scholarly journals Factors Affecting Long-Term-Care Residents' Decision-Making Processes as They Formulate Advance Directives

2005 ◽  
Vol 45 (5) ◽  
pp. 626-633 ◽  
Author(s):  
H. C. Lambert ◽  
M. A. McColl ◽  
J. Gilbert ◽  
J. Wong ◽  
G. Murray ◽  
...  
Keyword(s):  
Decision Making ◽  
Advance Directives ◽  
Long Term Care ◽  
Term Care ◽  
Factors Affecting ◽  
Decision Making Processes

scholarly journals Decision-making factors affecting different family members regarding the placement of relatives in long-term care facilities

2014 ◽  
Vol 14 (1) ◽  
Author(s):  
Ying-Chia Huang ◽  
Chiao-Lee Chu ◽  
Ching-Sung Ho ◽  
Shou-Jen Lan ◽  
Chen-Hsi Hsieh ◽  
...  
Keyword(s):  
Decision Making ◽  
Long Term Care ◽  
Family Members ◽  
Term Care ◽  
Factors Affecting ◽  
Care Facilities ◽  
Decision Making Factors

Long-Term Care Health Care Aides’ Perceptions of Decision-Making Processes in Transferring Residents to Acute Care Services

2018 ◽  
Vol 39 (8) ◽  
pp. 846-854
Author(s):  
Kaitlyn Tate ◽  
Jude Spiers ◽  
Rowan El-Bialy ◽  
Greta Cummings
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Long Term Care ◽  
Term Care ◽  
Care Services ◽  
Communication Processes ◽  
Decision Making Processes ◽  
Health Care Aides ◽  
Care Aides

Most transfers of long-term care (LTC) facility residents to the emergency department (ED) via 911 calls are necessary. Avoidable transfers can have adverse effects including increased confusion and dehydration. Around 20% of transfers are perceived to be avoidable or unnecessary, yet decision making around transfers is complex and poorly understood. Using a qualitative-focused ethnographic approach, we examined 20 health care aides’ (HCAs) perceptions of decision processes leading to transfer using experiential interview data. Inductive analysis throughout iterative data collection and analysis illuminated how HCAs’ familiarity with residents make them vital in initiating care processes. Hierarchical reporting structures influenced HCAs’ perceptions of nurse responsiveness to their concerns about resident condition, which influenced communications related to transfers. Communication processes in LTC facilities and the value placed on HCA concerns are inconsistent. There is an urgent need to improve conceptualization of HCA roles and communication structures in LTCs.

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.

Factors Affecting the Long-Term Care Preferences of the Elderly in Taiwan

2008 ◽  
Vol 29 (5) ◽  
pp. 293-301 ◽  
Author(s):  
Min-Huey Chung ◽  
Nanly Hsu ◽  
Yin-Chun Wang ◽  
Herng-Ching Lin ◽  
Ya-Li Huang ◽  
...  
Keyword(s):  
Long Term Care ◽  
The Elderly ◽  
Term Care ◽  
Factors Affecting

scholarly journals Practices and perspectives of primary care physicians in Japan and the United States about diagnosing dementia: a qualitative study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
M. Abe ◽  
S. Tsunawaki ◽  
M. Dejonckheere ◽  
C. T. Cigolle ◽  
K. Phillips ◽  
...  
Keyword(s):  
Primary Care ◽  
Early Intervention ◽  
Advance Directives ◽  
Primary Care Physicians ◽  
Long Term Care ◽  
Term Care ◽  
Care Services ◽  
The Us ◽  
Diagnosis Of Dementia

Abstract Background While dementia is a common problem in Japan and the US, primary care physicians' practices and perspectives about diagnosing dementia in these different healthcare systems are unknown. Methods Qualitative research was conducted in an ethnographic tradition using semi-structured interviews and thematic analysis in primary care settings across Japan and in the Midwest State of Michigan, US. Participants were a total of 48 primary care physicians, 24 each from Japan and the US participated. Both groups contained a mixture of geographic areas (rural/urban), gender, age, and years of experience as primary care physicians. Results Participants in Japan and the US voiced similar practices for making the diagnosis of dementia and held similar views about the desired benefits of diagnosing dementia. Differences were found in attitudes about the appropriate timing of formally diagnosing dementia. Japanese physicians tended to make a formal diagnosis when problems that would benefit from long-term care services emerged for family members. US physicians were more proactive in diagnosing dementia in the early stages by screening for dementia in health check-ups and promoting advance directives when the patients were still capable of decision-making. Views about appropriate timing of diagnostic testing for dementia in the two systems reflect what medical or nursing care services physicians can use to support dementia patients and caregivers. Conclusions Benefits of making the diagnosis included the need to activate the long-term care services in Japan and for early intervention and authoring advance directives in the US. Testing to establish an early diagnosis of dementia by primary care physicians only partly relates to testing and treatment options available. Benefits of making the diagnosis included the need to activate the long-term care services in Japan and for early intervention and authoring advance directives in the US.

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