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Home care across Europe: current structure and future challenges
- Editors:
- GENET Nadine, ed.
- Publisher:
- World Health Organization
- Publication year:
- 2012
- Pagination:
- 156p.
- Place of publication:
- Copenhagen
Currently, for every person over the age of 65 in the European Union, there are four people of working age. But by 2050 there will only be two. Demand for long-term care, of which home care forms a significant part, will inevitably increase in the decades to come. Despite the importance of the issue, however, up-to-date and comparative information on home care in Europe is lacking. This report attempts to fill some of that gap by examining current European policy on home care services and strategies. It examines a wide range of topics including the links between social services and health-care systems, the prevailing funding mechanisms, how service providers are paid, the impact of governmental regulation, and the complex roles played by informal caregivers. Drawing on a set of Europe-wide case studies, the report provides comparable descriptive information on many aspects of the organisation, financing and provision of home care across the continent. The report is designed to help frame the coming debate about how best to serve elderly citizens as European populations age.
Reminders that make sense: designing multisensory notifications for the home
- Author:
- MCGEE-LENNON Marilyn R.
- Journal article citation:
- Journal of Assistive Technologies, 6(2), 2012, pp.93-104.
- Publisher:
- Emerald
It is likely that technology will play a significant role in supporting people in their homes as they get older. The purpose of this paper is to present a synthesised overview of a project which is developing multimodal configurable reminder systems for the home. The aim of the MultiMemoHome Project is to understand more fully the different multimodal solutions available and to understand how effective and appropriate these methods are with real users in the home context. The paper presents an overview of multimodal interaction techniques and how they can be used to deliver messages to the user in a way that is more appropriate to the user's needs, the devices available, and the physical and social environment that the person is in when they receive a message. The paper argues that electronic reminders or notifications delivered in the home (such as appointments or when to take medication to your phone, computer or TV) should be available in multiple sensory modalities (visual, auditory, tactile and olfactory) in order to increase their usability and acceptability and make them accessible to a wider range of users. A set of guidelines and lessons learned on how to design usable and acceptable multimodal reminder systems for the home are presented.
HCBS: The next thirty years
- Authors:
- KANE Robert L., KANE Rosalie A.
- Journal article citation:
- Generations, 36(1), 2012, pp.131-134.
- Publisher:
- American Society on Aging
This article provides a brief perspective on the progress made over the past thirty years in long-term services and supports, how the paradigm around demand for and use of these services is shifting, and offers a forward-thinking, five-point action plan for putting HCBS(Home and Community Based Services) “front and center,” and moving HCBS into a prominent position as a first choice in long-term supports and services for older adults and people of all ages with disabilities. (Publisher abstract)
HCBS can keep people with dementia at home
- Author:
- CHERRY Debra L.
- Journal article citation:
- Generations, 36(1), 2012, pp.83-90.
- Publisher:
- American Society on Aging
Progress towards making HCBS (Home and Community Based Services) a mainstream choice for older adults is challenging when an older person has moderate to severe cognitive impairment. These individuals need a modified continuum of care: one that is dementia-capable. This article discusses approaches that make a difference for people with Alzheimer's Disease and related dementias who want to live at home and in their communities—and for their family members. (Publisher abstract)
Methodological challenges in the implementation and evaluation of social welfare policies
- Authors:
- ANDERSSON Katarina, KALMAN Hildur
- Journal article citation:
- International Journal of Social Research Methodology, 15(1), 2012, pp.69-80.
- Publisher:
- Taylor and Francis
As social reality is quite elusive, even regarding seemingly well-recognised everyday concepts and objects, assessments and evaluations of implementation policies will always present methodological challenges. There is a need to consider such assessments and evaluations in a critical perspective to investigate whether the desired knowledge is really being acquired. The purpose of this article is to address some of the challenges that underlie assessments and evaluations of the implementation of social welfare policies by presenting a rereading and analysis of an empirical study of elderly home care services. The rereading and analysis is described in terms of 4 stages: ecological analysis of institutions; shadowing; focus on common concepts and objects; and applying the analytical concept of boundary objects. The results reveal the emergence of a dissolution of common and professional key concepts and objects in these welfare services to a degree that challenges both the implementation policy and the evaluation of policy. The article concludes that this has methodological implications for the evaluation of implementation policies in general.
Promoting empathy in social care for older people
- Authors:
- STRANDBERG Thomas, EKLUND Jakob, MANTHORPE Jill
- Journal article citation:
- Working with Older People, 16(3), 2012, pp.101-110.
