scholarly journals Disparities in the Access to Different Types of Long-Term Care Services in Taiwan

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 705-705
Author(s):  
Ya-Mei Chen ◽  
Yuchi Young ◽  
Shih-Cyuan Wu ◽  
Hsiu-Hsi Chen ◽  
Yen-Po Yeh ◽  
...  
Keyword(s):  
Older Adults ◽  
Healthy Aging ◽  
Service Use ◽  
Long Term Care ◽  
International Comparisons ◽  
Sociodemographic Factors ◽  
Care Plan ◽  
Term Care ◽  
Income Status

Abstract Taiwan implemented version 1.0 of its 10-Year Long-Term Care Plan (TLTCP 1.0) in 2007, and version 2.0 (TLTCP 2.0) in 2017. The aim was to develop a system of home- and community-based services (HCBS) for long-term care (LTC). This study assessed and compared disparities in access to LTC services using one county’s database that claims made by 14,051 older adults who applied for LTC services from TLTCP 1.0 (n = 5,025) and TLTCP 2.0 (n = 9,026). We assessed LTC disparities related to five sociodemographic factors (age, gender, living status, urbanization, income status) and seven types of LTC services. Older adults who lived in a city were more likely to use multiple HCBS and transportation services. Older adults who lived alone were more likely to use home care and meal services but not other types of LTC services. All disparities in service use increased from TLTCP 1.0 to TLTCP 2.0. Part of a symposium sponsored by International Comparisons of Healthy Aging Interest Group.

scholarly journals DISPARITIES IN ACCESSING DIFFERENT TYPES OF LONG-TERM CARE SERVICES IN TAIWAN

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S157-S158
Author(s):  
Ya-Mei Chen ◽  
Shih-Chi Lin ◽  
Hsiao-Wei Yu ◽  
Shwu-Chong Wu ◽  
Shih-Cyuan Wu ◽  
...  
Keyword(s):  
Older Adults ◽  
Low Income ◽  
Long Term Care ◽  
Sociodemographic Factors ◽  
Care Plan ◽  
Claim Database ◽  
Term Care ◽  
Income Status ◽  
Home Based

Abstract A growing body of evidence documents pervasive social and demographic factors relating to disparities in long-term care (LTC). In 2007, Taiwan implemented its Ten-year Long-Term Care Plan version 1.0 (TLTCP 1.0) that aimed to develop a home-and community-based (HCBS) LTC system. In 2016, Taiwan began to implement TLTCP 2.0. To continue providing effective LTC, this study aimed to assess the disparities in access to LTC services using Taiwan’s LTC claim database from 2010 to 2013. A total of 87,438 older adults who had applied for LTC services from the TLTCP 1.0 were included. The study assessed LTC disparities related to five sociodemographic factors, including age, gender, living status, urbanization, and income status. Sixteen types of LTC services, including HCBS, home-based professional care, meal services, transportation, and institutional services were assessed. After controlling for the level of disability, we found that those who were older-old (age 80> over), male, and low-income were less likely to use HCBS, but more likely to use institutions services (p < 0.001). We also found that those who lived in the city were more likely to use HCBS and transportation services (p < 0.001). Yet, older adults living alone were more likely to use home care and meal services but not other types of LTC services (p < 0.001). In conclusion, the social disparities in access to LTC services in Taiwan remains, suggesting LTC 2.0 should continue monitoring and placing the LTC equity issue on the top priority.

scholarly journals Disability and Long-Term Care in Singapore

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 705-705
Author(s):  
Cynthia Chen Huijun ◽  
Ngee Choon Chia
Keyword(s):  
Older Adults ◽  
Older Persons ◽  
Healthy Aging ◽  
Long Term Care ◽  
Population Aging ◽  
International Comparisons ◽  
Term Care ◽  
Life Lessons ◽  
The Impact

