Decentralisation of long-term care in the Netherlands: the case of day care at green care farms for people with dementia

2013 ◽  
Vol 35 (4) ◽  
pp. 704-724 ◽  
Author(s):  
STÉPHANIE J. M. NOWAK ◽  
CLAUDIA C. M. MOLEMA ◽  
CAROLINE A. BAAN ◽  
SIMON J. OOSTING ◽  
LENNEKE VAANDRAGER ◽  
...  
Keyword(s):  
The Netherlands ◽  
Day Care ◽  
Central Government ◽  
Municipal Services ◽  
Term Care ◽  
Care Services ◽  
People With Dementia ◽  
Health And Social Care ◽  
Green Care Farms

ABSTRACTResponsibility for health and social care services is being delegated from central to local authorities in an increasing number of countries. In the Netherlands, the planned transfer of responsibility for day care for people with dementia from the central government to municipalities is a case in point. The impacts of this decentralisation process for innovative care concepts such as day care at green care farms are largely unknown. We therefore interviewed representatives of municipalities and green care farms to explore what consequences they expected of decentralisation for their organisations and people with dementia. Our study shows that communication and collaboration between municipalities and green care farms is relatively limited. Consequently, municipalities are insufficiently aware of how green care farms can help them to perform their new tasks and green care farmers know little about what municipalities expect from them in the new situation. We therefore recommend that municipalities and green care farms keep each other informed about their responsibilities, duties and activities to ensure a tailored package of future municipal services for people with dementia.

The Politics of Entitlement and Personalisation: Perspectives on a Proposed National Disability Long-term Care and Support Scheme in Australia

2012 ◽  
Vol 11 (3) ◽  
pp. 331-343 ◽  
Author(s):  
Michele Foster ◽  
Paul Henman ◽  
Jennifer Fleming ◽  
Cheryl Tilse ◽  
Rosamund Harrington
Keyword(s):  
Long Term Care ◽  
Individual Case ◽  
Term Care ◽  
Case Examples ◽  
The Past ◽  
Care Services ◽  
Trade Offs ◽  
Care And Support ◽  
Health And Social Care

Internationally, over the past two decades the theme of personalisation has driven significant reforms within health and social care services. In the Australian context, the principles of ‘entitlement based on need’ and ‘personalisation’ frame the proposed National Disability Long-Term Care and Support Scheme (LTCSS). In this article, we critically examine the interpretations and ambiguities of need and personalisation. We consider the administrative complexities of applying these principles in practice and the uncertainties about the roles of state and the market, and use individual case examples to illustrate areas of potential tension. Whether principles translate to deliver personalised services and avoid harmful trade-offs between access, equity and choice is the true test of social policy.

scholarly journals FACTORS ASSOCIATED WITH DIMINISHED COUGH INTENSITY IN COMMUNITY-DWELLING ELDERLY USING DAY CARE SERVICES: A PILOT STUDY

2019 ◽  
pp. 1-7
Author(s):  
R. Mikiya ◽  
C. Momoki ◽  
D. Habu
Keyword(s):  
Nutritional Status ◽  
Day Care ◽  
Peak Flow ◽  
Nutritional Assessment ◽  
Short Form ◽  
Mini Nutritional Assessment ◽  
Community Dwelling ◽  
Term Care ◽  
Care Services

Purpose: We investigated factors affecting diminished cough intensity in community-dwelling elderly using day care services. Participants and Methods: A total of 61 elderly males and females aged ≥65 years who were certified to receive long-term adult day care services were enrolled in this study. Assessments included: Cough intensity (assessed using cough peak flow measurements, as well as possible determinants of cough intensity, lifestyle, and demographic characteristics), nutritional status (using the Mini Nutritional Assessment-Short Form), dietary intake (using the Dietary Variety Score), routine activity (using the Japanese version of the International Physical Activity Questionnaire), care-related factors (including day care services utilization and an oral exercise regimen) as well as age, need for long-term care, gender, sarcopenia status, the Charlson Comorbidity Index, and body mass, limb skeletal mass, and respiratory indices. Results: A reduced cough peak flow (odds ratio 4.46, 95% confidence interval: 1.08–18.43) was associated with sarcopenia and was weakly (not significantly) associated with age, gender, and the Mini Nutritional Assessment-Short Form score. Conclusion: A reduced cough peak flow was independently associated with sarcopenia and associated with age, gender, and nutritional status.

