The Prevalence of Alzheimer’s Disease and Dementia in Alzheimer’s Disease in Patients of Long-Term Nursing Home Care in the Podlaskie Province in Poland

The characteristics of Alzheimer's disease (AD) create specialized problems of care for the Alzheimer's patient. Treatment for AD victims does not only involve medical procedures; rather, Alzheimer's disease is what Kahn termed a bio-psycho-social phenomenon. 1 Since the epidemiology of the disease is not treatable as such, the emphasis of Alzheimer's care is on management of its physical, social, and psychological manifestations. Therefore, nursing home care and home health care are not sufficient for AD victims. Alzheimer's patients need the specialized care we've called Alzheimer's care, which is directed toward meeting the specific needs of AD victims and their families. It is generally agreed that both in stitutional and home settings are appropriate for treating certain characteristics of Alzheimer's disease, depending on the degree to which the disease has progressed, financial circumstances, and the family's ability and willingness to keep the patient at home. The choice between nursing home placement and home care is, of course, ultimately the decision of the primary caregiver or family. If caregivers are unable or unwilling to serve as the primary support for a victim-because of their financial considerations, their own infirmities, or because the responsibility for care becomes overwhelming-a family may feel that the decision to place the patient in a nursing home is the only alternative. In our experience, we have found that specialized Alzheimer's care, delivered in a home setting, can place the responsibility for primary care with home care professionals. The environment or treatment setting is highly significant in the management of Alzheimer's disease. We have found that of the two major settings for treatment ofAD patients-the institution and the home-the home is significantly more adaptable to Alzheimer's care. The home environment is familiar and can, with planning and training, be very helpful in the care plan. Home health personnel assigned to such cases can be specifically selected, trained, and supervised to maximize their effectiveness in providing the highest quality of Alzheimer's care. Under the assumption that many families do have a choice in treatment settings for an AD victim and that the home may be the more effective treatment setting, this article will seek to explain the adaptability of the home health option for Alzheimer's care.

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Families, Alzheimer's Disease, and Nursing Homes

Journal of Applied Gerontology ◽

10.1177/073346488800700305 ◽

1988 ◽

Vol 7 (3) ◽

pp. 331-349 ◽

Cited By ~ 29

Author(s):

Nathan L. Linsk ◽

Baila Miller ◽

Roberta Pflaum ◽

Anna Ortigara-Vicik

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Nursing Home ◽

Nursing Homes ◽

Care Center ◽

Family Members ◽

Nursing Home Care ◽

Demonstration Program ◽

Home Setting

The Alzheimer's Disease Family Care Center program was established within an intermediate care teaching nursing home as a demonstration program to investigate ways to involve families in care of their relatives. In total, 45 family members participated in a program including an orientation session; a preliminary family involvement interview; contracts with family members, in which they chose specific tasks to engage in during visits; a five-session course on Alzheimer's disease and how families may be partners in care within the facility; and an ongoing family support group. Evaluation data sources include a baseline and 9-month follow-up questionnaire completed by families, preliminary and follow-up family interviews conducted by project codirectors, records of family visits, and family choices on contracts. Findings from the 23 family members who contracted for tasks during their visits and from the follow-up questionnaire completed by 25 family members showed that most sought social and emotional interactions with relatives, some maintained direct personal care activities, and only a few identified interest in extensive involvement with staff and facility. At follow-up, family members involved in the program reported they continued to feel close to their relatives. Many felt that their relatives were generally stable or improved with regard to cognitive function, but over a third noted difficulties in communicating. Participating family members reported that the program of staff supports helped them to feel more integral to the unit. They expressed a need for more education and support for their involvement in the nursing home setting. Project findings confirm previous studies recommending that programming at nursing homes needs to include specific institutional and staff supports to maintain and enhance family contributions to the long-term nursing home care of their relatives.

