scholarly journals An Iranian Model for Elderly Care in Residential Long-Term Care Institutions: A Delphi-Based Study

2021 ◽  
Vol 8 (3) ◽  
Author(s):  
Fatemeh Gavarskhar ◽  
Hossein Matlabi ◽  
Farid Gharibi
Keyword(s):  
Residential Care ◽  
Service Providers ◽  
Elderly Care ◽  
Developed Countries ◽  
Care Needs ◽  
Eligibility Criteria ◽  
Term Care ◽  
Related Services ◽  
Elderly Individuals ◽  
Care Models

Background: It is necessary to develop a functional and evidence-based model to meet the various care needs of elderly individuals. Objectives: The present study was conducted to propose a national residential care model for Iranian elderly individuals. Methods: A systematic review was designed to identify common models of residential care centers in developed countries. A two-round Delphi survey consisting of 48 potential and eligible experts was also conducted to make a consensus on the standards of residential care applicable to the Iranian model. The study experts were the professors and officers with at least 5 years of academic and executive experiences in geriatric health. Results: The primary questionnaire was prepared with 305 care standards which were obtained from well-developed elderly care models. In the first round, 40 questionnaires were given back and analyzed, and 232 care standards were approved by the experts. In the second round, 38 questionnaires were returned from 40 distributed questionnaires, and 40 consensus standards were approved (from 73 standards). Moreover, others failed to enter the ultimate model. In the final model, out of the 275 accepted standards, 102 (37.09%), 75 (27.27%), 42 (15.27%), 42 (15.27%), 9 (3.27%), and 5 (1.81%) standards were related to health-related services, service providers, public services, facilities of care centers, eligibility criteria, and financing, respectively. Conclusions: Given the high consensus of experts on developed standards and the unique comprehensiveness of criteria, the obtained model can be implemented after conducting a pilot study in the Iranian elderly care centers. It seems that the implementation of the model will improve the provided care leading to higher levels of life expectancy and quality of life among elderly individuals.

Informal caregivers in Chile: the equity dimension of an invisible burden

2019 ◽  
Vol 34 (10) ◽  
pp. 792-799 ◽  
Author(s):  
Pablo Villalobos Dintrans
Keyword(s):  
Long Term Care ◽  
Population Aging ◽  
Large Fraction ◽  
Informal Caregivers ◽  
Developed Countries ◽  
Lower Income ◽  
Vicious Cycle ◽  
Care Needs ◽  
Term Care

Abstract Population aging is driving a process of increase in long-term care needs in Chile and many countries around the world. In this context, this article asks about the consequences of this increase in informal caregivers, emphasizing the inequity issues arising from these changes. Using the CASEN 2017 survey, caregivers are identified and matched to people with long-term care needs. Results show that most caregivers are women, and a large fraction of them are also elderly; this is similar to what has been found previously in developed countries. Caregivers have fewer opportunities than non-caregivers, which translates into lower income-generating ability and higher poverty. The nature of these tasks creates a vicious cycle in which people get trapped with increasing needs and fewer resources to meet them. Important differences arise between caregivers and the rest of the population. Even more concerning is that these disparities are avoidable to some extent, adding an equity dimension to the problem. This emphasizes the need for the generation of policies that will support caregivers and meet their needs.

Supporting the Long-Term Residential Care Needs of Older Homeless People With Severe Alcohol-Related Brain Injury in Australia: The Wicking Project

2007 ◽  
Vol 8 (3) ◽  
pp. 141-148 ◽  
Author(s):  
Alice Rota-Bartelink ◽  
Bryan Lipmann
Keyword(s):  
Brain Injury ◽  
Older People ◽  
Residential Care ◽  
Service Providers ◽  
Challenging Behaviors ◽  
Homeless People ◽  
Homeless Population ◽  
Care Needs ◽  
Supported Accommodation

