scholarly journals ‘The Open Typology’: Towards Socially Sustainable Architectural and Care Types

2019 ◽  
Vol 16 (1) ◽  
Author(s):  
Davide Landi
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Health Care Providers ◽  
Open System ◽  
Care Delivery ◽  
Well Being ◽  
Care Providers ◽  
Contemporary Culture ◽  
Term Care ◽  
High Dependency

One aspect that characterises the twenty-first century is its accomplishments such as better health-care systems, improved economies, a reduction in infant mortality and a growing number of adults living longer. However, these accomplishments can have a downside. For example, people are living longer while at the same time dementia rates are increasing significantly. With the increase in demand for high-dependency-related services, while at the same time costs are spiralling possibly out of control of societal budgets, there is a need for a shift in the care model. Additionally, difficulties in defining a clear dividing line between normal ageing and pathological ageing have led to a stigmatisation of older adults as a social and economic burden. This type of segregation and stigmatisation must be addressed to ensure future care delivery is inclusive. The positive benefits of an inclusive care system are both social and economic, and at an individual level it can positively impact upon an older adult’s mental and physical well-being. Taking this into consideration, the aim of this paper is to describe and empirically explore Humanitas© in Deventer, the Netherlands, a nursing home with a population of 50 older adults with dementia, 80 people with severe physical suffering, 20 people with social difficulties, 10 people in short stay for recovery and 6 university students. This analysis will be adopted as a ‘tool’ for the definition of a new way of conceiving architectural types in contemporary culture, based on the concept of an ‘open system’ described by Richard Sennett. In this study, an open system is able to promote a new paradigm of care built upon inclusive collaboration and teamwork between different categories of health-care providers, volunteers, residents and their families. This will allow an alternative paradigm of older adults’ long-term care and its architectural correlate to ‘normalise’ ageing and its related mental and physical impairments, rather than to ‘medicalise’ and stigmatise.

scholarly journals Improving Care for Elders Who Prefer Informal Spaces to Age-Separated Institutions and Health Care Settings

2019 ◽  
Vol 3 (3) ◽  
Author(s):  
Stacy Torres ◽  
Xuemei Cao
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Health Care Providers ◽  
Public Transportation ◽  
Urban Areas ◽  
Health Care Services ◽  
Well Being ◽  
Care Providers ◽  
Third Places ◽  
Health Care Settings

Abstract Background and Objectives Despite advantages of urban areas (such as walkability, public transportation, nearby shopping, and health care services), challenges remain for elders aging in place to access care. The changing demographics of older adults, with higher rates of divorce, singlehood, and childlessness, often living alone and far from family, necessitate new strategies to support health and well-being. Research Design and Methods Drawing on 5 years of ethnographic fieldwork and 25 interviews with elders in New York City, this study presents empirical insights into older adults’ use of “third places” close to home, in conjunction with more formal settings. Results This article identifies external and internalized ageism and complicated age-based identity as important reasons why older adults preferred “third places” to age-separated spaces such as senior centers and formal settings such as health care settings. We find that neighborhood “third places” offer important physical venues for older adults to process negative or hurried interactions in other formal and age-separated places. Discussion and Implications This article makes policy suggestions for increasing access and usage of essential services, including developing attractive and appealing intergenerational spaces in which older community members can obtain services and dispatching caseworkers to public spaces where elders congregate. Furthermore, this article recommends improving exchanges between health care providers and older adults so that they feel recognized, respected, and cared for, which can improve health care outcomes.

scholarly journals The Impact of Attitudes and Behaviors on Nurse Satisfaction, Well-being, and Outcomes of Patient Care

2020 ◽  
pp. 15-17
Author(s):  
Alan H Rosenstein
Keyword(s):  
Health Care ◽  
Patient Care ◽  
Health Care Providers ◽  
Care Delivery ◽  
Well Being ◽  
Care Providers ◽  
Health Care Environment ◽  
Attitudes And Behaviors ◽  
And Behaviors ◽  
The Impact

Healthcare is a complex multidimensional system that depends upon effective communication and collaboration amongst all members of the health care team as the key ingredient for best patient care. In the current health care environment all health care providers are feeling the growing pressures on care delivery and the changing health dynamics which in many instances has negatively impacted their attitudes and behaviors toward medical care. Nursing is a key part of this process. In order to provide best patient care, affiliated organizations need to recognize how important staff satisfaction and engagement is to care continuity and provide the necessary resources and support to maintain staff physical, emotional, and behavioral well- being. The aim of the article is to review key literature findings to help organizations recognize the causes and consequences of stress and burnout and the importance of providing the appropriate support and resources to help nurses succeed.

scholarly journals “You Get Three Different Hats on and Try to Figure It Out:” Home-based Care Provision During a Disaster

