scholarly journals Age-Friendly Online Training Programs for Long-Term Services and Supports Staff to Improve Care for Older Adults

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 532-532
Author(s):  
Linda Edelman ◽  
Kara Dassel
Keyword(s):  
Older Adults ◽  
Rural Communities ◽  
Rural Areas ◽  
Urban Areas ◽  
Online Training ◽  
Team Leadership ◽  
Educational Opportunities ◽  
Opioid Use ◽  
Term Care

Abstract The purpose of our Geriatric Workforce Enhancement Program is to provide geriatric and primary care education and training to long-term care (LTC) providers and staff, health professions students and community members. Our LTC partners and the communities we serve are often very rural and travel to urban areas for training can be difficult. Therefore, we have developed four online training that are offered free to our partners and rural communities statewide. These programs are designed to integrate the aims of the Age-Friendly 4M’s model (i.e., What Matters, Mobility, Medication, Mentation). The LTC nurse residency program provides gerontological nursing and inter-professional leadership training (all 4M’s), in a synchronous online environment. The asynchronous Alzheimer’s Disease and Related Dementias training modules educate LTC staff and family caregivers about types, diagnosis and care of older adults with dementia (Mentation and Medication). The asynchronous Opioid Use in LTC modules were developed with partners to deliver live at LTC staff trainings about opioid stewardship (Medication). The LTC Learning Communities are monthly tele-health sessions for inter-professional LTC teams to discuss current issues and propose solutions (all 4M’s). We have successfully leveraged different synchronous and asynchronous online modalities to increase educational opportunities for formal and informal caregivers, including those in rural areas whose educational opportunities are geographically limited. To date our programs have reached over 500 individuals across our state, increasing knowledge about geriatric concepts, communication and team leadership. Moving forward, we will continue to develop and refine educational programs that promote the Age-Friendly geriatric-focused health care.

Development of a Palliative Care Education Program in Rural Long-Term Care Facilities

2007 ◽  
Vol 23 (3) ◽  
pp. 154-162 ◽  
Author(s):  
Kathy Kortes-Miller ◽  
Sonja Habjan ◽  
Mary Lou Kelley ◽  
Marilyn Fortier
Keyword(s):  
Palliative Care ◽  
Rural Communities ◽  
Rural Areas ◽  
Long Term Care ◽  
Care Homes ◽  
Term Care ◽  
Care Education ◽  
Palliative Care Education ◽  
Age Cohort

In North America, people 85 years and older are the fastest growing age cohort and long-term care homes are increasingly becoming the place of end-of-life care. This is especially true in rural communities where services are lacking. Staff in long-term care homes lack education about palliative care, but in rural areas, accessing education and the lack of relevant curricula are barriers. The focus of this paper is to describe an approach to developing and delivering a research-based palliative care education curriculum in rural long-term care homes. The approach included conducting a detailed assessment of staffs’ educational needs and preferred educational formats; developing a 15-hour interprofessional curriculum tailored to the identified needs; and delivering the curriculum on site in rural long-term care homes. Staff confidence and participation in delivering palliative care increased. Based on work in northwestern Ontario, Canada, this approach can serve as a model for palliative care education in other rural areas.

Current Status of the Long-term Care Security System for Older Adults in China

2020 ◽  
pp. 016402752094911
Author(s):  
Peng Du ◽  
Tingyue Dong ◽  
Jingyao Ji
Keyword(s):  
Older Adults ◽  
Rural Areas ◽  
Service Provision ◽  
Long Term Care ◽  
Care Service ◽  
Security System ◽  
Current Status ◽  
Term Care ◽  
Insurance System

In response to the increasing care demand of older adults and their families, the construction of the long-term care (LTC) security system has been widely recognized by the government, society and families. This article discusses the socio-demographic background, current situation, achievements and issues of this system. The LTC security system in China has achieved considerable progress in enriched service provision and expanded social insurance system pilot programs. However, the issues of unbalanced service provision and the explorative design of the insurance system still need to be resolved. Our recommendations for the development of the LTC security system include comprehensively reviewing the integrated care service system in terms of placing “old adults at the center,” addressing the long-standing divisions between urban and rural areas in service provision and insurance design, advancing research and discussion concerning pilot experiences and improving the unified evaluation and financial planning systems.

