Reconsidering Substitution in Long-Term Care: When Does Assistive Technology Take the Place of Personal Care?

One reason that nursing homes are a primary source of COVID-19 infections and deaths in the United States may be that workers hold multiple jobs. We use 2010-2019 Current Population Survey data to document the rate of second jobholding among nursing and long-term care workers. On average, 6.41% of personal care and nursing aides and 6.23% of licensed practical nurses and registered nurses hold second jobs; second job holding rates are 35% and 32% higher than those of other workers, respectively. Both wages and hours in the primary job are negatively associated with the probability of holding a second job for personal care and nursing aides, while lower hours are more strongly correlated with a second job for registered nurses and licensed practical nurses. Many of these workers move across health settings from their first to second jobs, and 15% of second jobs for personal care and nursing aides are in other “essential” occupations.

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EVENT-SPECIFIC EMOTIONAL EXPRESSION OF PERSONS WITH DEMENTIA IN LONG-TERM CARE: PRELIMINARY RESULTS

Innovation in Aging ◽

10.1093/geroni/igz038.1570 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S420-S420

Author(s):

Kyung Hee Lee ◽

Ji Yeon Lee ◽

Bora Kim ◽

Marie Boltz

Keyword(s):

Health Care Providers ◽

Emotional Expression ◽

Long Term Care ◽

Well Being ◽

Emotional Expressions ◽

Care Providers ◽

Personal Care ◽

Term Care ◽

Meal Time

Abstract Although dementia-related language, comprehension, and memory deficits occur fairly early stage in dementia, persons with dementia retain the ability to express their emotion even in the late stage of disease. However, health care providers do not know how to interpret emotional expressions that could be utilized as important signals of underlying needs and care preferences in persons with dementia. The purpose of this study was to explore the event-specific emotional expressions of persons with dementia in long-term care over a 6-month period. This was a longitudinal study using repeated observations. Emotional expressions were videotaped when three specific events (personal care, meal time, and activity) occurred at baseline, month 3 and month 6. A total of nine observations was made for each participant. We enrolled 13 participants so far; ten participants were completed 6 month follow up. The mean score of MMSE at baseline was 4.38; that of ADL was 16.62. On average, persons with dementia showed 9.93 episodes of positive emotional expression (PEE) per minute and 1.81 episodes of negative emotional expression (NEE) per minute. We found between person variations for both PEE and NEE. PEE and NEE were different by three types of events. Specifically, persons with dementia showed more PEE with activity than personal care and meal time and more NEE with personal care than the other two events. This study will provide better understanding of event-specific emotional expressions, and inform the development of emotion-oriented interventions programs to improve the psychological well-being of persons with dementia.

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Long Term Care Needs and Personal Care Services Under Medicaid

Journal of Health & Social Policy ◽

10.1300/j045v03n02_06 ◽

1991 ◽

Vol 3 (2) ◽

pp. 91-115 ◽

Cited By ~ 2

Author(s):

Howard A. Palley ◽

Julianne S. Oktay

Keyword(s):

Long Term Care ◽

Personal Care ◽

Care Needs ◽

Term Care ◽

Care Services

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Antibody Responses in Elderly Residential Care Persons following COVID-19 mRNA Vaccination

10.1101/2021.04.07.21254925 ◽

2021 ◽

Author(s):

David A Nace ◽

Kevin E Kip ◽

Octavia M Peck Palmer ◽

Michael R Shurin ◽

Katie Mulvey ◽

...

Keyword(s):

Antibody Response ◽

Assisted Living ◽

Independent Living ◽

Long Term Care ◽

Linear Regression Analysis ◽

Antibody Responses ◽

Personal Care ◽

Term Care ◽

Antibody Levels

Objective COVID-19 disproportionately impacts older adults residing at long-term care facilities. Data regarding antibody response to COVID-19 vaccines in this population is limited. Our objective was to quantify the presence and magnitude of antibody response in older, vaccinated residents at assisted living, personal care, and independent living facilities. Design A cross-sectional quality improvement study was conducted March 15-April 1, 2021 in the Pittsburgh region. Setting and Population Participants were volunteers at assisted living, personal care, and independent living facilities, who received mRNA COVID-19 vaccine. Conditions that obviate immune responses were exclusionary criteria. Methods Sera were collected to measure IgG anti-SARS-CoV-2 antibody level with reflex to total anti-SARS-CoV-2 immunoglobulin levels. Descriptive statistics, Pearson correlation coefficients, and multiple linear regression analysis were performed to evaluate relationships between factors potentially associated with antibody levels. Results All participants (N=70) had received two rounds of vaccination for COVID-19 and were found to have antibodies to SARS-CoV-2. There was wide variation in relative levels of antibodies as determined by extinction coefficients. Antibody levels trended lower in male sex, advanced age, steroid medications, and longer length of time from vaccination. Conclusions and Implications Higher functioning long-term care residents mounted detectable antibody responses when vaccinated with COVID-19 mRNA-based vaccines. This study provides preliminary information on level of population risk of assisted living, personal care, and independent living residents which can inform reopening strategies. Data suggests some degree of immunity is present during the immediate period following vaccination. However, protective effects of such vaccination programs remain to be determined in larger studies. Clinical protection is afforded not just by pre-formed antibody levels, but by ongoing adaptive immunity, which is known to be decreased in older individuals. Thus, the implications of these levels of antibodies in preventing COVID-19 disease must be determined by clinical follow-up.

