scholarly journals Do long-term care services match population needs? A spatial analysis of nursing homes in Chile

PLoS ONE ◽  
2018 ◽  
Vol 13 (6) ◽  
pp. e0199522 ◽  
Author(s):  
Pablo Villalobos Dintrans
2021 ◽  
Vol 12 (1) ◽  
pp. 155-180
Author(s):  
Laila Tingvold ◽  
Oddvar Førland

Introduction: Increased voluntary work in long-term care (LTC) is encouraged in white papers in Norway as well as in many other western states. This is due to the growth in the number of service recipients and a subsequent economic burden for the state. Voluntary work in nursing homes and home care services take place in different spatial contexts, but little attention has been paid to how the different contexts may potentially influence the possibilities for voluntary work. The aim of this study is to obtain new knowledge of the significance of context in recruitment of volunteers in LTC. Method: A cross-sectional study was conducted among leaders in nursing homes and home services in 50 municipalities across all regions of Norway. Descriptive analysis was used. Results: According to the leaders, home care services had less voluntary work than nursing homes. Respondents from home care scored “poor flow of information” and “low interest in the municipality” as major hinderances, more so than respondents from nursing homes did. Discussion: Nursing homes typically have many residents under one roof following a similar schedule. Thus, volunteer-run activities are held more easily at set times and incorporated into the daily life of the institutions. On the other hand, home dwellers in home care stay in a more individualised setting with more autonomy and can opt out of activities that nursing home residents would normally join. Skill acquisition, networking and socializing are common motivations for volunteering, and a nursing home setting may be an easier context to obtain this. The governmental endeavour for increased voluntary work in LTC can be seen as an effort to meet expected rises in public expenditure. However, the realism can be debated due to substantial challenges on the future potential of volunteerism in LTC, especially in the home care context.


10.2196/22316 ◽  
2021 ◽  
Vol 23 (8) ◽  
pp. e22316
Author(s):  
Hanne Marie Rostad ◽  
Randi Stokke

Background Welfare technologies are often described as a solution to the increasing pressure on primary health care services. However, despite initiating welfare technology projects in the health care sector and different government incentives, research indicates that it is difficult to integrate welfare technology innovations in a complex and varying setting, such as long-term care. Objective We aim to describe the types of welfare technology and the extent to which welfare technology is provided in long-term care (ie, nursing homes and home care services); examine whether the extent of welfare technology provision differs on the basis of municipal characteristics (ie, population size, centrality, the proportion of older inhabitants, and income); and identify how local governments (ie, municipalities) describe their efforts toward integrating welfare technologies in long-term care. Methods Quantitative and qualitative data about welfare technology from a larger cross-sectional survey about the provision of long-term care services in Norwegian municipalities were combined with registry data. Representatives of 422 Norwegian municipalities were invited to participate in the survey. Frequencies were used to describe the distribution of the types and extent of welfare technologies, whereas the Fisher exact test and Kruskal-Wallis one-way analysis of variance were used to determine the association between the extent of welfare technology and municipal characteristics. Free-form text data were analyzed using thematic analysis. Results A total of 277 municipalities were surveyed. Technology for safety was the most widespread type of welfare technology, whereas technology for social contact was the least prevalent. Two-thirds of the sample (183/277, 66.1%) in nursing home and (197/277, 71.1%) in home care services reported providing one or two different types of welfare technology. There was a statistically significant association between the extent of welfare technology and population size (in both nursing homes and home care services: P=.01), centrality (nursing homes: P=.01; home care services: P<.001), and municipal income (nursing homes: P=.02; home care services: P<.001). The extent of welfare technology was not associated with the proportion of older adults. The municipalities described being in a piloting phase and committing to future investment in welfare technology. Monetary resources were allocated, competency development among staff was initiated, and the municipalities were concerned about establishing collaborations within and between municipalities. Home care services seem to have a more person-centered approach in their efforts toward integrating welfare technologies, whereas nursing homes seem to have a more technology-centered approach. Conclusions Many municipalities provide welfare technologies; however, their extent is limited and varies according to municipal characteristics. Municipal practices still seem dominated by piloting, and welfare technologies are not fully integrated into long-term care services. Innovation with welfare technology appears top-down and is influenced by national policy but also reflects creating a window of opportunity through the organization of municipal efforts toward integrating welfare technology through, for example, collaborations and committing personnel and financial resources.


