The ‘Diversity-Compass’: Developing an Instrument for Health Care Professionals to Deal with Moral Issues Concerning Cultural, Religious and Sexual Diversity in Long-Term Care Organizations

2021 ◽  
Vol 66 (Special Issue) ◽  
pp. 109-110
Author(s):  
Charlotte Kröger ◽  
◽  
Suzanne Metselaar ◽  
◽  
◽  
...  
Keyword(s):  
Health Care Professionals ◽  
Participatory Design ◽  
Long Term Care ◽  
Population Diversity ◽  
Sexual Diversity ◽  
Moral Issues ◽  
Term Care ◽  
Moral Conflicts ◽  
Ethics Support

"Culture, religion, gender identity and sexual orientation play an important role in patients’ and professionals’ care preferences and communication. Population diversity leads to differing moral perspectives regarding health, wellbeing and care practices. This can generate value conflicts between patients and professionals concerning what good care is. Accordingly, increasing societal pluralism creates novel challenges for professionals regarding how they ought to deliver equitable and diversity-responsive care to minority populations. To support professionals in dealing with moral issues related to cultural, religious and sexual diversity in long-term-care organizations, we developed an ethics support instrument called the Diversity-Compass. The Diversity-Compass is a low-threshold instrument designed to help professionals in addressing and dealing with situations in which moral conflicts pertaining to diversity occur. We employed a participatory design and conducted seven focus groups (n=55), five expert interviews (n=5) and facilitated four meetings with a working group of various care professionals (n=18) who developed and tested preliminary versions of the instrument through iterative co-creation. Resulting from this process the Diversity-Compass emerged. Next to offering a question-based, reflection-invoking conversation method, the instrument includes seven specific tips to support professionals when engaging in conversations about diversity-related moral issues with patients or other professionals. Our study is an example of how bioethicists can provide clinical ethics support by using a participatory design and co-creatively developing an instrument to aid professionals in dealing with moral issues related to cultural, religious and sexual diversity in long-term care. The Diversity-Compass can be used by organizations and professionals to promote good, diversity-responsive care. "

Morality in the mundane

2011 ◽  
Vol 19 (1) ◽  
pp. 91-103 ◽  
Author(s):  
Linda Dauwerse ◽  
Sandra van der Dam ◽  
Tineke Abma
Keyword(s):  
Learning Styles ◽  
Long Term Care ◽  
Elderly Care ◽  
Mixed Methods Design ◽  
Moral Issues ◽  
Term Care ◽  
Ethics Support ◽  
Raising Awareness

Ethics support is called for to improve the quality of care in elderly institutions. Various forms of ethics support are presented, but the needs for ethics support remain unknown. Using a mixed-methods design, this article systematically investigates the specific needs for ethics support in elderly care. The findings of two surveys, two focus groups and 17 interviews demonstrate that the availability of ethics support is limited. There is a need for ethics support, albeit not unconditionally. Advice-based forms of ethics support are less appropriate as they are removed from practice. Ethics support should be tailored to the often mundane and easily overlooked moral issues that arise in long-term care. Attention should also be given to the learning styles of nurses who favour experiential learning. Raising awareness and developing a climate of openness and dialogue are the most suitable ways to deal with the mundane moral issues in elderly care.

Changing the Culture of Long-Term Care: Combating Heterosexism

2015 ◽  
Vol 20 (2) ◽  
Author(s):  
Susan Schwinn ◽  
Shirley Dinkel
Keyword(s):  
Long Term Care ◽  
The Elderly ◽  
Holistic Care ◽  
Culturally Competent ◽  
Sexual Diversity ◽  
Term Care ◽  
Culturally Competent Care ◽  
Staff Members ◽  
Unique Position

The purpose of this article is to describe how heterosexism impedes the provision of culturally competent care for lesbian, gay, bisexual, transgender, and queer (LGBTQ) residents in long-term care (LTC) facilities. LTC facilities continue to employ staff members who lack an understanding of sexuality and sexual diversity in the elderly. In this article, we identify the heterosexual assumption, namely heterosexism, as the primary issue surrounding the holistic care of the LGBTQ elder in LTC. We first review the literature related to LGBTQ elders in LTC facilities, identifying the themes that emerged from the review, specifically the definitions of homophobia and heterosexism; perceptions of LGBTQ elders as they consider placement in LTC facilities; and staff knowledge of and biases toward sexuality and sexual diversity in LTC settings. Then, we suggest approaches for changing the culture of LTC to one in which LGBTQ elders feel safe and valued, and conclude by considering how facility leaders are in a unique position to enable LGBTQ elders to flourish in what may be their last home.

Implementation of Case Costing with Ontario Case Costing Initiative (OCCI)

2013 ◽  
pp. 79-88
Author(s):  
Thuy Thi Thanh Hoang
Keyword(s):  
Decision Making ◽  
Health Care Professionals ◽  
Long Term Care ◽  
Statistical Data ◽  
Evidence Based ◽  
Term Care ◽  
Patient Level ◽  
Evidence Based Decision Making ◽  
Gain Access

Over the past decade there has been a tremendous spread of computerized systems in hospitals. The advancement provided an opportunity for hospitals to gain access to computerized clinical, financial, and statistical data. Case costing information is the integration of clinical, financial, and statistical data to provide costing information at the patient level. Ontario Case Costing Initiative (OCCI) is an undertaking of the Ontario Ministry of Health and Long-Term Care (MOHLTC). This chapter focuses on the implementation of case costing using OCCI as a guideline for a hospital. It addresses the process of implementation by discussing proposals for planning, implementing, transitioning, and evaluation of case costing. The adoption of the OCCI allows health care professionals to analyze integrated health information and further enables evidence-based decision making.