2021 ◽  
Author(s):  
Sue Anne Bell ◽  
Sarah Dickey ◽  
Marie-Anne Rosemberg
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Focus Groups ◽  
Health Care Providers ◽  
Well Being ◽  
Home Health ◽  
Qualitative Inquiry ◽  
Care Providers ◽  
Home Based ◽  
Home Based Care

Abstract Background: Home-based care is a vital, and growing, part of the health care system that allows individuals to remain in their homes while still receiving health care. During a disaster, when normal health care systems are disrupted, home-based care remains a vital source of support for older adults. The purpose of this study was to describe the experiences of home-based care providers in providing care to older adults during a disaster in order to inform future disaster planning.Methods: Using qualitative inquiry informed by the social ecological model, five focus groups were conducted with home health nurses (n=25) in two settings affected by Hurricane Irma and Hurricane Harvey. An open-source database of home health agencies participating in Centers for Medicare and Medicaid Services programs was used to identify participants. Data were manually coded and larger themes were generated from recurring ideas and concepts using an abductive analysis approach. Results: Twenty five participants were included in one of five focus groups. Of the 22 who responded to the demographic survey, 65% were registered nurses, 20% were Licensed Vocational Nurses (LVN), and 15% were other types of health care providers. 12% of the sample was male and 88% was female. Seven themes were identified in the analysis: the importance of the community in preparedness and response, government and corporations were viewed as unreliable, disasters exacerbate inequalities, the role of the family bond, the breakdown of preparedness is at implementation, the tension between caring for self and family and caring for patients, and the resilience and adaptability of home based care providers.Conclusions: While home-based care providers faced multiple challenges to providing care during and after a disaster, the importance of community supports and existing nursing models of care in the immediate period after the disaster were emphasized. This study informs the growing body of evidence on the value of home-based care in promoting safety and well-being for older adults during a disaster.

Spiritual Care in the Intensive Care Unit: A Narrative Review

2017 ◽  
Vol 33 (5) ◽  
pp. 279-287 ◽  
Author(s):  
Jim Q. Ho ◽  
Christopher D. Nguyen ◽  
Richard Lopes ◽  
Stephen C. Ezeji-Okoye ◽  
Ware G. Kuschner
Keyword(s):  
Health Care ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Health Care Providers ◽  
Spiritual Care ◽  
Health Care Professionals ◽  
Care Delivery ◽  
Well Being ◽  
Special Focus ◽  
Care Providers

Spiritual care is an important component of high-quality health care, especially for critically ill patients and their families. Despite evidence of benefits from spiritual care, physicians and other health-care providers commonly fail to assess and address their patients’ spiritual care needs in the intensive care unit (ICU). In addition, it is common that spiritual care resources that can improve both patient outcomes and family member experiences are underutilized. In this review, we provide an overview of spiritual care and its role in the ICU. We review evidence demonstrating the benefits of, and persistent unmet needs for, spiritual care services, as well as the current state of spiritual care delivery in the ICU setting. Furthermore, we outline tools and strategies intensivists and other critical care medicine health-care professionals can employ to support the spiritual well-being of patients and families, with a special focus on chaplaincy services.

scholarly journals Improving Quality and Access to Care in Long-Term Care Settings

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 328-328
Author(s):  
Nancy Dudley ◽  
Nancy Dudley
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Health Care Providers ◽  
Low Income ◽  
Workplace Violence ◽  
Independent Living ◽  
Long Term Care ◽  
Care Providers ◽  
Term Care

Abstract Innovative delivery models that assure access to quality care in long-term care settings are needed for the diverse high-risk aging U.S. population. The 2008 National Academy of Medicine report, “Retooling for an Aging America: Building the Health Care Workforce” highlighted the need for changing the roles of health care providers in order to provide high-quality and cost-effective care to older Americans. Moreover, from the providers’ perspective, workplace violence in health care institutions, such as nursing homes, negatively affect the delivery, quality, and accessibility of health care. In this symposium, we identify needs and care provisions in the context of older adults aging in long-term care settings and discuss the implications for policy and health care transformation. This symposium comprises three distinct presentations: (1) identifying and addressing the needs of diverse older adults aging in low-income independent living facilities in community health practice; and based on pilot survey results from nurses in the State of New Hampshire, (2) reframing residents’ violence directed toward providers as self-protection and (3) proposing legislative and policy changes designed to meet the needs of staff and residents of long-term care facilities. These presentations represent efforts across long-term care settings to improve access and quality of care in the context of diverse older adults aging in the U.S.

scholarly journals HEALTHCARE ACCESS AND SOCIAL ENGAGEMENT OF OLDER MINORITY ADULTS: EXPERIENCES NAVIGATING TRANSPORTATION BARRIERS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S902-S903
Author(s):  
December Maxwell ◽  
Rebecca L Mauldin ◽  
Dennis Kao
Keyword(s):  
Older Adults ◽  
Health Care ◽  
African American ◽  
Health Care Providers ◽  
Social Engagement ◽  
Healthcare Access ◽  
Well Being ◽  
Spatial Accessibility ◽  
Care Providers ◽  
Health And Well Being