2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Hanne Marie Rostad ◽  
Marianne Sundlisæter Skinner ◽  
Ragnhild Hellesø ◽  
Maren Kristine Raknes Sogstad

Abstract Background Numerous forces drive the evolution and need for transformation of long-term care services. During the previous decade, primary health care has assumed increased responsibility for developing and providing care services, but there is still limited knowledge about how European care service systems are evolving to address new tasks and patients. Based on data from Norwegian municipalities, this study aims to (1) describe the availability of specialised services in Norwegian nursing homes and home care services and (2) analyse whether structural factors, like population size and/or centrality, are associated with the availability of specialised services in nursing homes and home care. Methods This is a cross-sectional study of survey data. An online survey was designed specifically for this study. Its questions were developed from a comprehensive review of the literature and in partnership with a user panel. One representative from all of Norway’s 422 municipalities were invited to answer the survey from February to April 2019. In total, 277 municipalities completed the survey (response rate 66%). Chi-square analysis and Fisher’s exact test were used to test the associations between different categorical variables. Results Specialised care services were highly prevalent. For example, there were nursing home units specialising in dementia care (89%) and rehabilitation (81%) and home care teams for dementia care (79%) and reablement (76%). Approximately two-thirds of our sample were categorised as having high availability of specialisation in nursing home and home care services. The larger, more central municipalities had higher availability of specialisation compared to medium-sized and small, less central municipalities. Conclusions Our study indicates that a majority of nursing homes and home care services provide specialised and differentiated services that serve patient groups of different ages and diagnoses. Municipalities’ population size and centrality are associated with availability of specialised services in nursing homes and home care services.


2021 ◽  
Vol 2021 ◽  
pp. 1-19
Author(s):  
Y. P. Tsang ◽  
C. H. Wu ◽  
Polly P. L. Leung ◽  
W. H. Ip ◽  
W. K. Ching

Due to the global ageing population, the increasing demand for long-term care services for the elderly has directed considerable attention towards the renovation of nursing homes. Although nursing homes play an essential role within residential elderly care, professional shortages have created serious pressure on the elderly service sector. Effective workforce planning is vital for improving the efficacy and workload balance of existing nursing staff in today’s complex and volatile long-term care service market. Currently, there is lack of an integrated solution to monitor care services and determine the optimal nursing staffing strategy in nursing homes. This study addresses the above challenge through the formulation of nursing staffing optimisation under the blockchain-internet of things (BIoT) environment. Embedding a blockchain into IoT establishes the long-term care platform for the elderly and care workers, thereby decentralising long-term care information in the nursing home network to achieve effective care service monitoring. Moreover, such information is further utilised to optimise nursing staffing by using a genetic algorithm. A case study of a Hong Kong nursing home was conducted to illustrate the effectiveness of the proposed system. We found that the total monthly staffing cost after using the proposed model was significantly lower than the existing practice with a change of −13.48%, which considers the use of heterogeneous workforce and temporary staff. Besides, the care monitoring and staffing flexibility are further enhanced, in which the concept of skill substitution is integrated in nursing staffing optimisation.


