Search results for ‘Subject term:"older people"’ Sort:
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Personal assistance for older adults (65+) without dementia
- Authors:
- MONTGOMERY Paul, MAYO-WILSON Evan, DENNIS Jane
- Journal article citation:
- Campbell Systematic Reviews, 4(1), 2008, pp.1-52.
- Publisher:
- Wiley
This systematic review investigated the effectiveness of personal assistance versus any other form of care for older adults. Personal assistance is defined as paid support of at least 20 hours per week for people with impairments. Four studies were identified that met the inclusion criteria, which included 1,642 participants. They suggested that personal assistance may be preferred over other services; however, some people prefer other models of care. This review indicates that personal assistance probably has some benefits for some recipients and their informal caregivers. Paid assistance might substitute for informal care and cost government more than alternative arrangements; however, the relative total costs to recipients and society are unknown. While advocates may support personal assistance for myriad reasons, this review concluded that further studies were required to determine which models of personal assistance were most effective. (Edited publisher abstract)
Comparative costs of home care and residential care
- Authors:
- CHAPPELL Neena, et al
- Journal article citation:
- Gerontologist, 44(3), June 2004, pp.389-400.
- Publisher:
- Oxford University Press
This paper reports on Canadian research that examined the cost effectiveness of home care for seniors as a substitute for long-term institutional services. Two Canadian cities were included in the research: Victoria, British Columbia, and Winnipeg, Manitoba. The research computes the costs of formal care and informal care in both settings and ensures comparable groups of clients in both settings by comparing individuals at the same level of care. The results reveal that costs were significantly lower for community clients than for facility clients, regardless of whether costs only to the government were taken into account or whether both formal and informal costs were taken into account. When informal caregiver time is valued at either minimum wage or replacement wage, there was a substantial jump in the average annual costs for both community and facility clients relative to when informal caregiver time was valued at zero. Nevertheless, the results reveal that home care is significantly less costly than residential care even when informal caregiver time is valued at replacement wage.
Paying for long-term care for older people in the UK: modelling the costs and distributional effects of a range of options
- Authors:
- HANCOCK Ruth, et al
- Publisher:
- Personal Social Services Research Unit
- Publication year:
- 2006
- Pagination:
- 115p., bibliog.
- Place of publication:
- Canterbury
How best to finance long-term care has been the subject of considerable recent debate in the UK. The Government established the first Royal Commission in many years, to review the financing of long-term care and to make recommendations about future financing. Its key recommendation was that the nursing and personal care components of the fees of care homes and home-based personal care should be met by the state, without a means test. In England, Wales and Northern Ireland, means-testing has now been removed for nursing but not personal care. Scotland has made both nursing and personal care free of charge. Much of the current debate concerns whether personal care should be made free of charge throughout the UK. There are, however, other ways in which the system for funding long-term care could be reformed. There is a need for a more comprehensive range of options to be considered, informed by the latest policy developments in the UK and drawing on experience in other European countries. The study aims to project expenditure on long term care services for older people under a wide range of options for reforming the current system. It will provide for each option, projections to 2050 of: the total cost of long-term care for older people, in absolute terms and as a proportion of Gross Domestic Product; its breakdown between public and private sources, and within the public sector; how the costs borne by service users vary by the level of their income and wealth; the sensitivity of projections to assumptions about future numbers of older people, dependency levels, costs of formal care, supply of informal care and future demand for formal care.
Case management: effects of improved risk and value information
- Authors:
- WEISSER William G., et al
- Journal article citation:
- Gerontologist, 43(6), December 2003, pp.797-803.
- Publisher:
- Oxford University Press
The purpose of this study was to determine the impact on resource use of providing case managers with information on the potential for patients to benefit from home care services. Twenty-four case managers working in the Arizona Long Term Care System (ALTCS) were randomized into treatment and control groups. Members of the treatment group were given patient assessments for 25 ALTCS clients, estimates of the patients' risks for various adverse outcomes, and estimates of the aggregate potential benefit for each patient. Members of the control group were given only patient assessments (as is usual practice) for the same sample of 25 clients. Both groups were asked to independently write nonbinding care plans for each patient. The cost of each case manager's care plans was computed by multiplying standard costs per service times the mix and volume of services prescribed for each patient. Treatment group care plan costs were, on average, lower than control group costs and closely tracked variation in estimated patient risks. Comparison group care plan costs were unrelated to risks. Information about risk and potential benefit can improve targeting of services to long-term-care clients. A prospective study using such an approach is warranted to see if provision of risk and potential benefit information would produce better clinical and economic outcomes.
