scholarly journals Policy, plans and pathways: the ‘crisis’ transition to post-parental care for people ageing with intellectual disabilities in rural Australian carescapes

2017 ◽  
Vol 39 (4) ◽  
pp. 836-850 ◽  
Author(s):  
BRIDGET GARNHAM ◽  
LIA BRYANT ◽  
PAUL RAMCHARAN ◽  
NILAN YU ◽  
VALERIE ADAMS
Keyword(s):  
Primary Care ◽  
Rural Communities ◽  
Intellectual Disabilities ◽  
Parental Care ◽  
Long Term Care ◽  
Care Planning ◽  
Term Care ◽  
Care Giving ◽  
People With Intellectual Disabilities

ABSTRACTThe concurrent ageing of parental care-givers and people with intellectual disabilities is driving academic and social welfare concern for a post-parental care ‘crisis’. The ‘crisis’ typically pertains to a transition from primary care in the family home precipitated by the death or incapacity of older parents without a pre-planned pathway to post-parental care. This crisis is amplified in rural communities given low service engagement with families and a deficit of disability-supported accommodation and services. Academics, service providers and policy makers have responded through a problematisation of post-parental care planning. This focus continues to normalise informal care, burdens families with responsibility for planning, and diverts attention from structural deficits in the socio-political carescape. This paper attends to the Australian policy landscape in which long-term care-giving for families living with intellectual disability is enmeshed. It contends that the dyadic and didactic model of informal long-term care has profound implications for social service support and post-parental care planning. Problematisation of carers’ ‘need’ to relinquish primary care and for people with intellectual disabilities to transition to independent and supported living is necessary to unsettle the dominant policy and service discourse around the provision of services to sustain informal care-giving. Innovation is then needed to forge pathways of support for families in rural communities planning on continuing, transitioning and transforming care arrangements across the lifespan.

Practice resources

2018 ◽  
pp. 573-586
Author(s):  
Owen Barr ◽  
Bob Gates
Keyword(s):  
National Health Service ◽  
Health Service ◽  
Intellectual Disabilities ◽  
Long Term Care ◽  
Community Support ◽  
Term Care ◽  
People With Intellectual Disabilities ◽  
Nursing Roles

Nursing for people with intellectual disabilities has moved from a narrowly defined role, within long-term care, to a much broader role within the National Health Service and beyond. It is a health profession supported and endorsed by many as unique in its breadth of employment base, located as it is among the various sectors. The role of nurses for people with intellectual disabilities spans community support specialists, liaison nursing roles between services and agencies, and roles in secure or forensic health settings, and these roles offer support across all age ranges. With such exciting possibilities, in practice come challenges such as where to access up-to-date resources that will support nurses for people with intellectual disabilities and students in their practice. Where a student finds new resources for their jurisdiction, they may find it useful to append their own notes to the sections within this chapter; the layout of the book has been designed for students to make relevant notes on.

Health Literacy and Long-Term Care Needs among Thai Elderly in Rural Communities

2020 ◽  
Vol 103 (12) ◽  
pp. 1315-1324
Keyword(s):  
Depressive Symptom ◽  
Health Literacy ◽  
Rural Communities ◽  
Long Term Care ◽  
Health Knowledge ◽  
Elderly Persons ◽  
Care Needs ◽  
Term Care ◽  
Study Results

Background: Factors related to long-term care needs have been studied widely, but there is limited research about the influence of health literacy on long-term care needs among the elderly in rural communities where the social context and care environment are uniquely different. Objective: To examine factors influencing long-term care needs among Thai elderly in rural communities. Materials and Methods: The present study used the cross-sectional design. The study sample included 477 elderly persons, who were members of the communities in Nakhon Ratchasima Province. Multi-stage random sampling was used to select participants. They were interviewed using the demographic and health information questionnaire, the Thai Geriatric Depression Scale (TGDS), the health literacy scale of Thai adults and long-term care needs questionnaire. The selected factors examined as independent variables included some demographic factors, depressive symptom, and health literacy. Results: The present study results revealed significant positive relationships existing between long-term care needs with age and depressive symptom, while negative relationships between income and health literacy were reported. A hierarchical multiple regression analysis indicated that four of nine determinants of long-term care needs: age, depressive symptom, health knowledge and understanding, and ability managing their health condition significantly predicted long-term care needs at a level of 18% (R² adjusted=0.18, p<0.001). Conclusion: The present study results showed associations between personal and health literacy factors with long-term care needs. These findings prove that it is vitally important for healthcare professionals to consider the rural elderly’s mental health status and health literacy when providing care and planning treatment. Keywords: Health literacy, Long-term care needs, Rural community

scholarly journals Evaluating the integration of palliative care in national health systems: an indicator rating process with EAPC task force members to measure advanced palliative care development

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Natalia Arias-Casais ◽  
Eduardo Garralda ◽  
Miguel Antonio Sánchez-Cárdenas ◽  
John Y. Rhee ◽  
Carlos Centeno
Keyword(s):  
Primary Care ◽  
Palliative Care ◽  
Long Term Care ◽  
Task Force ◽  
National Level ◽  
Structured Interviews ◽  
Term Care ◽  
Care Facilities ◽  
Rating Process

