scholarly journals Paid Care Services and Transitioning Out of the Community among Diverse Older Adults with Dementia

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 955-955
Author(s):  
Maria Roche-Dean ◽  
Sol Baik ◽  
Heehyul Moon ◽  
Norma Coe ◽  
Anna Oh ◽  
...  
Keyword(s):  
Older Adults ◽  
Racial Differences ◽  
Future Research ◽  
Care Needs ◽  
Term Care ◽  
Subdistribution Hazard ◽  
Care Services ◽  
Home Based ◽  
Care Assistance ◽  
Using Data

Abstract Objectives Paid care provided in the home or through community organizations includes important support services for older adults with dementia such as cleaning and personal care assistance. These services could delay the transition to long-term care, but access may differ across sociodemographic groups. This study examined the relationship between paid care and transitioning out of the community among diverse older adults with dementia. Methods Using data from 303 participants (29.4% Black) with probable dementia in the National Health and Aging Trends Study (2011-2019), subdistribution hazard models estimated the association between receiving paid care at baseline and the probability of transitioning out of the community over the next eight years. Covariate selection was guided by the Andersen model of healthcare utilization. Results Paid care was associated with lower risk of transitioning out of the community (SHR = 0.70, 95% CI [0.50, 0.98]). This effect was similar after controlling for predisposing factors and most prominent after controlling for enabling and need for services factors (SHR = 0.63, 95% CI [0.42, 0.94]) and was only evident among Whites. There were no racial differences in the use of paid care, but Black participants were less likely to transition out of the community than Whites despite evidencing greater care needs. Discussion Paid care services may help delay transitions out of the community. Future research should seek to explain racial differences in access to and/or preferences for home-based, community-based, and residential care.

scholarly journals Longitudinal Follow-Up of Long-Term Care Planning Using PlanYourLifespan.org

2020 ◽  
pp. 073346482094306
Author(s):  
Vanessa Ramirez-Zohfeld ◽  
Anne Seltzer ◽  
Ana Ramirez ◽  
Ruqayyah Muhammad ◽  
Lee A. Lindquist
Keyword(s):  
Older Adults ◽  
Long Term Care ◽  
Long Term Effects ◽  
Care Needs ◽  
Term Care ◽  
User Perceptions ◽  
Care Plans ◽  
Age In Place ◽  
Care Services

Many older adults wish to age-in-place but do not have long-term care plans for when they may require more assistance. PlanYourLifespan.org (PYL) is an evidence-based tool that helps older adults understand and plan for their long-term care needs. We examined the long-term effects of PYL use on user perceptions and planning of long-term care services. Individuals who previously accessed PYL were invited to complete an online, nation-wide mixed methodology survey about end-user outcomes related to PYL. Among 115 completed surveys, users found PYL helpful with long-term planning for their future needs. Over half of website users reported having conversations with others because of PYL use. However, 40% of respondents reported not having a conversation with others about their plans; common themes for barriers to planning included procrastination and a lack of immediate support needs. Although PYL helps with planning, many people are still not communicating their long-term care plans.

scholarly journals Assisted Living Care for Special Populations

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 676-676
Author(s):  
Philip Sloane ◽  
Sheryl Zimmerman
Keyword(s):  
Older Adults ◽  
Mental Illness ◽  
Serious Mental Illness ◽  
Assisted Living ◽  
Sleep Disturbances ◽  
Future Research ◽  
Care Needs ◽  
Term Care ◽  
State Study ◽  
Hospice Use

Abstract Assisted living (AL) is a notable provider of residential long-term care for older adults; there are almost twice as many AL communities as nursing homes, and they provide care to more than 800,000 older adults. As AL has evolved, it has come to serve more individuals with cognitive, mental, and health care needs. For example, 70% of residents have sleep disturbances, 42% have moderate/severe dementia, and mortality rates average 14% annually. Care needs include those for behaviors such as agitation, serious mental illness, and at the end-of-life. However, not all AL communities provide similar care. This symposium will use national data and data from a seven state study of 250 AL communities to focus on four populations receiving care in AL: persons with dementia, serious mental illness, sleep disturbances, and on hospice. The first speaker will discuss how AL staff conceive of and respond to behavioral expressions of persons with dementia; the second will focus on the use of psychosocial/environmental practices for persons with dementia in AL. The third speaker will discuss the growing proportion of persons with serious mental illness in AL and related implications for care. The fourth presenter will address the high use of melatonin in AL, as well as resident- and community-level correlates of melatonin prescribing. The final speaker will examine hospice use in AL and how it varies based on community characteristics. These findings related to care and care needs for four key populations have important implications for practice, policy, and future research.

