scholarly journals LATE-LIFE SUICIDE: IDENTIFYING PREVENTION TARGETS AND MOBILIZING COMMUNITIES TO MANAGE RISK

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S824-S824
Author(s):  
Alexandria R Ebert ◽  
Emily S Bower ◽  
Yeates Conwell
Keyword(s):  
Suicide Risk ◽  
Long Term Care ◽  
Controlled Trial ◽  
Case Series ◽  
Late Life ◽  
World Health ◽  
Term Care ◽  
Nutrition Service ◽  
The Impact

Abstract Adults aged 70 and older have the highest suicide rates in most countries across the globe (World Health Organization, 2014). Prevalence may increase as the Baby Boomers transition into older adulthood (Phillips, 2014). Disease and disability increase risk for late-life suicide, thus identifying opportunities to intervene within the network of services utilized by older adults with illness and disability could reduce suicide risk. This symposium will explore the impact of disease and disability on late-life suicide risk, and present novel ideas for intervention and prevention. Emphasizing the conference theme, we will discuss prevention points spanning networks of care, including mental health and social services, and long-term care. Dr. Bower will frame the scope of the problem by presenting findings of age-stratified associations between physical illness and suicide attempt among older veterans using secondary data from a retrospective case-control study of veterans. Ms. Lutz will present findings on the relationship between disability and suicidal thoughts from a clinical trial of problem-solving therapy. Dr. Lane will discuss management and identification of suicide risk factors during the transition from independent living to long-term care through the lens of a case-series. Dr. Fullen will present preliminary findings from a novel, randomized controlled trial of a community-based suicide prevention training program for nutrition service volunteers. Dr. Yeates Conwell, Co-Director of the Center for the Study and Prevention of Suicide and Director of the Geriatric Psychiatry Program at the University of Rochester Medical Center, will serve as the discussant.

scholarly journals IDENTIFYING PREDICTORS OF GUILT FOLLOWING PLACEMENT OF FAMILY MEMBER WITH DEMENTIA INTO RESIDENTIAL LONG-TERM CARE

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S486-S487
Author(s):  
Tamara L Statz ◽  
Colleen M Peterson ◽  
Robyn Birkeland ◽  
Aneri Shah ◽  
Kobe Perez ◽  
...  
Keyword(s):  
Family Member ◽  
Family Caregivers ◽  
Long Term Care ◽  
Controlled Trial ◽  
Adult Child ◽  
Spousal Caregivers ◽  
Term Care ◽  
The Impact ◽  
Residential Long Term Care

Abstract Family caregivers of persons with dementia experience guilt for various reasons when placing their family member into residential long-term care (RLTC). Research has shown a relationship between guilt and overall caregiver burden; however, literature on predictors of guilt related to caregiving following RLTC placement is limited. The Residential Care Transition Module (RCTM) provides counseling and psychoeducation to family caregivers who have recently moved their family member with Alzheimer’s disease or a related dementias into RLTC. This semi-structured intervention provides counseling on various topics including guilt, grief, and family dynamics. Using treatment group data (N=87) from the parent RCTM randomized controlled trial, we identified the impact of caregiver status (i.e., adult child vs spousal caregivers), sense of caregiver competence, and relationship closeness on baseline measures of guilt status and magnitude. Preliminary analyses showed that adult child status was associated with greater prevalence of guilt (37.5%) compared to spousal caregivers (26.7%). In addition, qualitative case notes were coded to identify common themes of experiences of guilt to inform practice. Examples include: Guilt related to no longer being able to care for the family member at home; not meeting self-dictated expectations (e.g., not visiting or staying long enough); and feeling guilted into being a caregiver in the first place. The current analyses aim to help practitioners better predict risk for placement-related guilt and highlight specific issues practitioners should consider to help mitigate such feelings. Specific opportunities for intervention are discussed.

