Subacute care and rehabilitation

Subacute and rehabilitation services are likely to play an increasingly important role in the health and long-term care systems, as population ageing increases the prevalence of chronic disease and disability. The role and scope of these services is difficult to assess in the Australian context due to the paucity of standardised definitions and administrative reporting systems. This paper appraises the role of these services and reflects on principles and evidence that might underpin their future development.

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Forms of Providing and Financing Long-Term Care in OECD Countries

Review of Economic Perspectives ◽

10.1515/revecp-2017-0008 ◽

2017 ◽

Vol 17 (2) ◽

pp. 159-178 ◽

Cited By ~ 1

Author(s):

Renáta Halásková ◽

Pavel Bednář ◽

Martina Halásková

Keyword(s):

Cluster Analysis ◽

Long Term Care ◽

Formal System ◽

Principal Component ◽

Oecd Countries ◽

Population Ageing ◽

Term Care ◽

Care Systems ◽

Provision Of Care

Abstract Long-term care is being prioritised due to population ageing, and hand in hand with the development of professional provision of long-term care, public expendi-tures will be increasing. Mainly countries with a sharp increase in the number of people aged 80+ will have to address the sustainability of long-term care systems and the pro-curement of relevant services. This paper aims to evaluate the forms of provision and financing of long-term care in selected OECD countries. Provision and funding of long-term care in terms of a formal system are assessed based on selected criteria using analytical methods (principal component analysis and TwoStep cluster analysis). Results of the evaluation carried out in 2008 and 2013 by means of the selected indicators of long-term care, using TwoStep cluster analysis, confirmed both similar as well as different approaches to the provision and financing of long-term care in the analysed countries. The most marked differences in the provision of care based on indicators LTC recipients aged 65+ and LTC recipients in institutions as a percentage of total LTC recipients were found between the first cluster (Australia and Korea with the highest share of LTC recipients) and the second cluster (Czech Republic, Estonia, with the lowest share of LTC recipients). In financing of long-term care (LTC expenditures on institutions as a percentage of total LTC expenditures), the most significant differences were observed between the first (Australia, Korea, with the largest share of LTC expenditures on institutions) and third cluster (mainly Nordic countries, with the lowest share of LTC expenditures on institutions of total LTC expenditures).

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Population ageing in Asia

Oxford Textbook of Geriatric Medicine ◽

10.1093/med/9780198701590.003.0006 ◽

2017 ◽

pp. 43-48

Author(s):

Du Peng ◽

Cao Ting

Keyword(s):

Social Services ◽

Structural Changes ◽

Long Term Care ◽

Population Ageing ◽

First Century ◽

Term Care ◽

The World ◽

The Government

Decline in fertility, mortality, and rapid population migration has contributed to the structural changes of population in Asia. By the mid-twenty-first century, Asia will become the oldest region in the world with more than half (62%) of the world’s older population. While the pace of ageing differs across Asia, all countries/areas will face challenges to sustaining economic growth, while at the same time responding to a rising demand for social welfare and pension, health, and medical care—particularly long-term care and social services. It becomes increasingly recognized that relying on the role of family or the government to provide support for elders is not only unreliable but also costly. Policy and innovative initiatives should be made to emphasize collaboration among individuals, families, communities in enhancing home- and community-based care, creating an enabling environment, as well as supporting older persons’ participation in society.

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Panorama da produção científica sobre Cuidados Intermediários e Hospitais Comunitários: uma revisão integrativa

Saúde em Debate ◽

10.1590/0103-1104202112918 ◽

2021 ◽

Vol 45 (129) ◽

pp. 481-500

Author(s):

Érika Fernandes Tritany ◽

Túlio Batista Franco ◽

Paulo Eduardo Xavier de Mendonça

Keyword(s):