Willingness to live in eldercare institutions among older adults in urban and rural China: a nationwide study

2009 ◽  
Vol 30 (4) ◽  
pp. 583-608 ◽  
Author(s):  
RITA JING-ANN CHOU
Keyword(s):  
Older Adults ◽  
Rural Areas ◽  
Filial Piety ◽  
Long Term Care ◽  
Cultural Beliefs ◽  
Institutional Care ◽  
Policy Implications ◽  
Care Needs ◽  
Term Care

ABSTRACTRecent economic development and socio-cultural changes have made it increasingly difficult for Chinese families to provide eldercare. Consequently, institutional care has been strongly promoted to meet older adults' long-term care needs. Although it has been estimated that China needs more beds to meet such needs, unfilled beds have been reported nationwide. One reason for the low occupancy may be a lack of willingness among older adults to live in long-term care institutions. Based on a national survey of 20,255 older adults, this study examined the extent of willingness among older Chinese to live in eldercare institutions, and it was found that in urban and rural areas, only 20 and 17 per cent of older adults, respectively, were willing to do so. Using an integrated theoretical model and logistic regression analyses, this study shows that gender, perceived family harmony, perceived filial piety, socio-cultural beliefs and practices about raising children and eldercare, knowledge and opinion about eldercare institutions, and self-assessed economic status were associated with willingness to live in eldercare institutions for both urban and rural older adults, while other predictors of willingness had different effects. The paper concludes with a discussion of the substantive, theoretical and policy implications for long-term care in China.

scholarly journals Prediction the Contribution Rate of Long-Term Care Insurance for the Aged in China Based on the Balance of Supply and Demand

2020 ◽  
Vol 12 (8) ◽  
pp. 3144 ◽  
Author(s):  
Liangwen Zhang ◽  
Sijia Fu ◽  
Ya Fang
Keyword(s):  
Rural Areas ◽  
Urban Areas ◽  
Long Term Care ◽  
Population Census ◽  
Contribution Rate ◽  
Term Care ◽  
Disabled Elderly ◽  
Long Term Care Insurance ◽  
Per Capita

There are a large number of disabled elderly people in China, which results in huge care and financial burdens to their families and society. However, China has not yet launched a unified long-term care insurance (LTCI) system. This study aims to predict the contribution rate of LTCI in China from 2020 to 2050 based on the long-term care (LTC) cost of the disabled elderly, aged 65 and over, in order to provide strong evidence for the establishment of a unified and sustainable national LTCI system in China. The simulations are based on data from the population census data, the Chinese statistical yearbook, and the Chinese Longitudinal Healthy Longevity Survey (CLHLS) database. Based on the International Labor Organization (ILO) financing model from the perspective of fund balance, an overall simulation model and a Monte Carlo simulation are used to estimate the contribution rate of LTCI for disabled elderly from 2020 to 2050 in China. The total financial demands will increase sharply from 538.0 billion yuan in 2020 to 8530.8 billion yuan in 2050. Of that total, 80.2% will be required in urban areas. In addition, the per capita financial demands of care in urban and rural areas in 2050 will be approximately six times and 11 times higher than in 2020, respectively. The predicted results show that the overall contribution rate of LTCI in China will increase sharply from 1.46% in 2020 to 5.14% in 2050, an increase of about 3.5 times. By comparison, the contribution rate in 2020 will be close to 1.33% in Japan in 2015 and 1.40% in Germany in 2010. According to the 1:1 payment proportion between employer and employee, each side bears 0.68% of the insurance premium. From 2020 to 2050, the financial demands of long-term care for disabled elderly in China will increase, especially in urban areas, and the burden of per capita financial demands in rural areas will increase significantly. The overall contribution rate of LTCI will increase linearly and the payment burden of policyholders will increase year by year. This study provides evidence of the need for the establishment of a sustainable financing mechanism for multiple financial supplies.

