professional care
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2022 ◽  
Vol 25 (3) ◽  
Author(s):  
Magdalena Malczewska ◽  
Edyta Janus

Introduction: There are many difficulties connected with caring for an elderly person sufferring dementia. Symptoms such as aggression or apathy, as well as the progressive nature of the disorder, affect the attitude of both home and institutional caregivers towards the people for whom they care. An important element related to the provision of care is the relationship between a senior with dementia and those who provide the care (home and institutional caregivers). The aim of the article is to characterise and compare these relations. Material and methods: The study comprised 124 participants, 57 professional caregivers and 67 home carers. Two standardised questionnaires were used: the Neuropsychiatric Inventory Questionnaire (NPI-Q) and the Quality of Carer-Patient Relationship - QCPR Questionnaire. Additionally, the respondents provided socio-demographic data. The study was conducted via electronic media in the first quarter of 2021. Results: It was found that there is a significant difference in the relationship between home and institutional caregivers, with their charges in the dimension of "warmth and attachment" (measured by QCPR). People providing professional care have significantly higher scores in this area. There was also a significant difference between scores in the 'no conflict and criticism' dimension (measured by QCPR) for home and professional caregivers. Institutional caregivers, in relation to their care recipients, have a higher level of this indicator than home caregivers. Conclusions: Relationships between seniors with dementia and institutional or home carers differ with regard to some issues. The differences in relationships with seniors suffering dementia may be due to the time spent caring for this person and the caregiver's response to symptoms of dementia.


2021 ◽  
Author(s):  
◽  
Tom Loffhagen

<p>This thesis focuses on suicide bereavement, particularly of those parents who have lost children to suicide while in care of the state. I argue that, for these parents, action taken following the suicide of their children is an extension of the care that was given throughout their child’s lives. For parents of those suffering with mental health issues, care is fraught with confusion and tension. This is no more apparent than when they and their children are seeking professional care. Care is inextricably linked with responsibility, which as I will show, is a very important concept in understanding suicide prevention. Governance of regimes of care shapes bereavement through biopolitical responsibilisation. The conflict found within understandings of care lays the foundation for the conflated tensions that arise in suicide bereaved parents’ search for recognition and accountability of and for their child’s suicide. In this thesis I explore these actions to understand the motives and desires of these parents. In exploring these, meaning becomes a useful analytical lens, for meaning, care, and the projects that my participants undertake in search of answers were all intimately linked. Through understanding the actions of bereaved parents as an extension of the care for their children we can understand how these actions are shaped by the governance and regimes of care within New Zealand.</p>


2021 ◽  
Author(s):  
◽  
Tom Loffhagen

<p>This thesis focuses on suicide bereavement, particularly of those parents who have lost children to suicide while in care of the state. I argue that, for these parents, action taken following the suicide of their children is an extension of the care that was given throughout their child’s lives. For parents of those suffering with mental health issues, care is fraught with confusion and tension. This is no more apparent than when they and their children are seeking professional care. Care is inextricably linked with responsibility, which as I will show, is a very important concept in understanding suicide prevention. Governance of regimes of care shapes bereavement through biopolitical responsibilisation. The conflict found within understandings of care lays the foundation for the conflated tensions that arise in suicide bereaved parents’ search for recognition and accountability of and for their child’s suicide. In this thesis I explore these actions to understand the motives and desires of these parents. In exploring these, meaning becomes a useful analytical lens, for meaning, care, and the projects that my participants undertake in search of answers were all intimately linked. Through understanding the actions of bereaved parents as an extension of the care for their children we can understand how these actions are shaped by the governance and regimes of care within New Zealand.</p>


2021 ◽  
Vol 81 (6) ◽  
pp. 452-458
Author(s):  
Martin Werding

Abstract Care work can be provided in various forms and in differing institutional settings, ranging from private households over social networks and charitable organizations to public or private entities employing professional care persons. All these forms of care work create a value-added, but are subject to very different economic conditions. Focusing on professional care and building on German micro-data, the article shows preliminary evidence that there might be a »care wage-gap«, i.e., a systematic disadvantage of care workers compared to other professions in terms of their remuneration. It points out how this presumption could be thoroughly scrutinized and suggests possible reasons - among other things, the existence of informal care - that could be tested in subsequent steps.


