scholarly journals The Challenges Faced By Long-Term Care Residents and Their Families During COVID-19

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 450-451
Author(s):  
Liat Ayalon ◽  
Sharon Avidor
Keyword(s):  
Older Adults ◽  
Decision Making ◽  
Long Term Care ◽  
Qualitative Interviews ◽  
Family Members ◽  
Term Care ◽  
Protective Measures ◽  
Routine Treatment

Abstract The present research aims to examine the effects of protective measures due to the coronavirus disease (COVID-19) within long-term care (LTC) settings on the residents and their family members. Open-ended qualitative interviews were conducted with 14 family members of older adults who resided in LTC settings during the first wave of the pandemic in Israel. The first theme identified is Rupture, including physical disconnect; the disruption in routine treatment to residents; and decline in the satisfaction with the setting. The second theme is Response, including sharing viewpoints and involvement in decision making, as well as an intense ambivalence shared by family members. Our findings highlight the distress caused to residents and family members by the isolation and restrictions in LTC settings during the pandemic, and underscore values and priorities that are central to them and their family members, including maintaining continuity, transparency, and working in unison with their families.

scholarly journals “I Didn’t Meet My Mother; I Saw My Mother”: The Challenges Facing Long-Term Care Residents and Their Families in the Age of COVID-19

2021 ◽  
pp. 073346482110370
Author(s):  
Sharon Avidor ◽  
Liat Ayalon
Keyword(s):  
Older Adults ◽  
Decision Making ◽  
Long Term Care ◽  
Qualitative Interviews ◽  
Family Members ◽  
Term Care ◽  
Protective Measures ◽  
Routine Treatment

The present research examines the effects of protective measures due to the coronavirus disease 2019 (COVID-19) pandemic within long-term care (LTC) settings on residents and their family members. Open-ended qualitative interviews were conducted with 14 family members of older adults who resided in LTC settings during the first wave of the pandemic in Israel. The first theme identified is Rupture, including the physical disconnect; the disruption in routine treatment to residents; and decline in the satisfaction with the setting. The second theme is Response, including sharing viewpoints and involvement in decision-making, as well as an intense ambivalence shared by family members. Our findings highlight the distress caused to residents and family members by the isolation and restrictions in LTC settings during the pandemic and underscore values and priorities that are central to them and their family members, including maintaining continuity, transparency, and working in unison with their families, staff, and management.

scholarly journals Development and Field Testing of a Long-Term Care Decision Aid Website for Older Adults: Engaging Patients and Caregivers in User-Centered Design

2019 ◽  
Vol 60 (5) ◽  
pp. 935-946 ◽  
Author(s):  
Aubri S Hoffman ◽  
Daniel R Bateman ◽  
Craig Ganoe ◽  
Sukdith Punjasthitkul ◽  
Amar K Das ◽  
...  
Keyword(s):  
Older Adults ◽  
Decision Making ◽  
Decision Aid ◽  
Long Term Care ◽  
Action Plan ◽  
Family Members ◽  
Field Testing ◽  
Decisional Conflict ◽  
Term Care

Abstract Background and Objectives Decisions about long-term care and financing can be difficult to comprehend, consider, and communicate. In a previous needs assessment, families in rural areas requested a patient-facing website; however, questions arose about the acceptability of an online tool for older adults. This study engaged older adults and family caregivers in (a) designing and refining an interactive, tailored decision aid website, and (b) field testing its utility, feasibility, and acceptability. Research Design and Methods Based on formative work, the research team engaged families in designing and iteratively revising paper drafts, then programmed a tailored website. The field test used the ThinkAloud approach and pre-/postquestionnaires to assess participants’ knowledge, decisional conflict, usage, and acceptability ratings. Results Forty-five older adults, family members, and stakeholders codesigned and tested the decision aid, yielding four decision-making steps: Get the Facts, What Matters Most, Consider Your Resources, and Make an Action Plan. User-based design and iterative storyboarding enhanced the content, personal decision-making activities, and user-generated resources. Field-testing participants scored 83.3% correct on knowledge items and reported moderate/low decisional conflict. All (100%) were able to use the website, spent an average of 26.3 min, and provided an average 87.5% acceptability rating. Discussion and Implications A decision aid website can educate and support older adults and their family members in beginning a long-term care plan. Codesign and in-depth interviews improved usability, and lessons learned may guide the development of other aging decision aid websites.

scholarly journals Attitudes Toward Sexual Behaviors in Long-Term Care: Development of an Assessment Tool