2020 ◽  
Author(s):  
Hanne Marie Rostad ◽  
Randi Stokke

BACKGROUND Welfare technologies are often described as a solution to the increasing pressure on primary health care services. However, despite initiating welfare technology projects in the health care sector and different government incentives, research indicates that it is difficult to integrate welfare technology innovations in a complex and varying setting, such as long-term care. OBJECTIVE We aim to describe the types of welfare technology and the extent to which welfare technology is provided in long-term care (ie, nursing homes and home care services); examine whether the extent of welfare technology provision differs on the basis of municipal characteristics (ie, population size, centrality, the proportion of older inhabitants, and income); and identify how local governments (ie, municipalities) describe their efforts toward integrating welfare technologies in long-term care. METHODS Quantitative and qualitative data about welfare technology from a larger cross-sectional survey about the provision of long-term care services in Norwegian municipalities were combined with registry data. Representatives of 422 Norwegian municipalities were invited to participate in the survey. Frequencies were used to describe the distribution of the types and extent of welfare technologies, whereas the Fisher exact test and Kruskal-Wallis one-way analysis of variance were used to determine the association between the extent of welfare technology and municipal characteristics. Free-form text data were analyzed using thematic analysis. RESULTS A total of 277 municipalities were surveyed. Technology for safety was the most widespread type of welfare technology, whereas technology for social contact was the least prevalent. Two-thirds of the sample (183/277, 66.1%) in nursing home and (197/277, 71.1%) in home care services reported providing one or two different types of welfare technology. There was a statistically significant association between the extent of welfare technology and population size (in both nursing homes and home care services: <i>P</i>=.01), centrality (nursing homes: <i>P</i>=.01; home care services: <i>P</i>&lt;.001), and municipal income (nursing homes: <i>P</i>=.02; home care services: <i>P</i>&lt;.001). The extent of welfare technology was not associated with the proportion of older adults. The municipalities described being in a piloting phase and committing to future investment in welfare technology. Monetary resources were allocated, competency development among staff was initiated, and the municipalities were concerned about establishing collaborations within and between municipalities. Home care services seem to have a more person-centered approach in their efforts toward integrating welfare technologies, whereas nursing homes seem to have a more technology-centered approach. CONCLUSIONS Many municipalities provide welfare technologies; however, their extent is limited and varies according to municipal characteristics. Municipal practices still seem dominated by piloting, and welfare technologies are not fully integrated into long-term care services. Innovation with welfare technology appears top-down and is influenced by national policy but also reflects creating a <i>window of opportunity</i> through the organization of municipal efforts toward integrating welfare technology through, for example, collaborations and committing personnel and financial resources.


Long-term care for older adults is highly affect by the COVID-19 outbreak. The objective of this rapid review is to understand what we can learn from previous crises or disasters worldwide to optimize the care for older adults in long term care facilities during the outbreak of COVID-19. We searched five electronic databases to identify potentially relevant articles. In total, 23 articles were included in this study. Based on the articles, it appeared that nursing homes benefit from preparing for the situation as best as they can. For instance, by having proper protocols and clear division of tasks and collaboration within the organization. In addition, it is helpful for nursing homes to collaborate closely with other healthcare organizations, general practitioners, informal caregivers and local authorities. It is recommended that nursing homes pay attention to capacity and employability of staff and that they support or relieve staff where possible. With regard to care for the older adults, it is important that staff tries to find a new daily routine in the care for residents as soon as possible. Some practical tips were found on how to communicate with people who have dementia. Furthermore, behavior of people with dementia may change during a crisis. We found tips for staff how to respond and act upon behavior change. After the COVID-19 outbreak, aftercare for staff, residents, and informal caregivers is essential to timely detect psychosocial problems. The consideration between, on the one hand, acute safety and risk reduction (e.g. by closing residential care facilities and isolating residents), and on the other hand, the psychosocial consequences for residents and staff, were discussed in case of other disasters. Furthermore, the search of how to provide good (palliative) care and to maintain quality of life for older adults who suffer from COVID-19 is also of concern to nursing home organizations. In the included articles, the perspective of older adults, informal caregivers and staff is often lacking. Especially the experiences of older adults, informal caregivers, and nursing home staff with the care for older adults in the current situation, are important in formulating lessons about how to act before, during and after the coronacrisis. This may further enhance person-centered care, even in times of crisis. Therefore, we recommend to study these experiences in future research.


Sign in / Sign up

Export Citation Format

Share Document