Service use barriers differentiating care-givers' service use patterns

2011 ◽  
Vol 31 (8) ◽  
pp. 1307-1329 ◽  
Author(s):  
SONG-IEE HONG ◽  
LESLIE HASCHE ◽  
MI JIN LEE
Keyword(s):  
Informal Care ◽  
Service Use ◽  
The United States ◽  
Service Users ◽  
Care Giver ◽  
Term Care ◽  
Data Set ◽  
Use Patterns ◽  
Care Givers ◽  
Service Barriers

ABSTRACTThis study describes what types of service use barriers older adults' informal care-givers perceive and examines how these barriers differentiate care-giver service use patterns. Analysing the 2004 National Long-Term Care Survey and Informal Care-giver Data Set (N=1908) in the United States of America, this study reports the prevalence of service barriers for each type of service as well as for overall service use. Service barriers are measured in terms of availability, awareness, affordability, staff quality, privacy violation, complex bureaucracy, language barriers, qualification of each programme and no thought of service. Andersen's health behaviour model guides determinants related to care-giver service use patterns. As a main outcome, care-giver service use patterns (light service users, selective in-home users, and multiple service users) are examined in relation to service use barriers when other predisposing, enabling and need variables are controlled. Of the ten service use barriers defined in this study, awareness and no thought of service are the most prevalent barriers. Care-givers reporting service barriers of availability, awareness and affordability are more likely to be light service users compared to multiple service users and selective in-home service users. These findings highlight the significance of enhancing awareness of care-giver supportive services as well as increasing availability and financial support for service use.

scholarly journals The impact of informal care-giving networks on adult children's care-giver burden

2010 ◽  
Vol 31 (1) ◽  
pp. 34-51 ◽  
Author(s):  
NATALIA TOLKACHEVA ◽  
MARJOLEIN BROESE VAN GROENOU ◽  
ALICE DE BOER ◽  
THEO VAN TILBURG
Keyword(s):  
Informal Care ◽  
Adult Children ◽  
Adult Child ◽  
Path Model ◽  
Care Giver ◽  
Term Care ◽  
Older Parents ◽  
Care Givers ◽  
Care Giving ◽  
The Impact

ABSTRACTPrevious research on the care-giver burden experienced by adult children has typically focused on the adult child and parent dyad. This study uses information on multiple informal care-givers and examines how characteristics of the informal care-giving network affect the adult child's care-giver burden. In 2007, 602 Dutch care-givers who were assisting their older parents reported on parental and personal characteristics, care activities, experienced burden and characteristics of other informal care-givers. A path model was applied to assess the relative impact of the informal care-giving network characteristics on the care-giver burden. An adult child experienced lower care-giver burden when the informal care-giving network size was larger, when more types of tasks were shared across the network, when care was shared for a longer period, and when the adult child had no disagreements with the other members of the network. Considering that the need for care of older parents is growing, being in an informal care-giving network will be of increasing benefit for adult children involved in long-term care. More care-givers will turn into managers of care, as they increasingly have to organise the sharing of care among informal helpers and cope with disagreements among the members of the network.

The Effects of the Opioid Epidemic on Prescribing Practices in Long-Term Care Residents

2019 ◽  
Vol 34 (4) ◽  
pp. 258-267
Author(s):  
Lisa Yamagishi ◽  
Olivia Erickson ◽  
Kelly Mazzei ◽  
Christine O'Neil ◽  
Khalid M. Kamal
Keyword(s):  
Severe Pain ◽  
Long Term Care ◽  
Care Facility ◽  
The United States ◽  
Self Report ◽  
Prescribing Practices ◽  
Term Care ◽  
Data Set ◽  
Opioid Prescribing

OBJECTIVE: Evaluate opioid prescribing practices for older adults since the opioid crisis in the United States.<br/> DESIGN: Interrupted time-series analysis on retrospective observational cohort study.<br/> SETTING: 176-bed skilled-nursing facility (SNF).<br/> PARTICIPANTS: Patients admitted to a long-term care facility with pain-related diagnoses between October 1, 2015, and March 31, 2017, were included. Residents discharged prior to 14 days were excluded. Of 392 residents, 258 met inclusion criteria with 313 admissions.<br/> MAIN OUTCOME MEASURE: Changes in opioid prescribing frequency between two periods: Q1 to Q3 (Spring 2016) and Q4 to Q6 for pre- and postgovernment countermeasure, respectively.<br/> RESULTS: Opioid prescriptions for patients with pain-related diagnoses decreased during period one at -0.10% per quarter (95% confidence interval [CI] -0.85-0.85; P = 0.99), with the rate of decline increasing at -3.8% per quarter from period 1 and 2 (95% CI -0.23-0.15; P = 0.64). Opioid prescribing from top International Classification of Diseases, Ninth Revision category, "Injury and Poisoning" decreased in prescribing frequency by -3.0% per quarter from Q1 to Q6 (95% CI -0.16-0.10; P = 0.54). Appropriateness of pain-control was obtained from the Minimum Data Set version 3.0 "Percent of Residents Who Self-Report Moderate to Severe Pain (Short Stay)" measure; these results showed a significant increase in inadequacy of pain relief by 0.28% per quarter (95% CI 0.12-0.44; P = 0.009).<br/> CONCLUSION: Residents who self-report moderate- to severe pain have significantly increased since October 2015. Opioid prescriptions may have decreased for elderly patients in SNFs since Spring 2016. Further investigation with a larger population and wider time frame is warranted to further evaluate significance.

