scholarly journals Long-term care of the elderly: Current status, policies and dilemmas

Stanovnistvo ◽  
2012 ◽  
Vol 50 (1) ◽  
pp. 1-18 ◽  
Author(s):  
Gordana Matkovic

In Serbia, the long-term care as a system does not actually exist. One part of the system is regulated through cash benefits, one part through institutional social care and community-based social services, and one part is just being established under the health care system. The linkages among these segments are not strong and there is insufficient awareness of the need to regard the different parts of the system as being interdependent and interconnected. According to the different surveys, home care is needed for the daily functioning of more than 80,000 elderly people, especially for around 27,000 of those who are completely immobile. More than 300 thousand elderly persons have indicated that they are in need of some type of self-care support. By tradition, elderly people in Serbia rely primarily on family support. Some are getting the state support as well. Research shows that 62 thousand elderly persons (5 percent) receive attendance allowance; 9,000 elderly are accommodated in institutions (0.7 percent), while 11.7 thousand (1 percent) persons received some type of support through home care community based services. In addition, in Belgrade there are also 2,000 elderly who are beneficiaries of medical and palliative care at home. The government expenditures for these purposes can be very roughly estimated at 0.55 percent of GDP, largely for cash benefits (0.37 percent). Considered over a medium and longer term, the government expenditures on longterm care in Serbia will inevitably increase significantly, primarily due to an increase in the number and share of elderly people and the increase in additional life years spent in ill health or in need of assistance. An increase in the expenditures will also be influenced by a change in the family models and the increasing number of elderly that will be living alone, as well as the diminishing possibilities for reliance on the closest family members, especially due to emigration flows both at local and national levels. Finally, it is important not to neglect the effect of emulating more developed countries, as well as the EU?s pressure to adequately respond to the needs of the elderly. Therefore, the state and society must promptly prepare a systematic, comprehensive, timely and fiscally responsible response. This response must recognize the capacities of all stakeholders, from family to state and non-state and match the capacities with the appropriate roles in the system of long-term care provision.

Author(s):  
Frank J. Elgar ◽  
Graham Worrall ◽  
John C. Knight

ABSTRACTAs the demand for home care services increases, health care agencies should be able to predict the intake capacity of community-based long-term care (CBLTC) programs. Two hundred and thirty-seven clients entering a CBLTC program were assessed for activities of daily living (ADL) and cognitive and affective functioning and were then followed to monitor attrition and reasons why clients left the program. Compromised ADL functioning at baseline increased likelihood of death and institutionalization by 2 per cent each year. Over a 10-year period, reduced cognitive functioning at baseline increased the risk of death by 9 per cent and decreased the likelihood of leaving the program due to improvement by 18 per cent. Reduced affective functioning at baseline increased the risk of institutionalization during the course of the study by 3 per cent. Routine functional assessments with the elderly may help in the management of similar home care programs.


1999 ◽  
Vol 9 (4) ◽  
pp. 383-393 ◽  
Author(s):  
Norman J Vetter

The recent Royal Commission report on funding long-term care was produced following more than 100 visits and evidence from 400 organizations. It was set up following concern at the costs of long-term care for elderly people and what was seen to be the anomalous position of elderly people cared for by the NHS in long-term beds, where all costs were found by the state, albeit that elderly persons themselves lost most of their benefits. This contrasted with those in the social or independent sector, where payment has to be made unless the elderly person is poor.


2018 ◽  
Vol 21 (3) ◽  
pp. 293-300
Author(s):  
Helenice de Moura Scortegagna ◽  
Nadir Antonio Pichler ◽  
Lúcia Fernanda Fáccio

Abstract Objective: To identify the meanings attributed to the experience of spirituality when faced with life situations among elderly persons living in a long-term care facility. Method: A qualitative, exploratory and descriptive survey was carried out, based on interviews with eight elderly people living in a long-term care facility for the elderly in the state of Rio Grande do Sul, Brazil. Results: The content that emerged from the interviews underwent qualitative analysis for the extraction of units of significance and the elaboration of two thematic categories: Spirituality/religiosity as a direction of life and spirituality/religiosity as a meaning for life and a source of renewal, fulfilment and happiness. Conclusion: When describing the experience of spirituality as an important strategy for finding meaning in life, the elderly persons in this study revealed it to be a psychic and emotional support for coping with existential challenges. This knowledge allows professionals working in these institutions to invest in practices that incorporate spirituality as an element of the comprehensive care of the elderly.


2003 ◽  
Vol 54 (4) ◽  
pp. 277-284 ◽  
Author(s):  
Masanori Komatsu ◽  
Kayoko Hirata ◽  
Idumi Mochimatsu ◽  
Kazuo Matsui ◽  
Hajime Hirose ◽  
...  

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.


2008 ◽  
Vol 71 (2) ◽  
pp. 365-372 ◽  
Author(s):  
JENNIFER M. NELSON ◽  
ROBERT BEDNARCZYK ◽  
JOELLE NADLE ◽  
PAULA CLOGHER ◽  
JENNIFER GILLESPIE ◽  
...  

