Palliative and end-of-life care’s barriers for older adults

2019 ◽  
Vol 24 (1) ◽  
pp. 72-80
Author(s):  
Retno Indarwati ◽  
Rista Fauziningtyas ◽  
Gilang Dwi Kuncahyo ◽  
Rr Dian Tristiana ◽  
Chong Mei Chan ◽  
...  
Keyword(s):  
Older Adults ◽  
Nursing Home ◽  
End Of Life ◽  
Health Workers ◽  
Health Centre ◽  
Phenomenological Approach ◽  
Content Type ◽  
Professional Health ◽  
Qualitative Nature ◽  
The Government

Purpose A nursing home is a place that is familiar with death, since many older adults will spend the latter part of their lives in such a setting. However, research on this topic is still limited, especially in Indonesia. The purpose of this paper is to explore the barriers to successful palliative and, more generally, end-of-life care (EOLC) for older adults in nursing homes and to explore nurses’ views on the subject. Design/methodology/approach The study is of a qualitative nature and it employs a phenomenological approach. In-depth interviews with 15 nurses who taken care of older adults in a nursing home were conducted. The data were analysed using thematic content analysis. Findings Barriers to effective EOLC include lack of knowledge, ineffectual communication and insufficient resources. Research limitations/implications Better policies are needed, especially in training related to palliative/EOLC subjects and equitable distribution of professional health workers to overcome the barriers. The government should also encourage collaboration involving hospitals, Puskesmas (Health Centre Services), community and resident care settings in sharing knowledge and skills, especially for nurses. Originality/value The barriers identified in palliative and EOLC have been found to be almost identical to those encountered in other health services.

scholarly journals Family caregiving and place of death: Insights from cross-national analysis of the Harmonized End of Life Data

2020 ◽  
Author(s):  
Jennifer Ailshire ◽  
Margarita Osuna ◽  
Jenny Wilkens ◽  
Jinkook Lee
Keyword(s):  
United States ◽  
Older Adults ◽  
Nursing Home ◽  
End Of Life ◽  
Family Caregiving ◽  
The United States ◽  
Place Of Death ◽  
Life Data ◽  
Cross National ◽  
At Home

Abstract Objectives Family is largely overlooked in research on factors associated with place of death among older adults. We determine if family caregiving at the end of life is associated with place of death in the United States and Europe. Methods We use the Harmonized End of Life data sets developed by the Gateway to Global Aging Data for the Survey of Health, Ageing and Retirement in Europe (SHARE) and the Health and Retirement Study (HRS). We conducted multinomial logistic regression on 7,113 decedents from 18 European countries and 3,031 decedents from the United States to determine if family caregiving, defined based on assistance with activities of daily living, was associated with death at home versus at a hospital or nursing home. Results Family caregiving was associated with reduced odds of dying in a hospital and nursing home, relative to dying at home in both the United States and Europe. Care from a spouse/partner or child/grandchild was both more common and more strongly associated with place of death than care from other relatives. Associations between family caregiving and place of death were generally consistent across European welfare regimes. Discussion This cross-national examination of family caregiving indicates that family-based support is universally important in determining where older adults die. In both the United States and in Europe, most care provided during a long-term illness or disability is provided by family caregivers, and it is clear families exert tremendous influence on place of death.

Being an adult child of an elderly person living in a nursing home: a phenomenological approach to the Turkish case

2018 ◽  
Vol 19 (2) ◽  
pp. 117-125 ◽  
Author(s):  
Pelin Önder Erol ◽  
Elif Gün
Keyword(s):  
Nursing Home ◽  
Adult Children ◽  
Lived Experiences ◽  
Filial Piety ◽  
Elderly Person ◽  
Adult Child ◽  
Phenomenological Approach ◽  
Content Type ◽  
Elderly Parents ◽  
Wide Range