Intention to use respite services among informal care-givers of frail older adults in China: the role of care needs change

2020 ◽  
Vol 41 (1) ◽  
pp. 101-120 ◽  
Author(s):  
Qian Sun ◽  
Nan Lu ◽  
Nan Jiang ◽  
Vivian W. Q. Lou
Keyword(s):  
Older Adults ◽  
Elderly People ◽  
Informal Care ◽  
Respite Care ◽  
Intention To Use ◽  
Care Giver ◽  
Care Needs ◽  
Frail Older Adults ◽  
Care Givers ◽  
Time Invariant

AbstractPopulation ageing in China calls for evidence-based solutions, especially in terms of fulfilling long-term care needs among frail older adults. Respite services are identified as effective resources for alleviating care-giver burden and promoting the wellbeing of both older adults and their family care-givers. However, respite care is often under-used in China. This research aimed to examine factors associated with intention to use respite services among informal care-givers in Shanghai, mainland China. This study was part of the Longitudinal Study on Family Caregivers for Frail Older Adults in Shanghai. Pairs of older adults and their care-givers (N = 583) who successfully completed the 2013 and 2016 waves were included in the data analysis. Two logistic regression models were conducted, one with time-invariant and one with time-variant factors. The model with time-variant factors had greater explanatory power than the original Andersen model with time-invariant factors influencing intention to use respite services among care-givers. Care-givers had higher odds of intending to use respite services if they had higher care-giving burden, were caring elderly people who experienced care-giver transitions, or were caring for elderly people with increased function of ambulation or decreased function of feeding. The findings imply that change in functional health was a significant determinant of intention to use respite care. Relevant policy and service implications will be discussed.

The carer careers of son and daughter primary carers of their very old parents in Norway

2003 ◽  
Vol 23 (4) ◽  
pp. 471-485 ◽  
Author(s):  
TOR INGE ROMOREN
Keyword(s):  
Informal Care ◽  
Service Utilisation ◽  
Next Of Kin ◽  
Term Care ◽  
Older Parents ◽  
Formal Service ◽  
Care Givers ◽  
Care Recipients ◽  
Care Giving ◽  
Primary Care Giver

The purpose of this article is to analyse with longitudinal data from Norway the caring activities of sons and daughters who were the primary care-giver to a parent aged 80 or more years. The study sample consists of the 227 offspring care-givers in the Larvik study, which examined the illnesses and disabilities and the informal and formal care received until their deaths of all those aged 80 or more years in the town's population in 1981. Prospective and retrospective data were collected from that year about the health, functional losses and formal service utilisation of the older people. After the death of an older person in the study, the next-of-kin was interviewed about the informal care provided by relatives and friends during the same time span. The sequences and content of the care-giving activities differed little for son or daughter care-givers, except during a short escalation phase. The average duration of informal home care was shorter for sons than for daughters, primarily because a minority of the daughters had very long care-giving careers. The duration of the care recipients' stays in acute or long-term care institutions before death did not differ by the gender of the carer. Compared with many earlier studies, few gender differences in offspring care-giving activities were found. The findings suggest that the potential of sons to provide informal care to frail older parents is underestimated in modern societies.

Risk factors related to the admission of people with dementia into a long-term care institution in Spain: an explorative study

2016 ◽  
Vol 38 (1) ◽  
pp. 192-211
Author(s):  
ESTER RISCO ◽  
ESTHER CABRERA ◽  
M. CARME ALVIRA ◽  
MARTA FARRÉ ◽  
SUSANA MIGUEL ◽  
...  
Keyword(s):  
Risk Factors ◽  
Informal Care ◽  
Health Care Professionals ◽  
Long Term Care ◽  
Term Care ◽  
Care Institution ◽  
Care Givers ◽  
People With Dementia ◽  
Person With Dementia