Chronic Disease ◽

Long Term Care ◽

Rehabilitation Services ◽

Intermediate Care ◽

Community Hospitals ◽

Term Care ◽

Care Community ◽

Care Facilities ◽

Intermediate Care Facilities

RESUMO Mudanças epidemiológicas decorrentes do envelhecimento populacional motivaram transformações nos sistemas de saúde mundiais. Desde 1990, emergem discussões sobre Cuidados Intermediários (CI), visando diminuir hospitalizações, melhorar a coordenação do cuidado e estimular políticas públicas de cuidados próximos ao território. Este trabalho objetivou apresentar e analisar a literatura científica sobre CI, enfatizando serviços de Hospitais Comunitários. Realizou-se uma revisão integrativa, combinando os descritores “Intermediate Care”, “Community Hospitals”, “Intermediate Care Facilities”, “Long-Term Care”, “Hospitals Chronic Disease” e “Rehabilitation Services”, nos idiomas português, inglês e espanhol, nas bases Portal Regional da Biblioteca Virtual em Saúde, PubMed e Biblioteca Digital Brasileira de Teses e Dissertações. Após processo de busca e elegibilidade, foram incluídos 30 documentos para síntese qualitativa, provenientes de: Reino Unido, Noruega, Espanha, Dinamarca, Austrália e Itália. Resultados apontam para a eficácia, a efetividade e a eficiência dos CI, com boas avaliações por parte de profissionais e usuários. Os CI, como estratégia de fortalecimento da Atenção Primária à Saúde, redução de internações, favorecimento da independência funcional dos pacientes e seu retorno à comunidade, apresentam-se como uma inovação em saúde e aposta promissora. Entretanto, persistem lacunas na literatura que ensejam mais estudos sobre o tema, com vistas a subsidiar a tomada de decisão.

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Health and Care of an Ageing Population: Alignment of Health and Social Systems to Address the Need

Journal of Health Management ◽

10.1177/0972063421994992 ◽

2021 ◽

pp. 097206342199499

Author(s):

Sangay Thinley

Keyword(s):

Health Care ◽

Older People ◽

Long Term Care ◽

Health Care Systems ◽

Population Ageing ◽

Demographic Shift ◽

Term Care ◽

The Social ◽

Care Systems

Population ageing is both an achievement and challenge, an achievement as longevity is the result of successful prevention and control of diseases, decreasing fertility rates and overall socio-economic development. It is at the same time a challenge as the increasing number of older people and the resultant demographic shift are accompanied by the need to adjust and scale up the social and health care systems. The challenges are of particular relevance to the developing world where the demographic shift is occurring much faster. Comprehensive efforts based on country contexts are required in the following areas: (a) older persons and development, (b) health and well-being and (c) enabling and supportive environments to address population ageing needs. This article, however, focuses only on three most crucial issues, that is, livelihood, health care systems and care of the older dependent people. Measures to sustain the livelihood of older people, to align the health systems to provide care and to develop long-term care systems are highlighted. Person-centred care, integration and functional capacity are advocated. Further, ageing in place or living in one’s own home, community or a place with the closest fit with the person’s needs and preferences is considered very important for healthy ageing. In terms of enhancing livelihood, major policy changes and reforms to improve the social security systems and expanding coverage as well as increasing the amounts to minimum subsistence levels are highlighted. Another area which needs to be strengthened is the tradition of existing family support systems. The health systems alignment required are reflected for each health system building block, and focuses mainly on (a) developing and ensuring access to services that provide older-person-centred care; (b) shifting the clinical focus from disease to intrinsic capacity; and (c) developing or reorienting the health workforce to provide care as per alignment. Long-term care systems would best meet the needs of dependent older people if families, communities, civil society organisations and private sector are equally involved while governments play leadership roles in setting up and monitoring quality.

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Long-Term Care

10.1093/oxfordhb/9780198828389.013.30 ◽

2021 ◽

pp. 523-539

Author(s):

August Österle ◽

Heinz Rothgang

Keyword(s):

Welfare State ◽

Long Term Care ◽

State Policies ◽

Technological Advancement ◽

Care Needs ◽

Term Care ◽

Care Systems ◽

Welfare State Policies

This chapter describes and analyses the current state of long-term care and long-term care policies around the world. In the first part, after briefly retracing historical developments, the chapter examines the ways in which welfare state policies address long-term care. It studies regulation, finance, and delivery of long-term care. In the second part, the interconnectedness of welfare state policies, the role of families, non-profit, and for-profit market sectors, as well as novel arrangements between state, market, and family, in particular migrant care work, move to the centre of analysis. The third part focuses on major challenges and perspectives for long-term care systems and for long-term care research. Starting from a discussion of future long-term care needs and costs, it addresses the role of families in long-term care, workforce issues, financial sustainability, the quality of care, and the role of technological advancement for long-term care. With increasing needs and the changing contexts in which care is organized, long-term care has become a key concern of welfare state development in the twenty-first century.

