Lessons from abroad for funding long-term care in England: a prospective policy transfer perspective on official documents

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Martin Powell

PurposeMany governments stress the importance of “learning from abroad”. An analysis of official documents over a period of some 20 years examines learning from abroad in the case of funding long-term care in England through the lens of prospective policy transfer.Design/methodology/approachThe paper analyses the eight “official” documents in England that examined funding LTC from 1999 to 2019. It uses interpretive content analysis in a deductive approach that focuses on both manifest and latent content.FindingsOnly four of the eight documents gave more than a token level of attention to other nations, and of the remaining four, none fully satisfied the criteria or followed the recommendations of prospective policy transfer. Moreover, a rather limited pool of lessons from other nations is examined. Much of the material is rather descriptive, with limited explicit attention towards goals, problems, settings and policy performance, and a clear recommendation explicitly associated with a clear lesson or policy recommendation is rare.Originality/valueThis is the first analysis of the eight official documents that have discussed funding long-term care in England.

2014 ◽  
Vol 15 (4) ◽  
pp. 232-236 ◽  
Author(s):  
Lee Hooper ◽  
Diane K Bunn

Purpose – The purpose of this paper is to consider whether dehydration in older people should be used as a marker of lack of quality in long-term care provision. Design/methodology/approach – The piece examines the assumed relationship between dehydration and the quality of care, and then considers the factors that can lead to dehydration in older people. Findings – Even with the best care, older people, in the absence of a sense of thirst, and for fear of urinary accidents, difficulties getting to the toilet or choking, may choose to drink less than would be ideal for their health. While good care supports older people to minimise these problems, it also respects older people making their own decisions around when, what and how much to drink. It appears that dehydration may sometimes be a sign of good care, as well as arising from poor care. Social implications – Residential care homes should not be stigmatised on the basis of their residents being dehydrated, but rather helped to explore whether they are achieving an appropriate balance between care and quality of life for their residents. Originality/value – This discussion may be of use to those living in, working in, managing or assessing residential care.


2017 ◽  
Vol 37 (3/4) ◽  
pp. 134-147 ◽  
Author(s):  
Caroline Murphy ◽  
Thomas Turner

Purpose The undervaluing of care work, whether conducted informally or formally, has long been subject to debate. While much discussion, and indeed reform has centred on childcare, there is a growing need, particularly in countries with ageing populations, to examine how long-term care (LTC) work is valued. The purpose of this paper is to provide an overview of the way in which employment policies (female labour market participation, retirement age, and precarious work) and social policies (care entitlements and benefits/leave for carers) affect both informal carers and formal care workers in a liberal welfare state with a rapidly ageing population. Design/methodology/approach Drawing the adult worker model the authors use the existing literature on ageing care and employment to examine the approach of a liberal welfare state to care work focusing on both supports for informal carers and job quality in the formal care sector. Findings The research suggests that employment policies advocating increased labour participation, delaying retirement and treating informal care as a form of welfare are at odds with LTC strategies which encourage informal care. Furthermore, the latter policy acts to devalue formal care roles in an economic sense and potentially discourages workers from entering the formal care sector. Originality/value To date research investigating the interplay between employment and LTC policies has focused on either informal or formal care workers. In combining both aspects, we view informal and formal care workers as complementary, interdependent agents in the care process. This underlines the need to develop social policy regarding care and employment which encompasses the needs of each group concurrently.


2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Marie Beaulieu ◽  
Julien Cadieux Genesse ◽  
Kevin St-Martin

Purpose Among the ten Canadian provinces, Quebec has experienced the most significant excess mortality of older persons during COVID-19. This practice paper aims to present the chronology of events leading to this excess mortality in long-term care facilities (LTCFs) and a comprehensive analysis of the phenomenon. Design/methodology/approach Documented content from three official sources: daily briefings by the Quebec Premier, a report from the Canadian Armed Forces and a report produced by Royal Society of Canada experts were analysed. Findings Two findings emerge: the lack of preparation in LTCFs and a critical shortage of staff. Indeed, the massive transfer of older persons from hospitals to LTCFs, combined with human resources management and a critical shortage of permanent staff before and during the crisis, generates unhealthy living conditions in LTCFs. Originality/value To our knowledge, this paper is the first to analyse official Quebec and Canadian statements concerning COVID-19 from the angle of quality of life and protection of older adults in LTCFs.


2019 ◽  
Vol 37 (2) ◽  
pp. 565-578 ◽  
Author(s):  
Tsu-Wei Yu ◽  
Lu-Ming Tseng

PurposeThe purpose of this paper is to explore the role of commercial long-term care insurance (LTCI) in long-term care (LTC) services, and to elucidate the mediating roles of service quality and relationship satisfaction in the relationship between customization and loyalty. In addition, this study offers important recommendations for policy makers in formulating policy aimed at supporting the industry and regulating its customer relationships in life insurers in Taiwan.Design/methodology/approachStudy participants were policyholders of life insurance in Taiwan with experience in purchasing commercial LTCI. They were investigated through in-depth interviews and surveys. The hypotheses were tested using the structural equation modeling (SEM) analysis of variance.FindingsThe findings of this study are important for policy makers in formulating policy aimed at supporting the industry and regulating its customer relationships.Originality/valueThis study represents the first attempt to investigate the role of LTCI in LTC services in Taiwan. Likewise, this study improves our understanding of the main issues relating to the effect of customization on policyholder loyalty, and the partially mediating role of service quality and relationship satisfaction in the insurance marketing context.