Purpose A long-established cultural norm of filial piety may cause ambivalent feelings for adult children who are considered the primary caregivers for their elderly parents in Turkish culture, and whose parents have been placed into nursing homes. The purpose of this paper is to provide an insight to the lived experiences of adult children of elderly people living in a nursing home in Turkey. Design/methodology/approach Drawing upon dramaturgical theory and phenomenological methodology, the authors conducted interviews with ten adult children whose elderly parents had been admitted to a nursing home in Izmir, Turkey. Multi-stage purposeful random sampling was used as the sampling scheme. Thematic analysis was performed to interpret the data. Findings Three themes emerged from the data: adult children’s coping strategies, the ways in which the adult children rationalize their decisions, and the ways in which the adult children manage the placement process. The interviews revealed that the adult children often feel like social outcasts and experience a wide range of difficulties, including social pressures, their own inner dilemmas, and negotiations with their elderly parents. Originality/value An exploration for the lived experiences of adult children relating to the nursing home placement of their elderly parents contributes an insight about the well-established cultural norms that produce feelings of ambivalence.

Dementia: An Overview (Preprint)

2022 ◽  
Author(s):  
Anung Ahadi Pradana
Keyword(s):  
Support Groups ◽  
Health Workers ◽  
Communicable Diseases ◽  
Dementia Caregivers ◽  
Non Communicable Diseases ◽  
People With Dementia ◽  
Professional Health ◽  
The Government ◽  
Financial Burdens ◽  
Caregiver Burdens

BACKGROUND Dementia is a serious terminal and irreversible disease that often does not receive attention from the public compared to other non-communicable diseases. This disease causes a decline in cognitive function in individuals and makes them have to depend on others for 5-20 years of their life span. OBJECTIVE The purpose of this paper is to provide an overview of dementia and other things related to this disease. METHODS The writing method in this article uses a narrative review on several scientific sources and journal articles published in 2011-2021 from several databases such as Google Scholar, CINAHL, ProQuest, PubMed, and EBSCO. RESULTS Dementia is one of the non-communicable diseases that can cause a high burden on individuals, families, communities, and countries as a result of the unproductiveness and total dependence of people with dementia on their surrounding environment due to the decline in body functions that occur. The caregiver burden experienced by caregivers includes physical, psychological, social and financial burdens. Support and assistance from professional health workers for people with dementia as well as caregivers and families can be provided through several efforts such as providing information related to illness, assistance in the care provided, providing counseling to prevent caregiver burdens and other problems, forming support groups for dementia caregivers, and advocacy for people with dementia and their families to get their rights. CONCLUSIONS Change efforts and policy making by the government that are more pro-people with dementia can change the perception that has been in society so far to be more positive and can potentially contribute to people with dementia.

Public health challenges during the COVID-19 outbreak in Nepal: a commentary

2020 ◽  
Vol 34 (4) ◽  
pp. 373-376 ◽  
Author(s):  
Sharmistha Sharma ◽  
Jeevan Bhatta
Keyword(s):  
Public Health ◽  
Design Methodology ◽  
Health Workers ◽  
Health Interventions ◽  
Content Type ◽  
The Public ◽  
Public Health Challenges ◽  
Current Scenario ◽  
Public Health Officials ◽  
The Government

PurposeThe purpose of this paper is to depict the current scenario of coronavirus diseases 2019 (COVID-19) in Nepal, how the government is tackling this pandemic as well as look at the public health challenges that Nepal is facing and might face in the future.Design/methodology/approachThis paper is a viewpoint of COVID-19 activities conducted in Nepal.FindingsNepal is vulnerable to COVID-19, as it shares borders with China and India. Cases have started to be seen in different parts of Nepal. Government of Nepal has started various measures to control the spread of the virus such as deploying health workers, information sharing via different mediums. However, there are still many challenges that the government and public health officials need to be concerned about as well.Originality/valueThis paper provides information about the situation of COVID-19 in Nepal, how the government is handling, and public health challenges that may arise. This paper can be beneficial for further public health interventions.

scholarly journals Visceral Leishmaniasis in China: an Endemic Disease under Control

2015 ◽  
Vol 28 (4) ◽  
pp. 987-1004 ◽  
Author(s):  
Zhao-Rong Lun ◽  
Ming-Shui Wu ◽  
Yun-Fu Chen ◽  
Jun-Yun Wang ◽  
Xiao-Nong Zhou ◽  
...  
Keyword(s):  
Visceral Leishmaniasis ◽  
Rural Areas ◽  
Health Workers ◽  
Sand Fly ◽  
Current Status ◽  
Content Type ◽  
Control Programs ◽  
Treatment And Prevention ◽  
Special Value ◽  
The Government

