scholarly journals Managing multiple chronic conditions in the community: a Canadian qualitative study of the experiences of older adults, family caregivers and healthcare providers

2017 ◽  
Vol 17 (1) ◽  
Author(s):  
Jenny Ploeg ◽  
Nancy Matthew-Maich ◽  
Kimberly Fraser ◽  
Sinéad Dufour ◽  
Carrie McAiney ◽  
...  
2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S317-S318
Author(s):  
Jenny Ploeg ◽  
Marie-Lee Yous ◽  
Kimberly Fraser ◽  
Sinéad Dufour ◽  
Sharon Kaasalainen ◽  
...  

Abstract The management of multiple chronic conditions (MCC) in older adults living in the community is complex. Little is known about the experiences of interdisciplinary primary care and home providers who care for this vulnerable group. The aim of this study was to explore the experiences of healthcare providers in managing the care of community-living older adults with MCC and to highlight their recommendations for improving care delivery for this group. A qualitative interpretive description design was used. A total of 42 healthcare providers from two provinces in Canada participated in semi-structured interviews. Participants represented diverse disciplines (e.g., physicians, nurses, social workers, personal support workers) and settings (e.g., primary care and home care). Thematic analysis was used to analyze interview data. The experiences of healthcare providers managing care for older adults with MCC were organized into six major themes: (1) managing complexity associated with MCC, (2) implementing person-centred care, (3), involving and supporting family caregivers, (4) using a team approach for holistic care delivery, (5) encountering rewards and challenges in caring for older adults with MCC, and (6) recommending ways to address the challenges of the healthcare system. Healthcare providers highlighted the need for a more comprehensive integrated system of care to improve care management for older adults with MCC and their family caregivers. Specifically, they suggested increased care coordination, more comprehensive primary care visits with an interprofessional team, and increased home care support.


2020 ◽  
Vol 10 ◽  
pp. 2235042X2098119
Author(s):  
Jenny Ploeg ◽  
Anna Garnett ◽  
Kimberly D Fraser ◽  
Lisa Garland Baird ◽  
Sharon Kaasalainen ◽  
...  

Background: Older adults with multiple chronic conditions (MCC) rely heavily on caregivers for assistance with care. However, we know little about their psychosocial experiences and their needs for support in managing MCC. The purpose of this study was to explore the experiences of caregivers of older adults living in the community with MCC. Methods: This qualitative study was a secondary analysis of previously collected data from caregivers in Ontario and Alberta, Canada. Participants included caregivers of older adults (65 years and older) with three or more chronic conditions. Data were collected through in-depth, semi-structured interviews. Interview transcripts were coded and analyzed using Thorne’s interpretive description approach. Results: Most of the 47 caregiver participants were female (76.6%), aged 65 years of age or older (61.7%), married (87.2%) and were spouses to the care recipient (68.1%). Caregivers’ experiences of caring for community-living older adults with MCC were complex and included: (a) dealing with the demands of caregiving; (b) prioritizing chronic conditions; (c) living with my own health limitations; (d) feeling socially isolated and constrained; (e) remaining committed to caring; and (f) reaping the rewards of caregiving. Conclusions: Healthcare providers can play key roles in supporting caregivers of older adults with MCC by providing education and support on managing MCC, actively engaging them in goal setting and care planning, and linking them to appropriate community health and social support services. Communities can create environments that support caregivers in areas such as social participation, social inclusion, and community support and health services.


BMJ Open ◽  
2017 ◽  
Vol 7 (12) ◽  
pp. e018247 ◽  
Author(s):  
Elana Commisso ◽  
Katherine S McGilton ◽  
Ana Patricia Ayala ◽  
Melissa, K Andrew ◽  
Howard Bergman ◽  
...  

IntroductionPeople are living longer; however, they are not necessarily experiencing good health and well-being as they age. Many older adults live with multiple chronic conditions (MCC), and complex health issues, which adversely affect their day-to-day functioning and overall quality of life. As a result, they frequently rely on the support of friend and/or family caregivers. Caregivers of older adults with MCC often face challenges to their own well-being and also require support. Currently, not enough is known about the health and social care needs of older adults with MCC and the needs of their caregivers or how best to identify and meet these needs. This study will examine and synthesise the literature on the needs of older adults with MCC and those of their caregivers, and identify gaps in evidence and directions for further research.Methods and analysisWe will conduct a scoping review of the peer-reviewed and grey literature using the updated Arksey and O’Malley framework. The literature will be identified using a multidatabase and grey literature search strategy developed by a health sciences librarian. Papers, reports and other materials addressing the health and social care needs of older adults and their friend/family caregivers will be included. Search results will be screened, independently, by two reviewers, and data will be abstracted from included literature and charted in duplicate.Ethics and disseminationThis scoping review does not require ethics approval. We anticipate that study findings will inform novel strategies for identifying and ascertaining the health and social care needs of older adults living with MCC and those of their caregivers. Working with knowledge-user members of our team, we will prepare materials and presentations to disseminate findings to relevant stakeholder and end-user groups at local, national and international levels. We will also publish our findings in a peer-reviewed journal.