2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 264-264
Author(s):  
Tobias Stacke ◽  
Mike Rommerskirch-Manietta ◽  
Daniel Purwins ◽  
Christina Manietta ◽  
Armin Stroebel ◽  
...  

Abstract Background The tool “Preferences for Everyday Living Inventory” (PELI) for Nursing Homes (NH) was developed in the USA. In our project PELI-D, the PELI was translated from English into German and piloted in three care settings: Nursing Home (NH), Home Care (HC) and Adult Day Care (AD). Objective The objective is to provide insights in preferences of importance of older adults in need of care in Germany. Methods Data collection was carried out in 2019 on multiple measurement points: n=48 baseline (T0) and n=41 two-week follow-up (T1). Results The results indicate that the importance of certain preferences distinguishes between the care settings: In NH preferences for body care and aspects of professional care are important. Additionally, in HC the aspects of social contact and eating/drinking are perceived as important. Comparing T0 and T1, importance of the item’s daily routines, social contact and aspects of privacy seem to be reliable.


2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 1058-1058
Author(s):  
Kedong Ding

Abstract Background Current evidence on the effects of Care Coordination (CC) on older adults’ well-being and health service utilization is inconsistent. Previous studies are mostly limited to regional data and focus mostly on nurse-led CC instead of layperson Care Coordinators like family caregivers. This study explores the effects of having CC in a national sample of U.S. older adults and whether the coordinators’ professionalism impacts the effect of having CC on multidimensional health outcomes (Health outcomes were conceptualized as physical health, healthcare utilization, and care encounters). Methods Data were from the 2016 and 2018 waves of the Health and Retirement Study (HRS) (n=1,372). Multivariate regression models were used to examine the effects of CC on multidimensional health outcomes in 2016 and the longitudinal effects of having CC. We also tested the effect of Care Coordinators’ professionalism on the multidimensional health outcomes. All models controlled for sociodemographic characteristics and health status. Results Findings suggest that having CC doesn’t have a positive effect on older adults’ health outcomes. Having CC was associated with an increased number of acute diseases (β = 0.16, p &lt; .001) and nonacute diseases (β = 0.21, p &lt; .01) in longterm. The results regarding cross-sectional effects show that receiving care from a Coordinator was related to increased health service utilization. Participants with professional Care Coordinators were more likely to report receiving person-centered care (OR=1.60, p&lt;.05). Conclusion This study demonstrates the limited effects of CCs on older adults’ physical health outcomes, and emphasized the importance of care coordinators’ qualifications.


2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 535-536
Author(s):  
Jinjiao Wang ◽  
Meiling Ying ◽  
Yue Li

Abstract Little is known about the disparities in patient experience of home health (HH) care related to social vulnerability. This study examined the relationships of patient Medicare-Medicaid dual eligible status and race and ethnicity with patient experience of HH care. We analyzed national data from the Home Health Care Consumer Assessment of Healthcare Providers and Systems (HHCAHPS), Outcome and Assessment Information Set, Medicare claims and Area Health Resources File for 11,137 Medicare-certified HH agencies (HHA) that provided care for Medicare beneficiaries in 2017. Patient-reported experience of care star ratings (1-5) in HHCAHPS included 3 domains (professional care delivery, effective communication, and specific issues in direct patient care) with each dichotomized into high (4-5) and low (1-3) experience of care. The proportion of patients with dual eligibility and the proportion of racial/ethnic minorities were summarized at the HHA level. HHA with higher proportion of dual eligible patients were less likely to have high experience of care rating in professional care delivery (smallest Odds Ratio [OR]=0.514; 95% CI: 0.397, 0.665; p&lt;0.001), effective communication (smallest OR=0.442, 95% CI: 0.336, 0.583; p&lt;0.001), and specific direct care issues (smallest OR=0.697, 95% CI: 0.540, 0.899; p=0.006). HHA with higher proportion of racial/ethnic minorities were also less likely to have high patient experience of care rating across all three domains (smallest OR=0.265, 95% CI: 0.189, 0.370; p&lt;0.001). Disparities in patient experience of HH care exist and they are associated with low income and racial/ethnic minority status, indicating substantial unmet needs among these socially vulnerable patients.


