scholarly journals Maybe She’ll Make Some Friends?: Family Members Cultivating Intimacy in Assisted Living

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 486-487
Author(s):  
Andrea Fitzroy ◽  
Candace Kemp ◽  
Elisabeth Burgess
Keyword(s):  
Older Adults ◽  
Assisted Living ◽  
Intimate Relationships ◽  
Long Term Care ◽  
Participant Observation ◽  
Family Members ◽  
Later Life ◽  
Theory Approach ◽  
Term Care

Abstract Intimacy continues to be important in later life, including for older adults in long-term care settings such as assisted living (AL). Our past work shows that intimacy is a multi-dimensional process and can involve a variety of partners. Drawing on data from the qualitative longitudinal “Convoys of Care” study (R01AG044368), we extend this research to examine the role family members play in cultivating intimacy and close relationships of AL residents. Using a grounded theory approach, we analyzed 2,224 hours of participant observation, and formal interviews with 28 assisted living residents (aged 58-96) and their formal and informal care partners (n=114) from four diverse AL communities. Findings show that family members can play integral roles in residents’ experiences with intimacy, directly as relationship partners, and by facilitating or impeding residents’ contacts with others. Family members cultivated residents’ intimacy opportunities and experiences by direct engagement, resident advocacy, to non-involvement and disengagement. Family members’ roles in cultivating intimacy fluctuated over time, increasing at times of health concerns and family change. Perceptive family members considered older adults’ intimacy preferences when cultivating their intimate relationships. Family members concerned for the safety of their loved one sometimes acted as “gatekeepers” to intimacy by interfering in intimate relationships. We conclude with a discussion of implications for policy and practice aimed at improving the intimacy process and opportunities for older adults receiving long-term care.

scholarly journals Development and Field Testing of a Long-Term Care Decision Aid Website for Older Adults: Engaging Patients and Caregivers in User-Centered Design

2019 ◽  
Vol 60 (5) ◽  
pp. 935-946 ◽  
Author(s):  
Aubri S Hoffman ◽  
Daniel R Bateman ◽  
Craig Ganoe ◽  
Sukdith Punjasthitkul ◽  
Amar K Das ◽  
...  
Keyword(s):  
Older Adults ◽  
Decision Making ◽  
Decision Aid ◽  
Long Term Care ◽  
Action Plan ◽  
Family Members ◽  
Field Testing ◽  
Decisional Conflict ◽  
Term Care

Abstract Background and Objectives Decisions about long-term care and financing can be difficult to comprehend, consider, and communicate. In a previous needs assessment, families in rural areas requested a patient-facing website; however, questions arose about the acceptability of an online tool for older adults. This study engaged older adults and family caregivers in (a) designing and refining an interactive, tailored decision aid website, and (b) field testing its utility, feasibility, and acceptability. Research Design and Methods Based on formative work, the research team engaged families in designing and iteratively revising paper drafts, then programmed a tailored website. The field test used the ThinkAloud approach and pre-/postquestionnaires to assess participants’ knowledge, decisional conflict, usage, and acceptability ratings. Results Forty-five older adults, family members, and stakeholders codesigned and tested the decision aid, yielding four decision-making steps: Get the Facts, What Matters Most, Consider Your Resources, and Make an Action Plan. User-based design and iterative storyboarding enhanced the content, personal decision-making activities, and user-generated resources. Field-testing participants scored 83.3% correct on knowledge items and reported moderate/low decisional conflict. All (100%) were able to use the website, spent an average of 26.3 min, and provided an average 87.5% acceptability rating. Discussion and Implications A decision aid website can educate and support older adults and their family members in beginning a long-term care plan. Codesign and in-depth interviews improved usability, and lessons learned may guide the development of other aging decision aid websites.

scholarly journals Intimacy for older adults in long-term care: a need, a right, a privilege—or a kind of care?

2021 ◽  
pp. medethics-2020-107171
Author(s):  
Vanessa Schouten ◽  
Mark Henrickson ◽  
Catherine M Cook ◽  
Sandra McDonald ◽  
Nilo Atefi
Keyword(s):  
Older Adults ◽  
Long Term Care ◽  
Family Members ◽  
Well Being ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Term Care ◽  
Survey Tool ◽  
Whole Person