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Municipalities’ Decision to Care: At Home or in a Nursing Home

International Advances in Economic Research ◽

10.1007/s11294-020-09806-z ◽

2020 ◽

Vol 26 (4) ◽

pp. 327-342

Author(s):

Theis Theisen

Keyword(s):

Nursing Home ◽

Home Care ◽

Long Term Care ◽

Nursing Home Care ◽

Empirical Literature ◽

Term Care ◽

Scant Attention ◽

Insurance Mechanism ◽

Using Data

AbstractAn almost ideal demand system for long-term care is estimated using data from Norway, where the split of long-term care between home care and care in nursing homes is determined by municipalities. Previous literature has barely addressed what determines municipalities’ or other organizations’ allocations of resources to the sub-sectors of long-term care. The results show that home care is a luxury, while nursing home care is a necessity with respect to total expenditures on long-term care. Municipalities respond to high unit costs for home care by reducing that type of care. Municipalities are highly responsive to variations in the need for the two types of care and seem to provide a well-functioning insurance mechanism for long-term care. In the previous empirical literature, municipalities’ role as providers of insurance against the consequences of disabilities and frailty has received scant attention.

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Outcomes of Medicaid home‐ and community‐based long‐term services relative to nursing home care among dual eligibles

Health Services Research ◽

10.1111/1475-6773.13573 ◽

2020 ◽

Vol 55 (6) ◽

pp. 973-982

Author(s):

R. Tamara Konetzka ◽

Daniel H. Jung ◽

Rebecca J. Gorges ◽

Prachi Sanghavi

Keyword(s):

Nursing Home ◽

Home Care ◽

Nursing Home Care ◽

Community Based ◽

Dual Eligibles

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Poster 37 Long-Term Follow-up of Profoundly Brain-Injured Young Adults Discharged to Specialist Nursing Home Care

PM&R ◽

10.1016/j.pmrj.2012.09.667 ◽

2012 ◽

Vol 4 ◽

pp. S202-S202

Author(s):

Kyaw Nyein ◽

Wendy Stuttle ◽

Lynne Turner-Stokes ◽

Heather Williams

Keyword(s):

Young Adults ◽

Nursing Home ◽

Home Care ◽

Nursing Home Care ◽

Brain Injured ◽

Long Term Follow Up

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Obciążenie opiekunów nieformalnych a sprawność funkcjonalna i umysłowa pacjentów objętych opieką domową

Pomeranian Journal of Life Sciences ◽

10.21164/pomjlifesci.492 ◽

2018 ◽

Vol 64 (4) ◽

Author(s):

Alina Deluga ◽

Agnieszka Bartoszek ◽

Barbara Ślusarska ◽

Katarzyna Kocka ◽

Grzegorz Nowicki ◽

...

Keyword(s):

Nursing Home ◽

Home Care ◽

Informal Caregivers ◽

Female Gender ◽

Negative Influence ◽

Nursing Home Care ◽

Satisfaction With Care ◽

Mental Performance

ABSTRACTIntroduction: Family members as informal caregivers are the most common and important providers of caring services in the home environment of patients suffering from chronic diseases.The aim of the study was to assess the relationship between the functional and mental performance of patients being provided long-term nursing home care and the burden of their caregivers.Materials and methods: The study was carried out in the Lublin region from September 2016 to February 2017. The study group included 149 patients with chronic diseases under long-term nursing home care and their 150 informal caregivers. The burden of the caregivers was assessed by means of the Carers of Older People in Europe (COPE) Index questionnaire which is used to check different aspects of the caregivers’ roles, life situations and relationships with the care recipients. The patients’ functional performance was measured by means of the Barthel Index for Activities of Daily Living, while their mental performance was checked using the Abbreviated Mental Test Score.Results: According to the COPE Index, the caregivers’ burden for particular subscales was as follows: Negative Influence of Care (NIC) 11.80 (SD = 3.75), Positive Value of Care (PVC) 13.71 (SD = 2.07), Quality of Support (QS) 12.46 (SD = 2.69). It has been indicated that the worse the functional and mental performance of the patient under care, the greater the burden of the carers – NIC (p < 0.01), the lower the satisfaction with care – PVC (p < 0.01) and the lower the quality of support given – QS (p < 0.01). The deterioration of a patient’s mental performance correlates with the female gender of the caregiver and the longer duration of care.Conclusions: The lower functional and mental performance of patients who are being provided long-term nursing home care has a relationship to the experience of the negative effects of care by informal carers, lower satisfaction with care and lower quality of support.

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Conducting Clinical Research in Post-acute and Long-term Nursing Home Care Settings: Regulatory Challenges

Journal of the American Medical Directors Association ◽

10.1016/j.jamda.2019.04.022 ◽

2019 ◽

Vol 20 (7) ◽

pp. 798-803 ◽

Cited By ~ 1

Author(s):

Allison M. Gustavson ◽

Cynthia Drake ◽

Alison Lakin ◽

Andrea E. Daddato ◽

Jason R. Falvey ◽

...

