A scoping review to inform care coordination strategies for youth with traumatic brain injuries: Care coordination tools

2021 ◽  
pp. 205343452110706
Author(s):  
Brandy Shook ◽  
Cara Palusak ◽  
Susan C Davies ◽  
Jennifer P Lundine
Keyword(s):  
Scoping Review ◽  
Care Coordination ◽  
Brain Injuries ◽  
Unmet Needs ◽  
Chronic Health Condition ◽  
Service Access ◽  
Care Needs ◽  
Term Care ◽  
Care Plans

Introduction & importance Children with traumatic brain injury (TBI) report unmet needs several years after their injury and may require long-term care. However, this chronic health condition is often only treated and monitored in the short-term. Care for young persons with TBI often relies on parents to manage their child's complex care network. Effective care coordination can close these gaps and facilitate continuity of care for children with TBI. The purpose of this scoping review was to develop a better understanding of tools that improve care coordination for Children with Special Health Care Needs (CSHCN). This, in turn, can inform care for children with TBI. Methods A scoping review was conducted following the PRISMA framework and methodology. OVID/Medline, CINAHL, PsycINFO, EMBASE, and ERIC databases were searched for articles relevant to care coordination tools used with CSHCN. Results 21 articles met the criteria for inclusion in the review, and 6 major categories of care coordination tools were identified: telehealth, online health records and tools, care plans, inpatient discharge protocols, family training, and reminders. Discussion Studies examining telehealth, online tools, care plans, and family training care coordination interventions for CSHCN have shown positive outcomes and would be relevant strategies to improve the care of children with TBI. Future prospective research should investigate these tools to explore whether they might improve communication, reduce unmet needs, increase service access, and improve long-term outcomes for children with TBI.

scholarly journals Longitudinal Follow-Up of Long-Term Care Planning Using PlanYourLifespan.org

2020 ◽  
pp. 073346482094306
Author(s):  
Vanessa Ramirez-Zohfeld ◽  
Anne Seltzer ◽  
Ana Ramirez ◽  
Ruqayyah Muhammad ◽  
Lee A. Lindquist
Keyword(s):  
Older Adults ◽  
Long Term Care ◽  
Long Term Effects ◽  
Care Needs ◽  
Term Care ◽  
User Perceptions ◽  
Care Plans ◽  
Age In Place ◽  
Care Services

Many older adults wish to age-in-place but do not have long-term care plans for when they may require more assistance. PlanYourLifespan.org (PYL) is an evidence-based tool that helps older adults understand and plan for their long-term care needs. We examined the long-term effects of PYL use on user perceptions and planning of long-term care services. Individuals who previously accessed PYL were invited to complete an online, nation-wide mixed methodology survey about end-user outcomes related to PYL. Among 115 completed surveys, users found PYL helpful with long-term planning for their future needs. Over half of website users reported having conversations with others because of PYL use. However, 40% of respondents reported not having a conversation with others about their plans; common themes for barriers to planning included procrastination and a lack of immediate support needs. Although PYL helps with planning, many people are still not communicating their long-term care plans.

Unmet Long-Term Care Needs: An Analysis of Medicare-Medicaid Dual Eligibles

2005 ◽  
Vol 42 (2) ◽  
pp. 171-182 ◽  
Author(s):  
Harriet L. Komisar ◽  
Judith Feder ◽  
Judith D. Kasper
Keyword(s):  
Activities Of Daily Living ◽  
Daily Living ◽  
Long Term Care ◽  
Unmet Needs ◽  
State Governments ◽  
Care Needs ◽  
Community Based ◽  
Term Care ◽  
Dual Eligibles

People who are dually eligible for Medicare and Medicaid are the focus of fiscal struggles between federal and state governments. Drawing on a survey of community-based elderly “dual eligibles,” this paper examines how well their medical and long-term care needs are being met under the current combination of Medicare and Medicaid policies. While few people report difficulty getting medical care, 58% of people needing long-term care (help with activities of daily living) report unmet needs. As a result, many experience serious consequences, such as falls. Although unmet needs are substantial in all six states surveyed, we find the greater the use of paid home care in a state, the lower the likelihood of unmet needs, suggesting states' policies can make a difference.