BackgroundTo investigate attitudes of staff, residents and family members in long-term care towards sex and intimacy among older adults, specifically the extent to which they conceptualise sex and intimacy as a need, a right, a privilege or as a component of overall well-being.MethodsThe present study was a part of a two-arm mixed-methods cross-sectional study using a concurrent triangulation design. A validated survey tool was developed; 433 staff surveys were collected from 35 facilities across the country. Interviews were conducted with 75 staff, residents and family members.ResultsIt was common for staff, residents and family members to talk about intimacy and sexuality in terms of rights and needs. As well as using the language of needs and rights, it was common for participants to use terms related to well-being, such as fun, happiness or being miserable. One participant in particular (a staff member) described receiving intimate touch as a ‘kind of care’—a particularly useful way of framing the conversation.ConclusionWhile staff, residents and family frequently used the familiar language of needs and rights to discuss access to intimate touch, they also used the language of well-being and care. Reframing the conversation in this way serves a useful purpose: it shifts the focus from simply meeting minimum obligations to a salutogenic approach—one that focuses on caring for the whole person in order to improve overall well-being and quality of life.

The Impact of Long-Term Care Policy on the Percentage of Older Adults With Disabilities Cared for by Family Members in China: A System Dynamics Simulation

2020 ◽  
pp. 016402752092356
Author(s):  
Rong Peng ◽  
Bei Wu
Keyword(s):  
Older Adults ◽  
System Dynamics ◽  
Delivery System ◽  
Long Term Care ◽  
Family Members ◽  
Dynamics Simulation ◽  
Term Care ◽  
Adults With Disabilities ◽  
The Impact

This study examined the impact of current and future long-term care (LTC) policies on the family caregiving burden in China. System dynamics (SD) methodology was used to construct an LTC delivery system model that simulates the demand of LTC, living options, and LTC service use for disabled older adults. The model was based on three policy variables including the proportion of payment from LTC insurance, the growth rate of beds in LTC institutions, and the time to adjusting the capacity of community-based care. Results showed that the percentage of older adults with disabilities cared for by family members was projected to increase from 92.6% in 2015 to 97.8% in 2035, assuming no policy changes; under the mixed policy scenario, this percentage would reduce significantly to 63.8% in 2035. These findings illustrate that changes in LTC policy and delivery system have a significant impact on family care.

scholarly journals Perceptions of home in long-term care settings: before and after institutional relocation

2019 ◽  
Vol 40 (6) ◽  
pp. 1267-1290 ◽  
Author(s):  
Mineko Wada ◽  
Sarah L. Canham ◽  
Lupin Battersby ◽  
Judith Sixsmith ◽  
Ryan Woolrych ◽  
...  
Keyword(s):  
Older Adults ◽  
Physical Environment ◽  
Long Term Care ◽  
Family Members ◽  
Structured Interviews ◽  
Term Care ◽  
Before And After ◽  
The Impact ◽  
Sense Of Home

AbstractAlthough moving from institutional to home-like long-term care (LTC) settings can promote and sustain the health and wellbeing of older adults, there has been little research examining how home is perceived by older adults when moving between care settings. A qualitative study was conducted over a two-year period during the relocation of residents and staff from an institutional LTC home to a purpose-built LTC home in Western Canada. The study explored perceptions of home amongst residents, family members and staff. Accordingly, 210 semi-structured interviews were conducted at five time-points with 35 residents, 23 family members and 81 staff. Thematic analyses generated four superordinate themes that are suggestive of how to create and enhance a sense of home in LTC settings: (a) physical environment features; (b) privacy and personalisation; (c) autonomy, choice and flexibility; and (d) connectedness and togetherness. The findings reveal that the physical environment features are foundational for the emergence of social and personal meanings associated with a sense of home, and highlight the impact of care practices on the sense of home when the workplace becomes a home. In addition, tension that arises between providing care and creating a home-like environment in LTC settings is discussed.

Exploring the Relationships Between Families and Staff Caring for Residents in Long-Term Care Facilities: Family Members' Perspectives

2002 ◽  
Vol 21 (1) ◽  
pp. 39-46 ◽  
Author(s):  
James Gladstone ◽  
Evelyn Wexler
Keyword(s):  
Qualitative Study ◽  
Long Term Care ◽  
Participant Observation ◽  
Family Members ◽  
Positive Relationships ◽  
Term Care ◽  
Shared Experiences ◽  
Care Facilities

ABSTRACTThe purpose of this qualitative study was to learn more about the relationships that families develop with staff who work in the facilities in which their relatives live. Data were collected through participant observation in two long-term care facilities and through personal interviews with 61 family members. Five types of relationships emerged from the data, including relationships that were “collegial,” “professional,” “friendship,” “distant,” and “tense”. Several factors appeared to be associated with positive relationships developed between families and staff, including contact with purpose, shared experiences, and issues of trust. Families also reported a number of benefits from developing positive relationships with staff.