Long-Term Care Planning, Preparedness, and Response Among Rural Long-Term Care Providers

2020 ◽  
pp. 1-4
Author(s):  
Tiffany A. Radcliff ◽  
Jennifer A. Horney ◽  
Aram Dobalian ◽  
Blanca O. Macareno ◽  
Umar Y. Kabir ◽  
...  
Keyword(s):  
Rural Communities ◽  
Rural Areas ◽  
Long Term Care ◽  
Local Level ◽  
Federal State ◽  
Care Providers ◽  
Term Care ◽  
State And Local ◽  
Communication And Coordination

Abstract Objective: Rural Long-term Care (LTC) providers face unique challenges when planning, preparing for, and responding to disasters. We sought to better understand challenges and identify best practices for LTC in rural areas. Methods: Case studies including key informant interviews and site visits were conducted with LTC staff and emergency planning, preparedness, and response partners in three rural communities. Themes were identified across sites using inductive coding. Results: Communication across disaster phases continues to be a challenge for LTC providers in rural communities for all disaster types. Communication challenges limit LTC providers’ ability to address patient needs during emergencies and limit the resilience of providers and patients to future disasters. Limited coordination among local leadership and LTC providers prevents dissemination of information, resources, and services, and slows response and recovery time. Including LTC providers as stakeholders in planning and exercises may improve communication and coordination. Conclusion: More than two decades into efforts to increase preparedness of health care systems to all hazards, rural LTC facilities still face challenges related to communication and coordination. Agencies at the federal, state, and local level should include input from rural LTC stakeholders to address gaps in communication and coordination and increase their disaster resilience.

scholarly journals Estimating Long-Term Care Costs among Thai Elderly: A Phichit Province Case Study

2018 ◽  
Vol 2018 ◽  
pp. 1-11 ◽  
Author(s):  
Pattaraporn Khongboon ◽  
Sathirakorn Pongpanich
Keyword(s):  
Informal Care ◽  
Rural Areas ◽  
Urban Areas ◽  
Socioeconomic Development ◽  
Long Term Care ◽  
The Elderly ◽  
Term Care ◽  
Rural And Urban Areas ◽  
Rural And Urban

Background. Rural-urban inequality in long-term care (LTC) services has been increasing alongside rapid socioeconomic development. This study estimates the average spending on LTC services and identifies the factors that influence the use and cost of LTC for the elderly living in urban and rural areas of Thailand. Methods. The sample comprised 837 elderly aged 60 years drawn from rural and urban areas in Phichit Province. Costs were assessed over a 1-month period. Direct costs of caregiving and indirect costs (opportunity cost method) were analyzed. Binary logistic regression was performed to determine which factors affected LTC costs. Results. The total annual LTC spending for rural and urban residents was on average USD 7,285 and USD 7,280.6, respectively. Formal care and informal care comprise the largest share of payments. There was a significant association between rural residents and costs for informal care, day/night care, and home renovation. Conclusions. Even though total LTC expenditures do not seem to vary significantly across rural and urban areas, the fundamental differences between areas need to be recognized. Reorganizing country delivery systems and finding a balance between formal and informal care are alternative solutions.

scholarly journals PREDICTION OF THE NUMBER OF AND CARE COSTS FOR DISABLED OLDER ADULTS FROM 2020 TO 2050 IN URBAN AND RURAL AREAS IN CHINA

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S847-S847
Author(s):  
liangwen zhang ◽  
Ya Fang
Keyword(s):  
Older Adults ◽  
Rural Areas ◽  
Urban Areas ◽  
Census Data ◽  
The Elderly ◽  
Severe Disabilities ◽  
Term Care ◽  
Total Care ◽  
Urban And Rural Areas ◽  
Care Costs