For years, community service providers have been frustrated with the lack in availability of long-term, specialized supported accommodation for older people, particularly older homeless people, with severe acquired brain injury (ABI) and challenging behaviors. Although the incidence of ABI (particularly alcohol-related brain injury) is far wider than being confined to the homeless population, it is frequently misdiagnosed and very often misunderstood. Wintringham is an independent welfare company in Melbourne, Australia, that provides secure, affordable, long-term accommodation and high quality services to older homeless people. The high incidence of alcohol abuse among the resident population has led us to adapt our model of care to accommodate a complexity of need. However, there are some individuals with severely affected behaviors that continue to challenge Wintringham’s capacity to provide adequate support. The deficiency in highly specialized, long-term supported accommodation for older people with severe alcohol-related brain injury (ARBI) is the driving force behind this project. We aim to further develop and improve the current Wintringham model of residential care to better support people with these complex care needs. We will report on the synthesis of this project, which aims to test a specialized model that can be reproduced or adapted by other service providers to improve the life circumstances of these frequently forgotten people.

A Comparative Analysis of Costs to Government for Home Care and Long-term Residential Care Services, Standardized for Client Care Needs

2007 ◽  
Vol 26 (S1) ◽  
pp. 149-161 ◽  
Author(s):  
Marcus J. Hollander ◽  
Neena L. Chappell
Keyword(s):  
Home Care ◽  
Residential Care ◽  
Long Term Care ◽  
Lower Cost ◽  
Level Of Care ◽  
Care Needs ◽  
Term Care ◽  
Care Services ◽  
Residential Long Term Care

ABSTRACTThis paper reports on the results of analyses using administrative data from British Columbia for 10 years from fiscal 1987/1988 to 1996/1997, inclusive, to examine the comparative costs to government of long-term home care and residential care services. The analyses used administrative data for hospital care, physician care, drugs, and home care and residential long-term care. Direct comparisons for cost and utilization data were possible, as the same care-level classification system is used in BC for home care and residential care clients. Given significant changes in the type and/or level of care of clients over time, a full-time equivalent client strategy was used to maximize the accuracy of comparisons. The findings suggest that, in general, home care can be a lower-cost alternative to residential care for clients with similar care needs. The difference in costs between home care and residential care services narrows considerably for those who change their type and/or level of care, and home care was found to be more costly than long-term institutional care for home care clients who died. The findings from this study indicate that with the appropriate substitution for residential care services, in a planned and targeted manner, home care services can be a lower-cost alternative to residential long-term care in integrated systems of care delivery that include both sets of services.

Pflegerecht

2019 ◽  
Author(s):  
Constanze Janda
Keyword(s):  
Long Term Care ◽  
Service Providers ◽  
Legal Aspects ◽  
Point Of View ◽  
Eligibility Criteria ◽  
Term Care ◽  
The Social ◽  
Long Term Care Insurance ◽  
The Cost

The textbook is dealing with the fundamental legal aspects of the long-term care insurance and the fields of law related to that. The latest legislative developments and reforms, such as the two “Pflegestärkungsgesetze” are presented, thus the book is higly up-to-date. After defining and discussing the concept of “need of care”, the authors present the eligibility criteria and benefits in the long-term care insurance from the claimants’ point of view. Additionally, the legal relations between service providers and the cost-bearers as well as matters of quality assurance are reflected. The focus is set on the social care insurance (SGB XI), but benefits of the health care insurance (SGB V) and the social assistance scheme (SGB XII) related to care are dealt with, too. Schedules, case studies and sample examinations questions make the book a very helpful guide through the law of care for students of law, social work and care. Besides, pracitioners can get a concise overwiev on the recent development in care.