ABSTRACTRisk factors associated with admission of people with dementia to long-term care institutions need to be identified to support health-care professionals in dementia care at home. An explorative study, combining quantitative and qualitative data collection methods, was performed in people with dementia in Spain. The sample, consisting of people with dementia receiving formal care from health-care professionals but at risk of institutionalisation, and their informal care-givers; and people with dementia recently admitted to a long-term care institution, and their informal care-givers, was interviewed between November 2010 and April 2012. Perceived reasons for admission were determined through an open-ended question put to both groups. Presumed risk factors were collected with validated questionnaires and analysed using bivariate analysis. A total of 287 people with dementia and informal care-givers were studied. Reasons given by the institutionalised group were mostly related to the level of dependency of the person with dementia. People recently admitted to a long-term care institution had more cognitive impairment, a greater degree of dependency and poorer quality of life than those still living at home. Home-care services in Spain need to develop or improve interventions based on the risk factors identified in this study: informal care-giver profile, high cognitive impairment, high level of dependency and the poor quality of life of the person with dementia.

scholarly journals United States Forest Service Use of Forest Inventory Data: Examples and Needs for Small Area Estimation

2021 ◽  
Vol 4 ◽  
Author(s):  
Sarah S. Wiener ◽  
Renate Bush ◽  
Amy Nathanson ◽  
Kristen Pelz ◽  
Marin Palmer ◽  
...  
Keyword(s):  
United States ◽  
Forest Inventory ◽  
Small Area ◽  
Service Use ◽  
Small Area Estimation ◽  
Simulation Models ◽  
The United States ◽  
Northern Region ◽  
Data Set ◽  
Area Estimation

Forest Inventory and Analysis (FIA) data provides robust information for the United States Forest Service’s (USFS) mid-to-broad-scale planning and assessments, but ecological challenges (i.e., climate change, wildfire) necessitate increasingly strategic information without significantly increasing field sampling. Small area estimation (SAE) techniques could provide more precision supported by a rapidly growing suite of landscape-scale datasets. We present three Regional case studies demonstrating current FIA uses, how SAE techniques could enhance existing uses, and steps FIA could take to enable SAE applications that are user-friendly, comprehensive, and statistically appropriate. The Northern Region uses FIA data for planning and assessments, but SAE techniques could provide more specificity to guide vegetation management activities. State and transition simulation models (STSM) are run with FIA data in the Southwestern Region to predict effects of treatments and disturbances, but SAE could support model validation and more precision to identify treatable areas. The Southern Region used FIA to identify existing longleaf pine stands and evaluate condition, but SAE techniques within FIA tools would streamline analyses. Each case study demonstrates a desire to have FIA data on non-forested conditions and non-tree variables. Additional tools to measure statistical confidence would help maximize utility. FIA’s SAE techniques could add value to a widely used data set, if FIA can support key supplements to basic data and functionality.

scholarly journals The contributions of family care-givers at end of life: A national post-bereavement census survey of cancer carers’ hours of care and expenditures

2017 ◽  
Vol 31 (4) ◽  
pp. 346-355 ◽  
Author(s):  
Christine Rowland ◽  
Barbara Hanratty ◽  
Mark Pilling ◽  
Bernard van den Berg ◽  
Gunn Grande
Keyword(s):  
End Of Life ◽  
Informal Care ◽  
End Of Life Care ◽  
Family Care ◽  
Well Being ◽  
Background Information ◽  
Life Care ◽  
Data Set ◽  
Care Givers ◽  
Care Giving

Background: Family members provide vital care at end of life, enabling patients to remain at home. Such informal care contributes significantly to the economy while supporting patients’ preferences and government policy. However, the value of care-givers’ contributions is often underestimated or overlooked in evaluations. Without information on the activities and expenditures involved in informal care-giving, it is impossible to provide an accurate assessment of carers’ contribution to end-of-life care. Aim: The aim of this study was to investigate the contributions and expenditure of informal, family care-giving in end-of-life cancer care. Design: A national census survey of English cancer carers was conducted. Survey packs were mailed to 5271 people who registered the death of a relative to cancer during 1–16 May 2015. Data were collected on decedents’ health and situation, care support given, financial expenditure resulting from care, carer well-being and general background information. Results: In all, 1504 completed surveys were returned (28.5%). Over 90% of respondents reported spending time on care-giving in the last 3 months of the decedent’s life, contributing a median 69 h 30 min of care-giving each week. Those who reported details of expenditure (72.5%) spent a median £370 in the last 3 months of the decedent’s life. Conclusion: Carers contribute a great deal of time and money for day-to-day support and care of patients. This study has yielded a unique, population-level data set of end-of-life care-giving and future analyses will provide estimates of the economic value of family care-givers’ contributions.

scholarly journals Qualitative exploration of the experiences of informal care-givers for dependent older adults in Mexico City

2018 ◽  
Vol 39 (11) ◽  
pp. 2377-2396 ◽  
Author(s):  
Liliana Giraldo-Rodríguez ◽  
Nathalia Guevara-Jaramillo ◽  
Marcela Agudelo-Botero ◽  
Dolores Mino-León ◽  
Mariana López-Ortega
Keyword(s):  
Older Adults ◽  
Mexico City ◽  
Informal Care ◽  
Family Care ◽  
Structured Interviews ◽  
Care Needs ◽  
Cross Sectional ◽  
Term Care ◽  
Care Givers ◽  
Care Giving

