ECHO Care of the Elderly – Using Technology to Build Capacity of Primary Care Providers in Long-term Care

2019 ◽  
Vol 20 (3) ◽  
pp. B10-B11
Author(s):  
Sid Feldman ◽  
L. Sokoloff ◽  
S. Feldman ◽  
A. Moser ◽  
D. Conn

Author(s):  
Kevin Zhai ◽  
Azwa Dilawar ◽  
Mohammad S. Yousef ◽  
Sean Holroyd ◽  
Haithem El-Hammali ◽  
...  

Virtual reality (VR) describes a family of technologies which immerse users in sensorily-stimulating virtual environments. Such technologies have increasingly found applications in the treatment of neurological and mental health disorders. Depression, anxiety, and other mood abnormalities are of concern in the growing elderly population – especially those who reside in long-term care facilities (LTCFs). The transition from the familiar home environment to the foreign LTCF introduces a number of stressors that can precipitate depression. However, recent studies reveal that VR therapy (VRT) can promote positive emotionality and improve cognitive abilities in the elderly, both at home and in LTCFs. VR thus holds potential in allowing elderly individuals to gradually adapt to their new environments – thereby mitigating the detrimental effects of place attachment and social exclusion. Nevertheless, while the current psychological literature is promising, the implementation of VR in LTCFs faces many challenges. LTCF residents must gain trust in VR technologies, care providers require training to maximize the positive effects of VRT, and decision makers must evaluate both the opportunities and obstacles in adopting VR. Here, we concisely review the implications of depression related to place attachment in LTCFs, and explore the potential therapeutic applications of VR.



2021 ◽  
Vol 46 (3) ◽  
pp. 257-266
Author(s):  
Jonggeun Seo ◽  
Chung Mo Nam ◽  
Tae Hyun Kim ◽  
So-Hee Park

Objectives: This study conducted research using big data in order to overcome the limitations of existing qualitative research or analysis research. By analyzing keywords, the flow and role of long-term care insurance in society were analyzed.Methods: Issues were searched through text mining, one of the big data techniques, and the flow of agendas by period was examined by 3 time points (institutional settlement period, 1st basic plan, 2nd basic plan). Using R and NetMiner, Daum News (news.daum.net) and Naver News (news.naver.com) were web-scraped to collect 20,965 news articles, 4,994 articles were filtered for keyword extraction and analysis. Result: Looking at the characteristics of each data type, in all data types, long-term care institutions (including nursing homes) and care providers appear as the top keywords, and the keyword subgroup characteristics are ① grade/service, ② institution management, and ③ the employee group includes the keyword subgroup.Conclusions: This study is based on the subject of long-term care insurance for the elderly and applies big data analysis techniques, and can be used as a decision-making tool in establishing policies and systems.



2014 ◽  
pp. 367-380
Author(s):  
Linda L. Halcón ◽  
Constance Schein ◽  
Corjena Cheung

The use of integrative therapies continues to grow and a large percent (69%) of seniors do not discuss their use of integrative approaches with their primary care providers. Understanding the developmental tasks of older adulthood is necessary to provide holistic and integrative care. This includes understanding their journey, their understanding of health and their desired trajectory and relationships. Innovative care models are emerging that incorporate integrative approaches into the full continuum of care from home, to assisted living to long-term care.



2006 ◽  
Vol 18 (4) ◽  
pp. 643-652 ◽  
Author(s):  
Helena Feldman ◽  
A. Mark Clarfield ◽  
Jenny Brodsky ◽  
Yaron King ◽  
Tzvi Dwolatzky

Background: To determine the prevalence of dementia among the residents of geriatric institutions in the greater Jerusalem area.Methods: A population-based, cross-sectional survey of a representative sample, weighted according to the level of care, of 11 of the 88 long-term care (LTC) wards in 34 LTC institutions providing care for the elderly residents in the greater Jerusalem area in 1999. A single physician interviewed 311 residents. The presence of dementia was determined from medical records and by performance on the Modified Mini-mental State Examination (3MS) instrument (with a score less than 78/100 indicating significant cognitive impairment or suspected dementia), and professional care providers were interviewed for their opinion regarding the presence of dementia in each subject.Results: The mean age of the patients was 83.9 years and 75% were women. Overall, 180 residents, representing 49.9% of the weighted sample in Jerusalem LTC facilities, were determined to have dementia according to medical records, ranging from 22.9% in independent and frail care units to 97.7% in skilled nursing care wards. However, based on their performance on the 3MS, the prevalence of cognitive impairment with suspected dementia among the subjects was substantially greater, with the staff being unaware of this diagnosis in about one-quarter of the subjects.Conclusions: There is a high prevalence of dementia in geriatric institutions in the Jerusalem area, particularly in those providing greater care. Moreover, significant cognitive impairment is probably under-reported in the medical records.



2004 ◽  
Vol 5 (1) ◽  
pp. 53-60 ◽  
Author(s):  
John W. Traphagan

A central feature of Japan’s approach to community-based care of the elderly, including long-term home health care, is the emphasis on providing bath facilities. For mobile elders, senior centers typically provide a public bathing facility in which people can enjoy a relaxing soak along with friends who also visit the centers. In terms of in-home long-term care, visiting bath services are provided to assist family care providers with the difficult task of bathing a frail or disabled elder—a task made more problematic as a result of the Japanese style of bathing. I argue that the bath, as social service, is a culturally shaped solution to a specific problem of elder care that arises in the Japanese context as a result of the importance of the bath in everyday life for Japanese. While the services may be considered specific to Japan, some aspects of bathing services, particularly the mobile bath service, may also have applicability in the United States.