- Publisher:
- Emerald
The purpose of this paper is to identify connections between empathy and social care, considering the way in which services are underpinned by empathy between the older person receiving such support and the paid home-care worker. Five doctoral theses, published from 1996-2007, which discussed empathy among care workers of older people in Sweden were analysed. Methodologically, the examination underpinned an interpretive content analysis. The main themes which emerged during the analysis were: time, power, older adults, needs, caring-relationships, organisation, and personal ability. The meta-analysis revealed conflicting feelings among care workers. Most experienced frustration when they were not able to express empathy in their working practices. Empathy was typically hindered by lack of time, care workers' own needs, and inflexible home care systems. However, a key element of the job-satisfaction reported by care workers appeared to be its empathic nature. Most care workers perceive encounters with older people as opportunities to respond empathically rather than indifferently. The implications of these findings are discussed.
My home, my care, my voice: older people's experiences of home care in Wales
- Author:
- OLDER PEOPLE'S COMMISSIONER FOR WALES
- Publisher:
- Older People's Commissioner for Wales
- Publication year:
- 2012
- Pagination:
- 11p.
- Place of publication:
- Cardiff
Despite the overall proportion of older people in Wales increasing, the numbers receiving home care services continues to fall. The number of older people in receipt of home care services in 2011 was 4% lower than the previous year, and represents a 16% fall since 2002. The findings in this report focus on the results of the Commission’s survey of over a thousand older people aged 60 or over in receipt of home care in four local authority areas. The majority of older people receiving home care in Wales were positive about their experiences. Far too many people indicate that they rarely or never have enough time with their care workers and this issue attracted more negative comments than any other. Overall, older people were satisfied with their home care arrangements; but almost one in ten indicate that standards have declined.
Care regimes on the move: comparing home care for dependent older people in Belgium, England, Germany and Italy
- Authors:
- DEGAVRE Florence, et al
- Publisher:
- Universite Catholique de Louvan. Centre Interdisciplinaire de Recherche Travail, Etat et Societe
- Publication year:
- 2012
- Pagination:
- 290p.
- Place of publication:
- Charleroi
Taking the reforms of the 1990s as its starting point, this report examines the dynamics of change experienced by Belgium, England, Germany and Italy in their home care sectors. Central to our analysis is the process of “marketisation”. This constitutes one of the major trends in all these four countries, yet its nature and impact show important national variations. The data referred to in this report relate to developments in and around various home care sectors, and cover both societal and organisational dynamics. Country-based research teams gathered the information, each team following identical methodological guidelines. This report uses official documents and grey literature from the care sector to analyse the discourses underpinning reforms in the field. The conclusions of this research will be of relevance for any country or region struggling to design a home care system for an ageing population. The coordinators of this research project have submitted a proposal for a special issue of Ageing and Society based on the main chapters of this report.
The U.S. long term care system: development and expansion occurring retirement communities as an innovative model for aging in place
- Authors:
- GUO Kristina L., CATILLO Richard J.
- Journal article citation:
- Ageing International, 37(2), June 2012, pp.210-227.
- Publisher:
- Springer
- Place of publication:
- New York
This paper describes the importance of naturally occurring retirement communities (NORCs) in the United States to promote the health and mental well being of older individuals through the collaborative efforts of formal and informal home and community based services and support. NORCs are considered a crucial model for aging in place since older adults prefer to remain in the comfort of their homes, and services can be provided in a much more efficient and cost effective manner. This paper examines the strengths, opportunities, and challenges of existing NORCs and discusses the need for the development and expansion of additional NORC programs as an innovative and viable solution for older adults aging in place.
Home care or long-term care? Setting the balance of care in urban and rural Northwestern Ontario, Canada
- Authors:
- KULUSKI Kerry, et al
- Journal article citation:
- Health and Social Care in the Community, 20(4), July 2012, pp.438-448.
- Publisher:
- Wiley
This study investigated the extent to which community care packages could be provided at a lower cost than facility-based long-term care (LTC). Participants included 864 individuals on the LTC waiting list in urban and rural parts of north-western Ontario, Canada. A mixed methods design was used involving a retrospective chart review, the formation of case vignettes, the creation of community care packages with an expert panel of care managers, the costing of care packages and the calculation of potential diversion rates from LTC. Findings revealed that 8% of individuals in the urban area and 50% of individuals from the rural areas could potentially be safely diverted to the community and provided with a community care package at a cost lower than facility-based LTC. The authors concluded that there was potential for home and community care to replace costly long-term care, but doing so required building extra capacity in this sector, particularly in underserviced rural areas.