AbstractPopulation ageing and increasing prevalence of chronic diseases and their consequences, changes in family structure and a decrease in the potential pool of family care, increase the need for formal long-term care for older adults in Mexico, and the need to understand the experiences of informal care-givers and how this impacts their social, family and personal conditions. This study investigates the experience of informal care-givers of dependent older adults using a cross-sectional qualitative study with an ethnographic focus. Thematic analysis was performed. The study comprised 48 semi-structured interviews with care-givers of dependent older adults who are beneficiaries of an in-home medical programme in Mexico City. The average age of care-givers was 54.7 years (standard deviation = 13.1, range = 24–86) and 75 per cent (36) were women. Results show care-giving experiences are diverse and complex, and profoundly affect the care-giver's life in terms of emotional burden, health deterioration and adverse life conditions due to economic deprivation. They also revealed key aspects such as the need to improve communication between care-givers and health-care personnel, the need for training about specific care needs and opportunity costs incurred. This information can serve as a basis for generating support strategies that may be integrated into the in-home programme. It is essential to promote actions that consider the ‘dependent older adult–informal care-giver’ dyad, and that aim to reduce the care-giving burden.

scholarly journals Perceived value of support for older adults coping with multi-morbidity: patient, informal care-giver and family physician perspectives

2015 ◽  
Vol 36 (9) ◽  
pp. 1891-1914 ◽  
Author(s):  
GAYATHRI NAGANATHAN ◽  
KERRY KULUSKI ◽  
ASHLINDER GILL ◽  
LIISA JAAKKIMAINEN ◽  
ROSS UPSHUR ◽  
...  
Keyword(s):  
Older Adults ◽  
Informal Care ◽  
Health And Safety ◽  
Perceived Value ◽  
Family Health ◽  
Family Physicians ◽  
Care Giver ◽  
Structured Interviews ◽  
Supportive Services ◽  
Care Givers

ABSTRACTThis study investigated the perceived value of informal and formal supports for older adults with multi-morbidity from the perspectives of patients, care-givers and family physicians. Semi-structured interviews were conducted with 27 patients, their informal care-givers and their family physicians in an urban academic family health team in Ontario. Analysis was conducted using a General Inductive Approach to facilitate identification of main themes and build a framework of perceived value of supports. Participant views converged on supports that facilitate patient independence and ease care-giver burden. However, important differences in participant perceptions arose regarding these priorities. Physicians and care-givers valued supports that facilitate health and safety while patients prioritised supports that enable self-efficacy and independence. While formal supports which eased care-giver burden were viewed positively by all members of the triad, many patients also rejected formal supports, citing that informal support from their care-giver was available. Such conflicts between patient, care-giver and physician-perceived value of supports may have important implications for consumer and care-giver willingness to accept formal supports when supports are available. These findings contribute to the broader literature on community-based care by incorporating the perspectives of patients, informal care-givers and family physicians to understand better the barriers and facilitators of uptake of supportive services that contribute to successful ageing at home.

scholarly journals Socio-economic inequality in long-term care: a comparison of three time periods in the Netherlands

2021 ◽  
pp. 1-21
Author(s):  
Jens Abbing ◽  
Bianca Suanet ◽  
Marjolein Broese van Groenou
Keyword(s):  
The Netherlands ◽  
Informal Care ◽  
Long Term Care ◽  
Economic Status ◽  
Time Data ◽  
Term Care ◽  
Care Givers ◽  
Longitudinal Aging Study Amsterdam ◽  
Over Time

Abstract As a result of the rapid ageing of societies, meeting the demands for long-term care has become increasingly difficult. In the Netherlands, informal care is recognised as a key element to compensate for cut-backs in formal care provision. Formal, informal and privately paid long-term care services, however, are not used equally across socio-economic status (SES) groups and whether these inequalities have been reduced or exacerbated over time has not been researched. This study investigates to what extent educational and income inequalities in the use of formal, informal and privately paid care have changed over time. Data from the Longitudinal Aging Study Amsterdam (LASA) was used from three points in time: 1995 (N = 787), 2005 (N = 550) and 2015 (N = 473). Participants were between 75 and 85 years of age and living independently. The results indicate that lower SES groups are consistently more likely to use formal and informal care, and less likely to use privately paid care compared to higher SES groups. An increase in inequality was only found in the use of informal care; while informal care use is stable among lower SES groups, it decreases steeply among higher SES groups. These findings highlight the importance of education for explaining variation and changes over time in care use. Governmental efforts to mobilise informal care-givers might be outweighed by trends towards less long-term care.

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