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.

scholarly journals Population with Long-Term Care Needs in Six Latin American Countries: Estimation of Older Adults Who Need Help Performing ADLs

2021 ◽  
Vol 18 (15) ◽  
pp. 7935
Author(s):  
Mauricio Matus-Lopez ◽  
Alexander Chaverri-Carvajal
Keyword(s):  
Older Adults ◽  
Activities Of Daily Living ◽  
Latin American ◽  
Daily Living ◽  
Long Term Care ◽  
Care Needs ◽  
Term Care ◽  
Care Services ◽  
Latin American Countries

The population in Latin America is ageing, and there is an inevitable demand for long-term care services. However, there are no comparative analyses between Latin American countries of the dependency situation of older adults. This study aims to calculate and compare percentages of older adults who need help performing the activities of daily living in six Latin American nations. The study is observational, transversal, and cross-national and uses microdata drawn from national surveys conducted in Argentina (n = 3291), Brazil (n = 3903), Chile (n = 31,667), Colombia (n = 17,134), Mexico (n = 7909), and Uruguay (n = 4042). Comparable indicators of the need for help in performing the basic and instrumental activities of daily living were calculated. The percentages of older adults in need of help for basic activities of daily living ranged from 5.8% in Argentina to 11% in Brazil; for instrumental activities of daily living, from 13.8% in Mexico to 35.7% in Brazil; and combined, from 18.1% in Argentina to 37.1% in Brazil. Brazil thus has the highest indicators, followed by Colombia. The results warn of the frail physical condition of older people and the high potential demand for long-term care services. The information provided could be useful for further research on and planning for long-term care needs in Latin American and middle-income countries.

scholarly journals The Needs of Older Adults With Disabilities With Regard to Adaptation to Aging and Home Care: Questionnaire Study (Preprint)

2019 ◽  
Author(s):  
Laiyou Li ◽  
Ning Sun ◽  
Libo Yu ◽  
Xiaoxin Dong ◽  
Jing Zhao ◽  
...  
Keyword(s):  
Older Adults ◽  
Home Environment ◽  
Healthy Aging ◽  
Scientific Basis ◽  
Care Needs ◽  
Adults With Disabilities ◽  
Care Services ◽  
Home Based ◽  
Important Means ◽  
Home Based Care

BACKGROUND The home environment is an important means of support in home-based care services for older people. A home environment that facilitates healthy aging can help older adults maximize their self-care abilities and integrate and utilize care resources. However, some home environments fail to meet the needs of older adults with disabilities. OBJECTIVE This paper aimed to study the needs of older adults with disabilities with respect to adaptation to aging, and to analyze the associations of individual factors and dysfunction with those needs. METHODS A questionnaire survey was administered to 400 older adults with disabilities from 10 communities in Ningbo City, Zhejiang Province, China. The survey was conducted from August 2018 to February 2019. RESULTS A total of 370 participants completed the survey. The proportion of participants with mild dysfunction was the highest (128/370, 34.59%), followed by those with extremely mild (107/370, 28.92%), moderate (72/370, 19.46%), and severe (63/370, 17.03%) dysfunction. The care needs of older adults with extremely mild and mild dysfunction pertained primarily to resting, a supportive environment, and transformation of indoor activity spaces. The care needs of older adults with moderate dysfunction pertained mainly to resting and renovation of bathing and toilet spaces. Factors influencing the needs of older adults with disabilities were dysfunction (<i>P</i>=.007), age (<i>P</i>=.006), monthly income (<i>P</i>=.005), and living conditions (<i>P</i>=.04). CONCLUSIONS The needs of older adults with disabilities varied by the degree of dysfunction, and many factors influenced these needs in the community. These findings may provide a scientific basis for developing community-specific aging-related adaptation services for older adults with disabilities in the future.

scholarly journals The Needs of Older Adults With Disabilities With Regard to Adaptation to Aging and Home Care: Questionnaire Study

10.2196/16012 ◽  
2020 ◽  
Vol 7 (2) ◽  
pp. e16012
Author(s):  
Laiyou Li ◽  
Ning Sun ◽  
Libo Yu ◽  
Xiaoxin Dong ◽  
Jing Zhao ◽  
...  
Keyword(s):  
Older Adults ◽  
Home Environment ◽  
Healthy Aging ◽  
Scientific Basis ◽  
Care Needs ◽  
Adults With Disabilities ◽  
Care Services ◽  
Home Based ◽  
Important Means ◽  
Home Based Care

