Factors Related to Nursing Home Institutionalization of Elderly using Home Care Services

Abstract BackgroundThis study examines the risk factors associated with nursing home admission (NHA) in Belgium to contribute to a better planning of the future demand for nursing home (NH) services and health care resources.MethodsIndividual level linkage of the 2013 Belgian health interview survey data and health insurance data (2012 to 2018) was done. Only non-institutionalized participants, aged ≥65 years at the time of the survey were included in this study (n=1930). Participants were followed until NHA, death or end of study period, i.e., December 31, 2018. The risk of NHA was calculated using a competing risk analysis.ResultsOver the follow-up period (median 5.29 years), 226 individuals were admitted to a NH and 268 died without admission to a NH. The overall cumulative risk of NHA was 1.4%, 5.7% and 13.1% at, respectively 1 year, 3 years and the end of follow-up. After multivariable adjustment, higher age, low educational attainment, belonging to low income household, living alone, use of home care services and a number of need factor (e.g., history of falls, suffering from urinary incontinence, depression or Alzheimer disease, etc.) were significantly associated with a higher risk of NHA, while female, individuals with multimorbidity and increased contacts with health care providers were significantly associated with a decreased risk of NHA. Subjective health and limitations are both significant determinants of NHA, but subjective health is an effect modifier on the effect of limitations and vice versa.ConclusionsOur findings pinpoint important predictors of NHA in older adults, and offer possibilities of prevention to avoid or delay NHA for this population. The strong impact of need factors on the risk of NHA may indicate equitable access to NHA (i.e., those in need for support have access to NH). Practical implications include prevention of falls and appropriate and timely management of physical chronic conditions and neurodegenerative disorders. Focus should also be on people living alone to provide the appropriate social support and/or home care services. Further investigation of predictors of NHA should include contextual factors such as the availability of nursing-home beds, hospital beds, physicians and waiting lists for NHA.

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Does context matter? Voluntary work in long-term care

Nordic Journal of Social Research ◽

10.7577/njsr.3698 ◽

2021 ◽

Vol 12 (1) ◽

pp. 155-180

Author(s):

Laila Tingvold ◽

Oddvar Førland

Keyword(s):

Nursing Home ◽

Nursing Homes ◽

Home Care ◽

Long Term Care ◽

Home Care Services ◽

Voluntary Work ◽

Term Care ◽

Home Setting ◽

Care Services

Introduction: Increased voluntary work in long-term care (LTC) is encouraged in white papers in Norway as well as in many other western states. This is due to the growth in the number of service recipients and a subsequent economic burden for the state. Voluntary work in nursing homes and home care services take place in different spatial contexts, but little attention has been paid to how the different contexts may potentially influence the possibilities for voluntary work. The aim of this study is to obtain new knowledge of the significance of context in recruitment of volunteers in LTC. Method: A cross-sectional study was conducted among leaders in nursing homes and home services in 50 municipalities across all regions of Norway. Descriptive analysis was used. Results: According to the leaders, home care services had less voluntary work than nursing homes. Respondents from home care scored “poor flow of information” and “low interest in the municipality” as major hinderances, more so than respondents from nursing homes did. Discussion: Nursing homes typically have many residents under one roof following a similar schedule. Thus, volunteer-run activities are held more easily at set times and incorporated into the daily life of the institutions. On the other hand, home dwellers in home care stay in a more individualised setting with more autonomy and can opt out of activities that nursing home residents would normally join. Skill acquisition, networking and socializing are common motivations for volunteering, and a nursing home setting may be an easier context to obtain this. The governmental endeavour for increased voluntary work in LTC can be seen as an effort to meet expected rises in public expenditure. However, the realism can be debated due to substantial challenges on the future potential of volunteerism in LTC, especially in the home care context.

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Planning of Nursing Home Care Services in Jordan: Its Reality and Challenges

Asian Social Science ◽

10.5539/ass.v7n10p94 ◽

2011 ◽

Vol 7 (10) ◽

Cited By ~ 2

Author(s):

Hasan Salih Suliman Al-Qudah

Keyword(s):

Nursing Home ◽

Home Care ◽

Home Care Services ◽

Nursing Home Care ◽

Care Services

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Healthcare leaders’ use of innovative solutions to ensure resilience in healthcare during the Covid-19 pandemic: a qualitative study in Norwegian nursing homes and home care services

BMC Health Services Research ◽

10.1186/s12913-021-06923-1 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Hilda Bø Lyng ◽

Eline Ree ◽

Torunn Wibe ◽

Siri Wiig

Keyword(s):

