scholarly journals Live-in migrant care worker arrangements in Germany and the Netherlands: motivations and justifications in family decision-making

2019 ◽  
Vol 13 (2) ◽  
pp. 83-113 ◽  
Author(s):  
Vincent Horn ◽  
Cornelia Schweppe ◽  
Anita Böcker ◽  
María Bruquetas-Callejo
Keyword(s):  
Decision Making ◽  
The Netherlands ◽  
Analytical Framework ◽  
Term Care ◽  
Private Households ◽  
Starting Point ◽  
Decision Making Processes ◽  
Family Decision Making ◽  
Care Worker

Private households in ageing societies increasingly employ live-in migrant carers (LIMCs) to care for relatives in need of 24/7 care and supervision. Whilst LIMC arrangements are a common practice in Germany, they are only recently emerging in the Netherlands. Taking this development as a starting point, this study uses the countries’ different long-term care (LTC) regimes as the analytical framework to explore and compare the motivations and justifications of German and Dutch family carers who opt for an LIMC arrangment. Findings show that Dutch and German LTC regimes impact differently the decision-making processes of families, as well as on patterns of justification, through a combination of policies and social norms and their related expectations towards care and care work in old age.

scholarly journals Factors Affecting Long-Term-Care Residents' Decision-Making Processes as They Formulate Advance Directives

2005 ◽  
Vol 45 (5) ◽  
pp. 626-633 ◽  
Author(s):  
H. C. Lambert ◽  
M. A. McColl ◽  
J. Gilbert ◽  
J. Wong ◽  
G. Murray ◽  
...  
Keyword(s):  
Decision Making ◽  
Advance Directives ◽  
Long Term Care ◽  
Term Care ◽  
Factors Affecting ◽  
Decision Making Processes

scholarly journals Decision-making and health system strengthening: bringing time frames into perspective

2020 ◽  
Author(s):  
Abelali Belghiti Alaoui ◽  
Vincent De Brouwere ◽  
Bruno Meessen ◽  
Maryam Bigdeli
Keyword(s):  
Decision Making ◽  
Health System ◽  
Health Systems ◽  
Building Blocks ◽  
Analytical Framework ◽  
Health System Strengthening ◽  
Health Staff ◽  
Middle Income ◽  
Starting Point ◽  
Decision Making Processes

Abstract In many low-and middle-income countries, health systems decision-makers are facing a host of new challenges and competing priorities. They must not only plan and implement as they used to do but also deal with discontented citizens and health staff, be responsive and accountable. This contributes to create new political hazards susceptible to disrupt the whole execution of health plans. The starting point of this article is the observation by the first author of the limitations of the building-blocks framework to structure decision-making as for strengthening of the Moroccan health system. The management of a health system is affected by different temporalities, the recognition of which allows a more realistic analysis of the obstacles and successes of health system strengthening approaches. Inspired by practice and enriched thanks a consultation of the literature, our analytical framework revolves around five dynamics: the services dynamic, the programming dynamic, the political dynamic, the reform dynamic and the capacity-building dynamic. These five dynamics are differentiated by their temporalities, their profile, the role of their actors and the nature of their activities. The Moroccan experience suggests that it is possible to strengthen health systems by opening up the analysis of temporalities, which affects both decision-making processes and the dynamics of functioning of health systems.

Long-Term Care Health Care Aides’ Perceptions of Decision-Making Processes in Transferring Residents to Acute Care Services

2018 ◽  
Vol 39 (8) ◽  
pp. 846-854
Author(s):  
Kaitlyn Tate ◽  
Jude Spiers ◽  
Rowan El-Bialy ◽  
Greta Cummings
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Long Term Care ◽  
Term Care ◽  
Care Services ◽  
Communication Processes ◽  
Decision Making Processes ◽  
Health Care Aides ◽  
Care Aides

Most transfers of long-term care (LTC) facility residents to the emergency department (ED) via 911 calls are necessary. Avoidable transfers can have adverse effects including increased confusion and dehydration. Around 20% of transfers are perceived to be avoidable or unnecessary, yet decision making around transfers is complex and poorly understood. Using a qualitative-focused ethnographic approach, we examined 20 health care aides’ (HCAs) perceptions of decision processes leading to transfer using experiential interview data. Inductive analysis throughout iterative data collection and analysis illuminated how HCAs’ familiarity with residents make them vital in initiating care processes. Hierarchical reporting structures influenced HCAs’ perceptions of nurse responsiveness to their concerns about resident condition, which influenced communications related to transfers. Communication processes in LTC facilities and the value placed on HCA concerns are inconsistent. There is an urgent need to improve conceptualization of HCA roles and communication structures in LTCs.

Registered Dietitians’ Roles in Decision-making Processes For PEG Placement in the Elderly

2014 ◽  
Vol 75 (2) ◽  
pp. 78-83 ◽  
Author(s):  
Maria O.P. Szeto ◽  
Julie O'sullivan Maillet ◽  
Rebecca A. Brody ◽  
J. Scott Parrott
Keyword(s):  
Decision Making ◽  
Ethical Climate ◽  
The Elderly ◽  
Registered Dietitians ◽  
Term Care ◽  
Adequate Knowledge ◽  
Endoscopic Gastrostomy ◽  
Professional Characteristics ◽  
Decision Making Processes

Purpose: The role of registered dietitians (RDs) in decisionmaking for percutaneous endoscopic gastrostomy (PEG) placement was explored. The ethical climate in their workplace and the relationship between decision-making and the ethical climate were examined. Methods: The survey included 67 RDs in complex continuing care and long-term care settings in Ontario. Descriptive statistics were used to describe roles, ethical climate, and professional characteristics. Pearson's and nonparametric correlations were used to examine relationships between roles, ethical climate, and professional characteristics. Results: Among the respondents, 97% thought RDs had a role in decision-making processes. The majority of RDs were usually or always involved in two roles: identifying relevant nutrition issues (91.2%) and discussing feeding options and alternatives (80.7%). Dietitians’ roles in decision-making processes were more extensive when their relationship with physicians was positive (r=0.321, P=0.016), they had adequate knowledge (r=0.465, P<0.001) and adequate skills (r=0.520, P<0.001), and they were more satisfied with their role (r=0.554, P<0.001). Conclusions: Registered dietitians performed a variety of roles in decision-making processes concerning PEG placement in the elderly. A positive working relationship with physicians, knowledge, skills, and role satisfaction significantly increase RDs’ involvement with patients and families.

Issues of Capacity and Decision-Making in the Context of Delirium

2015 ◽  
Vol 24 (4) ◽  
pp. 140-145
Author(s):  
Kevin R. Patterson
Keyword(s):  
Decision Making ◽  
Patient Autonomy ◽  
Care Setting ◽  
Cognitive Change ◽  
Treatment Team ◽  
Precipitating Factors ◽  
Term Care ◽  
Decision Making Capacity ◽  
Fundamental Consideration

Decision-making capacity is a fundamental consideration in working with patients in a clinical setting. One of the most common conditions affecting decision-making capacity in patients in the inpatient or long-term care setting is a form of acute, transient cognitive change known as delirium. A thorough understanding of delirium — how it can present, its predisposing and precipitating factors, and how it can be managed — will improve a speech-language pathologist's (SLPs) ability to make treatment recommendations, and to advise the treatment team on issues related to communication and patient autonomy.

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