Health care professionals’ perspectives of advance care planning for people with dementia living in long-term care settings: A narrative review of the literature

Dementia ◽  
2015 ◽  
Vol 16 (4) ◽  
pp. 486-512 ◽  
Author(s):  
Esther-Ruth Beck ◽  
Sonja McIlfatrick ◽  
Felicity Hasson ◽  
Gerry Leavey
Keyword(s):  
Health Care ◽  
Advance Care Planning ◽  
Health Care Professionals ◽  
Long Term Care ◽  
Care Planning ◽  
Term Care ◽  
Early Integration ◽  
People With Dementia ◽  
Advance Care

This paper provides an overview of the evidence on the perspective of health care professionals (HCPs) in relation to advance care planning (ACP) for people with dementia, residing in long-term care settings. A narrative approach was adopted to provide a comprehensive synthesis of previously published literature in the area. A systematic literature search identified 14 papers for inclusion. Following review of the studies four themes were identified for discussion; Early integration and planning for palliative care in dementia; HCPs ethical and moral concerns regarding ACP; Communication challenges when interacting with the person with dementia and their families and HCPs need for education and training. Despite evidence, that HCPs recognise the potential benefits of ACP, they struggle with its implementation in this setting. Greater understanding of dementia and the concept of ACP is required to improve consistency in practice. Synthesising the existing evidence will allow for further understanding of the key issues, potentially resulting in improved implementation in practice.

Risk factors related to the admission of people with dementia into a long-term care institution in Spain: an explorative study

2016 ◽  
Vol 38 (1) ◽  
pp. 192-211
Author(s):  
ESTER RISCO ◽  
ESTHER CABRERA ◽  
M. CARME ALVIRA ◽  
MARTA FARRÉ ◽  
SUSANA MIGUEL ◽  
...  
Keyword(s):  
Risk Factors ◽  
Informal Care ◽  
Health Care Professionals ◽  
Long Term Care ◽  
Term Care ◽  
Care Institution ◽  
Care Givers ◽  
People With Dementia ◽  
Person With Dementia

ABSTRACTRisk factors associated with admission of people with dementia to long-term care institutions need to be identified to support health-care professionals in dementia care at home. An explorative study, combining quantitative and qualitative data collection methods, was performed in people with dementia in Spain. The sample, consisting of people with dementia receiving formal care from health-care professionals but at risk of institutionalisation, and their informal care-givers; and people with dementia recently admitted to a long-term care institution, and their informal care-givers, was interviewed between November 2010 and April 2012. Perceived reasons for admission were determined through an open-ended question put to both groups. Presumed risk factors were collected with validated questionnaires and analysed using bivariate analysis. A total of 287 people with dementia and informal care-givers were studied. Reasons given by the institutionalised group were mostly related to the level of dependency of the person with dementia. People recently admitted to a long-term care institution had more cognitive impairment, a greater degree of dependency and poorer quality of life than those still living at home. Home-care services in Spain need to develop or improve interventions based on the risk factors identified in this study: informal care-giver profile, high cognitive impairment, high level of dependency and the poor quality of life of the person with dementia.

scholarly journals COVID-19 Infections in Long-Term Care Facilities in Wuhan, China: Challenges and Lessons

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 18-18
Author(s):  
Yi Cai ◽  
Jing Wang ◽  
Bei Wu
Keyword(s):  
Health Care ◽  
Health Care Professionals ◽  
Living Arrangements ◽  
Long Term Care ◽  
Care Quality ◽  
Term Care ◽  
Frontline Workers ◽  
Precautionary Measures ◽  
The Impact

Abstract The impact of the COVID-19 infection on older residents and the direct frontline workers in long-term care (LTC) facilities in Wuhan, China deserves close attention. The fatality rate for older residents infected by the COVID-19 is among the highest in China Viral outbreaks are likely to occur in LTC facilities due to group-living arrangements, lack of precautionary measures, and older residents’ vulnerability to diseases. In this study, we aimed to explore different stakeholders’ experiences and challenges in the midst of the spread of the virus in LTC facilities. We conducted telephone interviews with four groups from two LTC facilities and two hospitals: twelve older residents (Four suspected cases and two infected), ten family members, four direct frontline workers (two infected), two nursing home managers, and four health care professionals working in the two hospitals that infected older residents were transferred to. We found that the gap in the transition of care quality between LTC facilities and local hospitals was widened during the COVID-19 outbreak. LTC facilities were slow to take precautionary measures and underprepared to handle the crisis after the infections occurred. The wellbeing of older residents was significantly impacted during the transition, particularly for those with dementia. Health care professionals in local hospitals were under tremendous stress providing treatments for older residents while ensuring their safety. There is an urgent need to improve transitional care and the capacity in preventing and handling this type of crisis for older residents in LTC.

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