Dementia, ageing, and the city: learning from the streets of Melbourne

2018 ◽  
Vol 22 (2) ◽  
pp. 104-114
Author(s):  
Rebecca McLaughlan ◽  
Michael Annear ◽  
Alan Pert
Keyword(s):  
Social Inclusion ◽  
Design Thinking ◽  
Ageing Population ◽  
Care Providers ◽  
Term Care ◽  
Ageing In Place ◽  
The University ◽  
The City ◽  
Speculative Design

One of the most difficult challenges associated with an ageing population will be a significant increase in the number of people living with dementia. In Australia, this number is estimated to triple by 2050; a situation that is reflected globally. This will place increased demands on health and long-term care providers but it should also force an examination of the ability of contemporary cities to facilitate or constrain inclusion. Globally, designers and students of this discipline are contributing their skills to the challenge of dementia but solutions are typically proposed at a product, institutional or suburban scale. This paper will present two propositional projects, created using a speculative design methodology within a design studio at The University of Melbourne, that provoke architects to more seriously interrogate what it means for a city to support social inclusion, independence and choice for those who are ageing in place. These projects illuminate new avenues for critical and necessary research. This paper will begin with a reflection on the limitations of the Hogeweyk Dementia Village (Amsterdam), considered the current gold standard in dementia design, to highlight the value of thinking speculatively within the context of dementia; to disrupt the limitations of contemporary design thinking and ask what role the architect can play in improving the lives of those living with dementia?

Informal Caregivers As Long-Term Care Providers: Differential Experiences By Gender

2002 ◽  
Author(s):  
Maryam Navaie-Waliser ◽  
Aubrey L. Spriggs ◽  
Penny H. Feldman
Keyword(s):  
Long Term Care ◽  
Informal Caregivers ◽  
Care Providers ◽  
Term Care

The Impacts of Long-Term Care Insurance on Health Care Utilization and Expenditure: Evidence From China

2022 ◽  
Author(s):  
He Chen ◽  
Jing Ning
Keyword(s):  
Health Care ◽  
Health Care Utilization ◽  
Treatment Effect ◽  
Health Expenditure ◽  
Long Term Care ◽  
Care Utilization ◽  
Ageing Population ◽  
Term Care ◽  
Long Term Care Insurance

Abstract Long-term care insurance (LTCI) is one of the important institutional responses to the growing care needs of the ageing population. Although previous studies have evaluated the impacts of LTCI on health care utilization and expenditure in developed countries, whether such impacts exist in developing countries is unknown. The Chinese government has initiated policy experimentation on LTCI to cope with the growing and unmet need for aged care. Employing a quasi-experiment design, this study aims to examine the policy treatment effect of LTCI on health care utilization and out-of-pocket health expenditure in China. The Propensity Score Matching with Difference-in-difference approach was used to analyse the data obtained from four waves of China Health and Retirement Longitudinal Study (CHARLS). Our findings indicated that, in the aspect of health care utilization, the introduction of LTCI significantly reduced the number of outpatient visits by 0.322 times (p<0.05), the number of hospitalizations by 0.158 times (p<0.01), and the length of inpatient stay during last year by 1.441 days (p<0.01). In the aspect of out-of-pocket health expenditure, we found that LTCI significantly reduced the inpatient out-of-pocket health expenditure during last year by 533.47 yuan (p<0.01), but it did not exhibit an impact on the outpatient out-of-pocket health expenditure during last year. LTCI also had a significantly negative impact on the total out-of-pocket health expenditure by 512.56 yuan. These results are stable in the robustness tests. Considering the evident policy treatment effect of LTCI on health care utilization and out-of-pocket health expenditure, the expansion of LTCI could help reduce the needs for health care services and contain the increases in out-of-pocket health care expenditure in China.

