scholarly journals Seniors’ Campus Continuums: Local Solutions for Broad Spectrum Seniors Care

2020 ◽  
Author(s):  
Frances Margaret Morton-Chang ◽  
Shilpi Majumder ◽  
Whitney Berta

Abstract Background: As demand and desire to “age-in-place” grows within an aging population, challenges exist to realizing this wish. Changing demographics and new areas of need have governments nationally and internationally calling for more focused attention on integrative approaches to health and well-being. Seniors’ Campus Continuums are models of care that seek to broaden access to an array of services and housing options to meet the growing health and social needs of aging populations in their communities . The objective of this study is to increase understanding of this integrative model through the exploration of factors that influence Campus development, functioning, and scope and extent of integration of care for older adults wishing to remain in their own home and community.Methods: This research uses a comparative case study approach across six bounded cases offering four physically co-located components – mixed independent housing options, internal community supports to residents, external community supports to the broader community, and a long-term care home – to explore how Seniors’ Campus Continuums operating in various contexts across Ontario, Canada integrate health, housing and social care for older adults.Results: Seniors’ Campus Continuums come in different shapes, sizes, and geographies however, they share many influencing factors in their evolution, design, function, and ability to integrate a broad range of supports and services for older adults with different and progressive needs. Enabling factors include i. rich historical legacies of helping people in need; ii. organizational vision and readiness to capitalize on key windows of opportunity; iii. leveraging organizational structure and capacity; iv. intentional physical and social design; v. broad services mix, amenities and innovative partnerships. Impeding factors include vi. policy hurdles and rigidities; vii. human resources shortages and inequities; and viii. funding limitations. A number of benefits afforded by campuses at an individual, organizational and system level were observed. Conclusion: Findings from this research provide detailed descriptions of campus continuums from inception to expansion and highlight opportunities to optimize their potential on many levels. At an individual level, campuses increase local access to a coordinated range of care services, supports and housing options that can be tailored to benefit their health and social care needs. At an organizational level, campuses offer enhanced collaboration opportunities across providers and partners to improve consistency and coordination of care, access to shared resources, expertise and infrastructure, improved economies of scale, and rich environments for training/research, education and volunteering. At a system level, they offer potential to address a diversity of health, social, financial, and housing needs to help seniors avoid premature or inappropriate use of higher intensity care settings. This study fills a gap in evidence-based research on this integrative model and offers lessons to consider for future “age-friendly” policy development.

2019 ◽  
Author(s):  
Frances Margaret Morton-Chang ◽  
Shilpi Majumder ◽  
Whitney Berta

Abstract Background As demand and desire to “age-in-place” grows within an aging population, challenges exist to realizing this wish. Changing demographics and new areas of need have governments nationally and internationally calling for more focused attention on integrative approaches to health and well-being. Seniors’ Campus Continuums seek bridge the “divide” between health and social care for residents and local community. This paper investigates factors that influence Campus evolution, ongoing functioning, and ability to offer wrap around care for older adults wishing remain in their own home and community. Methods This research uses a comparative case study approach across multiple bounded cases to explore how Seniors’ Campus Continuums operating in various contexts integrate health, housing and social care around older adults living on the campus and in the local community. Six seniors’ campuses from across Ontario offering four physically co-located components – mixed independent housing options, internal community supports to residents, external community supports to the broader community, and a long-term care home – were studied and compared. Results Eight factors that promote or impede Seniors’ Campus Continuum evolution, design and function, and ability to provide wrap-around care to older adults with progressive needs are identified including: i. historical legacies; ii. windows of opportunity; iii. organizational structure and capacity; iv. intentional physical and social design; v. campus services mix, amenities and partnerships; vi. policy rigidities and enablers; vii. human resources shortages and innovation; viii. funding limitations and opportunities. Together these factors describe opportunities to optimize care on many levels. Conclusion Seniors’ Campus Continuums offer creative boundary-spanning approaches to address a variety of needs while taking into account local contexts. At an individual level, campuses increase access to a range of care supports and housing options to benefit seniors’ health and wellbeing. At an organizational level, they offer consistency and coordination of care, improved economies of scale, and rich environments for training/research, education and volunteering. At a system level, they offer potential to help people avoid ending up in the “wrong places.” This study fills a gap in evidence-based research around understanding of this integrative model and offers lessons learned for future development.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Frances Morton-Chang ◽  
Shilpi Majumder ◽  
Whitney Berta