scholarly journals Enhancing family-based long-term care with a model of community integrated intermediary care (CIIC) service for Thai older adults in Chiang Mai, Thailand: Protocol for a cluster randomized controlled trial (Preprint)

2020 ◽  
Author(s):  
Myo Nyein Aung ◽  
Saiyud Moolphate ◽  
Motoyuki Yuasa ◽  
Thin Nyein Nyein Aung ◽  
Yuka Koyanagi ◽  
...  
Keyword(s):  
Older People ◽  
Long Term Care ◽  
Controlled Trial ◽  
World Health ◽  
Term Care ◽  
Randomized Controlled ◽  
Family Based ◽  
Cluster Randomized ◽  
Health Organization

BACKGROUND Thailand is one of the most rapidly aging countries in Asia. Traditional family-based care that has been the basis of most care for the older people is becoming unsustainable as families become smaller. In addition, women tend to be adversely affected as they still form the bulk of caregivers for older people, and many are likely to exit the labour market in order to provide care. Many family caregivers also have no or minimal training, and they may be called upon to provide quite complex care, raising the spectre of older people receiving sub-optimal care if they rely only on informal care that is provided by families and friends. Facing a rising burden of non-communicable diseases and age-related morbidity, Thai communities are increasingly in need of community integrated care model for older persons which can link existing health system and reduce the burden upon caring families. This need is common to many countries in the Association of Southeast Asian Nations (ASEAN). OBJECTIVE In this study, we aimed to assess the effectiveness of community-integrated intermediary care (CIIC) model to enhance family-based care for older people. METHODS This paper describes a cluster randomized controlled trial, comprising six intervention clusters and six control clusters that aim to recruit 2000 participants in each arm. This research protocol has been approved by the World Health Organization (WHO) Ethics Review Committee (ERC). The intervention clusters will receive an integrated model of care structured around 1) a community respite service, 2) the strengthening of family care capacity; and 3) an exercise program that aims to prevent entry into long-term care for older people. Control group clusters receive usual care i.e., the current system of long-term care common to all provinces in Thailand, consisting principally of a volunteer-assisted homecare service. The trial will be conducted in a period of two years. The primary outcome is the burden of family caregivers measured at a six month follow up, applying the caregiver burden inventory. Secondary outcomes consist of bio-psychosocial indicators including functional ability applying activity of daily living scale, depression applying geriatric depression scale and quality of life of older people applying the EuroQol 5-dimensions 5-levels scale. Intention-to-treat analysis will be followed. RESULTS n/A CONCLUSIONS Since ASEAN and many Asian countries share similar traditional family-based long-term care systems, the proposed CIIC model and the protocol for its implementation and evaluation may benefit other countries wishing to adopt similar community integrated care models for older people at risk of needing long-term care. CLINICALTRIAL World Health Organization Ethical Review Committee approval: WHO/ERC ID; ERC.0003064 Thailand Clinical Trial Registry, Trial registration number TCTR20190412004

scholarly journals Assessment of pharmacotherapeutic safety of medical prescriptions for elderly residents in a long-term care facility

2012 ◽  
Vol 48 (3) ◽  
pp. 477-485 ◽  
Author(s):  
Fabiana Rossi Varallo ◽  
Ingrid Stephanie Stein Ambiel ◽  
Luana Orlandelli Nanci ◽  
José Carlos Fernandes Galduróz ◽  
Patricia de Carvalho Mastroianni
Keyword(s):  
Long Term Care ◽  
Care Facility ◽  
World Health ◽  
Potentially Inappropriate Medications ◽  
Cross Sectional ◽  
Term Care ◽  
Term Care Facility ◽  
Long Term Care Facility ◽  
The Impact