Background The home environment is an important means of support in home-based care services for older people. A home environment that facilitates healthy aging can help older adults maximize their self-care abilities and integrate and utilize care resources. However, some home environments fail to meet the needs of older adults with disabilities. Objective This paper aimed to study the needs of older adults with disabilities with respect to adaptation to aging, and to analyze the associations of individual factors and dysfunction with those needs. Methods A questionnaire survey was administered to 400 older adults with disabilities from 10 communities in Ningbo City, Zhejiang Province, China. The survey was conducted from August 2018 to February 2019. Results A total of 370 participants completed the survey. The proportion of participants with mild dysfunction was the highest (128/370, 34.59%), followed by those with extremely mild (107/370, 28.92%), moderate (72/370, 19.46%), and severe (63/370, 17.03%) dysfunction. The care needs of older adults with extremely mild and mild dysfunction pertained primarily to resting, a supportive environment, and transformation of indoor activity spaces. The care needs of older adults with moderate dysfunction pertained mainly to resting and renovation of bathing and toilet spaces. Factors influencing the needs of older adults with disabilities were dysfunction (P=.007), age (P=.006), monthly income (P=.005), and living conditions (P=.04). Conclusions The needs of older adults with disabilities varied by the degree of dysfunction, and many factors influenced these needs in the community. These findings may provide a scientific basis for developing community-specific aging-related adaptation services for older adults with disabilities in the future.

scholarly journals Student-Led Fall Prevention Care Management Reduced Fall Risks at Assisted Living Facilities

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 238-238
Author(s):  
Hiroko Kiyoshi-Teo ◽  
Claire McKinley-Yoder ◽  
Erin Lemon ◽  
Olivia Ochoa
Keyword(s):  
Older Adults ◽  
Assisted Living ◽  
Fall Prevention ◽  
Fall Risk ◽  
Care Management ◽  
Assisted Living Facilities ◽  
Care Needs ◽  
Term Care ◽  
Fall Risks ◽  
The Impact

Abstract Older adults in residential care settings are four times more likely than those not living in care facilities to experience falls. Yet, fall prevention efforts at long-term care settings are under-resourced, under-regulated, and under-studied. To address this gap, we developed and studied the impact of a specialty clinical, Fall Prevention Care Management (FPCM), for nursing students to decrease older adults’ fall risks. We enrolled assisted living residents that facility liaison identified as being high fall risk (fall rates or fall risk were not tracked at the study sites) and MOCA ≥15, in 2 assisted living facilities in Northwest USA. Participants received weekly, 1-hour, individual, semi-structured, Motivational Interviewing-based care management visits by same students over 6 visits. Changes in fall risks were measured by the CDC STEADI assessment (unsteadiness & worry), Falls Self-Efficacy Scale International-Short (FESI-S), and Falls Behavioral Scale (FAB). Twenty-five residents completed the study. Students addressed the following (multiple responses possible): emotional needs (n=23), improved motivation to prevent falls (n=21), and individualized education/coaching (i.e., exercise, mobility aids) (n=10-17). FESI-S score improved from 16.0 to 14.4 (p=.001; decreased fear. FAB score improved from 2.94 to 3.10 (p=.05; more frequent fall prevention behaviors). Frequency of those who felt steady while standing or walking increased (24% to 40%, p=.07) and those who did not worry about falling increased (20% to 36%, p=.08). FPCM clinical offered valuable opportunity to address unmet care needs of older adults to reduce fall risks.

Child care needs of parents in paid work: An interpretation of findings from Australia's Welfare 1993: Services and Assistance

1995 ◽  
Vol 20 (2) ◽  
pp. 10-13
Author(s):  
Graeme Vaughan
Keyword(s):  
Child Care ◽  
Informal Support ◽  
Care Needs ◽  
Work Arrangements ◽  
Care Services ◽  
Paid Employment ◽  
Formal Services ◽  
Using Data ◽  
Australian Bureau Of Statistics ◽  
High Level