scholarly journals Policies for Later-Life Families in a Comparative European Perspective

2020 ◽  
pp. 331-367
Author(s):  
Pearl A. Dykstra ◽  
Maja Djundeva
Keyword(s):  
Long Term Care ◽  
Family Members ◽  
Extended Period ◽  
Later Life ◽  
Publicly Funded ◽  
Term Care ◽  
National Differences ◽  
Cash Benefits ◽  
The Right

AbstractIn this chapter, we consider cross-national differences in policies for later-life families in Europe, focusing on state support freeing family members from caring responsibilities or enabling them to care. These policies come under the umbrella of long-term care (LTC), help required by persons with a reduced degree of functional capacity for an extended period of time. Publicly funded LTC includes “in-kind” services, where care is provided by professionals at home or in an institution, and “cash benefits” which can be used to purchase professional care or which can be paid to informal caregivers as income support. Apart from long-term care for dependents themselves, there are policies supporting family members in their caregiving tasks: “cash for care” (financial compensation for helping those with impairments), “care leaves” (the right to be absent from work in order to care), and “care credits” (time spent on caring that is credited towards a basic pension).

scholarly journals Socioeconomic Inequalities in Home-Care Use Across Regional Long-term Care Systems in Europe

2020 ◽  
Vol 76 (1) ◽  
pp. 121-132 ◽  
Author(s):  
Ginevra Floridi ◽  
Ludovico Carrino ◽  
Karen Glaser
Keyword(s):  
Older Adults ◽  
Home Care ◽  
Fixed Effects ◽  
Long Term Care ◽  
Multilevel Models ◽  
Later Life ◽  
Socioeconomic Inequalities ◽  
Term Care ◽  
Individual Level

Abstract Objectives We examine whether socioeconomic inequalities in home-care use among disabled older adults are related to the contextual characteristics of long-term care (LTC) systems. Specifically, we investigate how wealth and income gradients in the use of informal, formal, and mixed home-care vary according to the degree to which LTC systems offer alternatives to families as the main providers of care (“de-familization”). Method We use survey data from SHARE on disabled older adults from 136 administrative regions in 12 European countries and link them to a regional indicator of de-familization in LTC, measured by the number of available LTC beds in care homes. We use multinomial multilevel models, with and without country fixed-effects, to study home-care use as a function of individual-level and regional-level LTC characteristics. We interact financial wealth and income with the number of LTC beds to assess whether socioeconomic gradients in home-care use differ across regions according to the degree of de-familization in LTC. Results We find robust evidence that socioeconomic status inequalities in the use of mixed-care are lower in more de-familized LTC systems. Poorer people are more likely than the wealthier to combine informal and formal home-care use in regions with more LTC beds. SES inequalities in the exclusive use of informal or formal care do not differ by the level of de-familization. Discussion The results suggest that de-familization in LTC favors the combination of formal and informal home-care among the more socioeconomically disadvantaged, potentially mitigating health inequalities in later life.

Racial and Ethnic Identity of Older Adults Residing in Assisted Living Facilities in Central Florida

2002 ◽  
Vol 3 (4) ◽  
pp. 185-191 ◽  
Author(s):  
Tracy L. Dietz ◽  
James D. Wright
Keyword(s):  
Older Adults ◽  
Social Services ◽  
Assisted Living ◽  
Long Term Care ◽  
Assisted Living Facilities ◽  
Term Care ◽  
Central Florida ◽  
New Methods ◽  
Racial And Ethnic Identity

In response to the growing concern over the provision of long-term care to an ever-expanding older population, new methods of delivering services to older adults are constantly being developed. The development and expansion of long-term care via assisted living facilities (ALFs) is one approach that has proven surprisingly popular all across the nation. Despite the popularity of ALFs, relatively little appears to be known about the residents of these facilities. This article examines the racial and ethnic identities and certain other characteristics of residents in a stratified probability sample of assisted living facilities in central Florida, a region that contains one of the nation’s densest populations of older adults. Fifty-nine facilities serving 1,805 residents were surveyed. Predictably, racial and ethnic minorities were significantly underrepresented among the residents of these facilities. Facilities serving relatively large minority populations were characterized by lower room rates and a larger proportion of beds set aside for Office of Social Services (OSS) residents (i.e., beds funded through state funds or by Medicaid). The general run of these findings suggests that as they have been implemented in central Florida, ALFs may well perpetuate preexisting socioeconomic inequalities among the aged population.

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