scholarly journals East Meets West: Home and Community Based Care to Enhance Aging in Place

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 384-384
Author(s):  
Takashi Amano ◽  
Megumi Inoue
Keyword(s):  
Older People ◽  
Home Health Care ◽  
Aging In Place ◽  
National Policy ◽  
The United States ◽  
Management Program ◽  
Community Based ◽  
Wide Range ◽  
Common Goals ◽  
Policy Priority

Abstract Although the magnitude and rate of aging in Japan and the United States differ, the drastic change in population structure has resulted in common challenges in both countries. One challenge is assisting older people in staying in the community. Enhancement of home- and community-based care allows older people to remain in their homes or spaces of their choice without moving into an institution to receive necessary care. This symposium includes four presentations (two from Japan and two from the U.S.) examining various efforts surrounding home- and community-based care designed to strengthen older people’s abilities to stay in the community. The presenters will cover a wide range of strategies that have been implemented in both countries. The first presenter will describe the development and delivery of a project to expand Arizona’s dementia capable system. The second presenter will describe initiatives of a professional association of geriatrics to promote the concept of aging in place. The third presenter will discuss the Home Hazard Removal Program (HARP), a new home hazard removal and fall risk self-management program delivered in the home by occupational therapists. The fourth presenter will discuss Japan’s national policy priority of promoting the use of home health care within the community-based integrated care system. The symposium will conclude with a review of similarities and differences of various efforts, summarize common goals and challenges, and identify best practices.

Dent Management Program

2004 ◽  
Author(s):  
Jackie McCoy ◽  
Scott Ironside
Keyword(s):  
The United States ◽  
Management Program ◽  
Assessment Model ◽  
Third Party ◽  
Time To Failure ◽  
Pipe Material ◽  
Engineering Analysis ◽  
Wide Range ◽  
History Of ◽  
Project Lead

Enbridge Pipelines Inc. owns and operates the world’s longest hydrocarbon transmission system, which traverses across the varying geophysical landforms of Canada and the United States. These pipelines range in diameter from 12” to 48” and were constructed between 1950 and 2003. The wide range of pipe sizes, practices used for construction, and landforms traversed result in a very challenging Dent Management Program. Standards such as CSA Z662-99, ASME B31.4, and B31.8 provide a criterion for the selection of dents that require repair. Experience has shown that these standards do not identify all dents that have a possibility of failure due to leak or rupture. Enbridge initiated a project to study dents with BMT Fleet Technology of Kanata Ontario, this study determined that the dent geometry in addition to the depth to pipe diameter ratio affects the propensity that a dent will fail. Recent research and development by a group sponsored project lead by BMT Fleet technology on dent characterization has combined the pipeline’s cyclic pressure history with the shape of the dent to predict a time to failure. Enbridge combines these tools along with new insights from field excavations into its Dent Management Program. The Dent Management Program includes a series of prioritization’s to determine which sections of pipelines require detailed dent analysis. Typical prioritization criteria are rocky terrain, larger occurrence of third party damage, and history of numerous dents or failures. The detailed analysis utilizes the BMT Fleet “Dent Characterization Criteria” which was developed using their Finite Element Dent Assessment Model. This model considers the geometry of the dent, pipe material properties and historical pressure data to predict a time to failure for each dent. This time to failure prediction requires some additional engineering analysis depending on how close the parameters of the actual pipe are to what was validated with the model. This engineering analysis will determine which dents are selected for excavation and examination. This model has provided Enbridge with a tool to better manage its dent program, and this will be proposed as an option to improve the existing standards.

Implementation of Quantitative Risk Assessment: Case Study

2014 ◽  
Author(s):  
David Mangold ◽  
W. Kent Muhlbauer ◽  
Jim Ponder ◽  
Tony Alfano
Keyword(s):  
Risk Assessment ◽  
Decision Making ◽  
Risk Management ◽  
The United States ◽  
Management Program ◽  
Quantitative Risk Assessment ◽  
Management Decision ◽  
Classical Statistics ◽  
Wide Range

Risk management of pipelines is a complex challenge due to the dynamic environment of the real world coupled with a wide range of system types installed over many decades. Various methods of risk assessment are currently being used in industry, many of which utilize relative scoring. These assessments are often not designed for the new integrity management program (IMP) requirements and are under direct challenge by regulators. SemGroup had historically used relative risk assessment methodologies to help support risk management decision-making. While the formality offered by these early methods provided benefits, it was recognized that, in order to more effectively manage risk and better meet the United States IMP objectives, a more effective risk assessment would be needed. A rapid and inexpensive migration into a better risk assessment platform was sought. The platform needed to be applicable not only to pipeline miles, but also to station facilities and all related components. The risk results had to be readily understandable and scalable, capturing risks from ‘trap to trap’ in addition to risks accompanying each segment. The solution appeared in the form a quantitative risk assessment that was ‘physics based’ rather than the classical statistics based QRA. This paper will outline the steps involved in this transition process and show how quantitative risk assessment may be efficiently implemented to better guide integrity decision-making, illustrated with a case study from SemGroup.

