Older people face poor levels of care

1993 ◽  
Vol 7 (31) ◽  
pp. 7-7
Author(s):  
Daniel Allen
Keyword(s):  
Older People ◽  
Levels Of Care

Acute hospitals and older people in Australia

2002 ◽  
Vol 22 (5) ◽  
pp. 637-646 ◽  
Author(s):  
JOHN MCCORMACK
Keyword(s):  
Older People ◽  
Early Discharge ◽  
Service Levels ◽  
Levels Of Care ◽  
Australian Health ◽  
Policy Responses ◽  
Acute Hospitals ◽  
Set Up ◽  
Financial Burdens ◽  
Management Groups

The Australian health care system is frequently portrayed as being in crisis, with reference to either large financial burdens in the form of hospital deficits, or declining service levels. Older people, characterised as a homogeneous category, are repeatedly identified as a major contributor to the crisis, by unnecessarily occupying acute beds while they await a vacancy in a residential facility. Several enquiries and hospital taskforce management groups have been set up to tackle the problem. This article reviews their findings and strategic recommendations, particularly as they relate to older people. Short-term policy responses are being developed which specifically target older people for early discharge and alternative levels of care, and which, while claiming positive intentions, may introduce new forms of age discrimination into the health system. Few of the currently favoured proposals promote age-inclusivity and older people's rights to equal access to acute care.

scholarly journals Is there an association between social determinants and care dependency risk?

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
A Schneider ◽  
S Blüher ◽  
U Grittner ◽  
V Anton ◽  
E Schaeffner ◽  
...  
Keyword(s):  
Older People ◽  
Social Determinants ◽  
Population Based ◽  
Multiple Model ◽  
Levels Of Care ◽  
Care Dependency ◽  
Partnership Status ◽  
Level 1 ◽  
And Gender ◽  
Prospective Longitudinal

Abstract Background Despite a growing body of knowledge about the morbidities and functional impairment which frequently lead to care dependency, the role of social determinants is not yet well understood. The purpose of this study was 1) to examine the effect of social determinants on care dependency onset and progression, and 2) to analyse the effect of social determinants on various levels of care dependency. Methods We used data from the Berlin Initiative Study (BIS), a prospective, longitudinal, population-based cohort study including 2069 older participants (≥70 years of age) with visits in 2009, 2011 and 2013. Care dependency was assessed if participants require substantial assistance in at least two activities of daily living for 90 minutes daily (level 1) or three hours+ daily (level 2). Social determinants were defined as partnership status, education, income, age and gender. Data were analysed with multi-state time to event regression modeling which simultaneously model several competing events, as well as not only first but also second or third event in one model. Results During the study period, 556 participants (27.5%) changed their status of care dependency. Persons who reported having no partner at baseline were care-dependent more often than participants with a partner (43.7% ’no partner’ / 27.1% ’with partner’). In the multiple model having no partner compared to having a partner was associated with a higher risk of transition from no care dependency to level 1 (HR: 1.25, 95%CI: 0.97-1.64), however failed significance. The significant association between care dependency and income and between care dependency and education ceased as well after adjustment for co-morbidities. Conclusions Results indicate that older people without a partner tend to be on a higher risk of care dependency onset but not on a higher risk of care dependency progression. Inequality between education and income groups can be explained in terms of morbidity. Key messages The significant association between care dependency and income and between care dependency and education can be explained in terms of morbidity. Results indicate that older people without a partner tend to be on a higher risk of care dependency onset but not on a higher risk of care dependency progression.

Understanding the caring capacity of informal networks of frail seniors: a case for care networks

2003 ◽  
Vol 23 (1) ◽  
pp. 115-127 ◽  
Author(s):  
NORAH KEATING ◽  
PAMELA OTFINOWSKI ◽  
CLARE WENGER ◽  
JANET FAST ◽  
LINDA DERKSEN
Keyword(s):  
Social Networks ◽  
Older People ◽  
Informal Sector ◽  
Long Term Care ◽  
Health Problems ◽  
Informal Networks ◽  
Term Care ◽  
Levels Of Care ◽  
Care Giving

Population ageing and constraints on public sector spending for older people with long-term health problems have led policy makers to turn to the social networks of older people, or the ‘informal sector’, as a source of long-term care. An important question arising from this policy shift is whether these social networks have the resources to sustain the high levels of care that can be required by older people with chronic health problems. In the face of both dire warnings about the imminent demise of the informal sector, and concurrent expectations that it will be the pillar of community long-term care, it is timely to undertake a critical analysis of the caring capacity of older people's social networks. In this paper we argue that the best way to understand the caring capacity of informal networks of frail older people is to establish their membership and caring capacity. It is useful to make conceptual distinctions between ‘social’, ‘support’, and ‘care-giving’ networks. We argue that transitions of networks from social through support to care roles are likely to show systematic patterns, and that at each transition the networks tend to contract as the more narrowly defined functions prevail. A focus on ‘care networks’, rather than the more usual ‘care dyads’, will move forward our understanding of the caring capacity of the informal sector, and also our ability to forge sound social and health policies to support those who provide care.

scholarly journals The Admission of Older People Into Residential Care Homes in Argentina: Coercion and Human Rights Abuse

2018 ◽  
Vol 59 (4) ◽  
pp. 610-618 ◽  
Author(s):  
Peter Lloyd-Sherlock ◽  
Bridget Penhale ◽  
Nelida Redondo
Keyword(s):  
Human Rights ◽  
Older People ◽  
Patient Survey ◽  
Cognitive Status ◽  
Care Homes ◽  
Survey Analysis ◽  
Data Set ◽  
Middle Income ◽  
Levels Of Care ◽  
Dependency Care

