scholarly journals Lessons Learned in Research to Address Wicked Problems Facing the Care of Older Adults Across the Care Continuum

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 699-699
Author(s):  
Debra Dobbs ◽  
Sheryl Zimmerman
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Wicked Problems ◽  
Lessons Learned ◽  
Wicked Problem ◽  
Future Research ◽  
Unexpected Finding ◽  
Term Care ◽  
Care Continuum

Abstract A wicked problem, by definition, has innumerable causes, is tough to describe, and doesn’t necessarily have a right answer. This describes today’s health care for older adults across the long-term care continuum. Our interdisciplinary group has almost as many years (n=70) of experience as GSA conducting research in community-based groups across the continuum of care from skilled nursing facilities, assisted living communities, adult day care, to independent living. In this symposium we will discuss lessons learned in recruitment, intervention delivery, and unexpected outcomes. Peterson will discuss lessons learned in using large data sets to derive actionable information on staff license mix and SNF complaints. Dobbs will discuss the utility of using hospice nurses to train ALC nurses in delivering palliative care. Lee will discuss lessons in engaging direct care workers in their need for sleep. Meng will discuss learning to embrace an unexpected finding that friendships developed in a dementia family caregiver music and mindfulness intervention were as meaningful as positive health outcomes. Buck will discuss lessons learned in recruiting a hidden group – informal caregivers with complicated grief. Finally, Zimmerman, as expert long-term services and support discussant, will pull the pieces together across the studies to facilitate discussion. Enrich your future research related to addressing wicked problems in health care for older adults by learning from our experiences.

scholarly journals Person-Centered Health Care: An Approach That Integrates Acute and Long-Term Care

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 704-704
Author(s):  
Yuchi Young ◽  
Barbara Resnick
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Health Systems ◽  
Long Term Care ◽  
The United States ◽  
World Population ◽  
Term Care ◽  
The Usa ◽  
Aged Society

Abstract The world population is aging. The proportion of the population over 60 will nearly double from 12% in 2015 to 22% in 2050. Global life expectancy has more than doubled from 31 years in 1900 to 72.6 years in 2019. The need for long-term care (LTC) services is expanding with the same rapidity. A comprehensive response is needed to address the needs of older adults. Learning from health systems in other countries enables health systems to incorporate best long-term care practices to fit each country and its culture. This symposium aims to compare long-term care policies and services in Taiwan, Singapore, and the USA where significant growth in aging populations is evidenced. In 2025, the aging population will be 20% in Taiwan, 20% in Singapore and 18 % in the USA. In the case of Taiwan, it has moved from aging society status to aged society, and to super-aged society in 27 years. Such accelerated rate of aging in Taiwan is unparalleled when compared to European countries and the United States. In response to this dramatic change, Taiwan has passed long-term care legislation that expands services to care for older adults, and developed person-centered health care that integrates acute and long-term care services. Some preliminary results related to access, care and patterns of utilization will be shared in the symposium. International Comparisons of Healthy Aging Interest Group Sponsored Symposium.

scholarly journals Places of living and places of dying: the case for preventing suicide in residential long-term care

2020 ◽  
pp. 1-16
Author(s):  
Briony Jain ◽  
Viktoryia Kalesnikava ◽  
Joseph E. Ibrahim ◽  
Briana Mezuk
Keyword(s):  
Older Adults ◽  
Suicide Prevention ◽  
Residential Care ◽  
Long Term Care ◽  
Public Health Problem ◽  
Future Research ◽  
Term Care ◽  
The Impact ◽  
Residential Long Term Care

Abstract This commentary addresses the increasing public health problem of suicide in later life and presents the case for preventing suicide in residential long-term care settings. We do so by examining this issue from the perspective of three levels of stakeholders – societal, organisational and individual – considering the relevant context, barriers and implications of each. We begin by discussing contemporary societal perspectives of ageing; the potential impact of ageism on prevention of late-life suicide; and the roles of gender and masculinity. This is followed by a historical analysis of the origin of residential long-term care; current organisational challenges; and person-centred care as a suicide prevention strategy. Finally, we consider suicide in long-term care from the perspective of individuals, including the experience of older adults living in residential care settings; the impact of suicide on residential care health professionals and other staff; and the impact of suicide bereavement on family, friends and other residents. We conclude with recommendations for policy reform and future research. This commentary aims to confront the often unspoken bias associated with preventing suicide among older adults, particularly those living with complex medical conditions, and invoke an open dialogue about suicide prevention in this population and setting.