Collier County, Florida: Consideration of Gasification as a Long-Term Waste Management Solution

2003 ◽  
Author(s):  
Stephen C. Schwarz ◽  
Daniel E. Dietch
Keyword(s):  
Waste Management ◽  
Solid Waste ◽  
Evaluation Process ◽  
The United States ◽  
Management Program ◽  
Waste To Energy ◽  
Current Status ◽  
Collier County ◽  
Wide Range

Collier County, Florida (“County”) is in the midst of developing an integrated waste management program. Unlike many counties, Collier County owns a landfill with sufficient long-term landfill capacity to last another 15 years. However, due to the Board of County Commissioner’s (“Board”) desire to have a 50-year solution for solid waste, the County has set upon a course to divert waste from the landfill to the maximum extent possible. In doing so, the County solicited long-term waste management solutions from private companies capable of processing the majority of the municipal solid waste generated in the County. Over the past two years, the County has considered several of these alternatives ranging from MSW composting to mass-burn waste-to-energy; however, based on an evaluation of a wide range of impacts, gasification was selected as the preferred alternative. With this focus, the County issued a Request for Proposal (“RFP”) in November 2001 for a design, build, own, operate, and finance gasification project. The County received three proposals in April 2002 in response to the RFP. To date, the County has completed the proposal evaluation process and has ranked the top two responsive firms: Interstate Waste Technologies (“IWT”) and Brightstar Environmental (Florida), LLC (“Brightstar”) based on experience, technical approach, business arrangement, and cost. If implemented, this project will be the only commercial gasification project operating in the United States. This paper will provide insight into various stages of the project, from development through to the current status of the project, as well as the strategic policy, financial, and technical considerations that make this opportunity a good fit for the County. An emphasis will also be placed on comparing and contrasting the benefits and drawbacks of each technology, such as processing methodology, cost, redundancy, and scalability.

National and International Adaptations of the Children’s Aid Society Model

2005 ◽  
Author(s):  
Janice Chu-Zhu
Keyword(s):  
New York ◽  
Technical Assistance ◽  
The United States ◽  
Culturally Sensitive ◽  
Community Schools ◽  
Community Based ◽  
Program Fidelity ◽  
Wide Range ◽  
Core Components ◽  
The One

When the CAS community schools first opened in New York City in 1992, they attracted many visitors interested in learning about and adapting our model. In response CAS created its National Technical Assistance Center for Community Schools (NTACCS) in 1994 to handle the increasing number of requests for information, coordinate the large number of visitors to the schools, and provide technical assistance in the process and operations involved in creating a community school. People who wish to adapt our model can now tour the various components of our program and meet with our staff to ask questions and learn about the implementation of our program. This chapter will explore the core components of the CAS model and how adaptation sites in the United States and other countries have been able to incorporate elements that represent their signature style and reflect the needs of their individual communities. An immediate dilemma occurs when program planners seek to learn from the experience of others—should they try to replicate the model precisely or should they try to adapt it to their own local circumstances? Replicators often speak of the importance of “program fidelity,” while adaptors talk about differing needs among various communities and populations. The National Institute of Mental Health (NIMH) astutely assesses the dilemma: “While individual tailoring may account for success at a given location, there is pressing need for theoretically grounded interventions that will be effective in a wide range of communities. Therein lies a challenge. On the one hand, ‘replication’ implies fidelity to the original while, on the other hand, ‘community-based and culturally sensitive’ implies expectation of variation and sensitivity to that variation. The need to vary interventions is widely accepted, but systematically developed and articulated only occasionally.” The NIMH study found two key components that improved the effectiveness of HIV prevention programs as they were implemented in multiple sites around the country. One component was that they were “community-based,” designed with the input and skills of the particular communities in which they were implemented. The second was that the programs were “culturally sensitive”—that is, they reflected the needs and cultures of the individuals expected to participate in the intervention and used media and messages relevant to those individuals and their lives.

Community-dwelling older adults' perceptions of dignity: core meanings, challenges, supports and opportunities

2013 ◽  
Vol 34 (8) ◽  
pp. 1292-1313 ◽  
Author(s):  
KATHY BLACK ◽  
DEBRA DOBBS
Keyword(s):  
Older Adults ◽  
Older People ◽  
The United States ◽  
Community Dwelling ◽  
Health Issues ◽  
Policy And Practice ◽  
Community Based ◽  
Self Identity ◽  
Community Dwelling Older Adults