Abstract Background and Objectives There is very little information about the appropriateness of procedures for admitting older people into care homes in low and middle-income countries like Argentina. This study provides the first systematic study of practice and assesses the extent to which current practice respects fundamental human rights. Research Design and Methods We apply different methods, including document review and national survey analysis. The study also includes a case study of a single city, La Plata, which draws on local key informant interviews, focus group discussions in different neighborhoods, and a clandestine surrogate patient survey led by local pensioners. This innovative design provides a highly triangulated and contextualized data set. Results Many older people admitted to care homes did not have high levels of care dependency. Care homes did not usually require or even seek the informed consent of older people, regardless of their cognitive status. There were indications of coercive admission by family members, sometimes in order to obtain access to older people’s homes and other property and finances. Discussion and Implications The study indicates the widespread abuse of the fundamental human rights of tens of thousands of older people in Argentina. There is a need for researchers, policy-makers, and civil society to acknowledge the scale of abuse and develop safeguards.

scholarly journals Improving care coordination for community-dwelling older Australians: a longitudinal qualitative study

2017 ◽  
Vol 41 (2) ◽  
pp. 144 ◽  
Author(s):  
Desley Harvey ◽  
Michele Foster ◽  
Edward Strivens ◽  
Rachel Quigley
Keyword(s):  
Older People ◽  
Care Transitions ◽  
Care Transition ◽  
Complex Care ◽  
Coordinated Care ◽  
Model Of Care ◽  
Care Needs ◽  
Levels Of Care ◽  
Transition Experiences ◽  
Complex Care Needs

Objective The aim of the present study was to describe the care transition experiences of older people who transfer between subacute and primary care, and to identify factors that influence these experiences. A further aim of the study was to identify ways to enhance the Geriatric Evaluation and Management (GEM) model of care and improve local coordination of services for older people. Methods The present study was an exploratory, longitudinal case study involving repeat interviews with 19 patients and carers, patient chart audits and three focus groups with service providers. Interview transcripts were coded and synthesised to identify recurring themes. Results Patients and carers experienced care transitions as dislocating and unpredictable within a complex and turbulent service context. The experience was characterised by precarious self-management in the community, floundering with unmet needs and holistic care within the GEM service. Patient and carer attitudes to seeking help, quality and timeliness of communication and information exchange, and system pressure affected care transition experiences. Conclusion Further policy and practice attention, including embedding early intervention and prevention, strengthening links between levels of care by building on existing programs and educative and self-help initiatives for patients and carers is recommended to improve care transition experiences and optimise the impact of the GEM model of care. What is known about the topic? Older people with complex care needs experience frequent care transitions because of fluctuating health and fragmentation of aged care services in Australia. The GEM model of care promotes multidisciplinary, coordinated care to improve care transitions and outcomes for older people with complex care needs. What does this paper add? The present study highlights the crucial role of the GEM service, but found there is a lack of systemised linkages within and across levels of care that disrupts coordinated care and affects care transition experiences. There are underutilised opportunities for early intervention and prevention across the system, including the emergency department and general practice. What are the implications for practitioners? Comprehensive screening, assessment and intervention in primary and acute care, formalised transition processes and enhanced support for patients and carers to access timely, appropriate care is required to achieve quality, coordinated care transitions for older people.

The Care of Older People

1952 ◽  
Vol 36 (2) ◽  
pp. 569-583 ◽  
Author(s):  
R. Ian Macdonald
Keyword(s):  
Older People

Self and Meaning in the Lives of Older People

2015 ◽  
Author(s):  
Peter G. Coleman ◽  
Christine Ivani-Chalian ◽  
Maureen Robinson
Keyword(s):  
Older People

The Relationship Between Antioxidant Nutrient Intake and Cataracts in Older People

2006 ◽  
Vol 76 (6) ◽  
pp. 359-366 ◽  
Author(s):  
Rodríguez-Rodríguez ◽  
Ortega ◽  
López-Sobaler ◽  
Aparicio ◽  
Bermejo ◽  
...  
Keyword(s):  
Vitamin C ◽  
Older People ◽  
Dietary Intake ◽  
Protective Effect ◽  
Elderly People ◽  
Nutrient Intake ◽  
Institutionalized Elderly ◽  
Weighing Method ◽  
The Relationship

This study investigated the relationship between the intake of antioxidant nutrients and the suffering of cataracts in 177 institutionalized elderly people (61 men and 116 women) aged ≥ 65 years. Dietary intake was monitored for 7 consecutive days using a "precise individual weighing" method. Subjects, who during their earlier years were exposed by their work to sunlight, had a greater risk of suffering cataracts (OR = 3.2; Cl: 1.1–9.3, P < 0.05) than those who worked indoors. A relationship was found between increased vitamin C intake and a reduced prevalence of cataracts (i.e., when comparing those above P95 for vitamin C intake with those below P5; (OR = 0.08; Cl: 0.01–0.75, P 0.05). Among subjects with cataracts, 12.1% had vitamin C intakes of < 61 mg/day (P10) and only 2.2% had intakes of > 183 mg/day (P95) (p < 0.01). Subjects who consumed > 3290 μg/day (P95) of lutein were less likely to have cataracts (OR = 0.086; Cl: 0.007–1.084; p < 0.05) than those whose consumption was < 256 μg/day (P5). In men, high intakes of zeaxanthin seemed to provide a protective effect against the problem (OR = 0.96; Cl: 0.91–0.99; p < 0.05). The results suggest an association exists between exposure to sunlight and the development of cataracts, and that vitamin C, lutein, and zeaxanthin offer some protection against this disorder.

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