Introducing consumer directed care in residential care settings for older people in Australia: views of a citizens’ jury

2018 ◽  
Vol 23 (3) ◽  
pp. 176-184 ◽  
Author(s):  
Kate Laver ◽  
Emmanuel Gnanamanickam ◽  
Craig Whitehead ◽  
Susan Kurrle ◽  
Megan Corlis ◽  
...  
Keyword(s):  
Older People ◽  
Residential Care ◽  
Service Providers ◽  
Management Strategies ◽  
Home Care Services ◽  
The Public ◽  
Care Services ◽  
People With Dementia ◽  
Risk Management Strategies ◽  
Care Models

Objectives Health services worldwide are increasingly adopting consumer directed care approaches. Traditionally, consumer directed care models have been implemented in home care services and there is little guidance as to how to implement them in residential care. This study used a citizens’ jury to elicit views of members of the public regarding consumer directed care in residential care. Methods A citizens’ jury involving 12 members of the public was held over two days in July 2016, exploring the question: For people with dementia living in residential care facilities, how do we enable increased personal decision making to ensure that care is based on their needs and preferences? Jury members were recruited through a market research company and selected to be broadly representative of the general public. Results The jury believed that person-centred care should be the foundation of care for all older people. They recommended that each person’s funding be split between core services (to ensure basic health, nutrition and hygiene needs are met) and discretionary services. Systems needed to be put into place to enable the transition to consumer directed care including care coordinators to assist in eliciting resident preferences, supports for proxy decision makers, and accreditation processes and risk management strategies to ensure that residents with significant cognitive impairment are not taken advantage of by goods and service providers. Transparency should be increased (perhaps using technologies) so that both the resident and nominated family members can be sure that the person is receiving what they have paid for. Conclusions The views of the jury (as representatives of the public) were that people in residential care should have more say regarding the way in which their care is provided and that a model of consumer directed care should be introduced. Policy makers should consider implementation of consumer directed care models that are economically viable and are associated with high levels of satisfaction among users.

scholarly journals VARIABILITY IN ACCESS TO VA’S AID AND ATTENDANCE PENSION BENEFIT: A MIXED-METHODS STUDY

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S744-S745
Author(s):  
Kali S Thomas ◽  
Emily Corneau ◽  
Stefanie Gidmark ◽  
Taylor Rickard ◽  
Susan Allen
Keyword(s):  
Mixed Methods ◽  
Low Income ◽  
Mixed Methods Study ◽  
Service Organizations ◽  
Pension Benefit ◽  
Care Needs ◽  
Eligibility Criteria ◽  
Term Care ◽  
Medical Centers

Abstract The Veterans Benefit Administration’s (VBA) Aid and Attendance enhanced pension benefit (A&A) is available to older, low-income Veterans who require assistance meeting their daily needs. However, reports indicate that A&A is underutilized with only 1/3 of eligible Veterans receiving this benefit. The objective of this mixed methods study is to characterize the variability in A&A enrollment across VA Medical Centers (VAMCs) and determine factors attributable to the variation. Using VA administrative data, we calculated the rate of enrollment in A&A among Veterans receiving pension. We then purposefully sampled 16 Chiefs of Social Work at VAMCs with the highest (n=7) and lowest (n=9) rates of enrollment. Interviews were transcribed, coded, and analyzed using conventional qualitative research methods. The rate of enrollment in A&A varies from <1% to 23% across VAMCs. VAMCs that had higher rates of enrollment were larger and more likely to be located in the South and Mid-Atlantic regions. Respondents at sites with low rates of enrollment indicate that education around the eligibility criteria is needed for VAMC staff. They also report that outreach to Veterans about this benefit is limited. Respondents at VAMCs with high rates of enrollment indicate that the relationships with VBA and Veterans Service Organizations facilitates access. Universally, respondents viewed the A&A benefit positively and note that it helps meet Veterans’ long-term care needs. As the Veteran population continues to age, it is important that VA ensure equal access to A&A for eligible Veterans. Implications of these findings and next steps will be discussed.

scholarly journals What composes desirable formal at-home elder care? An analysis for multiple service combinations

2020 ◽  
Author(s):  
Shinya Sugawara
Keyword(s):  
Health Status ◽  
Home Care ◽  
Elder Care ◽  
Elderly Care ◽  
The Elderly ◽  
Developed Countries ◽  
Term Care ◽  
Care Services ◽  
The Relationship ◽  
At Home