Multimorbidity, Consumer-Directed Care, and Drug-Related Harm

2021 ◽  
Vol 36 (3) ◽  
pp. 125-126
Author(s):  
Chris Alderman
Keyword(s):  
Health Care Providers ◽  
Developed Countries ◽  
Care Practice ◽  
Care Providers ◽  
Term Care ◽  
Societal Challenges ◽  
Psychiatric Conditions ◽  
New Treatments ◽  
Related Harm

People from developed countries around the world now routinely live into their 80s and beyond, and this is associated with a range of medical and societal challenges that must be addressed. It is relatively rare to encounter older people who are not affected by one or more chronic diseases, including conditions such as osteoarthritis, gastroesophageal reflux disease (GERD), hypertension, and depression. The concurrence of a number of medical and/or psychiatric conditions in the same patient has come to be referred to as multimorbidity, and it is a particularly familiar phenomenon observed by health care providers in settings such as the Emergency Department (ED), primary care practice, and long-term care facilities. Given that life expectancy continues to increase, and that there is considerable further investment in research for the development of new treatments, which will achieve adoption and be promoted to consumers, it is clear that multimorbidity is likely to be a driver for problems arising from medications that are vigorously promoted to consumers.

The Economics of Long-Term Care

2013 ◽  
Vol 14 (2) ◽  
pp. 343-375 ◽  
Author(s):  
Luigi Siciliani
Keyword(s):  
Long Term Care ◽  
Private Insurance ◽  
Care Home ◽  
Significant Proportion ◽  
Empirical Work ◽  
The United States ◽  
Ageing Population ◽  
Public Insurance ◽  
Term Care

Abstract Long-term care expenditure is expected to rise, driven by an ageing population. Given that public long-term care expenditure is high in many OECD countries, governments are increasingly concerned about its future growth. This study focuses on three relevant issues. First, we discuss factors that affect the growth of long-term expenditure and its projections. These include demographics, the balance in provision between informal and formal care, whether higher life expectancy translates into higher disability, the interrelation between health and long-term care, and whether long-term care suffers from Baumol’s disease. Second, given that a significant proportion of long-term care expenditure is nursing- and care-home expenditure, we discuss the role of government regulation aimed at ensuring that individuals receive appropriate quality of care in such institutions. We focus in particular on price regulation, competition, and the non-profit sector; these have been the subject of considerable empirical work (mainly in the United States). Third, we discuss the relative merits of public and private insurance. Countries differ greatly in their approach. Some countries have nearly exclusively public insurance but in others this is small. We consider the conditions under which public insurance can overcome the limitations of a private insurance market.

scholarly journals Long-Term Care of the Pediatric Kidney Transplant Recipient

2021 ◽  
pp. CJN.16891020
Author(s):  
Hilda E. Fernandez ◽  
Bethany J. Foster
Keyword(s):  
Transplant Recipient ◽  
Kidney Transplant ◽  
Graft Failure ◽  
Graft Function ◽  
Failure Rates ◽  
Care Providers ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Term Care

Pediatric kidney transplant recipients are distinguished from adult recipients by the need for many decades of graft function, the potential effect of CKD on neurodevelopment, and the changing immune environment of a developing human. The entire life of an individual who receives a transplant as a child is colored by their status as a transplant recipient. Not only must these young recipients negotiate all of the usual challenges of emerging adulthood (transition from school to work, romantic relationships, achieving independence from parents), but they must learn to manage a life-threatening medical condition independently. Regardless of the age at transplantation, graft failure rates are higher during adolescence and young adulthood than at any other age. All pediatric transplant recipients must pass through this high-risk period. Factors contributing to the high graft failure rates in this period include poor adherence to treatment, potentially exacerbated by the transfer of care from pediatric- to adult-oriented care providers, and perhaps an increased potency of the immune response. We describe the characteristics of pediatric kidney transplant recipients, particularly those factors that may influence their care throughout their lives. We also discuss the risks associated with the transition from pediatric- to adult-oriented care and provide some suggestions to optimize transition to adult-oriented transplant care and long-term outcomes.

scholarly journals Is Long-Term Care Person Centred? A Case Study

2021 ◽  
Author(s):  
Katarina Young
Keyword(s):  
Long Term Care ◽  
Direct Care ◽  
Care Providers ◽  
Term Care ◽  
Study Approach ◽  
Key Stakeholders ◽  
Direct Care Providers ◽  
Government Legislation

