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Rising from the COVID-19 crisis: policy responses in the long-term care sector
- Author:
- ORGANISATION FOR ECONOMIC CO-OPERATION AND DEVELOPMENT
- Publisher:
- Organisation for Economic Co-operation and Development
- Publication year:
- 2021
- Pagination:
- 13
- Place of publication:
- Paris
This brief looks at mortality rates in care homes, as well as the policy responses undertaken during the Covid-19 pandemic. The brief assesses the emergency preparedness of the sector and highlights the lessons learned, including policies to reduce isolation, testing strategies, care workforce and co-ordination with the health care sector. Key messages include: the long-term care (LTC) sector was generally ill-prepared to tackle a health emergency – deaths in the sector account for 40% of total COVID-19 deaths; most OECD countries banned visitors to LTC facilities and reduced group activities especially during the early months of the outbreak – such restrictions of visitors and group activities had a toll on resident’s well-being; access to testing and personal protective equipment (PPE) in the initial phases of the pandemic was not sufficiently prioritised in the sector; correct identification of symptoms among residents in care homes and staff was limited due to lack of initial knowledge on screening, insufficient access to health professionals and testing availability; high population density in LTC facilities has often been associated with worse outcomes; a higher LTC staffing rate was strongly associated with lower infection and LTC death rates across countries in early 2020; only seven OECD countries generated guidelines for better integration of care services with hospitals and only six improved access to palliative care; going forward, improving LTC preparedness requires an assessment of preparedness at the level of LTC facilities with detailed knowledge of human and material resources and regular actualisation of protocols for different scenarios. In addition, enhancing LTC response to emergencies requires co-ordination channels between public health authorities and the social sector, but also adequate follow-up mechanisms on the strategies undertaken with standardised data on infections and characteristics of facilities and residents. (Edited publisher abstract)
Does one dose of vaccine stop Covid-19 infection in care home residents?
- Author:
- UNIVERSITY COLLEGE LONDON. Institute of Health Informatics
- Publisher:
- University College London
- Publication year:
- 2021
- Pagination:
- 3
- Place of publication:
- London
Summarises findings from the VIVALDI study, which finds that a single dose of COVID-19 vaccine gives care home residents a good level of protection against COVID-19 infection after one month. Between December 2020 and March 2021, we investigated whether one dose of vaccine protects care home residents against COVID-19 infection. We looked at vaccination information, blood tests and nasal swab tests from 10,000 residents in 310 care homes across England. This was a period before most people in the UK had been offered their second COVID-19 vaccine. The results showed that one dose of vaccine provides some protection against COVID-19 in care home residents, but it is important to get a second dose to get the best level of protection. (Edited publisher abstract)
Do the determinants of health differ between people living in the community and in institutions?
- Authors:
- ASAKAWA Keiko, et al
- Journal article citation:
- Social Science and Medicine, 69(3), August 2009, pp.345-353.
- Publisher:
- Elsevier
The 1996/97 Canadian National Population Health Survey community and institutional surveys were utilised to identify factors associated with the selection of individuals to institutions. Whether the same determinants of health variables explain variations in health in those living in the community and those living in institutions were also examined. Logistic regression analysis was used to investigate factors associated with selection to institutions. Types of institutions included institutions for older people, psychiatric hospitals, and other rehabilitative institutions. Results showed that health status, age, chronic conditions, education, race, marital status, smoking and alcohol were associated with the probability of being in an institution. Multiple linear regression analyses (dependent variable: Health Utilities Index Mark 3 [HUI3] score) with individual characteristics, socio-economic status, and health risk factors were also estimated. Results showed that advanced age, higher number of chronic conditions, lower education, smoking and being an alcohol non-drinker were negatively and significantly associated with HUI3 scores for the community sample. Except for age, chronic conditions and being an alcohol non-drinker, none of these factors were significantly associated with HUI3 for the institutional sample. Moreover, the association between age and HUI3 was weaker for the institutional sample in comparison to the community sample. Implications are that, for those who are institutionalized, the usual determinants of health factors are less important. In conclusion, there appears to be important heterogeneity in determinants of health between persons living in the institution and community.
The place of assisted living in long-term care and related service systems
- Authors:
- STONE Robyn I., REINHARD Susan C.
- Journal article citation:
- Gerontologist, 47(3), December 2007, pp.23-32.