SUMMARYVisceral leishmaniasis (VL) caused byLeishmaniaspp. is an important vector-borne and largely zoonotic disease. In China, three epidemiological types of VL have been described: anthroponotic VL (AVL), mountain-type zoonotic VL (MT-ZVL), and desert-type ZVL (DT-ZVL). These are transmitted by four different sand fly species:Phlebotomus chinensis,P. longiductus,P. wui, andP. alexandri.In 1951, a detailed survey of VL showed that it was rampant in the vast rural areas west, northwest, and north of the Yangtze River. Control programs were designed and implemented stringently by the government at all administrative levels, resulting in elimination of the disease from most areas of endemicity, except the western and northwestern regions. The control programs consisted of (i) diagnosis and chemotherapy of patients, (ii) identification, isolation, and disposal of infected dogs, and (iii) residual insecticide indoor spraying for vector control. The success of the control programs is attributable to massive and effective mobilization of the general public and health workers to the cause. Nationally, the annual incidence is now very low, i.e., only 0.03/100,000 according to the available 2011 official record. The overwhelming majority of cases are reported from sites of endemicity in the western and northwestern regions. Here, we describe in some depth and breadth the current status of epidemiology, diagnosis, treatment, and prevention of the disease, with particular reference to the control programs. Pertinent information has been assembled from scattered literature of the past decades in different languages that are not readily accessible to the scientific community. The information provided constitutes an integral part of our knowledge on leishmaniasis in the global context and will be of special value to those interested in control programs.

“Healthcare as a refuge”: building a culture of care in Montreal for refugees and asylum-seekers living with HIV

2019 ◽  
Vol 12 (1) ◽  
pp. 16-27 ◽  
Author(s):  
Emilie Robert ◽  
Pierre-Marie David
Keyword(s):  
Asylum Seekers ◽  
Health Centre ◽  
System Reform ◽  
Content Type ◽  
Culture Of Care ◽  
The Government ◽  
Government Of Canada ◽  
Living With Hiv ◽  
Refugees And Asylum Seekers ◽  
Provision Of Care

Purpose Between 2012 and 2016, the Government of Canada modified health insurance for refugees and asylum seekers. In Quebec, this resulted in refusals of care and uncertainties about publicly reimbursed services, despite guaranteed coverage for people with this status under the provincial plan. The Chronic Viral Illness Service (CVIS) at the McGill University Health Centre in Montreal continued to provide care to refugees and asylum seekers living with HIV. The purpose of this paper is to explain how and why challenges brought by this policy change could be overcome. Design/methodology/approach A qualitative case study was conducted using interviews with patients and staff members, observation sessions and a review of media, documents and articles. A discussion group validated the interpretation of preliminary results. Findings The CVIS provides patient-centered care through a multidisciplinary team. It collectively responds to medical, social and legal issues specific to refugees. Its organizational culture and expertise explain the sustained provision of care. The team’s empathetic view of patients, anchored in the service’s history, care for men who have sex with men and commitment to human rights, is key. A culture of care developed over time thanks to the commitment of exemplary figures. Because they countered the team’s values, changes in refugee healthcare coverage strengthened the service’s culture of care. However, the healthcare system reform launched in 2014 in Quebec is perceived as jeopardizing the culture of care, as it makes, refugee and asylum-seeker patients a non-lucrative venture for providers. Originality/value This research analyzes the origin of sustained provision of care to refugees and asylum seekers living with HIV through the lens of culture of care. It considers the historical and political contexts in which this culture developed.