Abstract Background Palliative care (PC) development cannot only be assessed from a specialized provision perspective. Recently, PC integration into other health systems has been identified as a component of specialized development. Yet, there is a lack of indicators to assess PC integration for pediatrics, long-term care facilities, primary care, volunteering and cardiology. Aim To identify and design indicators capable of exploring national-level integration of PC into the areas mentioned above. Methods A process composed of a desk literature review, consultation and semi-structured interviews with EAPC task force members and a rating process was performed to create a list of indicators for the assessment of PC integration into pediatrics, long-term care facilities, primary care, cardiology, and volunteering. The new indicators were mapped onto the four domains of the WHO Public Health Strategy. Results The literature review identified experts with whom 11 semi-structured interviews were conducted. A total of 34 new indicators were identified for national-level monitoring of palliative care integration. Ten were for pediatrics, five for primary care, six for long-term care facilities, seven for volunteering, and six for cardiology. All indicators mapped onto the WHO domains of policy and education while only pediatrics had an indicator that mapped onto the domain of services. No indicators mapped onto the domain of use of medicines. Conclusion Meaningful contributions are being made in Europe towards the integration of PC into the explored fields. These efforts should be assessed in future regional mapping studies using indicators to deliver a more complete picture of PC development.

Healthcare in Rural Manitoba: Resources and Related Issues of Access

1989 ◽  
Vol 2 (2) ◽  
pp. 6-11
Author(s):  
John M. Horne
Keyword(s):  
Rural Communities ◽  
Geographic Distribution ◽  
Long Term Care ◽  
Efficient Allocation ◽  
Allocation Of Resources ◽  
Term Care ◽  
Healthcare Resources ◽  
Hospital Medical ◽  
Publicly Insured

This paper reviews the existing allocation of healthcare resources to and within rural Manitoba. The geographic distribution of hospital, medical and long-term care resources is described and discussed in relation to widely held perceptions of continuing problems in access to publicly insured care among residents of rural communities. Opportunities for more effective and efficient allocation of resources are identified, including various arrangements for sharing both facilities and personnel between communities.

scholarly journals Practices and perspectives of primary care physicians in Japan and the United States about diagnosing dementia: a qualitative study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
M. Abe ◽  
S. Tsunawaki ◽  
M. Dejonckheere ◽  
C. T. Cigolle ◽  
K. Phillips ◽  
...  
Keyword(s):  
Primary Care ◽  
Early Intervention ◽  
Advance Directives ◽  
Primary Care Physicians ◽  
Long Term Care ◽  
Term Care ◽  
Care Services ◽  
The Us ◽  
Diagnosis Of Dementia

Abstract Background While dementia is a common problem in Japan and the US, primary care physicians' practices and perspectives about diagnosing dementia in these different healthcare systems are unknown. Methods Qualitative research was conducted in an ethnographic tradition using semi-structured interviews and thematic analysis in primary care settings across Japan and in the Midwest State of Michigan, US. Participants were a total of 48 primary care physicians, 24 each from Japan and the US participated. Both groups contained a mixture of geographic areas (rural/urban), gender, age, and years of experience as primary care physicians. Results Participants in Japan and the US voiced similar practices for making the diagnosis of dementia and held similar views about the desired benefits of diagnosing dementia. Differences were found in attitudes about the appropriate timing of formally diagnosing dementia. Japanese physicians tended to make a formal diagnosis when problems that would benefit from long-term care services emerged for family members. US physicians were more proactive in diagnosing dementia in the early stages by screening for dementia in health check-ups and promoting advance directives when the patients were still capable of decision-making. Views about appropriate timing of diagnostic testing for dementia in the two systems reflect what medical or nursing care services physicians can use to support dementia patients and caregivers. Conclusions Benefits of making the diagnosis included the need to activate the long-term care services in Japan and for early intervention and authoring advance directives in the US. Testing to establish an early diagnosis of dementia by primary care physicians only partly relates to testing and treatment options available. Benefits of making the diagnosis included the need to activate the long-term care services in Japan and for early intervention and authoring advance directives in the US.

Palliative care provision in long-term care facilities differs across Europe: Results of a cross-sectional study in six European countries (PACE)

2019 ◽  
Vol 33 (9) ◽  
pp. 1176-1188 ◽  
Author(s):  
Maud ten Koppel ◽  
Bregje D Onwuteaka-Philipsen ◽  
Lieve Van den Block ◽  
Luc Deliens ◽  
Giovanni Gambassi ◽  
...  
Keyword(s):  
Palliative Care ◽  
Advance Care Planning ◽  
Long Term Care ◽  
Care Planning ◽  
Care Provision ◽  
Cross Sectional ◽  
Term Care ◽  
Care Facilities ◽  
Advance Care

Background: While the need for palliative care in long-term care facilities is growing, it is unknown whether palliative care in this setting is sufficiently developed. Aim: To describe and compare in six European countries palliative care provision in long-term care facilities and to assess associations between patient, facility and advance care planning factors and receipt and timing of palliative care. Design: Cross-sectional after-death survey regarding care provided to long-term care residents in Belgium, England, Finland, Italy, the Netherlands and Poland. Generalized estimating equations were used for analyses. Setting/participants: Nurses or care assistants who are most involved in care for the resident. Results: We included 1298 residents in 300 facilities, of whom a majority received palliative care in most countries (England: 72.6%–Belgium: 77.9%), except in Poland (14.0%) and Italy (32.1%). Palliative care typically started within 2 weeks before death and was often provided by the treating physician (England: 75%–the Netherlands: 98.8%). A palliative care specialist was frequently involved in Belgium and Poland (57.1% and 86.7%). Residents with cancer, dementia or a contact person in their record more often received palliative care, and it started earlier for residents with whom the nurse had spoken about treatments or the preferred course of care at the end of life. Conclusion: The late initiation of palliative care (especially when advance care planning is lacking) and palliative care for residents without cancer, dementia or closely involved relatives deserve attention in all countries. Diversity in palliative care organization might be related to different levels of its development.

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