scholarly journals Influence of socio-economic profile of neighbourhoods on the selection of home care strategies for older dependants

2021 ◽  
pp. 1-19
Author(s):  
Albert Julià ◽  
Sandra Escapa ◽  
Pedro Gallo
Keyword(s):  
Home Care ◽  
Older People ◽  
Public Services ◽  
Family Care ◽  
Public Care ◽  
Network Characteristics ◽  
Private Care ◽  
Care Services ◽  
Care Giving ◽  
Use Of Services

Abstract Care strategies for older dependants are determined by not only individuals or network characteristics, but also contextual factors. The objective of this study is to determine whether urban contexts (neighbourhoods) are linked to the use of family care (informal), public services or private care at home (formal). We applied logistic regression analysis to data from the Survey of People in a Situation of Dependence 2018. The sample was composed of 530 older people (55 years old and over) living in two types of socio-economic groups of neighbourhoods in Barcelona, Spain. The type of neighbourhood is relevant in explaining the home care that older dependants receive. In neighbourhoods with a high socio-economic level, dependants are more likely to use private services and less likely to use informal care services and public services, even after controlling for household income, degree of dependency, sex, age and the number of people in the household. Understanding the factors that determine the use of public care services, private care services or family care-giving is important due to the increment in the number of older people in the population. Our results suggest that differences in urban socio-economic contexts determine some inequalities in the use of services even after controlling for socio-economic individual differences. The characteristics of neighbourhoods should be considered to adjust care policies for older dependants.

scholarly journals Non-use of community health-care services – an exploratory cross-sectional study among family care-givers for older, home-dwelling persons with dementia

2020 ◽  
pp. 1-25
Author(s):  
Jill-Marit Moholt ◽  
Oddgeir Friborg ◽  
Nils Henriksen ◽  
Torunn Hamran ◽  
Bodil H. Blix
Keyword(s):  
Health Care ◽  
Community Health ◽  
Health Care Services ◽  
Family Care ◽  
Community Health Care ◽  
Cross Sectional ◽  
Care Services ◽  
Care Givers ◽  
Care Giving ◽  
Use Of Services

Abstract Community health-care services for older, home-dwelling persons with dementia tend to be underutilised. Family care-givers provide substantial care, and they often arrange for and co-ordinate health-care services on behalf of persons with dementia. The aim of this study was to examine family care-givers’ knowledge of unused services and their self-reported reasons for non-use of such services. We gathered cross-sectional survey data from 430 family care-givers of older persons with dementia in Northern Norway. Multinomial logistic regression analysis was used to identify predictors of family care-givers’ knowledge of unused services. An open-ended question regarding reasons for non-use of services was analysed by thematic text analysis. Characteristics of family care-givers (e.g. education level) and factors related to the care-giving circumstances (e.g. negative impact of care-giving) predicted family care-givers’ knowledge of unused services. Reasons for non-use of services were multifaceted and complex, and were related to attributes of the person with dementia and/or the family care-giver (e.g. reluctance to use services) and/or the health-care services (e.g. low quality). Although services were unused, several family care-givers indicated substantial needs for the services. Strategies aimed at addressing the non-use of services should emphasise individuals’ and families’ needs and the adaptation of information about available services and their benefits for both care recipients and family care-givers. A relationship-centred care approach is thus recommended in dementia care.

The Impact of Modernisation and Social Policy on Family Care for Older People in Japan

2000 ◽  
Vol 29 (2) ◽  
pp. 181-203 ◽  
Author(s):  
MAKOTO KONO
Keyword(s):  
Social Policy ◽  
Older People ◽  
Informal Care ◽  
Family Care ◽  
Family Values ◽  
Patriarchal Family ◽  
Care Services ◽  
And Gender ◽  
The Impact ◽  
Welfare Model

In Japan the ideology of familism has reproduced patriarchal family values. It successfully retained family centred welfare provision and gender inequality in informal care work, and ensured formal care services were residual. However, the advancement of modernisation has weakened the effectiveness of the informal care sector, and the demand for care has increased steadily along with the ageing of the population. Moreover, informal care based on the self-sacrifice of family carers tends to be less popular. This tendency is especially evident in the opinions of the younger generation and females. Furthermore, structural shifts in their working circumstances, particularly of females, makes the continuation of the patriarchal approach to informal care more difficult. In the field of the care of older people, as part of the strategy for restructuring the Japanese welfare system, the emphasis is now more on market activities, which is in accord with the assumptions underlying ‘the residual welfare model of social policy’ (Titmuss, 1974).

scholarly journals Unmet care needs are common among community-dwelling older people with memory problems in Finland

2019 ◽  
pp. 140349481989080 ◽  
Author(s):  
Mari S. Aaltonen ◽  
Lina H. Van Aerschot
Keyword(s):  
Home Care ◽  
Older People ◽  
Home Care Services ◽  
Community Dwelling ◽  
Care Needs ◽  
Care Services ◽  
Memory Problems ◽  
More Care ◽  
Community Dwelling Older People ◽  
With Memory