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Faculty Opinions recommendation of Prolonged antibiotic treatment in long-term care: role of the prescriber.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.718751995.793499620 ◽

2014 ◽

Author(s):

Daniel J Morgan

Keyword(s):

Antibiotic Treatment ◽

Long Term Care ◽

Term Care

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106 - Environmental Influences on the Cognitive and Psychological Well Being of Older Adults with Dementia

International Psychogeriatrics ◽

10.1017/s1041610220001842 ◽

2020 ◽

Vol 32 (S1) ◽

pp. 15-16

Author(s):

William E. Reichman ◽

L. Bradford Perkins ◽

Hilde Verbeek

Keyword(s):

Quality Of Life ◽

Older Adults ◽

Physical Environment ◽

Culture Change ◽

Long Term Care ◽

Small Scale ◽

Term Care

This symposium will review the latest data on the influence of environmental design and its attributes on the cognitive and psychological wellbeing of older adults living with dementia. The presenters will cover the myriad ways in which the physical environment of care can adapt to the changing demands of older adults with sensory, motor and cognitive deficits and foster optimal functioning and quality of life. The role of emerging technologies will also be reviewed as they complement the contribution of the design of the physical environment to the wellbeing of older adults with cognitive impairment. Information will be offered through a review of the existing research literature as well as case studies that illustrate the impact of environmental modification on fostering wellbeing and minimizing the emergence of the behavioral and psychological symptoms of dementia. The presenters will represent and integrate sensibilities that have emerged from the fields of architecture, cognitive neuroscience and psychology.How the Principles of the Culture Change Movement Inform Environmental Design and the Application of Technology in the Care of Older Adults Living with DementiaWilliam E. ReichmanThe culture change movement informs a number of principles that have been applied to more contemporary design concepts for the congregate care of older adults living with dementia. This talk will review the core tenets of the Culture Change Movement as exemplified by the Greenhouse, Dementia Village and other innovative models of congregate long-term care. Specific reference will be made to how these tenets have been operationalized around the world into the design of programming and the creation of residential care environments that foster a better quality of life for older adults and an enhanced work environment for care providers. This talk will also include the emerging role of technologies that complement innovative design of the environment and which foster optimized social and recreational functioning of older adults living with dementia.A Better Life Through a Better Nursing Home DesignL. Bradford PerkinsOver the last 20 years there has been extensive experimentation related to the role of the environment in the housing, care and treatment of persons with Alzheimer’s and other age related dementias. Prior to that time the typical housing and care environment was a locked unit in a skilled nursing or other restrictive senior living facility. In 1991 the Presbyterian Association on Aging in Western Pennsylvania opened Woodside Place on its Oakmont campus. This small 36 bed facility was designed to incorporate the latest research and care experience with persons suffering from these issues. This one small project, as well as the long post occupancy research led by Carnegie Mellon University, clearly demonstrated that individuals with Alzheimer’s and related forms of dementia could lead a healthier, happier, higher quality of life in a more residential, less restrictive environment. Not everything in this pioneering project worked, and five generations of living and care models have followed that have refined the ideas first demonstrated by Woodside Place. Bradford Perkins, whose firm designed Woodside Place and over 100 other related projects, will discuss what was learned from Woodside Place as well as the five generations of projects (and post occupancy research) that followed.Innovative dementia care environments as alternatives for traditional nursing homes: evidence and experiences from the NetherlandsHilde VerbeekKey goals of the dementia care environment focus on increasing autonomy, supporting independence and trying to enable one’s own lifestyle for as long as possible. To meet these goals, innovative, small-scale and homelike care environments have been developed that have radically changed the physical, social and organizational aspects of long-term care in the Netherlands. This presentation discusses various Dutch models that have implemented small-scale and homelike care environments, including green care farms, dementia village and citizen initiatives. The models reflect a common care concept, focusing on residents’ remaining strengths, providing opportunity for choice and aiming to sustain a sense of self and control. A small number of residents (usually 6 to 8) live together in a homelike environment and nursing staff are part of the household. Residents are encouraged to participate in daily household activities, emphasizing normalization of daily life with person-centred care. The physical environment resembles an archetypal home. This talk presents the scientific evidence on the impact and effects of these small-scale, homelike models on residents, their family caregivers and staff. Furthermore, the presentation will highlight working approaches and how these initiatives have positively influenced routine care across the long-term care spectrum.

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