Perception of risk of adverse outcomes of older people: comparison between nursing homes, day centers and home care services

2017 ◽  
Vol 18 (3) ◽  
pp. 212-220 ◽  
Author(s):  
Laetitia Teixeira ◽  
Maria João Azevedo ◽  
Sara Alves ◽  
Cátia L. Pires ◽  
Constança Paúl
Keyword(s):  
At Risk ◽  
Nursing Homes ◽  
Home Care ◽  
Older People ◽  
Perceived Risk ◽  
Home Care Services ◽  
Adverse Outcomes ◽  
Content Type ◽  
Care Services ◽  
Screen Instrument

Purpose In Portugal, the three main kinds of care services available for older people are nursing homes, day centers and home care services. The use of these care services is mostly based on complex socioeconomic and functional criteria; however it is not clear if this placement corresponds to a higher/lower risk of adverse outcomes. The purposes of this paper are: to characterize clients of each type of service; to estimate the proportion of individuals at perceived risk of each adverse outcome according to type of service; to assess the ability of the Risk Instrument for Screening in the Community (RISC) to identify the risk profiles according to type of service. Design/methodology/approach The sample comprised individuals aged 65+ (n=224), receiving care at home, in day centers or in nursing homes. The identification of individuals at risk for three adverse outcomes (institutionalization, hospitalization and death) was performed using a short pre-screen instrument (RISC). Findings The RISC identified mental state issues as the unique factor that differentiated clients according the type of care services (χ2 (6, N=224)=20.96, p=0.002), with day center presenting the lowest percentage of mental health concerns and nursing home presenting the highest percentage (44.44 and 71.91 percent, respectively). Additionally, a gradient was found between perceived risk of adverse outcomes (institutionalization and hospitalization) and care of levels required. Originality/value The RISC can be used to discriminate people in different settings of care and can be helpful in the selection of groups at risk that will benefit more from available services.

scholarly journals Choice and control for older people using home care services: how far have council-managed personal budgets helped?

2014 ◽  
Vol 15 (4) ◽  
pp. 210-219 ◽  
Author(s):  
Parvaneh Rabiee ◽  
Caroline Glendinning
Keyword(s):  
Home Care ◽  
Older People ◽  
Public Funding ◽  
Home Care Services ◽  
Care Staff ◽  
Staff Support ◽  
Content Type ◽  
User Choice ◽  
Care Services ◽  
And Control

Purpose – The purpose of this paper is to report the experiences of older people who use council-managed personal budgets (PBs) to fund home care services and their satisfaction with the level of choice and control they are able to exercise. Design/methodology/approach – Data were collected from 18 older people from eight home care agencies across three councils in England. All interviews were semi-structured and face-to-face. Findings – Despite some optimism about improvements in choice and flexibility experienced by older people using home care services, the findings from this small study suggest that the gap between the “ideal” of user choice and the “reality” of practice continues to be significant. The level of choice and control older people felt able to exercise to tailor home care services to their personal needs and preferences was restricted to low level choices. Other choices were constrained by the low levels of older people's PBs and council restrictions on what PBs can be spent on. Older people's understanding of limitations in public funding/pressures on agencies and their reluctance to play an active consumer role including willingness to “exit” from unsatisfactory care arrangements appeared to further challenge the potential for achieving greater choice and control through council-managed PBs. Originality/value – The English government's policy emphasis on personalisation of care and support and new organisational arrangements for managed PBs aim to promote user choice and control. This is the first study to report the experiences of older people using managed PBs under these new arrangements. The paper highlights areas of interests and concerns that social care staff, support planners and commissioners may need to consider.

scholarly journals Unmet care needs are common among community-dwelling older people with memory problems in Finland

2019 ◽  
pp. 140349481989080 ◽  
Author(s):  
Mari S. Aaltonen ◽  
Lina H. Van Aerschot
Keyword(s):  
Home Care ◽  
Older People ◽  
Home Care Services ◽  
Community Dwelling ◽  
Care Needs ◽  
Care Services ◽  
Memory Problems ◽  
More Care ◽  
Community Dwelling Older People ◽  
With Memory

Aims: Ageing in place has become a policy priority. Consequently, residential care has been reduced, and more older people with multiple care needs reside at home with the help of informal care and home care services. An increasing share of these people has memory disorders. We examined the extent to which memory problems, in addition to other individual characteristics, are associated with unmet care needs among community-dwelling older people. Methods: The study employed cross-sectional survey data from community-dwelling people aged 75+ collected in 2010 and 2015, analysed using binary logistic regression analysis. The study population consisted of people who had long-term illnesses or disabilities that limited their everyday activities ( N = 1928). Nine per cent reported substantial memory problems. Of these, 35.7% had a proxy respondent. Results: People with memory problems have more care needs than those with other types of disability or illness. They receive more care but still have more unmet needs than others. About a quarter of people with memory problems reported that they did not receive enough help. This result did not change significantly when the proxy responses were excluded. Even a combination of informal and formal home care was insufficient to meet their needs. Conclusions: Insufficient care for people with memory problems implies a serious demand for further development of home care services. The care needs of this population are often complex. Unmet needs represent a serious risk to the well-being of people with memory disorders, and may also create an extensive burden on their informal caregivers.