Foodborne illness is an important problem among the elderly. One risk factor for foodborne illness and diarrhea-associated mortality among the elderly is residence in a long-term care facility (LTCF); thus, these facilities must implement measures to ensure safe food. To assess safe food practices, knowledge, and policies, we used a mailed, self-administered questionnaire to survey food service directors at LTCFs that were certified to receive Medicare or Medicaid at eight Foodborne Diseases Active Surveillance Network (FoodNet) sites. Surveys were distributed to 1,630 LTCFs; 55% (865 of 1,568) of eligible facilities returned a completed questionnaire. Only three LTCFs completely followed national recommendations for prevention of Listeria monocytogenes contamination. Nine percent of LTCFs reported serving soft cheeses made from unpasteurized milk. Most LTCFs reported routinely serving ready-to-eat deli meats; however, few reported always heating deli meats until steaming hot before serving (only 19% of the LTCFs that served roast beef, 13% of those that served turkey, and 11% of those that served ham). Most LTCFs (92%) used pasteurized liquid egg products, but only 36% used pasteurized whole shell eggs. Regular whole shell eggs were used by 62% of facilities. Few LTCFs used irradiated ground beef (7%) or irradiated poultry products (6%). The results of this survey allowed us to identify several opportunities for prevention of foodborne illnesses in LTCFs. Some safety measures, such as the use of pasteurized and irradiated foods, were underutilized, and many facilities were not adhering to national recommendations on the avoidance of certain foods considered high risk for elderly persons. Enhanced educational efforts focusing on food safety practices and aimed at LTCFs are needed.


2002 ◽  
Vol 8 (2) ◽  
pp. 341-393 ◽  
Author(s):  
B.D. Rickayzen ◽  
D.E.P. Walsh

ABSTRACTThis paper develops a multiple state model to project the number of people with disabilities in the United Kingdom over the next 35 years, thereby identifying implications for demand for long-term care for the elderly in the future.The model requires three types of data: prevalence rate data, transition rate data and trends data. Recent trends in healthy life expectancy data are used to frame the assumptions made regarding changes in the disability rates of the U.K. population in the future.Although there will be a large increase in the number of elderly people in the U.K. over the next 35 years, the projections suggest that the implications for the number of elderly people requiring long-term care could be ameliorated by a reduction in the proportion of older people who are severely disabled.


Author(s):  
Katherine Glazebrook ◽  
Kenneth Rockwood ◽  
Paul Stolee ◽  
John Fisk ◽  
J. M. Gray

ABSTRACTFew studies of the risks of institutionalization of the elderly have had fully specified models using multivariate analysis, and several studies have examined highly selected populations, making their generalizability uncertain. We set out to examine the risks of institutionalization in elderly people in Nova Scotia. A case-control study, executed as part of the Canadian Study of Health and Aging examined 108 incident institutional cases and 533 community-dwelling elderly controls, using a standardized assessment interview conducted by trained interviewers. Multiple logistic regression analysis showed that advancing age, presence of dementia, functional impairment, poor self-rated health, recent hospital admission, and absence of a caregiver were important risks for entry into long term care. Institutions providing long-term care for the elderly need to be able to look after populations with a high prevalence of dementia and functional impairment.


2019 ◽  
Author(s):  
Chia-Shan Wu ◽  
Jiin-Ru Rong

Abstract Background Relocation to a long-term care (LTC) facility is a major life change for most elderly people. Following relocation, many elderly experience difficulties in adapting to changes in the living environment. Taiwan is increasingly becoming an "aging society” and the numbers of those who relocate from family residences to long-term residential care facilities have increased over years. However, in-depth evidence on the experiences of the elderly of their stay in LTC facilities in Taiwan is relatively sparse. This study aimed to explore the relocation experiences of the elderly to a LTC facility to inform policy and practice to address their needs effectively. Methods A qualitative study, using semi-structured in-depth interviews, was conducted to explore the experiences of 16 elderly people who have relocated to and lived in a LTC facility in Taiwan for up to a period of 12 months. All interviews were recorded, transcribed, and analyzed using grounded theory approach. Results Participants’ accounts reflected four interrelated key themes: wish to minimize the burden, but stay connected with the family; perceived barriers to adaptation; valuing tailored care; and acceptance and engagement. Each theme included interrelated subthemes that influenced one another and represented the different stages in the relocation journey. Most participants viewed relocation as a way of minimizing the burden of their care from family members, but desired to keep a close connection with family and friends. Participants recounted experiences of psychological resistance while making the decision to relocate. Fear of losing autonomy and the ability to perform self-care was a major reason for resistance to adapt. Provision of tailored care was accorded much value by the participants. The decision to accept the relocation and to adapt themselves to the new environment due to their needs for constant care was explicit in some accounts. Conclusions Relocation to LTC facility is a dynamic process in the first year of moving into the facility, and involves a range of emotions, feelings and experiences. Adaptation of the elderly into the LTC facility can be maximized if the relocation is well planned with provisions for individually tailored care and family involvement.


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