Separate and Unequal: A Time to Reimagine Dementia

2021 ◽  
pp. 1-5
Author(s):  
Pia Kontos ◽  
Mary L. Radnofsky ◽  
Phyllis Fehr ◽  
Mike R. Belleville ◽  
Frances Bottenberg ◽  
...  
Keyword(s):  
Long Term Care ◽  
Care Homes ◽  
Centralized Control ◽  
Term Care ◽  
The Arts ◽  
People With Dementia ◽  
Health And Social Care ◽  
Separate And Unequal ◽  
Residential Long Term Care

The rapid emergence of COVID-19 has had far-reaching effects across all sectors of health and social care, but none more so than for residential long-term care homes. Mortality rates of older people with dementia in residential long-term care homes have been exponentially higher than the general public. Morbidity rates are also higher in these homes with the effects of government-imposed COVID-19 public health directives (e.g., strict social distancing), which have led most residential long-term care homes to adopt strict “no visitor” and lockdown policies out of concern for their residents’ physical safety. This tragic toll of the COVID-19 pandemic highlights profound stigma-related inequities. Societal assumptions that people living with dementia have no purpose or meaning and perpetuate a deep and pernicious fear of, and disregard for, persons with dementia. This has enabled discriminatory practices such as segregation and confinement to residential long-term care settings that are sorely understaffed and lack a supportive, relational, and enriching environment. With a sense of moral urgency to address this crisis, we forged alliances across the globe to form “Reimagining Dementia: A Creative Coalition for Justice. ” We are committed to shifting the culture of dementia care from centralized control, safety, isolation, and punitive interventions to a culture of inclusion, creativity, justice, and respect. Drawing on the emancipatory power of the imagination with the arts (e.g., theatre, improvisation, music), and grounded in authentic partnerships with persons living with dementia, we aim to advance this culture shift through education, advocacy, and innovation at every level of society.

Dementia specialist care units

2017 ◽  
pp. 281-286
Author(s):  
Rebecca Palm ◽  
Sabine Bartholomeyczik
Keyword(s):  
Nursing Homes ◽  
Psychosocial Care ◽  
Specialist Care ◽  
Term Care ◽  
Active Involvement ◽  
Care Services ◽  
People With Dementia ◽  
And Training

Dementia specialist care units (DSCUs) provide care for people with dementia and severe challenging behaviour who live in nursing homes. They are an alternative care setting within traditional nursing homes. By providing certain physical design features, employing staff with additional dementia expertise and training, enhancing psychosocial care, and focusing on the active involvement of families, these units aim to improve the quality of life of people with dementia and their families. However, research has not demonstrated a clear benefit of DSCUs for people with dementia to date. Nevertheless, they are regarded as an essential pillar of dementia long-term care services and are a topic of several national dementia strategies.

scholarly journals Partnership between Primary Health and Social Care Services in the Long-Term Care of Older People with Dementia: A Vignette Study

2020 ◽  
Author(s):  
Ausrine Kontrimiene ◽  
Aurelija Blazeviciene ◽  
Ida Liseckiene ◽  
Gediminas Raila ◽  
Leonas Valius ◽  
...  
Keyword(s):  
Older People ◽  
Social Care ◽  
Informal Caregiver ◽  
Three Dimensional ◽  
Term Care ◽  
Primary Health ◽  
People With Dementia ◽  
Health And Social Care ◽  
Relationship Perception

Abstract Background. Dementia is considered to be a significant cause of disability and dependency for older people worldwide and it raises difficulties in providing adequate formal and informal assistance. Research on the experience of long-term care (LTC) services for older people with dementia is scarce in Eastern European countries. This study aimed to understand the system of care for older people with dementia from the perspective of health and social care workers providing LTC services in Lithuania. Methods. A total of 72 primary health care and social care professionals from public and private institutions in Kaunas city participated in this study. One-to-one interviews were conducted with family physicians, community nurses, psychiatrists, psychiatric nurses, and social workers. A vignette situation of two fictitious patients with dementia and their informal caregiver was discussed during the interviews. Data were analyzed using thematic analysis by induction approach.Results. Thematic analysis of the data revealed two main themes: LTC provision trajectory, and three-dimensional relationship perception in realization of LTC activities. LTC provision trajectory reflected activities performed as a response to the described situation embracing formal procedures for the endorsement of LTC needs as well as the range of LTC services. Three-dimensional relationship perception in realization of LTC activities mirrored the participants’ relationships with themselves, with each other, and with the informal caregiver.Conclusions. Our study revealed the potential of complex measures that could be instrumental for the refinement of the caregiving process. First, a change in the special needs’ endorsement logic is needed, shifting focus from medical diagnosis to functional abilities assessment. Second, establishing clear procedures for formal cooperation between the health and social care sectors in the trajectory of LTC service provision. Finally, finding an adequate balance between LTC and institutional care by creating a wider range of LTC services. A more consistent and coordinated delivery of services by both health and social care sectors seems to be an untapped resource for the improvement of the LTC potential.