Wise reasoning and political leadership amid COVID-19 pandemic: an exploratory study on Ghana

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Senanu Kwasi Kutor ◽  
Emmanuel Kyeremeh ◽  
Bernard Owusu ◽  
Daniel Amoak ◽  
Temitope Oluwaseyi Ishola
Keyword(s):  
Decision Making ◽  
Exploratory Study ◽  
Online Survey ◽  
Health Workers ◽  
Political Leadership ◽  
Management Decision ◽  
Political Leaders ◽  
Content Type ◽  
Research Participants ◽  
The Government

PurposeThis paper examines how one group of frontline health workers (nurses) amid coronavirus disease 2019 (COVID-19) pandemic perceive the Government of Ghana (GOG)'s decision to ease the lockdown restrictions when cases were increasing. This paper contributes to the literature on Igor Grossman's concept of wise reasoning and its applicability to COVID-19 management decision-making by political leaders.Design/methodology/approachThe paper employed an exploratory qualitative design. The decision to adopt qualitative method is linked to the paucity of research on wise reasoning, political leadership and COVID-19. The paper draws on qualitative online survey with 42 nurses located in Accra Metropolis, Ghana.FindingsThe paper demonstrates that a confluence of research participants perceived the government's act of easing the lockdown restrictions to be in bad faith on account of (1) nonrecognition of different perspectives and viewpoints from stakeholders and interest groups; (2) rising number of cases which naturally make the decision to lift the restriction unwise; (3) concerns about the prioritization of peripheral issues over citizens' health and (4) concerns about limited and robust health facilities and their implications.Research limitations/implicationsThe key claims must be assessed against the limitations of the study. First, the study is an exploratory study and, therefore, not intended for a generalization purpose. Second, the research participants are highly educated, and the responses in this study are skewed toward them.Originality/valueThe paper is novel in seeking to explore wise reasoning and political leadership during a global pandemic such as COVID-19. This exploratory study demonstrates that COVID-19, though devastating and causing havoc, presents an opportunity to test Igor Grossmann's wise reasoning framework about decision-making by political leaders. This extends the literature on wise reasoning beyond the discipline of psychology (the fact that all the authors are geographers) and Global North to Global South since the data for this study are gathered in Ghana.

scholarly journals Social Networks in Limbo. The Experiences of Older Adults During COVID-19 in Ghana

2021 ◽  
Vol 9 ◽  
Author(s):  
Emmanuel Akwasi Asante ◽  
Kofi Awuviry-Newton ◽  
Kwamina Abekah-Carter
Keyword(s):  
Older Adults ◽  
Social Networks ◽  
Community Outreach ◽  
Phenomenological Approach ◽  
Professional Services ◽  
Middle Income ◽  
Face To Face ◽  
Outreach Workers ◽  
The Government ◽  
The Impact

While studies exploring COVID-19 and its global influence have begun, social networks and support among older adults in low-and middle-income countries, such as Ghana have been inadequate despite its enormous relevance. Thus, the study presents the voices of older adults in Jamestown, Accra and their social networks during the COVID-19 pandemic in Ghana. Using a phenomenological approach, data were collected from 15 older adults through in-depth interviews on older adults' social network experiences during COVID-19 pandemic situation. Older adults generally struggled to maintain connections with their family members, friends, neighbors, and the community, especially during the lockdown. They ascribed their limited interaction to COVID-19 preventive measures, such as social distancing and the limitation of face-to-face meetings imposed by the government. Loneliness, stress, and depression are also linked to the breakdown of social networks. The findings provide a deeper understanding of the impact of COVID-19 on older adults' quality of life. It emerged that the Ghanaian society could reconsider the professional services of gerontologists, social workers, community outreach workers, and philanthropists in mitigating loneliness, stress, and depression among older adults in current and future pandemics.

scholarly journals MEMAKNAI PENTINGNYA PERAWATAN KESEHATAN MASYARAKAT DALAM MENINGKATKAN KUALITAS HIDUP

2020 ◽  
Vol 11 (1) ◽  
pp. 61-78
Author(s):  
Dwi Sogi Sri Redjeki
Keyword(s):  
Public Health ◽  
Health Care ◽  
Development Strategy ◽  
Health Workers ◽  
Scientific Paper ◽  
Continuous Variable ◽  
Public Health Care ◽  
Decentralized System ◽  
Professional Health ◽  
The Government