AbstractI estimate the relationship between combinations of multiple services for formal at-home elder care and health status. As a reasonable substitute for expensive institutional care, at-home formal elderly care is gaining popularity in developed countries. Because at-home care is composed of many small and complementary services, the relationship between multiple service combinations and health status requires analysis. However, the high dimensionality of these combinations makes estimation difficult. This study employs a regression analysis using care service combinations as cross-dummy explanatory variables. To reduce the combination dimensions, I select the combinations that are purchased jointly by a sufficient number of the elderly using basket analysis. I apply this method to claims data for Japanese long-term care, for which the social insurance program has resulted in the emergence of a market that offers many care services for the elderly. The empirical results show that only 200 combinations of 14 at-home care services are used by more than 0.03% of the insured in Japan. Of these combinations, rehabilitation services have a considerable positive correlation with the health status of the elderly. However, their use is limited owing to regional disparities in the location of such services.

scholarly journals LONG-TERM CARE IV A REVIEW OF THE LONG-TERM CARE INSURANCE PROGRAMS IN 15 PILOT CITIES IN CHINA

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S801-S801
Author(s):  
Yan Lin ◽  
Edward A Miller ◽  
Marc A Cohen ◽  
Pamela Nadash ◽  
Peng Du
Keyword(s):  
Long Term Care ◽  
Service Providers ◽  
Population Policy ◽  
Medical Insurance ◽  
Implementation Barriers ◽  
Care Needs ◽  
Term Care ◽  
Care Services ◽  
Long Term Care Insurance

Abstract China is now making all the efforts to solve the problem of who pays the bill for the rapidly increasing long-term care services. Since 2016, 15 cities in China have begun their pilot programs in long-term care insurance. Each city designed its own program. Some cities finance their long-term care services from medical insurance funding solely. Others supplement it with individual and/or employer contributions. This study documents the nature and extent of implementation of long-term care insurance across the 15 pilot cities to draw lessons for subsequent implementation nationally. This study used qualitative methods, including document review and key informant interviews with long-term care insurance administrators, medical insurance administrators, service providers in different settings and families and individuals who use long-term care services. Results reveal considerable variation in the specific attributes of the long-term care insurance programs implemented across the 15 participating cities, with respect to such characteristics as the target population, policy coverage, and payment methods, etc. Results also shed light on the achievements and challenges in implementing the long-term care insurance program. This study’s examination of long-term care insurance adoption in 15 Chinese cities serves as an important base with which to inform future national long-term care insurance design and implementation. It suggests that successful adoption of long-term care insurance across China will require administering jurisdictions to anticipate and address policy bottlenecks and implementation barriers that might otherwise inhibit program impact and effectiveness in addressing the growing long-term care needs of China’s aging population.

The Positive and Negative Consequences of “Managerialization”: Evidence From Japanese Nonprofit Elderly Care Service Providers

2018 ◽  
Vol 48 (2) ◽  
pp. 309-333 ◽  
Author(s):  
Yoshitaka Shirinashihama
Keyword(s):  
Financial Performance ◽  
Nonprofit Organizations ◽  
Service Providers ◽  
Care Service ◽  
Elderly Care ◽  
Negative Consequences ◽  
Related Services ◽  
Top Managers ◽  
Budgetary Control ◽  
Negative Effect

In recent decades, many researchers have pointed out that nonprofit organizations are becoming “managerialized.” Although the “managerialization” may enable these organizations to improve their financial performance, it may also reduce their unprofitable mission-related services. However, there are few studies examining both aspects simultaneously. This study focuses on the managerialization of nonprofit organizations, especially the tightness of budgetary control systems and characteristics of top managers, as well as the negative and positive consequences of becoming managerialized. To test our hypotheses, we collected information about Japanese nonprofit elderly care service providers using a survey. Research results revealed top managers with more experience tend to improve the financial performance of nonprofit elderly care service providers using tight budgetary control. However, the results show no relationship between tight budgetary control and the provision of unprofitable mission-related services. Thus, in our setting, managerialization has a positive effect; there is no negative effect.

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