Elderly people's accounts of home care rationing: missing voices in long-term care policy debates

Abstract Functional decline in older adults often lead towards acute or long-term care. In practice, caregivers often focus on completion of care tasks and of prevention of injuries from falls. This task based, safety approach inadvertently results in fewer opportunities for older adults to be actively involved in activities. Further deconditioning and functional decline are common consequences of this inactivity. To prevent or postpone these consequences Function Focused Care (FFC) was developed meaning that caregivers adapt their level of assistance to the capabilities of older adults and stimulate them to do as much as possible by themselves. FFC was first implemented in institutionalized long-term care in the US, but has spread rapidly to other settings (e.g. acute care), target groups (e.g. people with dementia) and countries (e.g. the Netherlands). During this symposium, four presenters from the US and the Netherlands talk about the impact of FFC. The first presentation is about the results of a stepped wedge cluster trial showing a tendency to improve activities of daily living and mobility. The second presentation is about a FFC training program. FFC was feasible to implement in home care and professionals experienced positive changes in knowledge, attitude, skills and support. The next presenter reports about significant improvements regarding time spent in physical activity and a decrease in resistiveness to care in a cluster randomized controlled trial among nursing home residents with dementia. The fourth speaker presents the content and first results of a training program to implement FFC in nursing homes. Nursing Care of Older Adults Interest Group Sponsored Symposium

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“Then They Trust You …”

NEW SOLUTIONS A Journal of Environmental and Occupational Health Policy ◽

10.1177/1048291117712544 ◽

2017 ◽

Vol 27 (2) ◽

pp. 225-245 ◽

Cited By ~ 5

Author(s):

Marsha Love ◽

Felipe Tendick-Matesanz ◽

Jane Thomason ◽

Davine Carter ◽

Myra Glassman ◽

...

Keyword(s):

Home Care ◽

Long Term Care ◽

Care Needs ◽

Term Care ◽

Team Members ◽

Physical Independence ◽

Care Workers ◽

Communications Skills ◽

Home Care Workers

The home care workforce, already at 2.7 million caregivers, will become the nation’s fastest growing occupation by 2024 as the senior boom generation accelerates the demand for in home services to meet its long-term care needs. The physically challenging work of assisting clients with intimate, essential acts of daily living places home care workers (HCWs) at risk for musculoskeletal disorders (MSDs); yet, HCWs typically receive little formal job training and may lack appropriate assistive devices. In this qualitative pilot study, HCW focus groups described workplace MSD risk factors and identified problem-solving strategies to improve ergonomic conditions. The results revealed that HCWs rely on their behavioral insights, self-styled communications skills and caring demeanor to navigate MSD risks to themselves and increase clients’ physical independence of movement. We suggest changes in employer and government policies to acknowledge HCWs as valued team members in long-term care and to enhance their effectiveness as caregivers.

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Bringing the Family in through the Back Door: the Stealthy Expansion of Family Care in Asian and European Long-Term Care Policy

Journal of Cross-Cultural Gerontology ◽

10.1007/s10823-017-9325-5 ◽

2017 ◽

Vol 32 (3) ◽

pp. 291-301 ◽

Cited By ~ 8

Author(s):

Naonori Kodate ◽

Virpi Timonen

Keyword(s):

Long Term Care ◽

Family Care ◽

Care Policy ◽

Term Care ◽

The Family ◽

Back Door

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LONG-TERM CARE POLICY OF KOREA

Innovation in Aging ◽

10.1093/geroni/igx004.3935 ◽

2017 ◽

Vol 1 (suppl_1) ◽

pp. 1074-1074

Author(s):

D. Sunwoo

Keyword(s):

Long Term Care ◽

Care Policy ◽

Term Care

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MaineHealth: Development, Implementation, and Success in Telehealth for Home Care

Telehealth and Medicine Today ◽

10.30953/tmt.v2.32 ◽

2018 ◽

Vol 2 (5) ◽

Author(s):

Robert Abel

Keyword(s):

Palliative Care ◽

Home Care ◽

Long Term Care ◽

Opinion Leaders ◽

Term Care ◽

National Conference ◽

Chief Nursing Officer ◽

Care At Home ◽

Medicine Today

No abstract available. Editor’s note: On March 16th and 17th, 2017, Telehealth and Medicine Today convened a national conference of opinion leaders to discuss and debate “Technologies and Tactics Transforming Long-term Care.” What follows is the lecture by Robert Abel who is the Chief Nursing Officer and Director of Palliative Care for MaineHealth Care at Home, a member of the MaineHealth system.

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An Empirical Study on Tele-Consultation In Home-Visit Nursing Care Setting Under Korean Long-Term Care Insurance System

Journal of Korean Gerontological Nursing ◽

10.17079/jkgn.2021.23.3.249 ◽

2021 ◽

Vol 23 (3) ◽

pp. 249-260

Author(s):

Jungsuk Lee ◽

Hee Seung Lee ◽

Yeongwoo Park ◽

Rahil Hwang

Keyword(s):

Home Care ◽

Nursing Care ◽

Home Visit ◽

Care Setting ◽

Long Term Care ◽

Service Providers ◽

Pilot Project ◽

Care Quality ◽

Term Care

Purpose: The National Health Insurance Service implemented a tele-consultation pilot project for in-home care using Information and Communication Technologies (ICTs). This study aims to investigate nurses’, doctors’, and families’ perceptions on the project.Methods: Using the pilot project database and perception survey data, this study provides a description of the satisfaction, re-participation motivation, and experiences of nurses, doctors, and families.Results: Tele-consultation for home-visit nursing was used to monitor health conditions and problems, such as pain and blood pressure, or health counseling for home-care beneficiaries. The beneficiaries' families showed higher levels of satisfaction than the service providers. Nurses and doctors had relatively positive perceptions about the usefulness of sharing information about beneficiaries, timeliness of providing nursing care, and convenience of communication. Meanwhile, nurses and doctors had negative perceptions of the sufficiency and accuracy of information obtained from tele-consultation, implying the necessity of adopting more advanced ICTs.Conclusion: This study suggests what must be considered when designing a tele-consultation service model in long-term care settings, especially in the home-visit nursing care setting. Innovative approaches using ICTs should be taken to improve home-visit nursing care quality in the era of super-aging and COVID-19.

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