ABSTRACTDignity is a universally important issue for all people, and particularly vital for older adults who face multiple losses associated with ageing. In the United States of America and beyond, the maintenance of dignity is a key aim of policy and service provision for older people. Yet surprisingly little research has been conducted into the meaning of dignity to community-based older adults in the context of everyday life. As life expectancy continues to increase worldwide, unprecedented numbers of people are living longer than ever before. The majority of older adults will face declining health and other factors that may impact dignity in the course of ageing in their communities. This paper reports on a study that explored older people's understandings and experiences of dignity through focus groups and a survey. Three key components of dignity are identified: autonomy, relational and self-identity. In addition, the paper discusses a range of factors that can facilitate or inhibit a sense of dignity for older people, including long-term health issues, sensory deficits and resilience to life events. Finally, the implications of these findings for policy and practice are considered in the context of American social structures and values.

scholarly journals The Uncertain Bodies and Spaces of Aging in Place

2013 ◽  
Vol 34 (3) ◽  
pp. 113-125 ◽  
Author(s):  
Lauren Penney
Keyword(s):  
Older Adults ◽  
Home Health Care ◽  
Aging In Place ◽  
Daily Practice ◽  
Chronically Ill ◽  
The United States ◽  
Home Health ◽  
Work Processes ◽  
Home Health Nurses ◽  
Household Members

In the United States, “aging in place” has been established as the preferred method of aging. This article examines the work, processes, and tensions involved in aging in place in the southwest US, focusing on the experiences of chronically ill older adults receiving Medicare-reimbursed home health care. Based on an in depth ethnography, it  examines the resources and work that go into aging in place amid uncertainty, and highlights how processes related to the integration of person and place are negotiated and contested between older adults, family members, and home health nurses. Drawing on definitions of place from geography, I argue that aging in place should be understood using a processual lens to highlight the ways that health regimes aimed at facilitating aging in place can, at times, reinforce and introduce sense of bodily risk, shift embodiment and daily practice, and require negotiations among household members. I also point to the difficulties people face in maintaining aging in place when supports are lacking and futures uncertain.

scholarly journals Re-Envisioning Aging in the Right Place to Disrupt Homelessness for Older People

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 292-292
Author(s):  
Rachel Weldrick ◽  
Sarah Canham ◽  
Joyce Weil
Keyword(s):  
Older People ◽  
Older Persons ◽  
Assessment Tool ◽  
Service Providers ◽  
Aging In Place ◽  
Policy And Practice ◽  
Housing Programs ◽  
Wide Range ◽  
Recent Developments ◽  
The Right

Abstract Recent developments in the aging-in-place literature have recognized the significance of aging-in-the-right-place. That is, aging in a place that supports an individual’s unique values, vulnerabilities, and lifestyles. This symposium will build upon existing research by critically examining the potential for older persons with experiences of homelessness (OPEH) and/or housing insecurity to age-in-the-right-place. Presenters will include interdisciplinary researchers with a diversity of perspectives stemming from gerontology, social work, and environmental design. The symposium will begin with Weldrick and Canham presenting a conceptual framework for aging-in-the-right-place that has been developed to outline indicators relevant to OPEH and housing-insecure older people. Elkes and Mahmood will then discuss findings from a study of service providers working with OPEH to consider the relative benefits and challenges of temporary housing programs. Following, Brais and colleagues will present findings from an environmental audit, developed as a novel assessment tool to evaluate the accessibility and physical design of housing programs for OPEH. A final presentation by Kaushik and Walsh will highlight findings from a photovoice study on perspectives of aging-in-the-right place among OPEH during the Covid-19 pandemic. Joyce Weil, an expert in measurement of person-place fit and life course inequalities, will discuss the implications of these papers and reflect on the potential for the aging-in-the-right-place framework to address the diverse needs of the growing population of OPEH through policy and practice. Together, the participants of the symposium will advance this emerging scholarship using a wide range of methods and perspectives.

scholarly journals Article Commentary: The interRAI Pediatric Home Care (PEDS HC) Assessment: Evaluating the Long-term Community-Based Service and Support Needs of Children Facing Special Healthcare Challenges

2015 ◽  
Vol 8 ◽  
pp. HSI.S30775 ◽  
Author(s):  
Charles D. Phillips ◽  
Catherine Hawes
Keyword(s):  
Home Care ◽  
The United States ◽  
Case Managers ◽  
Support Needs ◽  
Assessment Instruments ◽  
Community Based ◽  
Wide Range ◽  
Services And Supports ◽  
Age Range

The vast majority of assessment instruments developed to assess children facing special healthcare challenges were constructed to assess children within a limited age range or children who face specific conditions or impairments. In contrast, the interRAI Pediatric Home Care (PEDS HC) Assessment Form was specifically designed to assess the long-term community-based service and support needs of children and youth aged from four to 20 years who face a wide range of chronic physical or behavioral health challenges. Initial research indicates that PEDS HC items exhibit good predictive validity–-explaining significant proportions of the variance in parents’ perceptions of needs, case managers’ service authorizations, and Medicaid program expenditures for long-term community-based services and supports. In addition, PEDS HC items have been used to construct scales that summarize the strengths and needs of children facing special healthcare challenges. Versions of the PEDS HC are now being used in Medicaid programs in three states in the United States.

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