Abstract Disability for the elderly has become a crucial policy concerns in rapidly aging Asia counties, especially in China. This study aimed to predict the trend of the number of and care costs for disabled older adults from 2020 to 2050 in urban and rural areas in China. Population Administration Decision Information System was used to predict the population of China by urban and rural areas and age group from 2020 to 2050. Monte Carlo simulation and Policy Simulation Model were used to estimate the number and care costs of disabled elderly between urban and rural areas, based on the Chinese latest census data, statistical yearbook, and national survey database. The total disabled population rises rapidly from 43.75 million in 2020 to 91.4 million in 2050, of which 69.7% were urban adults. Compared with the values in 2020, the growth rates of the adults with mild, moderate and severe disabilities were 108%, 104% and 120% in 2050, respectively. The value were 167% and 39% in urban and rural areas, respectively. By 2050, the total care costs increase from 538.0 billion yuan in 2020 to 8530.8 billion yuan, of which 80.2% occurs in urban areas. The predicted results indicate that the numbers and care costs for disabled older adults increase sharply from 2020 to 2050, especially in urban areas of China. It provided a series of evidence for the establishment of the long-term care insurance system in China.

scholarly journals Urban–Rural Differences in Long-Term Care Service Status and Needs Among Home-Based Elderly People in China

2020 ◽  
Vol 17 (5) ◽  
pp. 1701
Author(s):  
Liangwen Zhang ◽  
Yanbing Zeng ◽  
Lixia Wang ◽  
Ya Fang
Keyword(s):  
Low Income ◽  
Rural Areas ◽  
Urban Areas ◽  
The Elderly ◽  
Influential Factors ◽  
Term Care ◽  
Home Based ◽  
Urban Rural ◽  
Young Old

Background: Long-term care (LTC) needs for the elderly have become increasingly crucial policy concerns in rapidly aging Asia, especially in China, the most populous nation. However, very few studies have examined the cohort differences in terms of their existing and expected utilization of LTC services, above all urban–rural differences. This study aims to evaluate the differences of LTC current status and needs between urban–rural areas and age groups, and to identify influencing factors causing the different LTC needs. Methods: The data come from the Chinese Longitudinal Health Longevity Survey in 2014. A total of 7192 home-based elderly aged ≥65 years by multistage sampling were enrolled. The Andersen Model was applied to categorize the influential factors into three components including predisposing, enabling and needs. Multivariate logistic regression analysis was used to analyze the influential factors of the three levels of LTC needs. Results: A total of 6909 valid sample sizes were included in this study. The overall LTC needs of the elderly showed a rapidly increasing trend among which older people had the highest needs for bathing (27.29%) and toileting (15.8%). It was also demonstrated the aged cohort between urban and rural exerted an impact on all aspects of LTC status and needs to varying degrees (p < 0.05). Compared with urban areas, the LTC needs for the elderly in rural areas was more vigorous, but the supply was seriously inadequate. The elderly who were older, living in rural areas, unmarried, non-farming, with low income, in poor health and having less autonomy had higher anticipated needs for LTC services (OR > 1, p < 0.01). Compared with the young-old in rural areas, the young-old in urban areas were prone to live alone (OR = 1.61, p < 0.01). The elderly who were older, living in rural areas, farming, with low income, lonely and depressed had higher anticipated needs for community-based services (1 < OR < 1.69, p < 0.05). Conclusions: The aged cohort in urban–rural distinction were facing an increasing need for immediate care due to the inadequate support being provided, especially among rural elderly. The oldest elderly in rural areas had higher LTC needs, and different levels of needs were affected by age, economic level, family support, health status and other related effects. This study provides evidence-based recommendation for further improving the construction and development of the LTC system in China.

