scholarly journals THE STRUCTURE OF CARE MANAGERS’ PRACTICE RESPECTING THE AUTONOMY OF THE FRAIL ELDERLY IN JAPAN

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S504-S504
Author(s):  
Chiemi Hata ◽  
Sachiko Kasahara
Keyword(s):  
Frail Elderly ◽  
Structural Equation ◽  
Goodness Of Fit ◽  
Long Term Care ◽  
Self Esteem ◽  
Equation Modeling ◽  
Term Care ◽  
Self Reflection ◽  
Care Managers

Abstract The objectives of current study are to clarify the structure of practice respecting the autonomy of the frail elderly under the Long-Term Care Insurance system in Japan and to discuss the related factors to the practice. The mailed self-administered questionnaire survey was conducted on 1398 care managers who working in In-Home Long-Term Care Support Providers in A City in Osaka with the condition that “office with multiple care managers engaged and one care manager with more than 5 years’ experience”. The response rate was 51.0% (713persons) and no missing data 615 (44.0%) was analyzed. Analysis was carried out using Mplus.ver8. The structure of practice respecting the autonomy of the frail elderly and the rerated factors were examined as a causal model using structural equation modeling. As the result, it was confirmed the goodness of fit to the data (RMSEA=0.049, CFI=0.927). By the confirmatory factor analysis, the care manager’s practice respecting the autonomy of the elderly was confirmed associating with three-factors structure; (1)data collection and assessment, (2) strength perspective and (3) professional relationship. Furthermore the practice was significantly affected by self-esteem of care-managers performance (β=0.494) and self-reflection to own work (β=0.269). In conclusion, the current study supported the hypothetical consideration in which self-esteem and self-reflection in care manager’s practice significantly affected the practice respecting the autonomy of the frail elderly.

scholarly journals FACTORS ASSOCIATED WITH MORTALITY AMONG LONG-TERM CARE RESIDENTS TRANSITIONING TO AND FROM EMERGENCY DEPARTMENTS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S821-S821
Author(s):  
Kaitlyn C Tate ◽  
Colin Reid ◽  
Patrick McLane ◽  
Garnet E Cummings ◽  
Brian H Rowe ◽  
...  
Keyword(s):  
Decision Making ◽  
Emergency Departments ◽  
Structural Equation ◽  
Organizational Context ◽  
Long Term Care ◽  
Care Transitions ◽  
Equation Modeling ◽  
Term Care ◽  
Risk Of Death

Abstract Studies examining risk of death during acute care transitions have highlighted potential predictors of death during transition. However, they have not closely examined the relationships and directional effects of organizational context, care processes, resident demographics and health conditions on death during transition. By employing structural equation modeling, we aimed to 1) identify predictive factors for residents who died during transitions from long term care (LTC) to emergency departments (EDs) and back; 2) examine relationships between identified organizational, process and resident factors with resident death during these transitions; and 3) identify areas for further investigation and improvement in practice. We tracked every resident transfer from 38 participating LTC facilities to two included EDs in two Western Canadian provinces from July 2011 to July 2012. Overall, 524 residents were involved in 637 transfers of whom 63 residents (12%) died during the transition. Sustained dyspnea (in both LTC and the ED), sustained change in level of consciousness (LOC) and severity measured by triage score were direct and significant predictors of resident death during transition. The model fit the data, (x2 = 83.77, df = 64, p = 0.049) and explained 15% variance in resident death. Dyspnea and change in LOC in both LTC and ED needs to be recognized regardless of primary reason for transfer. More research is needed to determine the specific influences of LTC ownership models, family involvement in decision-making, LTC staff decision-making on resident death during transition, and interventions to prevent pre-death transfers.

Impairment and Abuse of Elderly by Staff in Long-Term Care in Michigan: Evidence From Structural Equation Modeling

2010 ◽  
Vol 26 (1) ◽  
pp. 21-33 ◽  
Author(s):  
Tom Conner ◽  
Artem Prokhorov ◽  
Connie Page ◽  
Yu Fang ◽  
Yimin Xiao ◽  
...  
Keyword(s):  
Structural Equation Modeling ◽  
Structural Equation ◽  
Long Term Care ◽  
Equation Modeling ◽  
Term Care

scholarly journals Long-Term Care Nurses’ Intent to Stay, Job Characteristics, and Organizational Justice : A Structural Equation Model

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 85-85
Author(s):  
Lin Wang ◽  
Miao Miao ◽  
Xiaoping Yu
Keyword(s):  
Organizational Justice ◽  
Structural Equation ◽  
Long Term Care ◽  
Intent To Stay ◽  
Job Characteristics ◽  
Equation Modeling ◽  
Intention To Stay ◽  
Term Care ◽  
Convenience Sample

Abstract Background：Gratifying the elderly health-care demands and promoting high-quality of nursing services are based on the effort of long-term care(LTC) nurses. However, the high turnover rate of LTC nurses has become very serious in China. What remains unclear is whether the organizational justice and job characteristics affect the LTC nurses’ intention to stay. Objective: The aim was to investigate intention to stay among LTC nurses in relation to organizational justice and job characteristics. Method: A cross-sectional study was conducted with a convenience sample of 545 LTC nurses. Data collection was performed between July and November 2019. Data were analyzed using structural equation modeling. Results: Most of LTC nurses reported to stay in nursing or current work place, however they still had strong desire to leave if there were other job opportunities. Organizational justice and job characteristics were significant predictors of LTC nurses intent to stay. LTC nurses job characteristics partially mediates the relationship between organizational justice and intent to stay. Conclusion: This would suggest the importance of administrators/ managers understanding how to promote organizational justice, foster a justice climate and increase LTC nurses’ perceived job characteristics. The organizational justice culture programs should be develop as LTC nurses retention strategy.