The present study aimed to estimate the prevalence of elderly using potentially inappropriate medications (PIM) and with occurrence of potentially hazardous drug interactions (PHDI); to identify the risk factors for the prescription of PIM and to evaluate the impact of pharmaceutical intervention (PI) for the prescription of safer therapeutic alternatives. Therefore, a cross-sectional study was performed in a long-term care facility in São Paulo State, between December/2010 and January/2011. The medical records of the patients >60 years old who took any drugs were consulted to assess the pharmacotherapeutic safety of the medical prescriptions, in order to identify PIM and PHDI, according to the Beers (2003) and World Health Organization criteria, respectively. PI consisted of a guidance letter to the physician responsible for the institution, with the suggestions of safer equivalent therapeutics. Approximately 88% of the elderly took at least one drug, and for 30% of them the PIM had been prescribed. Most of the PIM identified (53.4%) act on the central nervous system. Among the 13 different DI detected, 6 are considered PHDI. Polypharmacy was detected as a risk factor for PIM prescription. After the PI there was no change in medical prescriptions of patients who had been prescribed PIM or PHDI. The data suggests that PI performed by letter, as the only interventional, method was ineffective. To contribute it a wide dissemination of PIM and PHDI among prescriber professionals is necessary for the selection of safer treatment for elderly. Additionally, a pharmacist should be part of the health care team in order to help promote rational use of medicines.

The impact of ageing on hospital care and long-term care—the example of Germany

Health Policy ◽  
2004 ◽  
Vol 67 (1) ◽  
pp. 57-74 ◽  
Author(s):  
Erika Schulz ◽  
Reiner Leidl ◽  
Hans-Helmut König
Keyword(s):  
Hospital Care ◽  
Long Term Care ◽  
Term Care ◽  
The Impact

scholarly journals Public reporting of performance measures in long-term care in Canada: does it make a difference?

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
M Poldrugovac ◽  
J E Amuah ◽  
H Wei-Randall ◽  
P Sidhom ◽  
K Morris ◽  
...  
Keyword(s):  
Performance Measures ◽  
Performance Indicators ◽  
Long Term Care ◽  
Public Reporting ◽  
Policy Implications ◽  
Term Care ◽  
Factors Affecting ◽  
Care Facilities ◽  
The Impact

Abstract Background Evidence of the impact of public reporting of healthcare performance on quality improvement is not yet sufficient to draw conclusions with certainty, despite the important policy implications. This study explored the impact of implementing public reporting of performance indicators of long-term care facilities in Canada. The objective was to analyse whether improvements can be observed in performance measures after publication. Methods We considered 16 performance indicators in long-term care in Canada, 8 of which are publicly reported at a facility level, while the other 8 are privately reported. We analysed data from the Continuing Care Reporting System managed by the Canadian Institute for Health Information and based on information collection with RAI-MDS 2.0 © between the fiscal years 2011 and 2018. A multilevel model was developed to analyse time trends, before and after publication, which started in 2015. The analysis was also stratified by key sample characteristics, such as the facilities' jurisdiction, size, urban or rural location and performance prior to publication. Results Data from 1087 long-term care facilities were included. Among the 8 publicly reported indicators, the trend in the period after publication did not change significantly in 5 cases, improved in 2 cases and worsened in 1 case. Among the 8 privately reported indicators, no change was observed in 7, and worsening in 1 indicator. The stratification of the data suggests that for those indicators that were already improving prior to public reporting, there was either no change in trend or there was a decrease in the rate of improvement after publication. For those indicators that showed a worsening trend prior to public reporting, the contrary was observed. Conclusions Our findings suggest public reporting of performance data can support change. The trends of performance indicators prior to publication appear to have an impact on whether further change will occur after publication. Key messages Public reporting is likely one of the factors affecting change in performance in long-term care facilities. Public reporting of performance measures in long-term care facilities may support improvements in particular in cases where improvement was not observed before publication.

scholarly journals A Cross-Sectional Study on the Impacts of Perceived Job Value, Job Maintenance, and Social Support on Burnout among Long-Term Care Staff in Hawaii