Geriatrics

2016 ◽  
pp. 319-330
Author(s):  
Ericka E. Tung
Keyword(s):  
Needs Assessment ◽  
Older Adult ◽  
Geriatric Assessment ◽  
Care Coordination ◽  
Long Term Care ◽  
Care Needs ◽  
Term Care ◽  
Multifaceted Approach ◽  
Holistic Understanding

The overarching goal of the geriatric assessment is to develop a holistic understanding of the older patient as a means to identify emerging problems and individual capabilities. This information guides treatment, care coordination, and evaluation of long-term care needs. Assessment of the older adult requires a multifaceted approach encompassing physical, cognitive, and psychosocial domains.

scholarly journals Is informal care sufficient to meet the long-term care needs of older people with disabilities in China? Evidence from the China Health and Retirement Longitudinal Survey

2019 ◽  
pp. 1-20 ◽  
Author(s):  
Wei Yang ◽  
Si Ying Tan
Keyword(s):  
Older People ◽  
Informal Care ◽  
Daily Living ◽  
Long Term Care ◽  
Unmet Needs ◽  
People With Disabilities ◽  
Care Provision ◽  
Care Needs ◽  
Term Care

Abstract Rapid demographic shifts and socio-economic changes are fuelling concerns over the inadequate supply of informal care – the most common source of care-giving for older people in China. Unmet long-term care needs, which are believed to cause numerous adverse effects on health, continue to increase. Drawing data from the 2015 wave of the China Health and Retirement Longitudinal Survey, this study explores the relationship between informal care provision and unmet long-term care needs among older people in China. We first examine the availability of informal care among older people with disabilities. We then analyse whether a higher intensity of informal care leads to lower unmet needs. Our findings suggest that the majority of older people with disabilities receive a low intensity of care, i.e. less than 80 hours per month. Besides, a higher intensity of informal care received could significantly lower the probabilities of unmet needs for the disabled older adults who have mainly instrumental activities of daily living limitations. Our study points out that informal care cannot address the needs of those who are struggling with multi-dimensional difficulties in their daily living. Our findings highlight a pressing need for the government to buttress the formal care provision and delivery systems to support both informal care-givers and disabled older people in China.

A scoping review to inform care coordination strategies for youth with traumatic brain injuries: Care coordination personnel

2022 ◽  
pp. 205343452110706
Author(s):  
Cara Palusak ◽  
Brandy Shook ◽  
Susan C. Davies ◽  
Jennifer P. Lundine
Keyword(s):  
Scoping Review ◽  
Care Coordination ◽  
Service Providers ◽  
Cost Of Care ◽  
Future Research ◽  
Term Care ◽  
Healthcare Needs ◽  
Care Coordinators ◽  
Outcomes For Children

Introduction & Importance: Effective, patient-centered care coordination has been shown to improve outcomes for children with special healthcare needs (CSHCN), who often have complex, long-term involvement with multiple service providers. Traumatic brain injury (TBI) can result in long-term physical, intellectual, social, and emotional disabilities that persist long after acute treatment. Yet, even though it is a chronic condition, TBI remains an area with scarce standardization and research surrounding the complex, long-term care coordination need in this population. The purpose of this scoping review is to summarize current research on outcomes in CSHCN after implementation of care coordinators, whether individual or teams, to inform future research for youth with TBI. Methods: OVID/Medline, CINAHL, PsycINFO, EMBASE, and ERIC databases were searched for articles relevant to care coordination and CSHCN. Results: 31 articles met inclusion criteria. Outcomes for children and families were grouped into 5 major categories: healthcare utilization, cost of care, disease status, parent and child quality of life, and healthcare satisfaction and perception of care. Discussion: Implementation of care coordinators, whether in the form of individuals, dyads, or teams, resulted in overall positive outcomes for CSHCN and their families across all 5 major outcome domains. Future research should be focused on the efficacy of care coordinators differing in profession, qualifications, and educational attainment specifically for the unique needs of children with TBI. Additionally, the application of care coordination within medical homes should be further investigated to increase proactive, preventative care of children with TBI and further reduce reactive, need-based treatment only.

scholarly journals Childhood Adversities and Unmet Needs of Older Chinese Adults: The Mediation Effects of Family Relationships

2021 ◽  
pp. 016402752110482
Author(s):  
Bo Hu ◽  
Mingyu Wei
Keyword(s):  
Older Adults ◽  
Family Relationships ◽  
Long Term Care ◽  
Unmet Needs ◽  
Care Needs ◽  
Childhood Adversities ◽  
Term Care ◽  
Mediation Effects ◽  
Older Chinese