Abstract Background As demand and desire to “age-in-place” grows within an aging population, and new areas of need emerge, governments nationally and internationally are focusing effort and attention on innovative and integrative approaches to health and well-being. Seniors’ Campus Continuums are models of care that seek to broaden access to an array of services and housing options to meet growing health and social needs of aging populations. The objective of this study is to increase understanding of this model and factors that influence their evolution, development, ongoing functioning and capacity to integrate care for older adults wishing to age in their own home and community. Methods This research uses a comparative case study approach across six-bounded cases offering four geographically co-located components (mixed housing options, internal and external community supports, and a long-term care home) in various contexts across Ontario, Canada. Onsite in-person and phone interviews with senior campus staff (N = 30), and campus partners (N = 11), enhanced by direct observation at campuses explored historical and current efforts to offer health, housing and social care continuums for older adults. Results Analysis highlighted eight key factors. Enabling factors include i. rich historical legacies of helping people in need; ii. organizational vision and readiness to capitalize on windows of opportunity; iii. leveraging organizational structure and capacity; iv. intentional physical and social design; v. broad services mix, amenities and innovative partnerships. Impeding factors include vi. policy hurdles and rigidities; vii. human resources shortages and inequities; and viii. funding limitations. A number of benefits afforded by campuses at different levels were also observed. Conclusion Findings from this research highlight opportunities to optimize campus potential on many levels. At an individual level, campuses increase local access to a coordinated range of health and social care services, supports and housing options. At an organizational level, campuses offer enhanced collaboration opportunities across providers and partners to improve consistency and coordination of care, and improved access to shared resources, expertise and infrastructure. At a system level, campuses can address a diversity of health, social, financial, and housing needs to help seniors avoid premature or inappropriate use of higher intensity care settings.


2020 ◽  
Author(s):  
Frances Margaret Morton-Chang ◽  
Shilpi Majumder ◽  
Whitney Berta

Abstract Background: As demand and desire to “age-in-place” grows within an aging population, and new areas of need emerge, governments nationally and internationally are focusing effort and attention on innovative and integrative approaches to health and well-being. Seniors’ Campus Continuums are models of care that seek to broaden access to an array of services and housing options to meet growing health and social needs of aging populations. The objective of this study is to increase understanding of this model and factors that influence their evolution, development, ongoing functioning and capacity to integrate care for older adults wishing to age in their own home and community.Methods: This research uses a comparative case study approach across six-bounded cases offering four geographically co-located components (mixed housing options, internal and external community supports, and a long-term care home) in various contexts across Ontario. Onsite in-person and phone interviews with senior campus staff (N=30), and campus partners (N=11), enhanced by direct observation at campuses explored historical and current efforts to offer health, housing and social care continuums for older adults.Results: Analysis highlighted eight key factors. Enabling factors include i. rich historical legacies of helping people in need; ii. organizational vision and readiness to capitalize on windows of opportunity; iii. leveraging organizational structure and capacity; iv. intentional physical and social design; v. broad services mix, amenities and innovative partnerships. Impeding factors include vi. policy hurdles and rigidities; vii. human resources shortages and inequities; and viii. funding limitations. A number of benefits afforded by campuses at different levels were also observed. Conclusion: Findings from this research highlight opportunities to optimize campus potential on many levels. At an individual level, campuses increase local access to a coordinated range of health and social care services, supports and housing options. At an organizational level, campuses offer enhanced collaboration opportunities across providers and partners to improve consistency and coordination of care, access to shared resources, expertise and infrastructure among other benefits. At a system level, campuses can address a diversity of health, social, financial, and housing needs to help seniors avoid premature or inappropriate use of higher intensity care settings.


