scholarly journals Home and Community-Based Services Between the USA and Taiwan

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 349-350
Author(s):  
Su-I Hou ◽  
Xian Cao
Keyword(s):  
Rural Areas ◽  
Informal Caregivers ◽  
Institutional Care ◽  
Community Based ◽  
Funding Sources ◽  
Limited Budget ◽  
The World ◽  
The Usa ◽  
Service Coverage ◽  
Community Based Services

Abstract Home and community-based services (HCBS) are critical to support our rapidly growing and aging population around the world. This paper takes initial steps to compare HCBS between the USA and Taiwan from four perspectives: funding sources, service types, challenges, and recommendations. Peer-reviewed articles and governmental reports (both English and Chinese) in the U.S.A. and Taiwan were reviewed. Analyses showed both countries mainly use tax dollars to fund HCBS. Although both countries have similar service categories, USA lack a clear organization scheme whereas Taiwan has detailed and clear services provisions. Workforce quality and shortage were common challenges for both countries, especially from culture perceptive. Recommendations for USA include expanded funding pool, better coordination between agencies, and rebalancing HCBS and institutional care with limited budget. Recommendations for Taiwan include expanded service coverage and quality to reduce disparity in rural areas, and providing more support for informal caregivers.

scholarly journals Use of Informal Support as a Predictor of Home- and Community-Based Services Utilization

2020 ◽  
Vol 76 (1) ◽  
pp. 133-140
Author(s):  
Kristen N Robinson ◽  
Heather L Menne ◽  
Raphael Gaeta
Keyword(s):  
Older Adults ◽  
Informal Caregivers ◽  
Behavioral Model ◽  
Study Data ◽  
Informal Support ◽  
Health Services Use ◽  
Community Based ◽  
Logistic Regression Models ◽  
Andersen Behavioral Model ◽  
Community Based Services

Abstract Objectives Home- and community-based services (HCBS) help older adults remain living safely in their homes by delaying or preventing the need for institutionalization. This analysis is guided by the Andersen Behavioral Model of Health Services Use to examine the association between informal support and use of HCBS. Method Health and Retirement Study data from 2011 and 2012 are used in the bivariate analyses and multivariate logistic regression models to examine differences in HCBS utilization among extremely vulnerable older adults who have informal caregivers and those who do not. Results For extremely vulnerable older adults who report difficulties with any instrumental or basic activities of daily living, use of HCBS is not strongly associated with access to informal caregivers. However, for this same population of extremely vulnerable older adults, those who live alone have roughly 3 times the odds of using any HCBS compared to those who do not live alone. Discussion Among already vulnerable older adults, this study revealed that living alone is an important enabling factor of the Andersen Behavioral Model as applied in HCBS research. Further investigation is needed to see if more resources should be allocated to senior centers and local providers to identify vulnerable older adults who live alone and may have unmet needs.

DEINSTITUTIONALIZATION OF THE CHILD CARE SYSTEM IN LITHUANIA

2020 ◽  
Vol 11 (4.1) ◽  
pp. 121-131
Author(s):  
Jolanta Pivoriene
Keyword(s):  
Child Care ◽  
Necessary Conditions ◽  
Institutional Care ◽  
Secondary Data ◽  
Community Based ◽  
Political Discourses ◽  
Qualitative Evidence ◽  
To Receive ◽  
Community Based Services ◽  
Care System

The reform of the child care system in Lithuania started with the Ministry of Social Security and Labor approving the Strategic Guidelines for Deinstitutionalization in 2012, followed by the Transition from Institutional Care to Community-Based Services in 2014. The strategic aim of the reform was to create a system including a comprehensive range of services that would enable every child and their family or guardians to receive individual services as well as community assistance according to their needs. The process of transformation of institutional care was designed in two steps: creation of the necessary conditions for the transformation, which took place in 2014 to 2017, and development of infrastructure in the regions, planned for 2017 to 2020, but now extended to 2023. The goal of this article is to discuss the deinstitutionalization process by presenting legal regulations, information about the conceptualization and scope of the project, and evidence based on documents and statistical and secondary data analysis. I will also discuss possible contradictions between analytical and political discourses, and quantitative and qualitative evidence.