 Latar belakang: Pembangunan perawatan kesehatan merupakan bentuk aktivitas dalam rangka mengisi kemerdekaan bangsa supaya dapat mewujudkan masyarakat yang sehat dan kuat. Salah satunya adalah dengan melakukan penyelenggaraan pelayanan kesehatan. Pelayanan kesehatan adalah sebuah kegiatan yang diberikan kepada individu maupun masyarakat oleh pemerintah dengan tujuan untuk mencegah dan menyembuhkan penyakit individu maupun masyarakat.Tujuan: Perawatan kesehatan masyarakat mengacu pada kemampuan untuk: a) membuat dan memelihara hubungan dengan orang lain; b) berinteraksi dengan baik dengan orang-orang dan lingkungan, sehingga dengan pemahaman kesehatan tersebut dapat menunjukkan kemampuan untuk beradaptasi dengan lingkungan yang berubah serta bertujuan memberikan pemaknaan sebagai kemampuan seseorang untuk berpikir secara konkrit, obyektif dalam norma dan kepatutan yang layak dalam sebuah atau suatu sistem (misal: keluarga, atau masyarakat) dalam rangka untuk merespons secara adaptif terhadap berbagai tantangan lingkungan. Metode: Penulisan ilmiah ini dilakukan dengan melakukan analisa akademik dari aspek berbagai sumber rujukan relevan sehingga menemukan makna teoritis baru dalam rangka menjawab tantangan perawatan kesehatan yang terjadi di masyarakat.Hasil: Paradigma perawatan kesehatan masyarakat merupakan suatu strategi baru pembangunan kesehatan yang memandang masalah kesehatan sebagai suatu variable kontinyu, direncanakan dalam suatu sistem desentralisasi, dengan kegiatan pelayanan yang senantiasa bersifat promotif untuk mengentaskan kesehatan masyarkat, oleh tenaga kesehatan professional bersama masyarakat yang partisipatif. Kata kunci: perawatgan kesehatan, kesehatan masyarakat, hidup sehat AbstractBackground: Health care development is a form of activity to fill the nation's independence which has a role to create a healthy and strong society. One of them is by conducting health services. Health service is an activity provided to individuals and communities by the government to prevent and cure individual and community diseases. Purpose: Public health care refers to the ability to: a) make and maintain relationships with others; b) interacts well with people and the environment, so that understanding of health can demonstrate the ability to adapt to a changing environment and aims to provide meaning as a person's ability to think concretely, objectively inappropriate norms and appropriateness in a system or system (e.g. family, or community) to respond adaptively to various environmental challenges. Method: This scientific paper is carried out by conducting academic analysis from various aspects of relevant reference sources to find new theoretical meaning to answer the challenges of health care that occur in society. Results: The public health paradigm is a new health development strategy that views health issues as a continuous variable, planned in a decentralized system, with service activities that are always promotive to alleviate public health, by professional health workers together with participatory communities. Keywords: health care, public health, healthy living 

scholarly journals An exploration of engagement in community based creative activities as an occupation for older adults

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Luned Edwards ◽  
Bethan Owen-Booth
Keyword(s):  
Older Adults ◽  
National Policy ◽  
Occupational Therapists ◽  
Well Being ◽  
Phenomenological Approach ◽  
Ageing Population ◽  
Creative Arts ◽  
Structured Interviews ◽  
Community Based ◽  
Content Type

Purpose The purpose of this study was to explore the experiences of older adults (aged 60 and over) participating in community-based creative arts. With an ever increasing ageing population, understanding the benefits of leisure occupations such as community creative arts will be vital for Occupational Therapists in facilitating participation and active engagement. Design/methodology/approach An empirical qualitative research design with an interpretive phenomenological approach was undertaken. A purposive sampling method enlisted four older adult volunteers whose experiences of creative arts were explored through semi-structured interviews. Interview data were analysed thematically. Findings Participants identified many benefits of engaging in community creative arts. Four main themes were identified, namely, “personal benefits”, “choice” in their occupation, “encouragement” to and from others, with the environment facilitating “socialising”. These resulted in improved occupational performance and positive well-being outcomes. Originality/value The study complements national policy and extends evidence-based practice on the potential well-being benefits on older adults. In support of the preventative agenda, occupational therapists may apply these findings to increase social prescribing within practice.

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