2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 86-86
Author(s):  
Barbara Weinstein ◽  
Jenna Littlejohn ◽  
Iracema Leroi

Abstract Many older adults being evaluated for dementia have unrecognized hearing and/or vision problems which can confound results of neuropsychological assessment(s) and can impact care recommendations. International care standards for detection, assessment, and management of people living with dementia (PwD) are rarely addressed yet are critical. We propose a set of recommendations crafted to foster the highest quality health care to enable PwD to live well with these combined impairments. The focus is detection, diagnosis, treatment, and support of PwD who have age-related hearing and/or vision impairments. The guiding principles underlying the recommendations was a focus on promotion of a person-centered approach, but to be pragmatic in considering all contextual levels including professional care pathways and socio-economic/policy factors internationally. The recommendations are inclusive of all stakeholders who work together to promote equity and mutual respect across the domains. The guidelines are designed to be pragmatic, implementable, resource sparing, and sustainable.


2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 1026-1027
Author(s):  
Ya-Mei Chen ◽  
Shih-Cyuan Wu ◽  
Kuan-Ming Chen ◽  
Chen-Wei Hsiang ◽  
Shiau-Fang Chao ◽  
...  

Abstract Background Taiwan, one of the fastest aging countries in the world, provides home-and community-based services (HCBS) care recipients through the second 10-Year Long-Term Care Plans (LTC Plans 2.0). The current study aimed to examine the impact of continuous use of HCBS offered by LTC plan 2.0 on older adults’ physical function change overtime. Methods This study used the LTC Plan 2.0 database and the National Health Insurance Plan claim dataset, and included 157,682 clients who had applied for and were evaluated for LTC services for the first time from 2018 through 2020 and continuously used any LTC Plan 2.0 services for six months. Outcome variables were measured by activities ofdaily living (ADLs) and instrumental activities of daily living (IADLs) between baseline assessment and the assessment after the six months of serivce utilization. Latent class analysis and generalized estimating equations were used to investigate the influences of different service use patterns on the changes in physical functions. Results Three subgroups of LTC recipients with different use patterns, including home-based personal care (home-based PC) services (n = 111,976; 71.01%), professional care services (n = 31,584; 20.03%), and community care services (n = 14,122; 8.96%) were identified. When compared to care recipients in the community care group, those in the home-based PC group improved more in IADL scores, and the professional care group improved more ADL scores. Conclusion Those receiving more professional services made more progress in ADL ability, but those in home-based PC made more progress in IADL ability.


2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 1009-1010
Author(s):  
Ya-Mei Chen ◽  
Shih-Cyuan Wu ◽  
Shiau-Fang Chao ◽  
Kuan-Ming Chen ◽  
Chen-Wei Hsiang ◽  
...  

Abstract Background Whether long-term care service use decreases older adults’ health care service use and cost has been a strong interest among aging countries, including Taiwan. The current study examined the impact of continuous use of HCBS offered by Taiwan’s LTC plan 2.0 on older adults’ health service utilization and cost overtime. Methods This study used the LTC Plan 2.0 database and the National Health Insurance Plan claim dataset, and included 151,548 clients who had applied for and were evaluated for LTC services for the first time from 2017 through 2019 and continuously used any LTC Plan 2.0 services for six months. Outcome variables were users’ health service utilization and health care cost 12 months before and after starting to continuously use HCBS. Latent class analysis and generalized estimating equations were used to investigate the influences of different service use patterns on the changes in physical functions. Results Three subgroups of LTC recipients with different use patterns, including home-based personal care (home-based PC) services (n = 107324, 70.8%), professional care services (n = 30466, 20.1%), and community care services (n = 13794, 9.1%) were identified. When compared to care recipients in the community care group, those in the home-based PC group had more emergency room expenditures (1 point/month, p&lt; 0.05) but less hospitalization expenditures (38 points/month, p&lt;0.001), while the professional care group had less emergency room and hospitalization expenditures (3 and 138 points/month, p&lt; 0.001). Conclusion Those receiving professional care and home care services spent less on health care service utilization.


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