Doubly Enhanced Annuities (DEANs) and the Impact of Quality of Long-Term Care under a Multi-State Model of Activities of Daily Living (ADL)

2019 ◽  
Vol 24 (1) ◽  
pp. 57-99
Author(s):  
Colin M. Ramsay ◽  
Victor I. Oguledo
Author(s):  
Huimin Zhang ◽  
Xiaoyi Zhang ◽  
Youhua Zhao ◽  
Jianfeng Huang ◽  
Wenwei Liu

The impact of formal care (co-paid by long term care (LTC) insurance) on informal care is critical to the improvement and promotion of public policy. We conducted an interview-based survey to examine how the use of formal care impacts the use of informal care in Shanghai, which was one of China’s first long-term insurance pilots in 2016. In addition to total informal care time, the following four types of informal care were considered: (1) household activities of daily living (HDL) tasks, (2) activities of daily living (ADL) tasks, (3) instrumental activities of daily living (IADL) tasks, and (4) supervision tasks. Of the 407 families, an average of 12.36 h (SD = 6.70) of informal care was crowded out each week. Among them, ADL tasks, HDL tasks, and supervision tasks were reduced an average of 4.60 (SD = 3.59), 5.50 (SD = 3.38), and 2.10 h (SD = 3.06) per week, respectively. Each additional hour of formal care reduced 0.473 h of informal care. Care recipients’ gender and health status were also determined to be associated with crowding out hours of informal care. These findings can be utilized as empirical evidence for decision-makers to consider the scope of funding for formal care, and this study provides comparable results to developing countries and regions.


2018 ◽  
Vol 82 (1) ◽  
pp. 15-26 ◽  
Author(s):  
Patricia De Vriendt ◽  
Elise Cornelis ◽  
Ruben Vanbosseghem ◽  
Valerie Desmet ◽  
Dominique Van de Velde

Introduction Meaningful activities of daily living promote the quality of life of residents of long-term care facilities. This project aimed to develop an approach to enable meaningful activities of daily living and to guide long-term care facilities in a creative and innovative attitude towards residents' meaningful activities of daily living. Method The approach was developed in six steps: (1) in-depth-interviews with 14 residents; (2) a survey with 171 residents; (3) a systematic map and synthesis review on interventions enriching meaningful activities of daily living; (4) qualitative analysis of 24 ‘good examples’ and, to support future implementation, (5) focus groups with staff ( n = 69). Results determined the components of the new approach which was (6) pilot-tested in one long-term care facility. Quantitative and qualitative data were gathered concerning benefits for the residents and feasibility for the staff. Results A client- and activity-oriented approach was developed, characterised by an active participatory attitude of residents and staff and a systematic iterative process. Significant positive effects were found for the number of activities, the satisfaction with the leisure offered, the social network, medication use, but not for quality of life. The approach appeared to be feasible. Conclusion This approach stimulates residents' meaningful activities of daily living and social life. Further investigation is needed to evaluate its outcome and implementation potentials.


2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 960-960
Author(s):  
Sara Luck ◽  
Katie Aubrecht

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.


Author(s):  
Muhammad Syakir Asrulsani ◽  
Mazlynda Md Yusuf

Funding for long-term care costs among elderly people is a critical matter, especially due to high costs and an unexpected length of time. Placement for long-term care that is funded under Jabatan Kebajikan Masyarakat (JKM) is very limited, hence, the next option is through private nursing homes. However, the cost could be up to RM 2,000 a month for each person. Therefore, Long- Term Care Insurance is an alternative to fund for Long-Term Care costs as it is expected to reduce financial burden during old age. It is a risk protection mechanism for an insured that needs health and financial protection when an individual is unable to do activities of daily living (ADL) or supports in instrumental activities of daily living (IADL). This paper reviews three models that have been used in pricing long-term care insurance. All three models use the equivalent principle of premium to price the insurance policy. However, the probability and assumptions used for each model differ, depending on the insured's needs and profile.


Author(s):  
Feliciano Villar ◽  
Rodrigo Serrat ◽  
Annette Bilfeldt ◽  
Joe Larragy

AbstractLiving in a long-term care (LTC) institution provides older people experiencing health and social problems with a comprehensive range of support services that address their quality of life. Despite access to such services, challenges arise in relation to their participation in key activities both within and outside the institution. This chapter examines such challenges, reviewing and describing ways to prevent exclusion along various domains, specifically social relationships, civic participation and socio-cultural life. Firstly, we discuss ways in which bio-medical models of care and the quality control systems, which are dominant in LTC services, standardise care, tending to put decisions exclusively in hands of staff, taking away residents’ autonomy, and ultimately curtailing rights and citizenship status. Secondly, we examine how LTC services might prevent such exclusion and promote older people’s participation in at least four respects: (1) prompting and supporting residents’ ability to take decisions on their own care, (2) favouring the maintenance and creation of social relationships, (3) enabling residents’ participation in the activities and management of the institution, and (4) guaranteeing residents’ rights and full access to citizenship. We discuss the impact and limitations of recent initiatives put into practice in these areas of practice.


2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S244-S244
Author(s):  
Juan Juan Sun ◽  
Haichao Wu

Abstract With the life expectancy in China continuing to increase, age-dependent chronic diseases are also likely to increase, as is the number of people with long-term care needs. This study evaluated the Long Term Care (LTC) needs of the Chinese older population and introduced related policy priorities. Using the 2014 and 2016 “China Longitudinal Aging Social Survey”, this study assessed the physical functions of older adults by measuring their ability to perform Activities of Daily Living independently, compared changes within the two years, and explored other related indicators including, Instrumental Activities of Daily Living, major chronic disease, and mental health conditions. The study also discussed the development of long-term care policies in China and highlighted the priorities of these policies.


2016 ◽  
Vol 31 (2) ◽  
pp. 325-328
Author(s):  
Tomohiko KAMO ◽  
Katsuhiko EGUCHI ◽  
Hideaki ISHII ◽  
Yusuke NISHIDA

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