2020 ◽  
Author(s):  
Frances Margaret Morton-Chang ◽  
Shilpi Majumder ◽  
Whitney Berta

Abstract Background: As demand and desire to “age-in-place” grows within an aging population, and new areas of need emerge, governments nationally and internationally are focusing effort and attention on innovative and integrative approaches to health and well-being. Seniors’ Campus Continuums are models of care that seek to broaden access to an array of services and housing options to meet growing health and social needs of aging populations. The objective of this study is to increase understanding of this model and factors that influence their evolution, development, ongoing functioning and capacity to integrate care for older adults wishing to age in their own home and community.Methods: This research uses a comparative case study approach across six-bounded cases offering four geographically co-located components (mixed housing options, internal and external community supports, and a long-term care home) in various contexts across Ontario. Onsite in-person and phone interviews with senior campus staff (N=30), and campus partners (N=11), enhanced by direct observation at campuses explored historical and current efforts to offer health, housing and social care continuums for older adults.Results: Analysis highlighted eight key factors. Enabling factors include i. rich historical legacies of helping people in need; ii. organizational vision and readiness to capitalize on windows of opportunity; iii. leveraging organizational structure and capacity; iv. intentional physical and social design; v. broad services mix, amenities and innovative partnerships. Impeding factors include vi. policy hurdles and rigidities; vii. human resources shortages and inequities; and viii. funding limitations. A number of benefits afforded by campuses at different levels were also observed. Conclusion: Findings from this research highlight opportunities to optimize campus potential on many levels. At an individual level, campuses increase local access to a coordinated range of health and social care services, supports and housing options. At an organizational level, campuses offer enhanced collaboration opportunities across providers and partners to improve consistency and coordination of care, access to shared resources, expertise and infrastructure among other benefits. At a system level, campuses can address a diversity of health, social, financial, and housing needs to help seniors avoid premature or inappropriate use of higher intensity care settings.


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 ◽  
Vol 48 (Supplement_3) ◽  
pp. iii1-iii16
Author(s):  
Marica Cassarino ◽  
Katie Robinson ◽  
Rosie Quinn ◽  
Fiona Boland ◽  
Marie E Ward ◽  
...  

Abstract Background Introducing Health and Social Care Professional (HSCP) teams to the emergency department (ED) has increasingly demonstrated benefits for ED patient and process outcomes. However, there is a dearth of research exploring the views of key ED stakeholders on the role of HSCP teams in care delivery the ED. This qualitative study investigated the perspectives of a wide range of ED stakeholders about HSCPs teams working in the ED. Methods A total of 65 participants including older adults who had recently attended the ED and their carers/relatives, ED doctors and nurses, HSCPs and pre-hospital staff participated in four World Café style focus groups and individual interviews across two Irish hospital sites. Written and audio-recorded data were transcribed and thematically analysed. Results Overall, participants expressed positive views on HSCPs working in teams in the ED, with benefits for patients, staff members and the hospital (Theme 1). Having an ED-based HSCP team was described as promoting effective and timely decision-making and a more integrated approach to patient care, particularly for frail older adults with complex needs (Theme 2). Barriers and enablers for effective implementation were identified at multiple levels (Theme 3) including the ED physical environment, (e.g., space and equipment), operational factors (e.g., working hours), and relations (e.g., patient-staff or staff-staff communication); factors at system level included availability of community resources and financial pressures. Conclusion Our study indicates overall acceptability of HSCPs working in teams in the ED and positive views on their contribution to enhance the quality care of older adults. However, a number of operational and relational factors need to be considered to ensure feasibility and effectiveness. This information is crucial to inform implementation.


2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S72-S72
Author(s):  
Sijia Wei ◽  
Eleanor S McConnell ◽  
Kayla Wright-Freeman ◽  
Amanda Woodward ◽  
Bada Kang ◽  
...  

