Long-Term Care Service Trajectories and Their Predictors for Persons Living With Dementia: Results From a Canadian Study

2017 ◽  
Vol 31 (1) ◽  
pp. 139-164 ◽  
Author(s):  
Denise S. Cloutier ◽  
Margaret J. Penning ◽  
Kim Nuernberger ◽  
Deanne Taylor ◽  
Stuart MacDonald
Keyword(s):  
Daily Living ◽  
Older Persons ◽  
Long Term Care ◽  
Care Service ◽  
Aging In Place ◽  
Publicly Funded ◽  
Canadian Study ◽  
Term Care ◽  
Transition Analysis

Objective: We used latent transition analysis to explore common long-term care (LTC) service trajectories and their predictors for older adults with dementia. Method: Using linked administrative data collected over a 4-year interval (2008-2011), the study sample included 3,541 older persons with dementia who were clients of publicly funded LTC in British Columbia, Canada. Results: Our results revealed relatively equal reliance on home care (HC) and facility-based residential care (RC) as starting points. HC service users were further differentiated into “intermittent HC” and “continuous HC” groups. Mortality was highest for the RC group. Age, changes in cognitive performance, and activities of daily living were important predictors of transitions into HC or RC. Discussion: Reliance on HC and RC by persons with dementia raises critical questions about ensuring that an adequate range of services is available in local communities to support aging in place and to ensure appropriate timing for entry into institutions.

Quality Improvement in Community-Based, Long-Term Care: Theory and Reality

1994 ◽  
Vol 20 (1-2) ◽  
pp. 59-77
Author(s):  
Eleanor D. Kinney ◽  
Jay A. Freedman ◽  
Cynthia A. Loveland Cook
Keyword(s):  
Daily Living ◽  
Long Term Care ◽  
Care Service ◽  
The Elderly ◽  
Community Based ◽  
Term Care ◽  
Care Theory ◽  
Care Services ◽  
Community Based Services

Community-based, long-term care has become an increasingly popular and needed service for the aged and disabled populations in recent years. These services witnessed a major expansion in 1981 when Congress created the Home and Community-Based Waiver authority for the Medicaid program. Currently, all states offer some complement of community-based, long-term care services to their elderly and disabled populations and nearly all states have Medicaid Home and Community-Based Services waivers which extend these services to their Medicaid eligible clients.An ever increasing proportion of the population is in need of community-based, long-term care services. Between nine and eleven million Americans of all ages are chronically disabled and require some help with tasks of daily living. In 1990, thirty percent of the elderly with at least one impaired activity of daily living used a community-based, long-term care service. Not surprisingly, expenditures for community-based, long-term care have increased.

Supporting Older Homeless Persons’ Positive Relocations to Long-Term Care: Service Provider Views

2020 ◽  
Vol 60 (6) ◽  
pp. 1149-1158
Author(s):  
Tamara Sussman ◽  
Rachel Barken ◽  
Amanda Grenier
Keyword(s):  
Older Persons ◽  
Long Term Care ◽  
Service Providers ◽  
Housing Stock ◽  
Care Service ◽  
Functional Limitations ◽  
Homeless Persons ◽  
Cross Sectional ◽  
Term Care

Abstract Background and Objectives This study sought to explore the challenges and opportunities associated with supporting older homeless persons’ relocations to long-term care (LTC) from the perspective of service providers. It aims to inform how to improve relocation processes for this vulnerable and growing subpopulation of older persons. Research Design and Methods This cross-sectional qualitative study employed semistructured face-to-face interviews with service providers from two Health and Social Service Centres in Montreal, Quebec. All interviews were audio-recorded, transcribed verbatim, and thematically analyzed in five stages. Results A total of eight service providers reported on their experiences supporting over 40 relocations of older homeless persons (50+) in the last year. According to participants, older homeless persons’ trajectories into LTC typically included a series of neglected medical issues followed by hospitalization and eventual relocation to LTC. Systemic barriers such as limited-time for proper planning, insufficient housing options for persons with minor functional limitations, disregard for preferred geographic location, multiple moves, and staff prejudices worked together to expedite premature relocation and challenge relocation processes. Discussion and Implications Older homeless persons appear to be at heightened risk of premature and challenging relocation processes. Expanding housing stock for persons with functional limitations, strengthening intersectoral collaborations, providing education and training to staff, and ensuring flexibility around rules and regulations in receiving LTC homes would both improve access to aging in place for this marginalized group of older persons and ensure conditions are in place to support positive relocations to LTC for those who require it.

Long-Term Care for Older Persons: A Policy Perspective

1984 ◽  
Vol 84 (10) ◽  
pp. 1331
Author(s):  
R. Craig Stotts ◽  
Nancy N. Eustis ◽  
Jay N. Greenberg ◽  
Sharon K. Patten
Keyword(s):  
Older Persons ◽  
Long Term Care ◽  
Term Care ◽  
Policy Perspective

scholarly journals High death rate of older persons from COVID-19 in Quebec (Canada) long-term care facilities: chronology and analysis

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Marie Beaulieu ◽  
Julien Cadieux Genesse ◽  
Kevin St-Martin
Keyword(s):  
Older Persons ◽  
Excess Mortality ◽  
Long Term Care ◽  
Human Resources Management ◽  
Armed Forces ◽  
Term Care ◽  
Content Type ◽  
Canadian Armed Forces ◽  
Care Facilities

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.

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