Keyword(s):

Nursing Home ◽

Home Care ◽

Clinical Research ◽

Nursing Home Care ◽

Regulatory Challenges

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Abstract W P296: Care Trajectories and Costs after Ischemic Stroke for Patients in the Veterans Health Administration

Stroke ◽

10.1161/str.46.suppl_1.wp296 ◽

2015 ◽

Vol 46 (suppl_1) ◽

Author(s):

Greg Arling ◽

Susan Ofner ◽

Laura Meyers ◽

Joanne Daggy ◽

Mat Reeves ◽

...

Keyword(s):

Ischemic Stroke ◽

Nursing Home ◽

Home Care ◽

Care Home ◽

Veterans Health Administration ◽

Nursing Home Care ◽

Rehabilitation Services ◽

Veterans Health ◽

Health Administration

Background: Patients vary greatly in their use of care after hospitalization for stroke. We classified stroke patients according to their care trajectories and associated costs in the 12-month period after hospital discharge. Methods: We followed a cohort of 3,811 veterans for one year after hospitalization with ischemic stroke in Veterans Health Administration facilities in 2007. Three discharge outcomes -- nursing home care, home care, and mortality -- were modeled jointly with Latent Class Growth Analysis. VA and Medicare costs were obtained for use of institutional care (inpatient acute, rehabilitation facility, and nursing home) and home care (home health, other home care, and outpatient rehabilitation). Covariates included patient age, NIHSS stroke severity and FIM scores measured at hospital discharge. Results: Members of the cohort had one of five care trajectories: 49% had a Rapid Recovery with little or no use of care in the 12 months after discharge, 15% had a Gradual Recovery with initially high nursing or home care use that tapered off over time, 9% had consistent use of Long-Term Home Care (HC), 13% had consistent use of Long-Term Nursing Home Care (NH), and 14% had an Unstable trajectory with multiple transitions between long-term and acute care. Patients with Long-Term NH and Unstable trajectories had the highest average total costs (greater than $60,000 per person) and patients with the Rapid Recovery trajectory had the lowest cost (less than $11,000 per person). Medicare accounted for 23% of total costs. In a multinomial regression model, the likelihood of a Long-Term NH, Long-Term HC or an Unstable Trajectory was greatest for persons with more severe strokes (higher NIHSS score), more disability (lower FIM score), and age 65 or older. About half of the veterans received rehabilitation services. Most rehabilitation was delivered in the NH. There was no clear association between use of rehabilitation and subsequent care trajectory. Conclusions: Care trajectories were explained partly by veteran health and functional status. However, we need a better understanding of system factors shaping care trajectories, particularly access to and use of rehabilitation services.

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Physical Health and Cognitive Ability Among Married Long-Term-Care Patients and Among Their Spouses—A Comparison Between Home Care and Nursing Home Care

International Psychogeriatrics ◽

10.1017/s1041610293001498 ◽

1993 ◽

Vol 5 (2) ◽

pp. 157-168 ◽

Cited By ~ 2

Author(s):

Ann-Christine Löfgren ◽

Gösta Bucht ◽

Sture Eriksson ◽

Tage Lundström

Keyword(s):

Nursing Home ◽

Cognitive Function ◽

Nursing Homes ◽

Home Care ◽

Physical Health ◽

Long Term Care ◽

Nursing Home Care ◽

Term Care ◽

Nursing Home Patients

The purpose of this study was to establish whether physical health and cognitive function in married long-term patients or in their spouses determines why some patients are cared for in home care while others reside in nursing homes. Out of 38 married couples with a sick spouse cared for in a nursing home, 23 couples were studied; out of 34 couples with a sick spouse cared for in home care, 22 patients and 25 spouses were studied. The results showed no significant differences in physical health score either between the two groups of patients, or between the two groups of spouses. Both home-care patients and nursing home patients had low cognitive function scores, but nursing home patients had significantly lower scores. A multivariate analysis showed that physical health and cognitive function explained only 20% of patients' residence. Between the two groups of spouses there was no difference in cognitive function score. The conclusion is that physical health status and cognitive function explain only to a small extent why married long-term care patients are cared for in nursing homes or in home care.

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