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 602-603
Author(s):  
Rachael Spalding ◽  
Emma Katz ◽  
Barry Edelstein
Keyword(s):  
Sexual Behaviors ◽  
Long Term Care ◽  
Assessment Tool ◽  
Qualitative Interviews ◽  
Family Members ◽  
Community Dwelling ◽  
Term Care ◽  
Care Development

Abstract Most older adults living in long-term care settings (LTCs) indicate that expressing their sexuality is important to them (Doll, 2013). Little is known about the general public’s attitudes towards sexual behaviors in LTCs. Attitudes of LTC residents’ family members are particularly important, as family members are most likely to visit residents and to care about their quality of life. Family members’ attitudes could in turn inform facility policies and management. We will present preliminary data from a series of qualitative interviews with community-dwelling adults regarding their attitudes. We will discuss how these data are being used to inform current work on a measure of attitudes toward sexual behavior in LTCs.

scholarly journals The Decision-Making and Communication Capacities of Older Adults with Dementia: A Population-Based Study

2014 ◽  
Vol 8 (1) ◽  
pp. 17-24 ◽  
Author(s):  
Kazuko Mitoku ◽  
Setsu Shimanouchi
Keyword(s):  
Older Adults ◽  
Decision Making ◽  
Long Term Care ◽  
Population Based ◽  
Term Care ◽  
Daily Lives ◽  
People With Dementia ◽  
Decision Making Capacity ◽  
One Year

The present study assessed the decision-making and communication capacities of older adults with dementia who required assistance and care and measured the subsequent changes in these capacities. Of 845 older adults who received long-term care between April 2003 and December 2004, about half of them without dementia were excluded and the remaining 448 were finally included in the analyses. These individuals were completed follow-up for assessment for two years. The data were obtained from the Long-Term Care Insurance Certification Committee for Eligibility in Gujo City. A total of 73.7% of people with dementia were somewhat capable of making decisions (32.4% were reported as being “always capable”; 41.3% were reported as being “sometimes capable”). A total of 93.7% were somewhat capable of communicating with others (78.3% were reported as being “always capable”; 15.4% were reported as being “sometimes capable”). The results indicate that older adults with dementia can participate in their own care decisions, even if they require assistance and support in their daily lives. The present study shows, however, that baseline decision-making capacity declined to about half what they were after one year and to about one-third of what they were after two years, suggesting that earlier efforts are needed to ensure that the preferences of individuals with dementia are reflected in their care.

scholarly journals Maybe She’ll Make Some Friends?: Family Members Cultivating Intimacy in Assisted Living

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 486-487
Author(s):  
Andrea Fitzroy ◽  
Candace Kemp ◽  
Elisabeth Burgess
Keyword(s):  
Older Adults ◽  
Assisted Living ◽  
Intimate Relationships ◽  
Long Term Care ◽  
Participant Observation ◽  
Family Members ◽  
Later Life ◽  
Theory Approach ◽  
Term Care

Abstract Intimacy continues to be important in later life, including for older adults in long-term care settings such as assisted living (AL). Our past work shows that intimacy is a multi-dimensional process and can involve a variety of partners. Drawing on data from the qualitative longitudinal “Convoys of Care” study (R01AG044368), we extend this research to examine the role family members play in cultivating intimacy and close relationships of AL residents. Using a grounded theory approach, we analyzed 2,224 hours of participant observation, and formal interviews with 28 assisted living residents (aged 58-96) and their formal and informal care partners (n=114) from four diverse AL communities. Findings show that family members can play integral roles in residents’ experiences with intimacy, directly as relationship partners, and by facilitating or impeding residents’ contacts with others. Family members cultivated residents’ intimacy opportunities and experiences by direct engagement, resident advocacy, to non-involvement and disengagement. Family members’ roles in cultivating intimacy fluctuated over time, increasing at times of health concerns and family change. Perceptive family members considered older adults’ intimacy preferences when cultivating their intimate relationships. Family members concerned for the safety of their loved one sometimes acted as “gatekeepers” to intimacy by interfering in intimate relationships. We conclude with a discussion of implications for policy and practice aimed at improving the intimacy process and opportunities for older adults receiving long-term care.

scholarly journals Intimacy for older adults in long-term care: a need, a right, a privilege—or a kind of care?