2017 ◽  
Vol 117 (6) ◽  
pp. 1244-1262 ◽  
Author(s):  
Dong-Shang Chang ◽  
Shu-Ming Liu ◽  
Yi-Chun Chen

Purpose The purpose of this paper is to find the key innovative principles for evaluating the long-term care (LTC) cloud system by exploring contradictory and complex points in its development. Design/methodology/approach The theory of inventive problem solving (TRIZ) and the decision-making trial and evaluation laboratory (DEMATEL) approaches are integrated to resolve complex contradictions in the system. The heuristic reasoning of TRIZ is applied to obtain innovation principles for an LTC cloud mining system. However, the importance and feasibility of these innovative principles require further assessment. In this study, DEMATEL is employed to clarify the complex relationships among the principles and evaluate their key influences. Findings This paper identifies six primary contradictions and derives 25 innovative principles for the resolution of these conflicts. Further analysis confirms three key innovative principles. First, the government should consider the overall planning of the cloud system platform, followed by the participation of other medical and LTC institutions. Second, the information capability of LTC institutions should be unified by recording the pathology data of care recipients to create an information exchange system. Third, LTC institutions should act in cooperation with medical institutions to provide professional medical capabilities. Originality/value The contributions of this paper are two-fold. First, this study provides an integrated methodology integrating the TRIZ and DEMATEL approaches to resolve LTC problems. Second, this research identifies the key innovative principles for developing an LTC cloud system in Taiwan.


2014 ◽  
Vol 33 (2) ◽  
pp. 177-192 ◽  
Author(s):  
Shereen Hussein ◽  
Jill Manthorpe ◽  
Mohamed Ismail

Purpose – The aim of this paper is to explore the effect of ethnicity and separate this from the other dynamics associated with migration among members of the long-term care workforce in England focusing on the nature and structure of their jobs. The analysis examines interactions between ethnicity, gender, and age, and their relations with “meso” factors related to job and organizational characteristics and “macro” level factors related to local area characteristics. Design/methodology/approach – The paper analyses new national workforce data, the National Minimum Data Set for Social Care (NMDS-SC), n=357,869. The paper employs descriptive statistical analysis and a set of logistic regression models. Findings – The results indicate that labour participation of British black and minority ethnic (BME) groups in long-term care work is much lower than previously believed. There are variations in nature of work and possibly job security by ethnicity. Research limitations/implications – While the national sample is large, the data were not purposively collected to examine differentials in reasons to work in the care sector by different ethnicity. Practical implications – The analysis highlights the potential to actively promote social care work among British BME groups to meet workforce shortages, especially at a time where immigration policies are restricting the recruitment of non-European Economic Area nationals. Originality/value – The analysis provides a unique insight into the participation of British BME workers in the long-term care sector, separate from that of migrant workers.


2019 ◽  
Author(s):  
Rosemary Ann Frey ◽  
Deborah Balmer ◽  
Michal Boyd ◽  
Jackie Robinson ◽  
Merryn Gott

Abstract Abstract Background: Older people in long-term care facilities are at a greater risk of receiving care at the end of life that does not adequately meet their needs, yet staff in long-term care are often unprepared to provide palliative care. The objective of the study was to explore hospice nurse experiences regarding the barriers and facilitators to the implementation of a palliative care educational intervention, Supportive Hospice Aged Residential Exchange (SHARE) in 20 long-term care facilities. Methods: Reflective logs (465), recorded over the course of the yearlong SHARE intervention by the three hospice nurses, who were the on-site mentors, were qualitatively analyzed by two researchers utilizing inductive content analysis. Results: Categories emerging from the logs include the importance of relationships, knowledge exchange, communication, and the challenges of providing palliative care in a long-term care setting. Conclusion: Evidence from the logs indicated that sustained relationships between hospice nurses and staff as well as reciprocal learning were key factors supporting the implementation of this palliative care educational intervention. Challenges remain however in relation to staffing levels, which further emphasizes the importance of hospice presence as a point of stability.


2020 ◽  
Vol 33 (3) ◽  
pp. 247-263
Author(s):  
Carol Wong ◽  
Edmund J. Walsh ◽  
Kayla N. Basacco ◽  
Monica C. Mendes Domingues ◽  
Darrin R.H. Pye

Purpose The purpose of this study is to examine the effects of managers’ authentic leadership, person–job match in the six areas of worklife (AWLs) and emotional exhaustion on long-term care registered nurses’ job satisfaction. Design/methodology/approach A secondary analysis of baseline data from a national survey of 1,410 Canadian registered nurses from various work settings was used in this study, which yielded a subsample of 78 nurses working in direct care roles in long-term care settings. Hayes’ PROCESS macro for mediation analysis in SPSS was used to test the hypothesized model. Findings Findings showed that authentic leadership significantly predicted job satisfaction directly and indirectly through AWLs and emotional exhaustion. Practical implications Authentic leadership may provide guidance to long-term care managers about promoting nurses’ job satisfaction, which is essential to recruiting and retaining nurses to meet the care needs of an aging population. Originality/value As demand for care of the aged is increasing and creating challenges to ensuring a sufficient and sustainable nursing workforce, it is important to understand factors that promote long-term care nurses’ job satisfaction. Findings contribute to knowledge of long-term care nurses by suggesting that managers’ authentic leadership can positively affect nurses’ job satisfaction directly and indirectly through positive perceptions of AWLs and lower emotional exhaustion.


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