Long-Term Care Diversity within the Care Continuum

1995 ◽  
Vol 14 (2) ◽  
pp. 245-262 ◽  
Author(s):  
Betty Havens
Keyword(s):  
Health Care ◽  
Long Term Care ◽  
Term Care ◽  
Care Continuum ◽  
Current State ◽  
Future System ◽  
Canadian Health ◽  
Canadian Health Care ◽  
Dynamic Series

ABSTRACTLong-term care spans a broad range of very diverse services and a pivotal location within the overall continuum of health and health care. Changes in one component of care affect and are affected by all other components as health care may be characterized as a dynamic series of interdependent processes and persons. The current state of Canadian health care, in general, and long-term care, in particular, demands the skilful juggling of universality and diversity to maximize both these characteristics without sacrificing either. In an atmosphere of reform and fiscal restructuring, the organizational, utilization and financing implications for this system on a tightrope are substantial. The challenges are of major proportions in maintaining a balance while securing a future system that is efficient, efficacious, equitable, effective and empowering.

A SHARP Response: Developing COVID-19 Research Aims in Partnership with the Seniors Helping as Research Partners (SHARP) Group

2021 ◽  
pp. 1-8
Author(s):  
Jacobi Elliott ◽  
Alexandra Whate ◽  
Heather McNeil ◽  
Alison Kernoghan ◽  
Paul Stolee ◽  
...  
Keyword(s):  
Older Adults ◽  
Long Term Care ◽  
Community Care ◽  
Future Research ◽  
Policy Planning ◽  
Term Care ◽  
Care Services ◽  
Home And Community Care ◽  
Research And Policy

Abstract COVID-19 has disproportionally impacted older adults, and has highlighted many issues, including extreme deficiencies in Canadian long-term care homes and gaps in home and community care services for older adults. In recent years, there has been a push towards better patient and family engagement in health system research, and with the onset of the pandemic, engaging older adults in research and policy planning is more important than ever. In this article, we describe the Seniors Helping as Research Partners (SHARP) approach to engagement with older adults as an example of how partnerships that engage older adults in the development of research aims and processes can help to ensure that future research meets the needs of older adults. SHARP members highlighted a number of areas for future COVID-19 research such as improvements to long-term care, enhancing access to home and community care, and a focus on aging and social isolation.

Pay-for-Performance and Long-Term Care

2019 ◽  
Author(s):  
Jun Li ◽  
Edward C. Norton
Keyword(s):  
Health Care ◽  
Acute Care ◽  
Long Term Care ◽  
Pay For Performance ◽  
Care Delivery ◽  
The United States ◽  
Future Research ◽  
Care Providers ◽  
Term Care

Pay-for-performance programs have become a prominent supply-side intervention to improve quality and decrease spending in health care, touching upon long-term care, acute care, and outpatient care. Pay-for-performance directly targets long-term care, with programs in nursing homes and home health. Indirectly, pay-for-performance programs targeting acute care settings affect clinical practice for long-term care providers through incentives for collaboration across settings. As a whole, pay-for-performance programs entail the identification of problems it seeks to solve, measurement of the dimensions it seeks to incentivize, methods to combine and translate performance to incentives, and application of the incentives to reward performance. For the long-term care population, pay-for-performance programs must also heed the unique challenges specific to the sector, such as patients with complex health needs and distinct health trajectories, and be structured to recognize the challenges of incentivizing performance improvement when there are multiple providers and payers involved in the care delivery. Although empirical results indicate modest effectiveness of pay-for-performance in long-term care on improving targeted measures, some research has provided more clarity on the role of pay-for-performance design on the output of the programs, highlighting room for future research. Further, because health care is interconnected, the indirect effects of pay-for-performance programs on long-term care is an underexplored topic. As the scope of pay-for-performance in long-term care expands, both within the United States and internationally, pay-for-performance offers ample opportunities for future research.

scholarly journals PALLIATIVE AND END-OF-LIFE CARE TO THE LGBT COMMUNITY

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S623-S623
Author(s):  
Gary L Stein ◽  
Cathy Berkman
Keyword(s):  
Older Adults ◽  
Health Care ◽  
End Of Life ◽  
End Of Life Care ◽  
Care Providers ◽  
Term Care ◽  
The Us ◽  
Lgbt Community ◽  
And Gender