Abstract Social networks impact the health and wellbeing of older adults. The importance of social networks drives the need to reliably measure social networks. Advancements and innovations in the internet, electronic and digital devices, social media and health care technology enriches our ability to collect social network and health data to overcome limitations in social network measurement. This scoping review will review approaches utilizing technology to assist the measurement and analysis of social networks among older adults in the context of health and social care. Joanna Briggs Institute methodology was followed; PubMed (MEDLINE), Sociological Abstracts, SocINDEX, CINAHL, and Web of Science were searched for related articles. Conference abstracts and proceedings were included. We discuss the gaps and advances in measurement of social networks of older adults using technology and implications for future research in social networks of older adults as a lever for improving health and well-being.


BMJ Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. e047353
Author(s):  
Henry Aughterson ◽  
Alison R McKinlay ◽  
Daisy Fancourt ◽  
Alexandra Burton

ObjectivesTo explore the psychosocial well-being of health and social care professionals working during the COVID-19 pandemic.DesignThis was a qualitative study deploying in-depth, individual interviews, which were audio-recorded and transcribed verbatim. Thematic analysis was used for coding.ParticipantsThis study involved 25 participants from a range of frontline professions in health and social care.SettingInterviews were conducted over the phone or video call, depending on participant preference.ResultsFrom the analysis, we identified 5 overarching themes: communication challenges, work-related stressors, support structures, personal growth and individual resilience. The participants expressed difficulties such as communication challenges and changing work conditions, but also positive factors such as increased team unity at work, and a greater reflection on what matters in life.ConclusionsThis study provides evidence on the support needs of health and social care professionals amid continued and future disruptions caused by the pandemic. It also elucidates some of the successful strategies (such as mindfulness, hobbies, restricting news intake, virtual socialising activities) deployed by health and social care professionals that can support their resilience and well-being and be used to guide future interventions.


2021 ◽  
Vol 30 ◽  
Author(s):  
Shiyu Lu ◽  
Tianyin Liu ◽  
Gloria H. Y. Wong ◽  
Dara K. Y. Leung ◽  
Lesley C. Y. Sze ◽  
...  

Abstract Aims Late-life depression has substantial impacts on individuals, families and society. Knowledge gaps remain in estimating the economic impacts associated with late-life depression by symptom severity, which has implications for resource prioritisation and research design (such as in modelling). This study examined the incremental health and social care expenditure of depressive symptoms by severity. Methods We analysed data collected from 2707 older adults aged 60 years and over in Hong Kong. The Patient Health Questionnaire-9 (PHQ-9) and the Client Service Receipt Inventory were used, respectively, to measure depressive symptoms and service utilisation as a basis for calculating care expenditure. Two-part models were used to estimate the incremental expenditure associated with symptom severity over 1 year. Results The average PHQ-9 score was 6.3 (standard deviation, s.d. = 4.0). The percentages of respondents with mild, moderate and moderately severe symptoms and non-depressed were 51.8%, 13.5%, 3.7% and 31.0%, respectively. Overall, the moderately severe group generated the largest average incremental expenditure (US$5886; 95% CI 1126–10 647 or a 272% increase), followed by the mild group (US$3849; 95% CI 2520–5177 or a 176% increase) and the moderate group (US$1843; 95% CI 854–2831, or 85% increase). Non-psychiatric healthcare was the main cost component in a mild symptom group, after controlling for other chronic conditions and covariates. The average incremental association between PHQ-9 score and overall care expenditure peaked at PHQ-9 score of 4 (US$691; 95% CI 444–939), then gradually fell to negative between scores of 12 (US$ - 35; 95% CI - 530 to 460) and 19 (US$ -171; 95% CI - 417 to 76) and soared to positive and rebounded at the score of 23 (US$601; 95% CI -1652 to 2854). Conclusions The association between depressive symptoms and care expenditure is stronger among older adults with mild and moderately severe symptoms. Older adults with the same symptom severity have different care utilisation and expenditure patterns. Non-psychiatric healthcare is the major cost element. These findings inform ways to optimise policy efforts to improve the financial sustainability of health and long-term care systems, including the involvement of primary care physicians and other geriatric healthcare providers in preventing and treating depression among older adults and related budgeting and accounting issues across services.


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