The extent to which the child care needs of parents in paid employment are adequately met is an important matter. This paper examines the issue using data published in the recent report from the Australian Institute of Health and Welfare, Australia's Welfare 1993: Services and Assistance. Data from recent surveys by the Australian Bureau of Statistics are used to supplement the report's findings.While families with both parents or the sole parent in paid employment are the major users of formal child care services many of them continue to experience difficulties in obtaining child care that meets their needs. Many of these families need to arrange their domestic and working lives to care for children within the family or rely on informal support by other family members, friends and neighbours. Many adopt a mix of strategies-formal services, informal support and flexible work arrangements-to meet their child care needs. These families show a high level of unmet demand for formal services; mothers in these families experience difficulties in balancing the competing demands of caring for children and paid employment.

scholarly journals Prevalence and Risk Factors of Postprandial Hypotension Among Japanese Older Adults in a Facility

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 222-222
Author(s):  
Noriko Suzuki ◽  
Masahiko Hashizume ◽  
Hideyuki Shiotani
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Older Adults ◽  
Older People ◽  
Future Research ◽  
Baseline Body Mass Index ◽  
Term Care ◽  
Postprandial Hypotension ◽  
Before And After ◽  
Japanese Older Adults

Abstract Postprandial hypotension (PPH) is an unrecognized sudden drop of blood pressure (BP) after meals and a hidden problem among older people including those living in long-term care facilities (LTCFs). Though PPH causes dizziness, falls, and syncope, it has received little attention from¬¬¬ healthcare workers (HCW) including caregivers, nurses and physicians, and risk factors of PPH should be carefully assessed to improve quality of life. Therefore, we aimed to examine the prevalence and risk factors of PPH in a LTCF in Japan. Participants were 114 older adults living in a LTCF in Japan (mean age 85.9 years old; 85 female (74%)). To examine PPH, blood pressure (BP) was measured before and after lunch. BP after meal was measured four times every 30 minutes. PPH is defined as a BP drop of 20 mmHg or more and we also defined a BP drop within a range of 19 to 15 mmHg as potential-PPH. As risk factors, we compared systolic and diastolic BP at baseline, body mass index, pulse rate, disease and complications between groups with/without PPH. The prevalence of PPH was 41% (47/114) and 52% with potential-PPH; 11% (13/114) added. Among risk factors, systolic BP was significantly higher in those with PPH (142.6 vs 123.5 mmHg, p &lt;0.001). This study revealed that PPH & potential-PPH occurred in half of the subjects in a LTCF in Japan. HCW need to focus on high systolic BP to predict PPH and future research is necessary to prevent and cope with PPH for older people.

scholarly journals Coprescribing of Benzodiazepines and Opioids in Older Adults: Rates, Correlates, and National Trends

2018 ◽  
Vol 74 (12) ◽  
pp. 1910-1915 ◽  
Author(s):  
Taeho Greg Rhee
Keyword(s):  
Older Adults ◽  
Future Research ◽  
Physician Visits ◽  
Prescribing Trends ◽  
Clinical Diagnoses ◽  
Nationally Representative ◽  
Using Data ◽  
National Trends ◽  
Ambulatory Medical Care ◽  
Over Time

Abstract Background To estimate prescribing trends of and correlates independently associated with coprescribing of benzodiazepines and opioids among adults aged 65 years or older in office-based outpatient visits. Methods I examined a nationally representative sample of office-based physician visits by older adults between 2006 and 2015 (n = 109,149 unweighted) using data from the National Ambulatory Medical Care Surveys (NAMCS). National rates and prescribing trends were estimated. Then, I used multivariable logistic regression analyses to identify demographic and clinical factors associated with coprescriptions of benzodiazepines and opioids. Results From 2006 to 2015, 15,954 (14.6%) out of 109,149 visits, representative of 39.3 million visits nationally, listed benzodiazepine, opioid, or both medications prescribed. The rate of prescription benzodiazepines only increased monotonically from 4.8% in 2006–2007 to 6.2% in 2014–2015 (p < .001), and the rate of prescription opioids only increased monotonically from 5.9% in 2006–2007 to 10.0% in 2014–2015 (p < .001). The coprescribing rate of benzodiazepines and opioids increased over time from 1.1% in 2006–2007 to 2.7% in 2014–2015 (p < .001). Correlates independently associated with a higher likelihood of both benzodiazepine and opioid prescriptions included: female sex, a visit for chronic care, receipt of six or more concomitantly prescribed medications, and clinical diagnoses of anxiety and pain (p < .01 for all). Conclusion The coprescribing rate of benzodiazepines and opioids increased monotonically over time in outpatient care settings. Because couse of benzodiazepines and opioids is associated with medication burdens and potential harms, future research is needed to address medication safety in these vulnerable populations.

Sign in / Sign up

Export Citation Format

Share Document