- Publisher:
- Oxford University Press
The purpose of this article is to describe how assisted living (AL) fits with other long-term-care services. The authors analyzed the evolution of AL in the United States, including the populations served, the services offered, and federal and state policies that create various incentives or disincentives for using AL to replace other forms of care such as nursing home care or home care. Provider models that have emerged include independent senior housing with services, freestanding AL, nursing home expansion, and continuing care retirement communities. Some integrated health systems have also built AL into their array of services. Federal and state policy rules for financing and programs also shape AL, and states vary in how deliberately they try to create an array of options with specific roles for AL. Among state policies reviewed are reimbursement and rate-setting policies, admission and discharge criteria, and nurse practice policies that permit or prohibit various nursing tasks to be delegated in AL settings. Recent initiatives to increase flexible home care, such as nursing home transition programs, cash and counselling, and money-follows-the-person initiatives may influence the way AL emerges in a particular state. Implications: There is no single easy answer about the role of AL. To understand the current role and decide how to shape the future of AL, researchers need information systems that track the transitions individuals make during their long-term-care experiences along with information about the case-mix characteristics and service needs of the clientele.
Planning consents for care homes - the challenges and opportunities
- Author:
- BUCKNELL Steve
- Journal article citation:
- Journal of Care Services Management, 1(3), April 2007, pp.252-261.
- Publisher:
- Taylor and Francis
This paper explores the challenges and opportunities facing those seeking to gain planning permission for new-build care homes. It highlights the need for more homes and those shortcomings in the current planning system that hinder new development. The description of the planning system is very simplified, and is focused on the system in England and Wales. The system in Scotland and Northern Ireland is broadly similar. This paper is aimed at operators of care homes, rather than developers or property professionals.
Paying for care: third-party top-ups and cross-subsidies
- Author:
- CCC
- Publisher:
- CCC
- Publication year:
- 2007
- Pagination:
- 24p.
- Place of publication:
- London
Third-party top-ups and the hidden cross-subsidy of care costs are matters of deep concern. Current practices are inequitable and they have evolved by stealth from a position where top ups are paid for "extra services" over and above needed care to a point where they are becoming necessary to secure care. Fundamentally, the way that top-ups are now required is symptomatic of the chronic under-funding of care and a cause of distress to care recipients and their families and to many of those who have to adopt such practice.
An empirical typology of residential care/assisted living based on a four-state study
- Authors:
- SOOK Nan, et al
- Journal article citation:
- Gerontologist, 46(2), April 2006, pp.238-248.
- Publisher:
- Oxford University Press
Residential care/assisted living describes diverse facilities providing non–nursing home care to a heterogeneous group of primarily elderly residents. This article derives typologies of assisted living based on theoretically and practically grounded evidence. The authors obtained data from the Collaborative Studies of Long-Term Care, which examined 193 assisted living facilities in four states: Florida, Maryland, New Jersey, and North Carolina. By using mixture modeling, typologies were derived in five different ways, based on: structure; process; resident case-mix; structure and process; and structure, process, and resident case-mix. Although configurations of typologies varied as a function of criterion variables used, common themes emerged from different cluster solutions. A typology based on resident case-mix yielded a five-cluster solution, whereas a typology based on structure, process, and resident case-mix resulted in six distinct clusters. Medicaid case-mix/psychiatric illness and high resident impairment were two clusters identified by both strategies. Because of the wide variation in structure, residents, and services within assisted living facilities, typologies such as those described here may be useful in clinical practice, research, and policy. To the extent that public payment defines its own cluster, the potential for inequities in care merits careful attention.
Assisted living in all of its guises
- Author:
- HERNANDEZ Mauro
- Journal article citation:
- Generations, 29(4), Winter 2006, pp.16-23.
- Publisher:
- American Society on Aging
This article looks at different models of providing assisted living in the United States as a means of long term care.
Choosing a care home
- Author:
- GOUDGE Mary V.
- Publisher:
- How To Books
- Publication year:
- 2004
- Pagination:
- 175p.
- Place of publication:
- Oxford
As the age of the population is rising, so is the demand for homes where frail, elderly and others who are unable to look after themselves can be offered long term care. This text presents practical advice on how to plan this critically important move and ensure that it works well for all concerned.
National Care Homes Research and Development Forum
- Author:
- COOK Glenda
- Journal article citation:
- Generations Review, 15(4), October 2005, pp.48-49.
- Publisher:
- British Society of Gerontology
The National Care Homes Research and Development forum was established on 19th November 2003 to provide a platform for practitioners and researchers to network, share information and ideas arising from their work. This article gives a rationale for the development of the forum and highlights its current work.