scholarly journals Who Doesn’t Come Home? Factors Influencing Mortality Among Long-Term Care Residents Transitioning to and From Emergency Departments in Two Canadian Cities

2020 ◽  
pp. 073346482096263
Author(s):  
Kaitlyn Tate ◽  
R. Colin Reid ◽  
Patrick McLane ◽  
Garnet E. Cummings ◽  
Brian H. Rowe ◽  
...  
Keyword(s):  
Structural Equation ◽  
Long Term Care ◽  
Equation Modeling ◽  
Future Research ◽  
Term Care ◽  
Palliative Care Consultation ◽  
Level Of Consciousness ◽  
Standardized Reporting ◽  
Using Data

Residents of long-term care (LTC) whose deaths are imminent are likely to trigger a transfer to the emergency department (ED), which may not be appropriate. Using data from an observational study, we employed structural equation modeling to examine relationships among organizational and resident variables and death during transitions between LTC and ED. We identified 524 residents involved in 637 transfers from 38 LTC facilities and 2 EDs. Our model fit the data, (χ2 = 72.91, df = 56, p = .064), explaining 15% variance in resident death. Sustained shortness of breath (SOB), persistent decreased level of consciousness (LOC) and high triage acuity at ED presentation were direct and significant predictors of death. The estimated model can be used as a framework for future research. Standardized reporting of SOB and changes in LOC, scoring of resident acuity in LTC and timely palliative care consultation for families in the ED, when they are present, warrant further investigation.

scholarly journals Drivers of Old-Age Dependence and Long-Term Care Usage in Switzerland—A Structural Equation Model Approach

Risks ◽  
2019 ◽  
Vol 7 (3) ◽  
pp. 92 ◽  
Author(s):  
Iegor Rudnytskyi ◽  
Joël Wagner
Keyword(s):  
Informal Care ◽  
Structural Equation ◽  
Long Term Care ◽  
Functional Limitations ◽  
Elderly Person ◽  
Individual Characteristics ◽  
Equation Modeling ◽  
Term Care ◽  
Swiss Health

Long-term care (LTC) encompasses a set of services provided to impaired and dependent elderly people. To assess the level of the dependence several scales are used, including activities of daily living (ADL), instrumental ADL (IADL) and functional limitations. Once an elderly person fails to perform these activities independently, he or she requires special assistance. Help can be provided as informal care by relatives and as formal care by professionals. The aim of this research is to study individual characteristics that relate to the demand of LTC and to analyze the relation between formal and informal care. We base our study on data from the Swiss Health Survey focusing on respondents aged over 65 years. Using the structural equation modeling technique, we develop a statistical model that considers the dependence concept as a latent variable. This hidden dependence variable combines three indices linked to the limitations in ADL, in IADL and functional limitations. Accounting for causality links between covariates enables us to include the indirect effect of pathologies on the receipt of LTC mediated via dependence. In our model, we do not assume a causal relationship between formal and informal care. From our results, we observe a significant impact of pathologies as well as of the socio-demographic factors on the demand for LTC. The relationship between formal and informal care is found to be of both a complementary and substitutional nature.

scholarly journals Will the demands by the covid-19 pandemic increase the intent to quit the profession of long-term care managers? A repeated cross-sectional study in Germany

2021 ◽  
Author(s):  
Timo-Kolja Pförtner ◽  
Holger Pfaff ◽  
Kira Isabel Hower
Keyword(s):  
Online Survey ◽  
Long Term Care ◽  
Intention To Leave ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Term Care ◽  
Care Managers ◽  
Care Facilities ◽  
Inpatient Nursing

Abstract The Corona pandemic poses major demands for long-term care, which might have impacted the intention to quit the profession among managers of long-term care facilities. We used cross-sectional data of an online survey of long-term care managers from outpatient and inpatient nursing and palliative care facilities surveyed in April 2020 (survey cycle one; n = 532) and between December 2020 and January 2021 (survey cycle two; n = 301). The results show a significant association between the perceived pandemic-specific and general demands and the intention to leave the profession. This association was significantly stronger for general demands in survey cycle two compared with survey cycle one. The results highlight the pandemic’s immediate impact on long-term care. In view of the increasing number of people in need of care and the already existing scarcity of specialized nursing staff, the results highlight the need for initiatives to ensure the provision of long-term care, also and especially in such times of crisis.

scholarly journals Building ‘implicit partnerships’? Financial long-term care entitlements in Europe

2020 ◽  
Vol 53 (4) ◽  
pp. 697-712
Author(s):  
Joan Costa-Font ◽  
Valentina Zigante
Keyword(s):  
Frail Elderly ◽  
Long Term Care ◽  
European Countries ◽  
Financial Resources ◽  
Policy Reforms ◽  
Term Care ◽  
Elderly Individuals ◽  
Public Subsidies ◽  
Increasing Demand

Abstract The design of public subsidies for long-term care (LTC) programmes to support frail, elderly individuals in Europe is subject to both tight budget constraints and increasing demand preassures for care. However, what helps overcoming the constraints that modify LTC entitlements? We provide a unifying explanation of the conditions that facilitate the modification of public financial entitlements to LTC. We build on the concept of ‘implicit partnerships’, an implicit (or ‘silent’) agreement, encompassing the financial co-participation of both public funders, and families either by both allocating time and/or financial resources to caregiving. Next, we provide suggestive evidence of policy reforms modifying public entitlements in seven European countries which can be classified as either ‘implicit user partnerships’ or ‘implicit caregiver partnerships’. Finally, we show that taxpayers attitudes mirror the specific type of implicit partnership each country has adopted. Hence, we conclude that the modification of long-term care entitlements require the formation of some type of ‘implicit partnership'.

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