Long-Term Care Insurance, marketization and the quality of care: ‘good time living’ in a recently established nursing home in a suburb of Tokyo

Japan Forum ◽  
2010 ◽  
Vol 21 (2) ◽  
pp. 209-231
Author(s):  
Reiko Abe Auestad
Keyword(s):  
Nursing Home ◽  
Quality Of Care ◽  
Long Term Care ◽  
Good Time ◽  
Term Care ◽  
Long Term Care Insurance

scholarly journals QUALITY OF CARE IN A LONG-TERM CARE COMMUNITY

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S506-S506
Author(s):  
Laura A Murray ◽  
Melinda Heinz
Keyword(s):  
Nursing Home ◽  
Quality Of Care ◽  
Long Term Care ◽  
Medical Model ◽  
Care Facility ◽  
Term Care ◽  
Care Community ◽  
Memory Care

Abstract Older adults may need to reside in long-term care facilities for additional assistance. However, research indicates differences in the quality of care. The purpose of this study was to conduct a naturalistic observation, recording factors affecting the quality of care residents received in a long-term care community. Over a three-week period, observations took place in the nursing home, assisted living, and memory care portions of the community. We predicted that there would be more issues negatively impacting quality of care in the nursing home area due to its medical model philosophy. Open-observations were recorded, coded, and analyzed for themes. Results indicated that the most significant issue influencing quality of care in all areas of the long-term care facility was communication (N = 57 recorded instances). Approximately 66% of recorded communication issues in the nursing home were negative compared to positive (25%) or neutral (8%) instances. Elderspeak was prevalent with staff using high pitched voices or saying “hun” to residents. At times, staff spoke too loudly to residents who did not have hearing impairment or would talk about residents in front of other residents, not taking into consideration privacy. In the memory care environment, positive examples were noted. Staff was friendly and worked together as a team, creating a positive work environment. Overall, results indicated staff members may need professional development in the area of communication, particularly staff working in the nursing home. In addition, reminding staff while it is their workplace it is also the resident’s home would be beneficial.

Quality of Life: The Institutional Culture Defined by Administrative and Resident Values

1988 ◽  
Vol 7 (3) ◽  
pp. 389-405 ◽  
Author(s):  
Helene D. Grossman ◽  
Audrey S. Weiner
Keyword(s):  
Quality Of Life ◽  
Quality Assurance ◽  
Nursing Home ◽  
Quality Of Care ◽  
Long Term Care ◽  
Institutional Culture ◽  
Quality Assurance Program ◽  
Term Care

As the graying population, increasing costs, and public regulation place new demands on the institutional long-term care setting, administrators face a major challenge in ensuring quality of care and of life. Quality of life in long-term care has been defined by the subjective importance and perceived availability of autonomy, interpersonal relations, and security. Quality of care is the effective provision of health care resources in appropriate quantity and duration to respond to actual need. As such, it is but one, albeit essential, component of quality of life in the nursing home. These two concepts are based on somewhat different underlying values that create different criteria for decision making. We use the experience of one urban 1, 100-bed multilevel nursing home to illustrate how a multifaceted quality-assurance program including resident input can be developed and implemented using quality of life standards to define and evaluate institutional culture and practices. Mechanisms for monitoring quality of life include a quality-assurance department, grievance/complaint procedures, resident government, staff committees, structured rounds, and educational programs. Examples illustrate how an emphasis on quality of life and of care can result in institutional conflict and how such conflicts can be reconciled.

Nursing Home Reform and the Politics of Long-Term Care

1987 ◽  
Vol 20 (02) ◽  
pp. 232-241
Author(s):  
Catherine Hawes
Keyword(s):  
Nursing Home ◽  
Quality Of Care ◽  
Long Term Care ◽  
Nursing Home Care ◽  
American Health Care System ◽  
Term Care ◽  
State Budgets ◽  
The Face

Nursing home care has been described as the most troubled and troublesome segment of the American health care system. Despite the annual expenditure of billions of dollars, extensive regulation, and the emergence of an increasingly sophisticated and concentrated industry, significant problems persist. Inadequate quality of care continues to be a serious and pervasive problem. Discrimination against patients whose care is paid for by Medicaid and Medicare, as well as against those with “heavy care” or extensive needs, is rampant. Costs have escalated at a phenomenal rate and continue to represent a substantial fiscal burden, causing one state Medicaid director to refer to nursing home payments as “the black hole of state budgets.”These circumstances are neither new nor surprising. They are, in fact, the result of rather startling failures in the public sector that are rooted in the special nature of the politics of long-term care. This article discusses the history of public policy toward nursing homes and the politics of long-term care, emphasizing problems in assuring acceptable quality of care. It also addresses the possibilities for reform during the next two years, particularly in light of new patient advocate and nursing home reform coalitions that promise to change the face of long-term care politics.

scholarly journals Understanding contributors to quality of care in long-term care and changes under COVID-19

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 960-960
Author(s):  
Sara Luck ◽  
Katie Aubrecht
Keyword(s):  
Quality Of Care ◽  
Long Term Care ◽  
The United States ◽  
Control Measures ◽  
Qualitative Description ◽  
Care Staff ◽  
Term Care ◽  
The Impact

Abstract Nursing home facilities are responsible for providing care for some of the most vulnerable groups in society, including the elderly and those with chronic medical conditions. In times of crisis, such as COVID-19 or other pandemics, the delivery of ‘regular’ care can be significantly impacted. In relation to COVID-19, there is an insufficient supply of personal protective equipment (PPE) to care for residents, as PPE not only protects care staff but also residents. Nursing homes across the United States and Canada have also taken protective measures to maximize the safety of residents by banning visitors, stopping all group activities, and increasing infection control measures. This presentation shares a research protocol and early findings from a study investigating the impact of COVID-19 on quality of care in residential long-term care (LTC) in the Canadian province of New Brunswick. This study used a qualitative description design to explore what contributes to quality of care for residents living in long-term care, and how this could change in times of crisis from the perspective of long-term care staff. Interviews were conducted with a broad range of staff at one LTC home. A semi-structured interview guide and approach to thematic analysis was framed by a social ecological perspective, making it possible to include the individual and proximal social influences as well as community, organizations, and policy influencers. Insights gained will improve the understanding of quality of care, as well as potential barriers and facilitators to care during times of crisis.

The vulnerability of nursing home residents to the Covid-19 pandemic

2020 ◽  
Vol 23 (2-3) ◽  
pp. 57-60 ◽  
Author(s):  
Edward H Wagner
Keyword(s):  
Nursing Home ◽  
Long Term Care ◽  
Nursing Home Residents ◽  
Nursing Assistants ◽  
Nursing Home Care ◽  
Term Care ◽  
Staff Members ◽  
Care Facilities

Residents in nursing homes and other long-term care facilities comprise a large percentage of the deaths from Covid 19. Is this inevitable or are there problems with NHs and their care that increase the susceptibility of their residents. The first U.S. cluster of cases involved the residents, staff, and visitors of a Seattle-area nursing home. Study of this cluster suggested that infected staff members were transmitting the disease to residents. The quality of nursing home care has long been a concern and attributed to chronic underfunding and resulting understaffing. Most NH care is delivered by minimally trained nursing assistants whose low pay and limited benefits compel them to work in multiple long-term care settings, increasing their risk of infection, and work while ill. More comparative studies of highly infected long-term care facilities with those organizations that were able to better protect their residents are urgently needed. Early evidence suggests that understaffing of registered nurses may increase the risk of larger outbreaks.

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