2021 ◽  
Vol 18 (2) ◽  
pp. 476
Author(s):  
Bum Jung Kim ◽  
Sun-young Lee
Keyword(s):  
Social Support ◽  
Long Term Care ◽  
Cross Sectional Study ◽  
Care Staff ◽  
Hierarchical Regression ◽  
Sectional Study ◽  
Cross Sectional ◽  
Term Care ◽  
The Impact

Extensive research has demonstrated the factors that influence burnout among social service employees, yet few studies have explored burnout among long-term care staff in Hawaii. This study aimed to examine the impact of job value, job maintenance, and social support on burnout of staff in long-term care settings in Hawaii, USA. This cross-sectional study included 170 long-term care staff, aged 20 to 75 years, in Hawaii. Hierarchical regression was employed to explore the relationships between the key independent variables and burnout. The results indicate that staff with a higher level of perceived job value, those who expressed a willingness to continue working in the same job, and those with strong social support from supervisors or peers are less likely to experience burnout. Interventions aimed at decreasing the level of burnout among long-term care staff in Hawaii may be more effective through culturally tailored programs aimed to increase the levels of job value, job maintenance, and social support.

Evaluating and Motivating Activation in Long Term Care: Lessons From a Pilot Study

2021 ◽  
Vol 10 (1) ◽  
pp. 42-46
Author(s):  
J. Jbilou ◽  
A. El Bouazaoui ◽  
B. Zhang ◽  
J.L. Henry ◽  
L McDonald ◽  
...  
Keyword(s):  
Long Term Care ◽  
Driving Simulator ◽  
Care Home ◽  
Lessons Learned ◽  
Term Care ◽  
Care Facilities ◽  
Technological Intervention ◽  
The Impact ◽  
Research Recommendations

Older adults living in long-term care facilities typically receive insufficient exercise and have long periods of the day when they are not doing anything other than sitting or lying down, watching television, or ruminating (Wilkinson et al., 2017). We developed an intervention called the Experiential Centivizer, which provides residents with opportunities to use a driving simulator, watch world travel videos, and engage in exercise. We assessed the impact of the intervention on residents of a long-term care home in Fredericton, NB, Canada. In this paper, we report on the results observed and highlight the lessons learned from implementing a technological intervention within a long-term care setting. Practical and research recommendations are also discussed to facilitate future intervention implementation in long-term care.

scholarly journals Issues Related to Late-Life Sexuality: Sex in Long-Term Care

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 602-602
Author(s):  
Rachael Spalding ◽  
Peter Lichtenberg
Keyword(s):  
Best Practice ◽  
Long Term Care ◽  
Social Stigma ◽  
Late Life ◽  
Assessment Tools ◽  
Geographical Differences ◽  
Term Care ◽  
Practical Applications ◽  
Ethical And Legal Issues

Abstract Despite surrounding social stigma and stereotypes of the “asexual older adult,” older adults, including those residing in long-term care facilities, indicate that expressing their sexuality continues to be important to them (Doll, 2013). This presentation will feature presentations regarding recent research and perspectives relevant to late-life sexuality with a focus on how issues of sexual expression may particularly emerge in long-term care settings. Dr. Maggie Syme will present findings from mixed-methods, consumer-based approaches that elucidate how current and future long-term care residents view late-life sexuality, with a focus on the practical applications of these findings to inform facility administration and policies. Ethical and legal issues surrounding sexuality in long-term care will be discussed by Dr. Pamela Teaster, who will present ethical models that can translate into potential best-practice recommendations and strategies. Rachael Spalding will discuss the paucity of psychometrically sound assessment tools for measuring attitudes towards late-life sexuality and discuss their development of such a measure. Finally, Dr. Lilanta Bradley and Dr. Pamela Payne-Foster will present a framework for sexual agency in late-life and identify relevant gaps in the literature regarding gender, ethnicity/race, and geographical differences. Ultimately, this presentation will offer a forum for lively discussion among attendees regarding these pertinent topics.

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