2021 ◽  
pp. medethics-2020-107171
Author(s):  
Vanessa Schouten ◽  
Mark Henrickson ◽  
Catherine M Cook ◽  
Sandra McDonald ◽  
Nilo Atefi
Keyword(s):  
Older Adults ◽  
Long Term Care ◽  
Family Members ◽  
Well Being ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Term Care ◽  
Survey Tool ◽  
Whole Person

BackgroundTo investigate attitudes of staff, residents and family members in long-term care towards sex and intimacy among older adults, specifically the extent to which they conceptualise sex and intimacy as a need, a right, a privilege or as a component of overall well-being.MethodsThe present study was a part of a two-arm mixed-methods cross-sectional study using a concurrent triangulation design. A validated survey tool was developed; 433 staff surveys were collected from 35 facilities across the country. Interviews were conducted with 75 staff, residents and family members.ResultsIt was common for staff, residents and family members to talk about intimacy and sexuality in terms of rights and needs. As well as using the language of needs and rights, it was common for participants to use terms related to well-being, such as fun, happiness or being miserable. One participant in particular (a staff member) described receiving intimate touch as a ‘kind of care’—a particularly useful way of framing the conversation.ConclusionWhile staff, residents and family frequently used the familiar language of needs and rights to discuss access to intimate touch, they also used the language of well-being and care. Reframing the conversation in this way serves a useful purpose: it shifts the focus from simply meeting minimum obligations to a salutogenic approach—one that focuses on caring for the whole person in order to improve overall well-being and quality of life.

Factors related to the decision-making for moving the older adults into long-term care facilities in Taiwan

2016 ◽  
Vol 17 (9) ◽  
pp. 1319-1327 ◽  
Author(s):  
Yen-Ping Hsieh ◽  
Ying-Chia Huang ◽  
Shou-Jen Lan ◽  
Ching-Sung Ho
Keyword(s):  
Older Adults ◽  
Decision Making ◽  
Long Term Care ◽  
Term Care ◽  
Care Facilities

The Impact of Long-Term Care Policy on the Percentage of Older Adults With Disabilities Cared for by Family Members in China: A System Dynamics Simulation

2020 ◽  
pp. 016402752092356
Author(s):  
Rong Peng ◽  
Bei Wu
Keyword(s):  
Older Adults ◽  
System Dynamics ◽  
Delivery System ◽  
Long Term Care ◽  
Family Members ◽  
Dynamics Simulation ◽  
Term Care ◽  
Adults With Disabilities ◽  
The Impact

This study examined the impact of current and future long-term care (LTC) policies on the family caregiving burden in China. System dynamics (SD) methodology was used to construct an LTC delivery system model that simulates the demand of LTC, living options, and LTC service use for disabled older adults. The model was based on three policy variables including the proportion of payment from LTC insurance, the growth rate of beds in LTC institutions, and the time to adjusting the capacity of community-based care. Results showed that the percentage of older adults with disabilities cared for by family members was projected to increase from 92.6% in 2015 to 97.8% in 2035, assuming no policy changes; under the mixed policy scenario, this percentage would reduce significantly to 63.8% in 2035. These findings illustrate that changes in LTC policy and delivery system have a significant impact on family care.

scholarly journals Perceptions of home in long-term care settings: before and after institutional relocation

2019 ◽  
Vol 40 (6) ◽  
pp. 1267-1290 ◽  
Author(s):  
Mineko Wada ◽  
Sarah L. Canham ◽  
Lupin Battersby ◽  
Judith Sixsmith ◽  
Ryan Woolrych ◽  
...  
Keyword(s):  
Older Adults ◽  
Physical Environment ◽  
Long Term Care ◽  
Family Members ◽  
Structured Interviews ◽  
Term Care ◽  
Before And After ◽  
The Impact ◽  
Sense Of Home

AbstractAlthough moving from institutional to home-like long-term care (LTC) settings can promote and sustain the health and wellbeing of older adults, there has been little research examining how home is perceived by older adults when moving between care settings. A qualitative study was conducted over a two-year period during the relocation of residents and staff from an institutional LTC home to a purpose-built LTC home in Western Canada. The study explored perceptions of home amongst residents, family members and staff. Accordingly, 210 semi-structured interviews were conducted at five time-points with 35 residents, 23 family members and 81 staff. Thematic analyses generated four superordinate themes that are suggestive of how to create and enhance a sense of home in LTC settings: (a) physical environment features; (b) privacy and personalisation; (c) autonomy, choice and flexibility; and (d) connectedness and togetherness. The findings reveal that the physical environment features are foundational for the emergence of social and personal meanings associated with a sense of home, and highlight the impact of care practices on the sense of home when the workplace becomes a home. In addition, tension that arises between providing care and creating a home-like environment in LTC settings is discussed.

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