Ensuring equality and adequacy of care for older adults is vitally important. This study investigates the relationships between childhood adversities and unmet long-term care needs of older adults in China and the mediation effects of family relationships. The data came from a nationally representative sample of older Chinese adults aged 60 and over with long-term care needs ( N = 2186). We conducted mediation analyses and decomposed the total effects of childhood adversities on unmet needs into direct and indirect effects. The probability of unmet needs is significantly higher among older adults experiencing childhood adversities. Satisfaction with marriage mediates the association between childhood adversities and unmet personal care needs. Relationships with children mediate the association between childhood adversities and unmet domestic care needs. The causes of unmet needs can be traced back to early life, which underscores the importance of concerted efforts in family, education and long-term care policies to tackle unmet needs.

scholarly journals Scoping Review: Home and Community-Based Service Waiver Programs and Person-Reported Outcomes

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 848-849
Author(s):  
Taylor Bucy ◽  
John Mulcahy ◽  
Eric Jutkowitz ◽  
Tetyana Shippee
Keyword(s):  
Scoping Review ◽  
Service Use ◽  
Long Term Care ◽  
Medication Management ◽  
International Studies ◽  
Care Needs ◽  
Community Based ◽  
Term Care ◽  
Use Patterns

Abstract State Medicaid programs are rebalancing their long-term care spending from nursing home to home and community-based services (HCBS). Emphasis on person-centered and person-directed care warrants investigation into models of HCBS delivery that promote quality of life. We performed a scoping review of the literature to catalogue the breadth of the studies describing HCBS waiver programs targeting adults (18+). We identified 757 articles, and after duplicate removal and reconciliation, we excluded articles on children or adolescents, non-peer reviewed reports, international studies, and articles that did not describe HCBS waiver programs. After abstract and title review, 292 articles met our inclusion criteria. Most included articles (22.3%) were single state descriptive evaluations or evaluations of service use patterns among participants. 17.8% of included articles examined multi-state or national variation in program trends, while 17.1% made national program conclusions without a major focus on interstate comparison. Less common were studies examining integrated care or dual-eligibles (7.5%), PACE (3.4%), medication management (3.1%), quality and satisfaction of both consumer and caretaker perspectives (3.8%) and consumer-only perspectives (5.1%). The remaining articles focused on HIV (4.1%), TBI (1.4%) or ID/DD (14.4%) waiver programs. The 8.9% of articles addressing quality and satisfaction consisted mostly of interviews, either with state Medicaid administrators or with care recipients and/or caregivers. Consumer reported satisfaction and unmet care needs were the primary outcomes examined. Given the heightened focus on long-term care as a result of the ongoing coronavirus pandemic, this review justifies further exploration into the delivery and outcomes of state-directed HCBS waiver programs.

Health Literacy and Long-Term Care Needs among Thai Elderly in Rural Communities

2020 ◽  
Vol 103 (12) ◽  
pp. 1315-1324
Keyword(s):  
Depressive Symptom ◽  
Health Literacy ◽  
Rural Communities ◽  
Long Term Care ◽  
Health Knowledge ◽  
Elderly Persons ◽  
Care Needs ◽  
Term Care ◽  
Study Results

Background: Factors related to long-term care needs have been studied widely, but there is limited research about the influence of health literacy on long-term care needs among the elderly in rural communities where the social context and care environment are uniquely different. Objective: To examine factors influencing long-term care needs among Thai elderly in rural communities. Materials and Methods: The present study used the cross-sectional design. The study sample included 477 elderly persons, who were members of the communities in Nakhon Ratchasima Province. Multi-stage random sampling was used to select participants. They were interviewed using the demographic and health information questionnaire, the Thai Geriatric Depression Scale (TGDS), the health literacy scale of Thai adults and long-term care needs questionnaire. The selected factors examined as independent variables included some demographic factors, depressive symptom, and health literacy. Results: The present study results revealed significant positive relationships existing between long-term care needs with age and depressive symptom, while negative relationships between income and health literacy were reported. A hierarchical multiple regression analysis indicated that four of nine determinants of long-term care needs: age, depressive symptom, health knowledge and understanding, and ability managing their health condition significantly predicted long-term care needs at a level of 18% (R² adjusted=0.18, p<0.001). Conclusion: The present study results showed associations between personal and health literacy factors with long-term care needs. These findings prove that it is vitally important for healthcare professionals to consider the rural elderly’s mental health status and health literacy when providing care and planning treatment. Keywords: Health literacy, Long-term care needs, Rural community

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