Abstract Public systems for long term care (LTC) redistribute resources between generations. Population aging is one of the most significant transformations in the 21st century, where the number of older persons aged 60 years and above is expected to double by 2050, rising to 2.1 billion. We used the Future Elderly Model (FEM) to project the impact of population aging in Singapore up to the year 2050. The FEM is a dynamic economic and demographic microsimulation model. By 2050, the total number of older adults with potential limitation in activities of daily living (ADL) was projected to increase to 275 thousand (18.9%). With the increasing prevalence of disability and chronic diseases, older adults might not have sufficient savings to meet future needs sustainably, despite the expansion of disability insurance from ElderShield to CareShield Life. Lessons and best practices for LTC could be transferred from our experiences to other aging cities globally. Part of a symposium sponsored by International Comparisons of Healthy Aging Interest Group.

scholarly journals EAST MEETS WEST: IMPROVING HEALTH AND LONG-TERM CARE FOR OLDER ADULTS IN THE U.S. AND CHINA

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S243-S244
Author(s):  
Bei Wu ◽  
Jie Hua Lu
Keyword(s):  
Older Adults ◽  
Healthy Aging ◽  
Long Term Care ◽  
Panel Discussion ◽  
Community Dwelling ◽  
Term Care ◽  
Spousal Caregiving ◽  
Pragmatic Clinical Trials ◽  
The U.S

Abstract As the number of older adults in the U.S. and China continues to increase, promoting healthy aging is essential for individuals, family, and society. Both countries face many similar issues due to their aging populations, including prolonging healthy life expectancy and providing quality of care. However, the change in demographics brings with it unique challenges for both the U.S and China. This forum invites scholars and researchers from these two countries to share their knowledge and insights on promoting healthy aging and improving care for older adults. This forum includes five presentations and one-panel discussion. Two presentations will focus on long-term care (LTC) in China, one is to forecast the needs of LTC in the next five decades, and the other is to evaluate the current LTC needs and discuss LTC policy. Using the data from the Health and Retirement Study, the third presentation aims to re-conceptualize spousal caregiving as a dyad-level phenomenon and provides a dynamic view of the spousal caregiving experiences. The last two presentations will focus on promoting healthy aging through clinical interventions. The fourth one is to evaluate the effectiveness of adaptive computer-based cognitive training among community-dwelling older adults in China. The last presentation provides some examples of using pragmatic clinical trials to improve the care of older adults in skilled nursing facilities in the U.S. After the five presentations, the three panelists will provide feedback to the presentations and share their views on healthy aging with the audience.

Long-Term Care for Older Adults in ASEAN Plus Three: The Roles of Family, Community, and the State in Addressing Unmet Eldercare Needs

2018 ◽  
Vol 30 (10) ◽  
pp. 1499-1515 ◽  
Author(s):  
Wei-Jun Jean Yeung ◽  
Leng Leng Thang
Keyword(s):  
Older Adults ◽  
Low Income ◽  
Long Term Care ◽  
Elderly Women ◽  
Unmet Need ◽  
Care Plan ◽  
Cultural Norms ◽  
Term Care ◽  
Home Based

Objective: To introduce this Special Issue that focuses on understanding the issues surrounding the long-term care (LTC) in selected societies in Southeast and East Asian countries. Method: We first provide demographic and socioeconomic context for these countries and then summarize the seven articles in this issue. Results: The articles highlight the rapidly rising demand for LTC in this region in the next few decades given the declining fertility, lengthening life expectancy, and increasing migration. They also discuss challenges and strategies in meeting these demands. Most countries are ill prepared to cope with the demand for LTC with older adults heavily rely upon female family members for care. Elderly women in low-income households have the greatest unmet need. Discussion: Home-based and community-based services are set to become an integral part of the LTC system. It is important to incorporate older adults’ cultural norms and wishes in their care plan and provision.