Long-Term Services and Supports for Older Adults: A Review of Home and Community-Based Services Versus Institutional Care

2015 ◽  
pp. 150527102958001 ◽  
Author(s):  
Andrea Wysocki ◽  
Mary Butler ◽  
Robert L. Kane ◽  
Rosalie A. Kane ◽  
Tetyana Shippee ◽  
...  
Keyword(s):  
Older Adults ◽  
Institutional Care ◽  
Community Based ◽  
Services And Supports ◽  
Community Based Services

CHANGES OF THE ORGANIZATIONS, PROVIDING SOCIAL SERVICES, IN THE CONTEXT OF DEINSTITUTIONALIZATION

2018 ◽  
Vol 1 ◽  
Author(s):  
Janina Čižikienė ◽  
Audronė Urmanavičienė
Keyword(s):  
Social Services ◽  
Inpatient Care ◽  
Institutional Care ◽  
Developed Countries ◽  
Community Based ◽  
Term Care ◽  
Expert Interview ◽  
The Individual ◽  
Community Based Services

The challenges of globalization are the reason why the EU countries are looking for the ways to make the provision of social services most effective and best fitted to the customer’s needs. In 1960s, deinstitutionalization processes started to take place in many developed countries with the aim to reduce the inpatient care and to develop the community-based services. Deinstitutionalization is replacement of inpatient care with the services that are more in line with the individual interests of each customer. Currently, it is essential in Lithuania, where institutional care is widespread, and the services, provided in the institutions, are ineffective due to their depersonalization, strict procedure, and work with a group of the customers. They are not adapted to individual needs of a person, however, the main services that have no alternatives and are required for long-term care of the persons with intellectual disabilities, mental disorders, and for children, left without parental care, remain. The following research methods were applied: analysis of scientific literature and documents, expert interview, analysis and interpretation of the research results. The review of literature and the research data, presented in the article, reveal the issues of deinstitutionalization process of the organizations, providing social services, as well as the challenges faced in reorganization of children’s care homes.

scholarly journals Spreading Telehealth for Older Adults in Rural Areas Through Network of Geriatric Interprofessional Teams

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 796-796
Author(s):  
Steven Barczi ◽  
Megan Gately ◽  
Lauren Welch ◽  
Kathryn Nearing ◽  
Stephen Thielke ◽  
...  
Keyword(s):  
Older Adults ◽  
Rural Areas ◽  
Urban Areas ◽  
Care Needs ◽  
Community Based ◽  
Team Care ◽  
Geriatric Consultation ◽  
Complex Care Needs ◽  
Nursing Professionals ◽  
Community Based Services

Abstract Older adults living in rural areas have limited access to geriatrics interprofessional team care. In the Veteran healthcare system, geriatric teams such as geriatricians, nursing professionals, social workers, pharmacists and psychologists, located in urban areas link up with rural clinics to provide geriatric consultation remotely through clinical video telehealth and other means in the project GRECC Connect. Since its inception in 2014, the service has now grown to 16 geriatric teams offering consultation to over 100 clinic sites serving older rural Veterans. GRECC Connect delivered over 2,000 consultations in 2019, meeting complex care needs by identifying and linking geriatric services and management to patients with geriatric syndromes. The network of established geriatric teams, local champions and a shared Electronic Health Record facilitated the spread, while ongoing effort to build and maintain relationships between consultants and local rural provider teams and other community based services are important for ongoing success.