Nursing Home ◽

Nursing Homes ◽

Home Care ◽

Home Care Services ◽

Care Practice ◽

Second Phase ◽

Research Attention ◽

Care Services ◽

Systems Research ◽

Innovative Solutions

Abstract Background The Covid-19 pandemic introduced a global crisis for the healthcare systems. Research has paid particular attention to hospitals and intensive care units. However, nursing homes and home care services in charge of a highly vulnerable group of patients have also been forced to adapt and transform to ensure the safety of patients and staff; yet they have not received enough research attention. This paper aims to explore how leaders in nursing homes and home care services used innovative solutions to handle the Covid-19 pandemic to ensure resilient performance during times of disruption and major challenges. Methods A qualitative exploratory case study was used to understand the research question. The selected case was a large city municipality in Norway. This specific municipality was heavily affected by the Covid-19 pandemic; therefore, information from this municipality allowed us to gather rich information. Data were collected from documents, semi-structured interviews, and a survey. At the first interview phase, informants included 13 leaders, Head of nursing home (1 participant), Head of Sec. (4 participants), Quality manager (4 participants), Head of nursing home ward (3 participants), and a Professional development nurse (1 participant), at 13 different nursing homes and home care services. At the second phase, an online survey was distributed at 16 different nursing homes and home care services to expand our understanding of the phenomenon from other leaders within the case municipality. Twenty-two leaders responded to the survey. The full dataset was analysed in accordance with inductive thematic analysis methodology. Results The empirical results from the analysis provide a new understanding of how nursing homes and home care leaders used innovative solutions to maintain appropriate care for infected and non-infected patients at their sites. The results showed that innovative solutions could be separated into technology for communication and remote care, practice innovations, service innovations, and physical innovations. Conclusion This study offers a new understanding of the influence of crisis-driven innovation for resilience in healthcare during the Covid-19 pandemic. Nursing home and home care leaders implemented several innovative solutions to ensure resilient performance during the first 6–9 months of the pandemic. In terms of resilience, different innovative solutions can be divided based on their influence into situational, structural, and systemic resilience. A framework for bridging innovative solutions and their influence on resilience in healthcare is outlined in the paper.

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Prevalence of Different Combinations of Antiepileptic Drugs and CNS Drugs in Elderly Home Care Service and Nursing Home Patients in Norway

Epilepsy Research and Treatment ◽

10.1155/2016/5153093 ◽

2016 ◽

Vol 2016 ◽

pp. 1-8 ◽

Cited By ~ 5

Author(s):

Kjell H. Halvorsen ◽

Cecilie Johannessen Landmark ◽

Anne Gerd Granas

Keyword(s):

Nursing Home ◽

Nursing Homes ◽

Home Care ◽

Antiepileptic Drugs ◽

Care Service ◽

Home Care Services ◽

Home Care Service ◽

Elderly Home ◽

Care Services ◽

Nursing Home Patients

Introduction. Antiepileptic drugs (AEDs) are used to treat different conditions in elderly patients and are among the drug classes most susceptible to be involved in drug-drug interactions (DDI). The aim of the study was to describe and compare use of AEDs between home care service and nursing home patients, as these patients are not included in nationwide databases of drug utilization. In the combined population, we investigate DDI of AEDs with other central nervous system- (CNS-) active drugs and DDIs involving AEDs in general. Materials and Methods. Point-prevalence study of Norwegian patients in home care services and nursing homes in 2009. At the patient level, we screened for different DDIs involving AEDs. Results. In total, 882 patients (7.8%) of 11,254 patients used AEDs and number of users did not differ between home care services and nursing homes (8.2% versus 7.7%). In the combined population, we identified 436 potential DDIs in 45% of the patients. Conclusions. In a large population of elderly, home care service and nursing home patients do not differ with respect to exposure of AEDs but use more AEDs as compared to the general population of similar age. The risk of DDIs with AEDs and other CNS-active drugs should be taken into consideration and individual clinical evaluations are assessed in this population.

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The prevalence of leg ulcers in nursing home-care services in North-Rhine Westphalia

Pflege ◽

10.1024/1012-5302.15.1.16 ◽

2002 ◽

Vol 15 (1) ◽

pp. 16-23 ◽

Cited By ~ 6

Author(s):

Jochen Laible ◽

Herbert Mayer ◽

Georges C.M. Evers

Keyword(s):

Nursing Home ◽

Home Care ◽

Home Care Services ◽

Ulcus Cruris ◽

Nursing Home Care ◽

Leg Ulcers ◽

Häusliche Pflege ◽

Care Services

Mit dieser Arbeit wurden durch ein deskriptiv-exploratives Querschnittsdesign erstmalig verlässliche Daten zur Prävalenz des Ulcus cruris in der häuslichen Pflege erhoben. Eine randomisierte Stichprobe von 520 häuslichen Pflegediensten in Nordrhein-Westfalen wurde im März 2000 angeschrieben und mittels standardisiertem Fragebogen zu ihren Patienten mit Ulcus cruris befragt. Ermittelt wurden neben der Trägerschaft der Einrichtungen und deren geographische Ansiedlung auch die demographischen Daten der Betroffenen sowie die Dauer und die Ursachen der Ulcera. Auf einer Grundlage der Angaben von 161 Pflegediensten mit insgesamt 12156 Patienten und 326 Betroffenen konnte eine Gesamtprävalenz von 2,68% (± 0.29%) für das Ulcus cruris in der häuslichen Pflege errechnet werden. Das Alter der 326 Betroffenen beträgt im Durchschnitt 77,5 Jahre. Frauen sind mehr als doppelt so häufig betroffen wie Männer, was jedoch im Wesentlichen auf eine höhere Lebenserwartung der Frauen zurückzuführen ist. Fast ein Viertel der Ulcera sind unbekannter Genese. Dieses Ergebnis dürfte ein großes Problem für die häusliche Pflege darstellen, da die Anwendung von Kompressionsverbänden oder -strümpfen für den Behandlungserfolg beim Ulcus cruris von entscheidender Bedeutung und von den ursächlichen Faktoren abhängig ist. Die ausgesprochene Chronizität der Ulcus-Erkrankung bestätigt sich auch in dieser Untersuchung. Durchschnittlich zehn Monate beträgt die Dauer für das aktuelle Ulcus cruris. Für die Betroffenen sind jedoch jahre- oder gar jahrzehntelange Heilungsverläufe keine Seltenheit. In fast 80% der Fälle erfolgt die Wundversorgung einmal täglich durch die häuslichen Pflegedienste.

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