderly, home care service and nursing home patients do not differ with respect to exposure of AEDs but use more AEDs as compared to the general population of similar age. The risk of DDIs with AEDs and other CNS-active drugs should be taken into consideration and individual clinical evaluations are assessed in this population.


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