Aims: Ageing in place has become a policy priority. Consequently, residential care has been reduced, and more older people with multiple care needs reside at home with the help of informal care and home care services. An increasing share of these people has memory disorders. We examined the extent to which memory problems, in addition to other individual characteristics, are associated with unmet care needs among community-dwelling older people. Methods: The study employed cross-sectional survey data from community-dwelling people aged 75+ collected in 2010 and 2015, analysed using binary logistic regression analysis. The study population consisted of people who had long-term illnesses or disabilities that limited their everyday activities ( N = 1928). Nine per cent reported substantial memory problems. Of these, 35.7% had a proxy respondent. Results: People with memory problems have more care needs than those with other types of disability or illness. They receive more care but still have more unmet needs than others. About a quarter of people with memory problems reported that they did not receive enough help. This result did not change significantly when the proxy responses were excluded. Even a combination of informal and formal home care was insufficient to meet their needs. Conclusions: Insufficient care for people with memory problems implies a serious demand for further development of home care services. The care needs of this population are often complex. Unmet needs represent a serious risk to the well-being of people with memory disorders, and may also create an extensive burden on their informal caregivers.

scholarly journals Dementia and Migration: Family Care Patterns Merging With Public Care Services

2017 ◽  
Vol 28 (1) ◽  
pp. 16-29 ◽  
Author(s):  
Mette Sagbakken ◽  
Ragnhild Storstein Spilker ◽  
Reidun Ingebretsen
Keyword(s):  
Family Care ◽  
Public Care ◽  
Care Services ◽  
Care Patterns ◽  
And Migration

Perception of risk of adverse outcomes of older people: comparison between nursing homes, day centers and home care services

2017 ◽  
Vol 18 (3) ◽  
pp. 212-220 ◽  
Author(s):  
Laetitia Teixeira ◽  
Maria João Azevedo ◽  
Sara Alves ◽  
Cátia L. Pires ◽  
Constança Paúl
Keyword(s):  
At Risk ◽  
Nursing Homes ◽  
Home Care ◽  
Older People ◽  
Perceived Risk ◽  
Home Care Services ◽  
Adverse Outcomes ◽  
Content Type ◽  
Care Services ◽  
Screen Instrument

Purpose In Portugal, the three main kinds of care services available for older people are nursing homes, day centers and home care services. The use of these care services is mostly based on complex socioeconomic and functional criteria; however it is not clear if this placement corresponds to a higher/lower risk of adverse outcomes. The purposes of this paper are: to characterize clients of each type of service; to estimate the proportion of individuals at perceived risk of each adverse outcome according to type of service; to assess the ability of the Risk Instrument for Screening in the Community (RISC) to identify the risk profiles according to type of service. Design/methodology/approach The sample comprised individuals aged 65+ (n=224), receiving care at home, in day centers or in nursing homes. The identification of individuals at risk for three adverse outcomes (institutionalization, hospitalization and death) was performed using a short pre-screen instrument (RISC). Findings The RISC identified mental state issues as the unique factor that differentiated clients according the type of care services (χ2 (6, N=224)=20.96, p=0.002), with day center presenting the lowest percentage of mental health concerns and nursing home presenting the highest percentage (44.44 and 71.91 percent, respectively). Additionally, a gradient was found between perceived risk of adverse outcomes (institutionalization and hospitalization) and care of levels required. Originality/value The RISC can be used to discriminate people in different settings of care and can be helpful in the selection of groups at risk that will benefit more from available services.

scholarly journals Continuous glucose monitoring in older people with diabetes receiving home care - A feasibility study

2020 ◽  
Author(s):  
Annette Bævre Larsen ◽  
Monica Hermann ◽  
Marit Graue
Keyword(s):  
Risk Assessment ◽  
Home Care ◽  
Older People ◽  
Assessment Tool ◽  
Glucose Monitoring ◽  
Cognitive Status ◽  
Ease Of Use ◽  
Quality Of Data ◽  
Care Services

Abstract BackgroundHypoglycemic incidents in older people can cause severe health problems, enhance general age-related disabilities and cause frailty. Little is known about incidences of hypoglycemia in older home-dwelling people with diabetes. Thus, the aim of this study was to examine the feasibility of capturing hypoglycemia and issues associated with increased risk of hypoglycemia by use of continuous glucose monitoring (CGM) and standardized questionnaires among older home dwelling individuals with diabetes type 2 receiving home care.MethodsCGM with the Ipro2 blinded monitoring system were performed for five days in six home-dwelling individuals ≥ 75 years diagnosed with diabetes and receiving home care. Demographic (age, gender, living arrangements) and clinical data (diabetes diagnoses and duration, diabetes medication, documented treatment goal, available glycosylated hemoglobin (HbA1c),) were collected from electronic patient records in home care services. Feasibility (ease of use, quality of data, time spent) of standardized questionnaires to identify the risk of hypoglycemia (the McKellar Risk Assessment Tool), risk of malnutrition (the Mini Nutritional Assessment (MNA)), functional status (the Individual-based Statistics for Nursing and Care Services (IPLOS)) and cognitive status (the Mini Mental Status Exam (MMSE)) was also assessed. Questionnaire data was collected by a study nurse in the individuals’ home.ResultsThe practical use of CGM was satisfactory, with no major remarks about discomfort or technical errors, except for one participant with skin reaction (redness). Collecting data with the McKellar Risk Assessment Tool, MNA and IPLOS worked well according to quality of data, time spent and ease of use. The MMSE survey required extensive training of personnel to be conducted.ConclusionThe feasibility study informs an upcoming study on the incidence and risk factors of hypoglycemia in home dwelling older individuals. We will ascertain that personnel who will use the MMSE questionnaire to collect cognitive status and skills are familiar with the tool and adequately educated and trained before study start. The use of blinded CGM in this population was well tolerated and can be used ‘as is’ for future studies.

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