People diagnosed with dementia in Sweden: What type of home care services and housing are they granted? A cross-sectional study

2018 ◽  
Vol 47 (2) ◽  
pp. 229-239 ◽  
Author(s):  
Elzana Odzakovic ◽  
Lars-Christer Hydén ◽  
Karin Festin ◽  
Agneta Kullberg
Keyword(s):  
Home Care ◽  
Older People ◽  
Care Service ◽  
Home Care Services ◽  
Cross Sectional Study ◽  
Home Care Service ◽  
Sectional Study ◽  
Dementia Diagnosis ◽  
Cross Sectional ◽  
Care Services

Aims: This study aims to examine what types of home care services and housing are granted to people with a dementia diagnosis and how these types are associated with socio-demographic factors (sex, age, marital status, native or foreign born, and regional area). Methods: A cross-sectional study of all people diagnosed with dementia in three Swedish counties was conducted from the medical records in 2012. Logistic regression analysis was carried out to investigate associations between home care services and housing and socio-demographic variables. Results: In total, 17,405 people had a dementia diagnosis, and the majority were women, aged 80+ years, and unmarried. Some 72% were living in ordinary housing and 28% lived in special housing. Of those who lived in ordinary housing, 50% did not receive any home care service. Not receiving any type of home care services was less common for older people and was also associated with being married and living in rural municipalities. The most common home care services granted were home help and personal care. Special housing was more common for older people, unmarried persons, and those living in rural municipalities. Conclusions: Most people with a dementia diagnosis were living in ordinary housing, and, surprisingly, half of those did not receive any type of home care service. This knowledge is essential for making the living conditions and needs of people living with dementia more visible and to provide good home care services for people with dementia and their families.

Mental Health and Social Care Providers Facing Requests of Assisted suicide from Elderly in Nursing Homes in Switzerland

2017 ◽  
Vol 41 (S1) ◽  
pp. S11-S12
Author(s):  
D.A. Castelli Dransart ◽  
S. Voélin ◽  
S. Elena
Keyword(s):  
Nursing Homes ◽  
Older People ◽  
Assisted Suicide ◽  
Social Care ◽  
Home Care Services ◽  
Care Providers ◽  
Care Services ◽  
Health And Social Care ◽  
Competing Interest

IntroductionIn some Swiss states, right-to-die associations are allowed to assist older people in nursing homes provided that certain requirements are fulfilled.ObjectivesTo investigate how health and social care providers and their institutions reacted to and dealt with requests of assisted suicide.MethodAn exploratory qualitative study was carried out in the States of Fribourg and Vaud among 40 professionals working in nursing homes, home care services or social welfare agencies.ResultsThe requests of assisted suicide questioned the professional mission, the quality of accompaniment provided to the older people and both professional and personal values. Health and social care providers were required to ponder over ethical dilemmas or decisions. Several challenges were reported, such as: taking into account and articulating personal freedom or needs with collective functioning or organizational constraints before, during and after the assisted suicide; reconciliating self-determination with protection towards vulnerable people (beneficere, non maleficere).ConclusionsAssisted suicide challenges and changes professional end-of-life practices. Education and support should be provided to health and social care providers faced with it.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Age does not come alone: Identifying and implementing older people's views of quality in home care services

2004 ◽  
Vol 5 (1) ◽  
pp. 24-31 ◽  
Author(s):  
Norma Raynes ◽  
Lydia Coulthard ◽  
Charlotte Glenister ◽  
Bogusia Temple
Keyword(s):  
Home Care ◽  
Older People ◽  
Service Providers ◽  
Care Service ◽  
Round Table ◽  
Home Care Services ◽  
Home Care Service ◽  
Round Table Discussion ◽  
Quality Service ◽  
Care Services

This paper describes a study that explored older people's views and priorities on what made for quality in home care services, ways of accessing these and enabling them to become part of mainstream service monitoring. It took place in a city in the north of England, in 2000. The research was funded by the Joseph Rowntree Foundation. Older people's definitions of a quality home care service go outside the service boundaries that are set by social service departments who define the quality specifications for home care services and commission them. Older people had a joined‐up perspective of what contributes to quality in a home care service including, for example, in their definitions of a quality service: access to transport to get out of the house, aids, adaptations and health care. They emphasised the importance of domestic help, which has been reported in other studies. To obtain information on their definitions of a quality service older people were offered the choice of a home‐based interview or participation in a focus group. Following the collection of the data on quality a round table discussion was arranged. The purpose of this was to explore how older people's views on the quality of home care services could become part of routine monitoring, to shape further development and assist in commissioning. Older people who had participated in the first part of the study were invited to attend this, as were local commissioners, service providers and elected members with executive responsibility for older people's services. The recommendations of this round table are discussed.

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