Formal and informal care for people with dementia: variations in costs over time
- Authors:
- SCHNEIDER Justine, et al
- Journal article citation:
- Ageing and Society, 23(3), May 2003, pp.303-326.
- Publisher:
- Cambridge University Press
The services used by people with dementia and their carers were measured at three time points over 17 months. This analysis is unusual in that both informal care and formal inputs were costed. The costs estimates for informal inputs developed here may be applied to other data sets. Two hypotheses to explain the inter-relationship between informal and formal care inputs, substitution and supplementation, were compared in analysing the data. This paper explores the variations in costs according to the living arrangements of the people with dementia, by level of dependency and over time, and finds systematic differences. The costs of the inputs from co-resident carers consistently exceeded the costs of formal services, with informal care constituting up to 40 per cent of the total costs burden for dementia care. When informal inputs were included, non-domestic residential care emerged as less, not more, costly than care in the community. There was a shift in costs burden from health services to social services over time as more people moved into non-domestic settings. Multivariate analyses identified several predictors of informal and formal care costs: physical disability, level of cognitive impairment, living in non-domestic settings, and formal care provided. Non-domestic care predicted lower inputs of both formal and informal services. Dementia level was positively associated with informal inputs. Physical frailty was associated with more formal care, but less informal care. More formal service inputs predicted higher informal care inputs. There is evidence of supplementation of informal care by formal services in the early stages of care, followed by substitution as the person with dementia enters residential care.
Over the threshold: an exploration of intensive domiciliary support for older people
- Authors:
- CURTICE Lisa, et al
- Publisher:
- Scotland. Scottish Executive Central Research Unit
- Publication year:
- 2002
- Pagination:
- 119p.,bibliog.
- Place of publication:
- Edinburgh
This study aimed to examine the extent to which frail older people are able to remain in their own homes with intensive and flexible domiciliary care packages. In particular, it sought to explore the factors influencing the delivery of intensive flexible support, whether users have the choice, the contribution of various sectors, the impact of local authority purchasing and cost effectiveness.
Mental and physical frailty in older people: the costs and benefits of informal care
- Author:
- -
- Journal article citation:
- Ageing and Society, 18(3), May 1998, pp.317-354.
- Publisher:
- Cambridge University Press
Describes the financial, opportunity and social costs and benefits of providing informal support to frail older people within an economic framework. Around half the supporters reported financial costs or lost social opportunities. A minority of supporters had reduced their working hours or withdrawn from employment because of caregiving. Nearly all supporters reported at least one social cost and identified at least one positive aspect of caregiving. The benefits of caregiving were not consistently related to co-residency, relationship of supporter or frailty type. Possible strategies for decreasing the costs and increasing the benefits of caregiving are discussed.
Community care and older people
- Author:
- VICTOR Christina R.
- Publisher:
- Stanley Thornes
- Publication year:
- 1997
- Pagination:
- 189p.,bibliog.
- Place of publication:
- Cheltenham
Presents a concise review of the demographic context underpinning all aspects of community care, and looks at the way community care has developed in the context of formal and informal services. Presents an integrated review of available data and research and gives full consideration to the costs and effectiveness of service provision, as well as looking at issues around housing. Goes on to compare relevant data between Britain and other developed countries.
How costly is it to care for disabled elders in a community setting?
- Authors:
- HARROW Brooke S., TENNSTEDT Sharon L., McKINLAY John B.
- Journal article citation:
- Gerontologist, 35(6), December 1995, pp.803-813.
- Publisher:
- Oxford University Press
Describes the total cost of care, including both informal caregiving and formal services for a cohort of disabled elderly living in the community in the USA. Increased disability was associated with increased costs. High-cost elders were more likely to be severely disabled, live with their caregiver, and become institutionalised. For most elders, even the cost of a complete substitution of informal care for formal services, plus living expenses, was less costly than nursing home care.