More Care at Home: The Challenge of Creating Viable Community Alternatives to Nursing Home Care

2005 ◽  
Vol 6 (1) ◽  
pp. 9-14 ◽  
Author(s):  
Alene Hokenstad

Creating a national long-term care (LTC) delivery “infrastructure”—one that would make home-based care more accessible to people with extensive needs—will be a major undertaking. It will require new service organizations that have the authority to provide and coordinate an appropriate array of services. Medicaid Managed Long-Term Care (MLTC) and the Programs of All-Inclusive Care for the Elderly (PACE) offer two promising examples of what the service organizations of the future might look like. The history of how these plans developed illuminates challenges that others will encounter. Further expansion of these types of organizations requires resolution of resource, staffing, and operational issues.

1996 ◽  
Vol 8 (4) ◽  
pp. 561-574 ◽  
Author(s):  
Lena Annerstedt ◽  
Junko Sanada ◽  
Lars Gustafson

The dynamic processes and the way they interact in shaping a care system for demented patients are analyzed and discussed. The development of disability/dependency, interpreted in a simulation model based on Katz's index of ADL and Berger's scale “Rating the severity of senility,” gave insight into the interplay of four care levels: psychogenatric long-term care for patients with severe behavioral disturbances, nursing-home care for patients with highly reduced ADL capacity who are often moderately to severely demented, group-living care for the demented with less dominating ADL dependency, and residential care for the elderly frail with or without symptoms of dementia. For each facility in this chain of care, characteristics in patients' symptomatology and behavior could also be identified. Resources necessary in order to fulfill goals in caring differed between each facility.


2017 ◽  
Vol 20 (2) ◽  
pp. 286-299 ◽  
Author(s):  
Fátima Ferreira Roquete ◽  
Carolina Campos Ricci Frá Batista ◽  
Rodrigo Caetano Arantes

Abstract Objective: to analyze the care and management demands of Long-Term Care Facilities for the Elderly (LTCFs) in Brazil. Method: an integrative review of literature was carried out, organized into six stages: a) elaboration of a guiding question; b) online search of LILACS, SciELO, PubMed, the CAPES Portal and the Brazilian Society of Geriatrics and Gerontology databases; c) article selection, following the exclusion and inclusion criteria, with the sample composed of 17 articles; d) commented analysis of the selected articles; e) deliberation on the results obtained, formulated from the synthesis and interpretation of the selected studies; f) presentation of the results of the review. Results: the care demands identified are related to the process of caring and assume a working team with geriatric and gerontological knowledge, while the management demands include the means and resources needed so the care can be provided effectively. However, the LTCFs were found to rely on professionals who are unprepared to provide care or to assume an organizational management role, meaning care for the elderly is restricted to the essentials for their basic needs. Conclusion: the care demands were easily identified in the analyzed publications, however, there is a lack of research that evaluates management demands in a broader and more in-depth manner. It is suggested that studies aiming to broaden theoretical knowledge of the care and management demands of LTCFs are carried out, to stimulate effective and positive actions in the practices of these institutions, seeking to offer top quality care to elderly persons that live in these facilities, that responds to the real needs of their current stage of life.


Author(s):  
Mårten Lagergren

RÉSUMÉLes modes de référence de patients entre différents niveaux de soins dans un système local de soins de longue durée pour personnes âgées et handicapées sont décrits et analysés à l'aide des données collectées de 1985 à 1991 dans la commune de Solna grâce au système de contrôle appelé ASIM. Ces références entre niveaux de soins avaient lieu dans les deux sens, mais la fréquence des transferts vers le bas était faible comparée au nombre de transferts vers le haut – en particulier pour les foyers-logements et les résidences-hôtels. Pour tous les niveaux de soins, on a constaté de grandes variations dans le degré d'incapacité des personnes prises en charge, suggérant le charactère non-systématique des procédés d'évaluation lors de l'admission dans les services de soins. Une analyse des changements intervenus avec le temps dans les modes de référence a illustré l'interdepéndence des différents niveaux des soins. La réduction des ressources des services de soins hospitaliers de longue durée a eu pour résultats un arrêt presque total des références à partir des résidences-hôtels et une augmentation générale de l'incapacité moyenne des patients pris en charge.


2007 ◽  
Vol 30 (5) ◽  
pp. 498-507 ◽  
Author(s):  
Tarja Heponiemi ◽  
Marko Elovainio ◽  
Juha Laine ◽  
Laura Pekkarinen ◽  
Martin Eccles ◽  
...  

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