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Running to stand still? Two decades of trade union activity in the Irish long-term care sector

Transfer European Review of Labour and Research ◽

10.1177/10242589211028461 ◽

2021 ◽

pp. 102425892110284

Author(s):

Caroline Murphy ◽

Michelle O’Sullivan

Keyword(s):

Trade Unions ◽

Public Expenditure ◽

Long Term Care ◽

Personal Care ◽

Decent Work ◽

Term Care ◽

Policy Regimes ◽

Care Services ◽

Care Workers

This article examines the ongoing efforts of trade unions in Ireland to protect and improve the working conditions of personal care workers amid employment and social policy regimes associated with a liberal welfare state. Comparatively low public expenditure on care and the increasing marketisation of care services have undermined the provision of decent work. This article assesses two major union campaigns related to personal care workers over two decades, and reviews the key priorities that have emerged for unions during the COVID-19 pandemic. We consider whether the outcomes of these campaigns have been converted into enhanced rewards for workers and discuss the continuing challenges for union campaigning.

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Event-Specific Emotional Expression of Persons Living With Dementia in Long-term Care: A 6 Months Follow-up Study

Clinical Nursing Research ◽

10.1177/10547738211047047 ◽

2021 ◽

pp. 105477382110470

Author(s):

Kyung Hee Lee ◽

Ji Yeon Lee ◽

Bora Kim ◽

Marie Boltz

Keyword(s):

Long Term Care ◽

Social Activity ◽

Well Being ◽

Emotional Expressions ◽

Personal Care ◽

Term Care ◽

Mixed Effect ◽

Mixed Effect Models ◽

Facility Type

This longitudinal study aimed to explore the event-specific emotional expressions of persons living with dementia in long-term care during a 6-month period with repeated observations. Emotional expressions at three specific events (mealtime, personal care, and social activity) were videotaped at the beginning, month 3, and month 6. Thirty participants were enrolled, and nine observations were made for each participant. Mixed-effect models were used for statistical analysis. The type of care events, the person who provides care, and the facility type were associated with emotional expressions. Specifically, personal care, interaction with non-nursing providers, and facility type were associated with positive emotional expressions. Negative emotional expressions were related to personal care, interaction with family or volunteer, and facility type. This study provides a better understanding of event-specific emotional expressions and knowledge to support the development of emotion-oriented intervention programs to improve the psychological well-being of persons living with dementia.

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Long term care will "implode" unless personal care comes free

BMJ ◽

10.1136/bmj.327.7418.770-a ◽

2003 ◽

Vol 327 (7418) ◽

pp. 770-a-770

Author(s):

K. Burke

Keyword(s):

Long Term Care ◽

Personal Care ◽

Term Care

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Winners and Losers: Assessing the Distributional Effects of Long-Term Care Funding Regimes

Social Policy and Society ◽

10.1017/s1474746407003703 ◽

2007 ◽

Vol 6 (3) ◽

pp. 379-395 ◽

Cited By ~ 2

Author(s):

Ruth Hancock ◽

Ariadna Juarez-Garcia ◽

Adelina Comas-Herrera ◽

Derek King ◽

Juliette Malley ◽

...

Keyword(s):

Long Term Care ◽

Simulation Models ◽

Income Group ◽

Personal Care ◽

Term Care ◽

Distributional Effects ◽

Tax Rate ◽

The Public ◽

The Uk

Using two linked simulation models, we examine the public expenditure costs and distributional effects of potential reforms to long-term care funding in the UK. Changes to the means tests for user contributions to care costs are compared with options for the abolition of these means tests (‘free’ personal care). The latter generally cost more than the former and benefit higher income groups more than those on lower incomes (measuring income in relation to the age-specific income distribution). Reforms to the means tests target benefits towards those on lower incomes. However, the highest income group are net losers if free personal care is financed by a higher tax rate on higher incomes and the effect on the whole population considered.

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