2021 ◽  
Vol 7 ◽  
pp. 233372142110320
Author(s):  
Celeste Fung ◽  
Soha Shah ◽  
Mary Helmer-Smith ◽  
Cheryl Levi ◽  
Erin Keely ◽  
...  

Introduction eConsult allows primary care providers (PCPs) to access timely specialist advice and informs patient care. To understand the use of eConsult in long-term care (LTC) settings, we examined the clinical content and types of questions asked by LTC PCPs. Methods A descriptive, retrospective study of eConsults submitted through the Champlain BASE™ eConsult Service between January 1, 2017, and December 31, 2018, by LTC PCPs was conducted. Cases were classified using validated taxonomies. Descriptive statistics were generated for content and question type classifications, service utilization data, and close-out survey responses. Results 22 LTC PCPs submitted 113 eConsults. They sought advice about drug treatment (58%), diagnosis (44%), and management (38%) in a breadth of clinical areas, often skin-related (39%). Long-term care PCPs frequently asked more than one question type (42%). They received advice within 1 week (91%) and rated eConsult as very helpful and educational. Three case examples are presented. Conclusion This study demonstrates the type of advice LTC PCPs are seeking through eConsult and its usefulness in this setting. Long-term care stakeholders are encouraged to consider implementing eConsult in other regions, as a means to improve access to timely specialist advice, support clinical decision-making, and improve residents’ quality of life.



2021 ◽  
Vol 24 (1) ◽  
pp. 36-43
Author(s):  
Navena R. Lingum ◽  
Lisa Guttman Sokoloff ◽  
James Chau ◽  
Sid Feldman ◽  
Shaen Gingrich ◽  
...  

Background Older adults are entering long-term care (LTC) homes with more complex care needs than in previous decades, resulting in demands on point-of-care staff to provide additional and specialty services. This study evaluated whether Project ECHO® (Extension for Community Healthcare Outcomes) Care of the Elderly Long-Term Care (COE-LTC)—a case-based online education program—is an effective capacity-building program among interprofessional health-care teams caring for LTC residents. Methods A mixed-method, pre-and-post study comprised of satisfaction, knowledge, and self-efficacy surveys and exploration of experience via semi-structured interviews. Participants were interprofessional health-care providers from LTC homes across Ontario. Results From January–March 2019, 69 providers, nurses/nurse practitioners (42.0%), administrators (26.1%), physicians (24.6%), and allied health professionals (7.3%) participated in 10 weekly, 60-minute online sessions. Overall, weekly session and post-ECHO satisfaction were high across all domains. Both knowledge scores and self-efficacy ratings increased post-ECHO, 3.9% (p = .02) and 9.7 points (p < .001), respectively. Interview findings highlighted participants’ appreciation of access to specialists, recognition of educational needs specific to LTC, and reduction of professional isolation. Conclusion We demonstrated that ECHO COE-LTC can be a successful capacity-building educational model for interprofessional health-care providers in LTC, and may alleviate pressures on the health system in delivering care for residents.



Author(s):  
George A. Heckman ◽  
Veronique M. Boscart ◽  
Robert S. McKelvie ◽  
Teresa D’Elia ◽  
Osman Osman ◽  
...  

RÉSUMÉL'insuffisance cardiaque (IC) est fréquente chez les résidents en soins de longue durée (SLD), et peut représenter 40 pour cent des transferts aux soins aigus. Des lignes directrices de l’IC de la Société canadienne de cardiologie approuvent les traitements standards, mais les résidents de SLD sont moins susceptibles de recevoir un traitement.* Cette étude qualitative a utilisé des groupes de discussion pour explorer les perceptions, de 18 médécins et infirmières praticiennes dans trois foyers de l’Ontario, des pratiques de soins de l’IC et les défis de SLD. Par exemple, les participants ont rapporté les défis concernant aptitudes diagnostiques et les connaissances procédurales de l’IC. Ils ont également identifié la nécessité de la collaboration interprofessionnelle et la clarification des rôles pour améliorer les soins et les résultats de l’IC. Pour résoudre ces problèmes, les interventions multi-modales et l'enseignement de chevet sont requis. Le leadership a été considéré comme essentielle pour améliorer les soins de l’IC. Plusieurs préoccupations ont surgi concernant les lacunes dans les connaissances et les déficits cliniques chez les fournisseurs de soins primaires qui traitent l'insuffisance cardiaque chez les résidents de SLD. Pour améliorer les soins de l'IC à long terme, des solutions éducatives et interprofessionnelles multi-modales et cliniquement ciblées sont nécessaires.



2005 ◽  
Vol 24 (2) ◽  
pp. 151-159 ◽  
Author(s):  
Cara Tannenbaum ◽  
Danielle Labrecque ◽  
Christiane Lepage

ABSTRACTThis work seeks to identify factors that facilitate or diminish care-providers' propensity to improve continence care in long-term care (LTC) settings. We conducted a cross-sectional qualitative study using focus group methodology in four long-term care institutions in Montreal, QC. Forty-two nurses, nursing assistants, and orderlies caring for incontinent elderly residents were asked how they perceived urinary incontinence (UI), how it was being managed, and what factors enabled or hindered continence care in their institution. Content analysis was used. Facilitating and inhibiting elements of three individual/internal factors (beliefs about UI, attitudes towards the elderly, and knowledge about UI) and five institutional/external factors (workload demands, type of patient, environmental support, co-worker support, and attributes of UI interventions) emerged as important determinants of care-providers' propensity to manage UI. To be successful, continence programs must target multidimensional elements that take into account personal, systems, and organizational level factors.



2002 ◽  
Author(s):  
Maryam Navaie-Waliser ◽  
Aubrey L. Spriggs ◽  
Penny H. Feldman


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