Location Matters: Disparities in the Likelihood of Receiving Services in Late Life

2020 ◽  
pp. 009141502094820
Author(s):  
Raven H. Weaver ◽  
Karen A. Roberto
Keyword(s):  
Older Adults ◽  
Service Delivery ◽  
Home Care ◽  
Rural Areas ◽  
Late Life ◽  
Community Based ◽  
Fresh Food ◽  
Delivery Strategies ◽  
To Receive ◽  
Community Based Services

Moving beyond typical dichotomous rural–urban categorizations, this study examines older adults’ likelihood of receiving home- and community-based services. Data from 1608 individuals aged 60+ who requested assistance from Area Agencies on Aging in Virginia in 2014–2015 were analyzed; 88% of individuals received at least one service. Receiving services was associated with geographic-based factors. Individuals living in completely rural areas were significantly less likely to receive any service compared to individuals in mostly rural (OR = 2.46, p = .003) and mostly urban (OR = 1.97, p = .024) areas. There were subtle but significant geographic-based differences in the likelihood of receiving specific services including food/meal, fresh food, information and referral, in-home care, utilities support, and transportation. Findings provide nuanced insights about geographic-based disparities in the receipt of services and suggest the need for new and modified service delivery strategies that maximize older adults’ ability to live.

scholarly journals Promoting social inclusion? The impact of village services on the lives of older people living in rural England

2010 ◽  
Vol 31 (2) ◽  
pp. 243-264 ◽  
Author(s):  
PETER DWYER ◽  
IRENE HARDILL
Keyword(s):  
Rural Areas ◽  
Social Inclusion ◽  
Older Men ◽  
Community Based ◽  
Rural Residents ◽  
Goods And Services ◽  
Meaningful Participation ◽  
The Impact ◽  
Rural England ◽  
Community Based Services

ABSTRACTDrawing on data from a qualitative study, this paper explores the impact of ‘village services’ on the lives of people aged 70 or more years living in rural England. Throughout the paper, the phrase ‘village services’ refers to six community-based services and activities provided to help meet the needs of older rural residents, namely lunch clubs, welfare rights information and advice services, befriending schemes and community warden support, in rural areas in three regions of England. It is argued that, in various ways, village services promote social inclusion by enhancing older rural residents' access to the resources, rights, goods and services that encourage social interaction and meaningful participation in community life. It is clear, however, that the overwhelming majority of users of village services are female, that older men are often reluctant to engage with the services on offer, and that the providers of village services need to find new and innovative ways of engaging with older men in rural areas. It is concluded that restricted revenue and capital resources means that the expansion of village services so that they may better meet the requirements of older rural men is unlikely.

scholarly journals EXPERIENCE OF FORMING OF ENERGY AUTONOMY IN RURAL AREAS: ASSESSING THE ROLE OF COOPERATIVES

2020 ◽  
pp. 23-40
Author(s):  
Inna HONCHARUK
Keyword(s):  
Rural Areas ◽  
Alternative Fuels ◽  
Biogas Production ◽  
Electricity Consumption ◽  
Successful Operation ◽  
Eu Member States ◽  
Rate Of Increase ◽  
The World ◽  
The Usa ◽  
Energy Autonomy

The publication addresses climate change issues caused by fossil fuel emissions. It is established that the rate of increase of the air temperature in Ukraine is ahead of the world tendencies, as a result of which in Ukraine the widespread of droughts, an increase in land areas prone to desertification is probable. The effect of increasing the share of alternative fuels in total energy production on reducing greenhouse gas emissions in the world has been investigated. The volume of electricity consumption by household and non-household consumers and the price increase for them are analyzed; population of Ukraine and employment status of rural population. It is proposed to solve the problems of reducing the burden of payment for energy resources and creating new jobs in rural areas through the creation of energy cooperatives. The concept of "energy cooperative" is defined and economic models of energy cooperatives that can be applied by Ukrainian territorial communities and economic structures to ensure energy autonomy are proposed. The article analyzes the experience of setting up and operating energy cooperatives in the EU Member States, the USA and other countries of the world on the following grounds: field of activity; the form of ownership; sources of financing; social effect and others. Examples of successful operation and emergence of energy cooperatives in Ukrainian communities are provided, which provide energy autonomy for individual agricultural enterprises and community residents through the production of fuel from agricultural and forestry waste; launching a solar or wind power plant that sells electricity to the grid at a “green” rate; biogas production from biomass; production and use of solar water heaters and the like. The author's vision of the main directions of development of economic decarbonisation is formulated.

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