Association of long-term care utilization and functional ability in older adults

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
K Kyaw
Keyword(s):  
Older Adults ◽  
Functional Ability ◽  
Daily Living ◽  
Healthy Aging ◽  
Long Term Care ◽  
World Health ◽  
Health Priorities ◽  
High Quality ◽  
Term Care

Abstract Background Healthy Ageing is the process of developing and maintaining the functional ability that enables wellbeing in older age as per the World Health Organization (WHO). Establishing foundations necessary for improvements in long-term care (LTC) systems for increasing the world's older adults is one of the public health priorities. LTC provides assisted daily living (ADLs), instrumental assisted daily living (IDALs), healthcare, and social services. This study aims to assess the association of LTC utilization and functional ability in the two industrialized countries with a globalized aging perspective. This study would guide to identify the approaches for establishing fundamentals, developing and sustaining a trained workforce to achieve high-quality, healthy aging. Methods This retrospective longitudinal population-based study, individuals age 65 and above from the national data of the United Kingdom, UK, (English Longitudinal Study of Aging) and the United States, U.S, (Health and Retirement Study). The outcome is LTC: nursing home and home care. Predictors: functional status: scores of ADLs and IADLs, and declining ADLs and IADLs. Covariates are age, gender, marital status, income, chronic diseases. Multiple logistic regression analysis was carried out in SAS software version 9.4, p-vale (p) <0.05. Results LTC utilization (UK) is associated with declining IADLs (OR: 15.01, 95%CI: 1.62,139.23), p- 0.02 with adjustments for covariates. LTC utilization (U.S) is associated with declining ADLs (OR: 2.66, 95%CI:1.82,3.87) and IADLs (OR: 2.42, 95%CI:1.73,3.40), both at p-<0.001. With adjustment for covariates, LTC utilization (U.S) is associated with declining ADLs (OR: 2.20,95%CI:1.51,3.22), p-0.001 and declining IADLs (OR: 2.12, 95%CI:1.49,3.02), p-<0.001. Conclusions Declining functional ability is associated with LTC utilization. This study guide to improve LTC systems to develop personalized social and healthcare foundations, increase the trained workforce. Key messages To demonstrate the long-term care (LTC) utilization by declining functional capacity in the UK and the US older adults to a better understanding of the distribution of LTC utilization between them. To guide developing approaches in the improving long-term care system to achieve high-quality, healthy aging through evidence findings of this national study.

Uitbraak COVID-19 in de verpleeghuiszorg

2020 ◽  
Keyword(s):  
Older Adults ◽  
Nursing Home ◽  
Nursing Homes ◽  
Long Term Care ◽  
Informal Caregivers ◽  
Rapid Review ◽  
Daily Routine ◽  
Term Care ◽  
Care Facilities

Long-term care for older adults is highly affect by the COVID-19 outbreak. The objective of this rapid review is to understand what we can learn from previous crises or disasters worldwide to optimize the care for older adults in long term care facilities during the outbreak of COVID-19. We searched five electronic databases to identify potentially relevant articles. In total, 23 articles were included in this study. Based on the articles, it appeared that nursing homes benefit from preparing for the situation as best as they can. For instance, by having proper protocols and clear division of tasks and collaboration within the organization. In addition, it is helpful for nursing homes to collaborate closely with other healthcare organizations, general practitioners, informal caregivers and local authorities. It is recommended that nursing homes pay attention to capacity and employability of staff and that they support or relieve staff where possible. With regard to care for the older adults, it is important that staff tries to find a new daily routine in the care for residents as soon as possible. Some practical tips were found on how to communicate with people who have dementia. Furthermore, behavior of people with dementia may change during a crisis. We found tips for staff how to respond and act upon behavior change. After the COVID-19 outbreak, aftercare for staff, residents, and informal caregivers is essential to timely detect psychosocial problems. The consideration between, on the one hand, acute safety and risk reduction (e.g. by closing residential care facilities and isolating residents), and on the other hand, the psychosocial consequences for residents and staff, were discussed in case of other disasters. Furthermore, the search of how to provide good (palliative) care and to maintain quality of life for older adults who suffer from COVID-19 is also of concern to nursing home organizations. In the included articles, the perspective of older adults, informal caregivers and staff is often lacking. Especially the experiences of older adults, informal caregivers, and nursing home staff with the care for older adults in the current situation, are important in formulating lessons about how to act before, during and after the coronacrisis. This may further enhance person-centered care, even in times of crisis. Therefore, we recommend to study these experiences in future research.