Abstract The lesbian, gay, bisexual, and transgender (LGBT) community experiences discrimination and stigma in accessing health care and social services – including palliative, hospice, and long-term care – across cultures and countries. Health care providers may fail to recognize, acknowledge or address disparities in care. Providers and institutions may be uncomfortable with gender and sexuality issues, and often fail to inquire about sexual orientation and gender identity. It is estimated that there are approximately 2.7 million LGBT adults in the U.S. age 50 and older and approximately 1.1 million age 65 and older. In the UK, an estimated 5-7% of the population identify as LGBT; there are between 600,000 and 840,000 LGBT adults aged 65+. With the projected increased number of older adults and improved treatments that extend the life of seriously ill individuals, even greater numbers of LGBT older adults, and their families, will require palliative and end-of-life in the coming years. Researchers in the US and UK have found that LGBT older adults living in the community and in long-term care facilities experience inadequate, disrespectful, and abusive care due to their sexual orientation and gender identity status. They fear being open about their identities, not receiving equal or safe treatment, and having their family of choice and designated surrogates disrespected or ignored by health care staff. This symposium will describe the experiences of LGBT individuals and their family members, and compare commonalities and differences faced by LGBT communities in the US and UK in accessing palliative and end-of-life care.

scholarly journals Position Statement for Mental Health Care in Long-Term Care During COVID-19

2021 ◽  
Vol 24 (4) ◽  
pp. 367-372
Author(s):  
Claire Checkland ◽  
Sophiya Benjamin ◽  
Marie-Andrée Bruneau ◽  
Antonia Cappella ◽  
Beverley Cassidy ◽  
...  
Keyword(s):  
Mental Health ◽  
Older Adults ◽  
Health Care ◽  
Mental Health Care ◽  
Long Term Care ◽  
Systems Of Care ◽  
Position Statement ◽  
Mental Health Needs ◽  
Term Care

COVID-19 has disproportionately impacted older adults in long-term care (LTC) facilities in Canada. There are opportunities to learn from this crisis and to improve systems of care in order to ensure that older adults in LTC enjoy their right to the highest attainable standard of health. Measures are needed to ensure the mental health of older adults in LTC during COVID-19. The Canadian Academy of Geriatric Psychiatry (CAGP) and Canadian Coalition for Seniors’ Mental Health (CCSMH) have developed the following position statements to address the mental health needs of older adults in LTC facilities, their family members, and LTC staff. We outlined eight key considerations related to mental health care in LTC during COVID-19 to optimize the mental health of this vulnerable population during the pandemic. 

Strategic partnerships enhance resources for care of rural-dwelling older adults

2018 ◽  
Vol 19 (4) ◽  
pp. 242-250
Author(s):  
Lyn M. Holley ◽  
Christopher M. Kelly ◽  
Jerome Deichert ◽  
Silvester Juanes ◽  
Loretta Wolf
Keyword(s):  
Older Adults ◽  
Quality Of Care ◽  
Long Term Care ◽  
Care Facility ◽  
Future Research ◽  
Term Care ◽  
Content Type ◽  
Residential Long Term Care

Purpose The purpose of this paper is to disseminate a new model that addresses the urgent social challenge of providing adequate long-term care in rural circumstances through innovative use of existing resources, and to suggest future research. Design/methodology/approach This paper is exploratory in and is based upon the analysis of qualitative observations (interviews and site visits) framed in the financial and operational records of the facility studied, macro- and micro-level demographics, and the scholarly and practice literatures. Findings Significant cost savings upon implementation, improvements in quality of care and both worker and client satisfaction were observed. Research limitations/implications The model has been in operation only one year; the trend has been positive, however, more research is needed to identify its stability and develop a more refined description of its components: while essential features of this innovative model can be applied in any residential long-term care situation, replicating its success is obviously linked with the skill and authority of the director. Evaluation research is currently in progress. Practical implications The paper suggests budget-neutral solutions to persistent challenges of caring for older adults in rural circumstances. Social implications Quality and financing of long-term residential care for elders is insufficient and worsening. This model addresses problems central to financing and quality of care by connecting existing resources in new ways. It does not require additional funding or changes in qualifications required for jobs. Originality/value The model is the original creation of a residential long-term care facility director working with a network of partnerships that he discovered and developed: partnerships include a broad range of organizations in the public and non-profit sectors, and the state university.

Sign in / Sign up

Export Citation Format

Share Document