Outcomes of the Maryland Person-Centered Hospital Discharge Program: A Pilot Targeting Decreasing Long-Term Care Use and Hospital Readmissions

2015 ◽  
Vol 16 (1) ◽  
pp. 48-58 ◽  
Author(s):  
Allison Payne Carew ◽  
Barbara Resnick
Keyword(s):  
At Risk ◽  
Nursing Home ◽  
Hospital Discharge ◽  
Long Term Care ◽  
Care Coordinator ◽  
Term Care ◽  
Skilled Nursing ◽  
Care Coordinators

The Person-Centered Hospital Discharge Program (PCHDP) was offered by the Centers for Medicare and Medicaid Services as a way to improve care to Medicare and Medicaid beneficiaries in Maryland. The PCHDP used a care nurse/coordinator to facilitate the successful transition of patients at risk for becoming eligible for Medicaid. The purpose of this study was to examine the outcomes of the PCHDP pilot, explore factors that influenced hospital and long-term care admissions following hospital discharge, and obtain operational data to develop new programs with related objectives. Area Agencies on Aging were provided with a care coordinator who obtained patient data, developed an individualized care plan, and determined visit frequency and length of services. Multivariate analysis of variance was conducted to examine differences between those hospitalized or admitted to a skilled nursing facility during the follow-up period. The sample consisted of 359 at-risk patients, and the mean length of follow-up was approximately two months. Most patients did not go to the emergency room (N = 319, 88%) during the period of follow-up and were not admitted to an acute care setting (N = 301, 84%) or skilled nursing home (N = 322, 86%). Those who were rehospitalized were slightly younger and had more visits from the care coordinator. We anticipate that the care coordinators identified individuals at greatest need for follow-up and support. Future research should explore ways in which these care coordinators can intervene to prevent hospital readmission and long-term nursing home care.

scholarly journals New Institutionalization in Long‐Term Care After Hospital Discharge to Skilled Nursing Facility

2017 ◽  
Vol 66 (1) ◽  
pp. 56-63 ◽  
Author(s):  
Addie Middleton ◽  
Shuang Li ◽  
Yong‐Fang Kuo ◽  
Kenneth J. Ottenbacher ◽  
James S. Goodwin
Keyword(s):  
Hospital Discharge ◽  
Long Term Care ◽  
Skilled Nursing Facility ◽  
Nursing Facility ◽  
Term Care ◽  
Skilled Nursing

Uitbraak COVID-19 in de verpleeghuiszorg

2020 ◽  
Keyword(s):  
Older Adults ◽  
Nursing Home ◽  
Nursing Homes ◽  
Long Term Care ◽  
Informal Caregivers ◽  
Rapid Review ◽  
Daily Routine ◽  
Term Care ◽  
Care Facilities

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.

Predictors of Mortality in Board and Care Homes

1997 ◽  
Vol 36 (1) ◽  
pp. 77-87 ◽  
Author(s):  
Nicholas G. Castle
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Social Services ◽  
Long Term Care ◽  
Significant Proportion ◽  
The Elderly ◽  
Term Care ◽  
Care Facilities ◽  
Board And Care

Long-term care institutions have emerged as dominant sites of death for the elderly. However, studies of this trend have primarily examined nursing homes. The purpose of this research is to determine demographic, functional, disease, and facility predictors and/or correlates of death for the elderly residing in board and care facilities. Twelve factors are found to be significant: proportion of residents older than sixty-five years of age, proportion of residents who are chair- or bed-fast, proportion of residents with HIV, bed size, ownership, chain membership, affiliation with a nursing home, number of health services provided other than by the facility, the number of social services provided other than by the facility, the number of social services provided by the facility, and visits by Ombudsmen. These are discussed and comparisons with similar studies in nursing homes are made.

scholarly journals Mental well‐being of staff in long‐term care facilities at risk

2021 ◽  
Author(s):  
Chiaki Ura ◽  
Tsuyoshi Okamura ◽  
Akinori Takase ◽  
Masaya Shimmei ◽  
Yukan Ogawa
Keyword(s):  
At Risk ◽  
Long Term Care ◽  
Well Being ◽  
Term Care ◽  
Care Facilities ◽  
Mental Well Being

scholarly journals Impact of Frailty on Medical and Long-Term Care Expenditures for the Elderly Age 75 or Over in Japan

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 176-176
Author(s):  
Hiroto Yoshida ◽  
Yuriko Kihara
Keyword(s):  
Long Term Care ◽  
The Elderly ◽  
Elderly Age ◽  
Term Care ◽  
Intentional Weight Loss ◽  
Long Term Care Insurance ◽  
And Gender ◽  
The Impact

Abstract This study examined the impact of frailty on medical and long-term care expenditures in an older Japanese population. The subjects were those aged 75 years and over who responded to the survey (March 2018) in Bibai, Hokkaido, Japan (n=1,203) and have never received certification of long-term care insurance at the survey. We followed up 867 individuals (72.1%) until the end of December 2018 (10 month-period). We defined frailty as a state in performing 4 items and over of 15 items which were composed of un-intentional weight loss, history of falls, etc. Among 867 subjects, 233 subjects (26.9%) were judged to be frailty group, and 634 subjects (73.1%) non-frailty group. We compared period to the new certification of long-term care insurance (LTCI), accumulated medical and long-term care expenditures adjusted for age and gender between the two groups during the follow-up period. Cox proportional hazard models were used to examine the association between baseline frailty and the new certification of LTCI. The relative hazard ratio (HR) was higher in frailty group than non-frailty group (HR=3.51, 95% CI：1.30-9.45, P=.013). The adjusted mean accumulated medical and long-term care expenditures per capita during the follow-up were significantly (P=.002) larger for those in the frailty group (629,699 yen), while those in the non-frailty group were 450,995 yen. We confirmed strong economic impact of frailty in the elderly aged 75 or over in Japan.

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