scholarly journals Rural and Non-Rural Digital Divide Persists in Older Adults: Internet Access, Usage, and Perception

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 412-413
Author(s):  
Hee Yun Lee ◽  
Eun Young Choi ◽  
Youngsun Kim ◽  
Jessica Neese ◽  
Yan Luo
Keyword(s):  
Older Adults ◽  
Rural Communities ◽  
Digital Divide ◽  
Rural Areas ◽  
Technology Use ◽  
Urban Areas ◽  
Internet Access ◽  
Cross Sectional ◽  
Older Americans ◽  
Comprehensive Plans

Abstract Despite the overall increase in Internet use among older adults, the digital divide within older Americans remains substantial. This trend is particularly true for older adults living in rural areas. Informed by the Social Determinants of Health Framework, our study aims to examine how one’s residential area relates to (1) Internet Access, (2) subtypes of usage patterns, and (3) perceptions on technology use. Cross-sectional data were drawn from the 2012 Health and Retirement Study (HRS). The sample consisted of 18,196 older adults aged 50 and above (47.6% rural residents). A series of linear and logistic regression analyses were performed. Our models controlled for demographic characteristics, socioeconomic status, and health conditions. Compared to older adults living in urban areas, those residing in rural areas had 29% lower odds of internet access. Living in rural areas predicted lower levels of all sub-types of technology use (communication, financial, health, and media technology). In addition, non-users in rural areas showed more unfavorable perceptions of technology than urban residents. They were more likely to conceive technology as “too complicated”, “too hard to learn”, and “too difficult to keep up with all changes.” Our findings suggest that substantial segments of older adults in rural areas are still behind in accessing and adopting digital technology. Targeted intervention efforts are urgently needed to reduce technology inequality including comprehensive plans to expand broadband access and building mobile technology infrastructure for rural communities.

scholarly journals Fostering Continuity of Care for Massachusetts Long-Term Care Residents on Medication for Opioid Use Disorder

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 53-53
Author(s):  
Rosanna Bertrand ◽  
Chiara Moore ◽  
Katherine Fillo ◽  
Katherine Saunders ◽  
Stephanie Baker ◽  
...  
Keyword(s):  
Older Adults ◽  
Best Practices ◽  
Prescription Drugs ◽  
Long Term Care ◽  
Continuum Of Care ◽  
Opioid Use Disorder ◽  
Opioid Use ◽  
Term Care ◽  
The Continuum

Abstract In 2016, the CDC estimated that 2.1 million Americans had Opioid Use Disorder (OUD); about 1.8 million related to prescribed painkillers. Older adults are especially susceptible; SAMHSA estimates that 2.7 million older adults will misuse prescription drugs by 2020. The Massachusetts Department of Public Health (MDPH) issued a 2016 Circular Letter advising long-term care facility (LTCF) administrators that, if otherwise eligible for admission, facilities are expected to admit individuals diagnosed with OUD, and provide medication for OUD (MOUD) as prescribed. Yet, many facilities express concern for admitting residents with OUD. The MDPH and their partners are conducting a multi-faceted training/technical support (TS) program to foster best practices across the continuum of care, targeting LTCF. The 15-month program consists of in-person learning sessions, a comprehensive toolkit, on-site TS, weekly contact, and a peer-to-peer webinar. Pre-training data indicated that 24 of 42 recruited LTCFs had not admitted residents with OUD. Although licensed LTCF practitioners can obtain a waiver to prescribe certain MOUD, only 4 of the 28 LTCF medical directors interviewed had done so. Subject matter experts led topic-specific discussions in the first learning session to educate on OUD/MOUD, dispel myths, make community connections, and provide resources. Almost all participants agreed that the session met the objectives of understanding OUD as a chronic disease, recognizing the stigma of OUD, gaining knowledge of MOUD treatments, and obtaining strategies to enhance best practices across the continuum of care. All items on the pre/post-session assessments indicated a significant increase in understanding (37% versus 60%, respectively).

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