scholarly journals Partnership between primary health and social care services in the long-term care of older people with dementia: a vignette study

2020 ◽  
Author(s):  
Ausrine Kontrimiene ◽  
Aurelija Blazeviciene ◽  
Ida Liseckiene ◽  
Gediminas Raila ◽  
Leonas Valius ◽  
...  
Keyword(s):  
Older People ◽  
Social Care ◽  
Informal Caregiver ◽  
Three Dimensional ◽  
Term Care ◽  
Primary Health ◽  
People With Dementia ◽  
Health And Social Care ◽  
Relationship Perception

Abstract Background Dementia is considered to be a significant cause of disability and dependency for older people worldwide and it raises difficulties in providing adequate formal and informal assistance. Research on the experience of long-term care (LTC) services for older people with dementia is scarce in Eastern European countries. This study aimed to understand the system of care for older people with dementia from the perspective of health and social care workers providing LTC services in Lithuania. Methods A total of 72 primary health care and social care professionals from public and private institutions in Kaunas city participated in this study. One-to-one interviews were conducted with family physicians, community nurses, psychiatrists, psychiatric nurses, and social workers. A vignette situation of two fictitious patients with dementia and their informal caregiver was discussed during the interviews. Data were analyzed using thematic analysis by induction approach. Results Thematic analysis of the data revealed two main themes: LTC provision trajectory, and three-dimensional relationship perception in realization of LTC activities. LTC provision trajectory reflected activities performed as a response to the described situation embracing formal procedures for the endorsement of LTC needs as well as the range of LTC services. Three-dimensional relationship perception in realization of LTC activities mirrored the participants’ relationships with themselves, with each other, and with the informal caregiver. Conclusions Our study revealed the potential of complex measures that could be instrumental for the refinement of the caregiving process. First, a change in the special needs’ endorsement logic is needed, shifting focus from medical diagnosis to functional abilities assessment. Second, establishing clear procedures for formal cooperation between the health and social care sectors in the trajectory of LTC service provision. Finally, finding an adequate balance between LTC and institutional care by creating a wider range of LTC services. A more consistent and coordinated delivery of services by both health and social care sectors seems to be an untapped resource for the improvement of the LTC potential.

scholarly journals Association between receipt of social care and multimorbidity: evidence from a population-sized cohort in Scotland

2019 ◽  
Vol 4 (3) ◽  
Author(s):  
David Henderson ◽  
Iain Atherton ◽  
Nick Bailey ◽  
Colin McCowan ◽  
Stewart Mercer
Keyword(s):  
Social Care ◽  
Developed Countries ◽  
Societal Implications ◽  
Term Care ◽  
Long Term Conditions ◽  
Care Services ◽  
Health And Social Care ◽  
Care Survey ◽  
The Relationship

Multimorbidity, the presence of two or more long-term conditions, is associated with numerous negative outcomes. Little is known, however, about the relationship between multimorbidity and social care use (also known as long-term care). This is important as many developed countries seek to integrate health and social care services as a means of improving quality of services at the same time as making efficiency savings. The aim of the study was to assess the relationship between receipt of formal social care services, sociodemographic variables, and two proxy measures of multimorbidity. For this retrospective population-based observational study including all individuals over the age of 65 in Scotland in financial years 2014/15 and 2015/16 (n= 975,265), we linked the Scottish Social Care Survey (which holds information on those receiving social care from local authorities) to administrative NHS community prescribing and demographic records. The main outcome binary measure was presence or not in the social care survey. Two proxy measures of multimorbidity were derived from prescribing data. We used logistic regression models and report Average Marginal Effects (AME). Fifteen percent of all individuals received formal social care services. After adjustment for other modelled factors, multimorbidity showed an increasing magnitude of effect on receipt of social care (AME 16.4% (95% CI 16.2-16.6%) increased probability for 9+ medicines compared to 0-2 medicines, AME 18.8% (95% CI 18.5-19.1%) increased probability for 6+ BNF chapters compared to 0 BNF chapters). The magnitude of effect of deprivation on social care receipt was lower (AME 5.1% (95% CI 4.8-5.4%) increased probability in the most deprived area decile compared to the most affluent) after adjusting for multimorbidity and other demographic factors. This is one of the first studies to demonstrate an association between multimorbidity and receipt of social care. Increasing prevalence of multimorbidity has greater societal implications than previously described.

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