2019 ◽  
Author(s):  
Kah Mun Foo ◽  
Meena Sundram ◽  
Helena Legido-Quigley

Abstract Background About one-third of all adults worldwide were diagnosed with multiple chronic conditions (MCCs). Literature had found several challenges of providers and patients coping with managing MCCs in the community, and yet limited research studies that consider their viewpoints in combination. A qualitative study involving healthcare providers and users was thus conducted to examine facilitators and barriers of managing patients with MCCs in the community in Singapore. Methods This involves 26 semi-structured interviews with 10 physicians, 2 caregivers and 14 patients seeking treatment in the polyclinics that provides subsidised primary care services. Topic guides were developed with reference from literature review, Chronic Care Model (CCM) and Framework for patient-centred access to healthcare. Results Despite perceived affordable charges and availability of support system, some patients still encountered financial difficulties in managing care. These include inadequacy of the nation-wide medical savings scheme to cover outpatient treatment and medications. Half of the healthcare users did not know where to seek help. While patients could access comprehensive services in polyclinics, those that did not turn up might not receive timely care. Furthermore, patients reported long consultation waiting time. Physicians were able to propose and drive quality improvement projects to improve care quality. However, there were challenges of delivering safe and quality care with limited consultation duration due to the need to manage waiting time, inadequate communication with specialists to coordinate care, and resource constraints in managing complex patients. Although providers could equip patients with self-management and lifestyle related guidelines, patients’ actions are influenced by multiple factors including work nature, beliefs and environment. Conclusions There were barriers on care access, delivery and self-management as reported. It is crucial to adopt whole-of-society approach involving individuals, community, institutions and policymakers to improve and support MCCs management. This study has also highlighted the importance to consider different viewpoints of healthcare providers and users in policy formulation and community care planning.


JMIR Aging ◽  
2018 ◽  
Vol 1 (1) ◽  
pp. e2 ◽  
Author(s):  
Jenny Ploeg ◽  
Carrie McAiney ◽  
Wendy Duggleby ◽  
Tracey Chambers ◽  
Annie Lam ◽  
...  

2020 ◽  
Author(s):  
Kah Mun Foo ◽  
Meena Sundram ◽  
Helena Legido-Quigley

Abstract Background About one-third of all adults worldwide were diagnosed with multiple chronic conditions (MCCs). Literature had found several challenges of providers and patients coping with managing MCCs in the community, and yet limited research studies that consider their viewpoints in combination. A qualitative study involving healthcare providers and users was thus conducted to examine facilitators and barriers of managing patients with MCCs in the community in Singapore. Methods This involves 26 semi-structured interviews with 10 physicians, 2 caregivers and 14 patients seeking treatment in the polyclinics that provides subsidised primary care services. Topic guides were developed with reference from literature review, Chronic Care Model (CCM) and Framework for patient-centred access to healthcare. Results Despite perceived affordable charges and availability of support system, some patients still encountered financial difficulties in managing care. These include inadequacy of the nation-wide medical savings scheme to cover outpatient treatment and medications. Half of the healthcare users did not know where to seek help. While patients could access comprehensive services in polyclinics, those that did not turn up might not receive timely care. Furthermore, patients reported long consultation waiting time. Physicians were able to propose and drive quality improvement projects to improve care quality. However, there were challenges of delivering safe and quality care with limited consultation duration due to the need to manage waiting time, inadequate communication with specialists to coordinate care, and resource constraints in managing complex patients. Although providers could equip patients with self-management and lifestyle related guidelines, patients’ actions are influenced by multiple factors including work nature, beliefs and environment. Conclusions There were barriers on care access, delivery and self-management as reported. It is crucial to adopt whole-of-society approach involving individuals, community, institutions and policymakers to improve and support MCCs management. This study has also highlighted the importance to consider different viewpoints of healthcare providers and users in policy formulation and community care planning.


2020 ◽  
Author(s):  
Kah Mun Foo ◽  
Meena Sundram ◽  
Helena Legido-Quigley

Abstract Background: Approximately one-third of all adults worldwide are diagnosed with multiple chronic conditions (MCCs). The literature has identified several challenges facing providers and patients coping with managing MCCs in the community, yet few studies have considered their viewpoints in combination. A qualitative study involving healthcare providers and users was thus conducted to examine facilitators and barriers of managing patients with MCCs in the community in Singapore.Methods: This study involves 26 semi-structured interviews with 10 physicians, 2 caregivers and 14 patients seeking treatment in the polyclinics that provide subsidised primary care services. Topic guides were developed with reference to the literature review, Chronic Care Model (CCM) and framework for patient-centred access to healthcare.Results: Despite the perceived affordability and availability of the support system, some patients still encountered financial difficulties in managing care. These include inadequacy of the nation-wide medical savings scheme to cover outpatient treatment and medications. Half of healthcare users did not know where to seek help. While patients could access comprehensive services in polyclinics, those who did not visit the clinics might not receive timely care. Furthermore, patients reported long consultation waiting time.Physicians were able to propose and drive quality improvement projects to improve care quality. However, there were challenges to delivering safe and quality care with limited consultation duration due to the need to manage high patient load and waiting time, inadequate communication with specialists to coordinate care, and resource constraints in managing complex patients.Although providers could equip patients with self-management and lifestyle-related guidelines, patients’ actions are influenced by multiple factors, including work requirements, beliefs and environment.Conclusions: There were barriers on care access, delivery and self-management. It is crucial to adopt a whole-of-society approach involving individuals, community, institutions and policymakers to improve and support MCC management. This study has also highlighted the importance of considering the different viewpoints of healthcare providers and users in policy formulation and community care planning.


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