scholarly journals Frailty and hospitalization-associated disability after pneumonia: A prospective cohort study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Chan Mi Park ◽  
Wonsock Kim ◽  
Hye Chang Rhim ◽  
Eun Sik Lee ◽  
Jong Hun Kim ◽  
...  
Keyword(s):  
Older Adults ◽  
Primary Outcome ◽  
Long Term Care ◽  
Functional Decline ◽  
Tube Feeding ◽  
Term Care ◽  
Pneumonia Severity ◽  
Frailty Assessment ◽  
Nasogastric Tube Feeding

Abstract Background Pneumonia is a major cause of morbidity and mortality in older adults. The role of frailty assessment in older adults with pneumonia is not well defined. Our purpose of the study was to investigate 30-day clinical course and functional outcomes of pneumonia in older adults with different levels of frailty. Methods A prospective cohort was conducted at a university hospital in Seoul, Korea with 176 patients who were 65 years or older and hospitalized with pneumonia. A 50-item deficit-accumulation frailty index (FI) (range: 0–1; robust < 0.15, pre-frail 0.15–0.24, mild-to-moderately frail 0.25–0.44, and severely frail ≥ 0.45) and the pneumonia severity CURB-65 score (range: 0–5) were measured. Primary outcome was death or functional decline, defined as worsening dependencies in 21 daily activities and physical tasks in 30 days. Secondary outcomes were intensive care unit admission, psychoactive drug use, nasogastric tube feeding, prolonged hospitalization (length of stay > 15 days), and discharge to a long-term care institution. Results The population had a median age 79 (interquartile range, 75–84) years, 68 (38.6 %) female, and 45 (25.5 %) robust, 36 (47.4 %) pre-frail, 37 (21.0 %) mild-to-moderately frail, and 58 (33.0 %) severely frail patients. After adjusting for age, sex, and CURB-65, the risk of primary outcome for increasing frailty categories was 46.7 %, 61.1 %, 83.8 %, and 86.2 %, respectively (p = 0.014). The risk was higher in patients with frailty (FI ≥ 0.25) than without (FI < 0.25) among those with CURB-65 0–2 points (75 % vs. 52 %; p = 0.022) and among those with CURB-65 3–5 points (93 % vs. 65 %; p = 0.007). In addition, patients with greater frailty were more likely to require nasogastric tube feeding (robust vs. severe frailty: 13.9 % vs. 60.3 %) and prolonged hospitalization (18.2 % vs. 50.9 %) and discharge to a long-term care institution (4.4 % vs. 59.3 %) (p < 0.05 for all). Rates of intensive care unit admission and psychoactive drug use were similar. Conclusions Older adults with frailty experience high rates of death or functional decline in 30 days of pneumonia hospitalization, regardless of the pneumonia severity. These results underscore the importance of frailty assessment in the acute care setting.

Older Adults Diagnosed With Schizophrenia in Long-term Care Facilities: Life Course Theory for Holistic Nursing Research and Practice

2021 ◽  
pp. 089801012110253
Author(s):  
Verónica G. Walker ◽  
Elizabeth K. Walker
Keyword(s):  
Older Adults ◽  
Life Course ◽  
Health Beliefs ◽  
Long Term Care ◽  
Life Course Theory ◽  
Nursing Research ◽  
Term Care ◽  
Holistic Nursing ◽  
Care Facilities

Older adults diagnosed with schizophrenia (OADWS) often enter long-term care facilities with unique challenges related to trauma and stress experienced throughout their life course. Health care workers often report that when they work with this population, they feel unprepared due to limited training. In this article, life course theory is presented as a lens for holistic nursing research and as a way for nurses to adapt interventions already used with cognitively impaired older adults (e.g., those diagnosed with Alzheimer's disease) for OADWS in long-term care. It is hoped that these ideas will facilitate discussion of ways to inform training for holistic long-term care of OADWS. Holistic principles of nursing addressed with life course theory as a lens include the following: (a) accounting for strengths and challenges; (b) honoring experiences, values, and health beliefs; (c) viewing interrelationships with the environment; and (d) nurturing of peace, wholeness, and healing.

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