Abstract Transportation is vital in the daily lives of older adults and provides access to health care services and health enhancing activities, such as social engagement. Disparities in mobility exist for older African American and Hispanic adults compared to non-Hispanic Whites, including higher likelihood of driving cessation at an earlier age and having a higher risk for reduced life space. This poster presents findings from a qualitative analysis of data from the Using Geo-Ethnography to Explore the Spatial Accessibility of Health Services for Aging Minorities Study (GeoSAS), a mixed methods study of older minority adults in Houston, TX. Using interpretive phenomenological analysis, the transcripts of semistructured interviews with 23 older adults (13 African American and 10 Hispanic; 17 female; mean age = 71.3 yrs, SD = 6.3 years) were analyzed to address the research question: What are the mobility experiences and perceptions of minority older adults regarding healthcare access and social engagement? Based on an ecological systems theoretical framework, we found reciprocal influences of (1) healthcare systems and transportation utilization and (2) participants’ health and well-being, mobility, and social engagement. Support from family members and financial capacity were critical for participants’ mobility. Implications of this research include educating health care providers about patients’ transportation experiences and barriers, optimizing social support to increase mobility, and addressing systematic disparities in transportation access to enhance health and well-being for older minority adults.

Interdisciplinary Therapy Assessments for the Older Adult

2012 ◽  
Vol 17 (1) ◽  
pp. 11-16
Author(s):  
Lynn Chatfield ◽  
Sandra Christos ◽  
Michael McGregor
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Standardized Testing ◽  
Health Care Providers ◽  
Outcome Measurement ◽  
Care Providers ◽  
Patient Centered ◽  
Screening Process ◽  
Evidenced Based ◽  
Changing Economy

In a changing economy and a changing industry, health care providers need to complete thorough, comprehensive, and efficient assessments that provide both an accurate depiction of the patient's deficits and a blueprint to the path of treatment for older adults. Through standardized testing and observations as well as the goals and evidenced-based treatment plans we have devised, health care providers can maximize outcomes and the functional levels of patients. In this article, we review an interdisciplinary assessment that involves speech-language pathology, occupational therapy, physical therapy, and respiratory therapy to work with older adults in health care settings. Using the approach, we will examine the benefits of collaboration between disciplines, an interdisciplinary screening process, and the importance of sharing information from comprehensive discipline-specific evaluations. We also will discuss the importance of having an understanding of the varied scopes of practice, the utilization of outcome measurement tools, and a patient-centered assessment approach to care.

Genetic Predispositions, Prophylactic Treatments and Private Health Insurance: Nothing is Better Than a Good Pair of Genes

1997 ◽  
Vol 23 (1) ◽  
pp. 45-68 ◽  
Author(s):  
Alexandra K. Glazier
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Genetic Predisposition ◽  
Genetic Linkage ◽  
Dna Analysis ◽  
Care Delivery ◽  
Medical Community ◽  
Care Providers ◽  
Linkage Studies ◽  
Prophylactic Measures

Discovering the genetic basis of a particular disease is not only of great interest to the medical community; private health insurers are also anxiously awaiting the results of genetic linkage studies. Apart from the scientific value of DNA studies, the results of genetic linkage research are relevant to health care delivery in two principal ways. First, identifying the genetic origin of a disease may allow doctors to detect the disease earlier. If doctors know that an individual is genetically predisposed to a particular disease, then health care providers can increase screening efforts and watch for early symptoms. Second, if an individual has a genetic predisposition to a particular disease, health care providers may employ preventive or “prophylactic" measures to reduce or eliminate the risk of developing the disease or condition to which the individual is genetically predisposed. Genetic linkage studies will soon allow more individuals to learn of their own genetic predispositions to certain diseases. Currently genetic predisposition tests (both pedigrees of family history and DNA analysis) can indicate that an individual is at high risk for developing a disease.

Nurse Practitioner Challenges to the Orthodox Structure of Health Care Delivery: Regulation and Restraints on Trade

1985 ◽  
Vol 11 (2) ◽  
pp. 195-225
Author(s):  
Karla Kelly
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Health Care Delivery ◽  
Nurse Practitioners ◽  
Nurse Practitioner ◽  
Allied Health ◽  
Care Delivery ◽  
The United States ◽  
Care Providers ◽  
Allied Health Care

AbstractUntil recently, physicians have been the primary health care providers in the United States. In response to the rising health care costs and public demand of the past decade, allied health care providers have challenged this orthodox structure of health care delivery. Among these allied health care providers are nurse practitioners, who have attempted to expand traditional roles of the registered nurse.This article focuses on the legal issues raised by several major obstacles to the expansion of nurse practitioner services: licensing restrictions, third party reimbursement policies, and denial of access to medical facilities and physician back-up services. The successful judicial challenges to discriminatory practices against other allied health care providers will be explored as a solution to the nurse practitioners’ dilemma.

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