In Ontario long-term care (LTC) settings, person-centred care (PCC) is promoted by government legislation, accreditation organizations and professional practice guidelines aiming to integrate this approach. However, there is currently no standardized approach to providing PCC in LTC. The purpose of this study was to examine public policies on PCC in Ontario and explore how they are interpreted and translated into practice in LTC. A qualitative case study approach was used to examine the perspectives of key stakeholders at one LTC facility in Ontario. Focus groups were conducted with residents, family members, direct care providers and managers. Through content analysis, findings were organized into four categories showcasing both overlapping and differential understandings of PCC in practice: 1) conceptualization, 2) barriers, 3) facilitators, and 4) evaluation. Identified tensions between policy and the delivery of PCC highlight systemic issues that must be addressed to enable equitable person-centred LTC rooted in resident-identified priorities.

scholarly journals A diversity-sensitive long-term care for gay and lesbian elders in need of care – Results of the research project GLESA

2018 ◽  
Vol 5 (1) ◽  
pp. 53-63
Author(s):  
Ralf Lottmann ◽  
Ingrid Kollak
Keyword(s):  
Social Inclusion ◽  
Long Term Care ◽  
Qualitative Content Analysis ◽  
Gay And Lesbian ◽  
Research Project ◽  
Term Care ◽  
Need Of Care ◽  
Care Services ◽  
Care Facilities

AbstractThis paper presents results of the research project „Gleichgeschlechtliche Lebensweisen und Selbstbestimmung im Alter“ (GLESA) by the Alice Salomon University of Applied Sciences, Berlin, and the Berlin School of Economics and Law concerning the needs of gay and lesbian elders regarding long-term care. The main focus is on the expectations and perceptions of long-term care (facilities) of the interviewees living in a gay housing project in Berlin, Germany. The study is based on 26 interviews: with eleven gay, one lesbian and three heterosexual tenants – two of them lived in a shared community with long-term care services. Another eleven interviews were conducted with experts (five cis-female, four cis-male and two transgender) working in social and health services (social workers, carers and psychologists). The data was gathered via problem-centered interviews (Witzel 2000) and analysed with Mayrings‘ (2007) qualitative content analysis. Long-term care aspects were one out of five dimensions of the analysis. The study illustrates the discomfort of LGB elders regarding regular care services. The interviewees prefer LGB(T*I)-friendly facilities, in part because they demonstrate overt signs of diversity and promise a high competence of LGB(T*I) personnel in terms of self-determination, awareness, visibility and knowledge about LGBT*I communities. Finally, the authors advocate enhancing the concept of culture-sensitive long-term care according to diversity-sensitive aspects. A better understanding of diversity will help to better consider individuality and biographies in long-term care (facilities) and to support the social inclusion of LGB(T*I) elders in need of care.

Requirements-Based Design of Serious Games and Learning Software

2019 ◽  
pp. 1-34
Author(s):  
Brock Randall Dubbels
Keyword(s):  
Design Thinking ◽  
Care Facility ◽  
Serious Game ◽  
Multiple Traits ◽  
Term Care ◽  
Long Term Care Facility ◽  
Learning Software ◽  
Newly Hired

A serious game can be entertaining and enjoyable, but it is designed to facilitate the acquisition of skills and knowledge performance in the workplace, classroom, or therapeutic context. Claims of improvement can be validated through assessments successful, measurable practice beyond the game experience, the targeted context of the workplace, classroom, or clinical using the same tools as multiple traits and multiple measure (MTMM) models. This chapter provides a post-mortem describing the development of the initial design and development of a measurable model to inform the design requirements for validation for a serious game. In this chapter, the reader will gain insight into the implementation of lean process, design thinking, and field observations for generative research. This data informs the assessments and measurement of performance, validated through the MTMM model criteria for requirements. The emphasis examines the role of research insights for onboarding and professional development of newly hired certified nursing assistants in a long-term care facility.

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