Ethical Considerations in the Conduct of Electronic Surveillance Research

2006 ◽  
Vol 34 (3) ◽  
pp. 611-619 ◽  
Author(s):  
Ashok J. Bharucha ◽  
Alex John London ◽  
David Barnard ◽  
Howard Wactlar ◽  
Mary Amanda Dew ◽  
...  

Nearly 2.5 million Americans currently reside in nursing homes and assisted living facilities in the United States, accounting for approximately five percent of persons sixty-five and older. The aging of the “Baby Boomer” generation is expected to lead to an exponential growth in the need for some form of long-term care (LTC) for this segment of the population within the next twenty-five years. In light of these sobering demographic shifts, there is an urgency to address the profound concerns that exist about the quality-of-care (QoC) and quality-of-life (QoL) of this frailest segment of our population.

Author(s):  
Marshall B. Kapp

This chapter focuses on medical-legal issues that may arise in the context of identifying psychiatric needs and providing psychiatric care for older persons in long-term care institutional settings, specifically residents of nursing facilities and assisted living facilities. Following general observations about the present regulatory climate in the United States governing nursing facilities and assisted living facilities, the chapter explores mental health assessment requirements for residents of those venues. Key legal responsibilities and restrictions regarding the psychiatric treatment of those residents are then discussed, as well as several areas of concern about potential exposure to litigation and liability on the part of long-term care providers. Finally, some of the most salient future legal and policy challenges confronting those who plan, fund, provide, and evaluate long-term care institutional psychiatric services are noted.


2009 ◽  
Vol 14 (2) ◽  
pp. 37-41 ◽  
Author(s):  
Margaret P. Calkins ◽  
Jennifer Brush

Abstract The entire field of long-term care is under tremendous pressure to change. Traditional environmental approaches based on staff-centric or medical models are no longer considered appropriate in long-term care settings. The new emphasis is on person-centered or self-directed care. This is reflected in settings where people can live comfortably and feel at home, as opposed to feeling like they are in a hospital. Increasingly, nursing homes are working to be more like assisted living facilities, which emphasize privacy, dignity, and choice. These changes affect all aspects of care from structure of governance to staff training to management structure and facility design. This article will cover the issues and the possible solutions to ensuring that long-term care living is more like a home than a hospital.


2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 960-960
Author(s):  
Sara Luck ◽  
Katie Aubrecht

Abstract Nursing home facilities are responsible for providing care for some of the most vulnerable groups in society, including the elderly and those with chronic medical conditions. In times of crisis, such as COVID-19 or other pandemics, the delivery of ‘regular’ care can be significantly impacted. In relation to COVID-19, there is an insufficient supply of personal protective equipment (PPE) to care for residents, as PPE not only protects care staff but also residents. Nursing homes across the United States and Canada have also taken protective measures to maximize the safety of residents by banning visitors, stopping all group activities, and increasing infection control measures. This presentation shares a research protocol and early findings from a study investigating the impact of COVID-19 on quality of care in residential long-term care (LTC) in the Canadian province of New Brunswick. This study used a qualitative description design to explore what contributes to quality of care for residents living in long-term care, and how this could change in times of crisis from the perspective of long-term care staff. Interviews were conducted with a broad range of staff at one LTC home. A semi-structured interview guide and approach to thematic analysis was framed by a social ecological perspective, making it possible to include the individual and proximal social influences as well as community, organizations, and policy influencers. Insights gained will improve the understanding of quality of care, as well as potential barriers and facilitators to care during times of crisis.


2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S161-S161
Author(s):  
Rebecca L Mauldin ◽  
Kathy Lee ◽  
Antwan Williams

Abstract Older adults from racial and ethnic minority groups face health inequities in long-term care facilities such as nursing homes and assisted living facilities just as they do in the United States as a whole. In spite of federal policy to support minority health and ensure the well-being of long-term care facility residents, disparities persist in residents’ quality of care and quality of life. This poster presents current federal policy in the United States to reduce racial and ethnic health disparities and to support long-term care facility residents’ health and well-being. It includes legislation enacted by the Patient Protection and Affordable Care Act of 2010 (ACA), regulations of the U.S. Department of Health and Human Services (DHHS) for health care facilities receiving Medicare or Medicare funds, and policies of the Long-term Care Ombudsman Program. Recommendations to address threats to or gaps in these policies include monitoring congressional efforts to revise portions of the ACA, revising DHHS requirements for long-term care facilities staff training and oversight, and amending requirements for the Long-term Care Ombudsman Program to mandate collection, analysis, and reporting of resident complaint data by race and ethnicity.


2005 ◽  
Vol 19 (2) ◽  
pp. 181-196 ◽  
Author(s):  
Elizabeth R. A. Beattie ◽  
JunAh Song ◽  
Shane LaGore

Wandering, a challenging behavior associated with dementia, affects many residents of long-term care facilities and can result in elopement, injury, and death. Most studies of wandering have taken place in nursing homes (NH). Expansion of the long-term care sector over the last 2 decades has resulted in a surge in options such as assisted living facilities (ALF). This study compared wandering behavior of residents (N = 108) in 21 long-term care facilities (15 NH, 6 ALF). Staff used the Revised Algase Wandering Scale-Nursing Home Version (RAWS-NH) to quantify wandering. While there were some differences in demographic variables (i.e., race, motor ability) between NH and ALF participants, no significant differences were found in either RAWS-NH overall or any of the 6 subscale scores. This suggests that the expression of wandering is similar in long-term care residents across all dimensions of the RAWS-NH regardless of facility type. Findings are of concern for those involved in the safe management and protection of residents at risk for wandering, particularly in long-term care facilities with underregulated staffing and training requirements.


2013 ◽  
Vol 41 (2) ◽  
pp. 501-513 ◽  
Author(s):  
Y. Tony Yang ◽  
Gilbert Gimm

The call for family and medical leave reform in the United States was largely the result of sweeping demographic shifts that occurred in the workforce after the 1950s, coupled with an ever-increasing life expectancy and changing social norms concerning the role of women as caretakers. By the early 1990s, the number of women in the workforce had nearly tripled from 1950. During that same period, life expectancy increased by six years for males and seven for females. Meanwhile, the first wave of the Depression-era generation began to reach the age of retirement. In short, the parents of American workers were living longer and retiring in greater numbers while more women, who were more likely to be informal caregivers, decided to join the workforce. As a result, many families with ill or elder parents began to turn to institutional long-term care.


Author(s):  
Tahira I. Lodhi ◽  
Tania Alchalabi

Given the increase in the geriatric population, the norms of long-term care systems will be forced to change in societies all over the world. This chapter provides an overview of the different levels of care available, from independent living to inpatient, subacute, rehab, assisted living facilities, group homes, and long-term care. A case study is provided of a couple’s declining health trajectory and worsening functional status, identifying resources that pay for various levels of care. Given that care plans must be tailored to the patient’s needs and circumstance, this review provides the foundation to build the structure of a transition or discharge plan. The use of complementary and alternative medicine in long-term care facilities is briefly covered.


2018 ◽  
Vol 2 (1) ◽  
pp. 16-22
Author(s):  
Amanda F. Masri ◽  
Martin S. Rice ◽  
Barbara Kopp Miller ◽  
R. Nathaniel Foster

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