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COVID-19 and long-term care policy for older people in Japan
- Authors:
- ESTEVEZ-ABE Margarita, IDE Hiroo
- Journal article citation:
- Journal of Aging and Social Policy, early cite May 2021,
- Publisher:
- Routledge
- Place of publication:
- Philadelphia, USA
Japan’s initial response to COVID-19 was similar to that of the US. However, the number of deaths in Japan has remained very low. Japan also stands out for the relatively low incidence of viral transmission in Long-Term Care Facilities (LTCFs) compared to both European countries and the United States. This paper argues that Japan’s institutional decision to lockdown Long-Term Care facilities as early as mid-February – weeks earlier than most European countries and the US – contributed to lowering the number of deaths in LTCFs. This paper highlights a few lessons from the Japanese experience: (i) the presence of hierarchically organized government agencies whose sole missions are elderly care; (ii) the presence of effective communication channels between LTCFs and the regulatory authorities; and (iii) the well-established routine protocols of prevention and control in LTCFs. (Edited publisher abstract)
Exploring the personal and environmental factors related to length of stay in assisted living
- Author:
- FIELDS Noelle L.
- Journal article citation:
- Journal of Gerontological Social Work, 59(3), 2016, pp.205-221.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
This study explored to what extent personal and environmental factors, as defined by the ecological model of aging, help us to understand length of stay in assisted living (AL). A convenience sample (N = 218) of administrative records of AL residents admitted between the years 2006 and 2011 was collected and included AL residents' demographic and healthcare information as well as dates of admission and discharge. Cox regression was used to determine which personal and environmental factors influenced length of stay in three AL programs. Number of medical diagnoses, level of care score, and facility were found to be significant predictors of length of stay. The analyses identified a median survival time of 32 months as well as critical periods for discharge from AL. Implications for future research and social work practice are presented. (Publisher abstract)
The impact of devolution: long-term care provision in the UK
- Author:
- BELL David
- Publisher:
- Joseph Rowntree Foundation
- Publication year:
- 2010
- Pagination:
- 41p., bibliog.
- Place of publication:
- York
This report on long-term care provision policies, from a series on the impact of 10 years devolved government in the United Kingdom, considers the constraint that tax and benefit structure (control of which remains centrally within the Departmental Expenditure Limits (DEL) system), has on Scotland, Northern Ireland, Wales and England. The importance of having secondary social care, funded from Annually Managed Expenditure by the Department for Work and Pensions (DWP) and less bound to annual budgets than DEL, in minimising diversity of delivered care is discussed. The inability of devolved governments to steer DWP, due to weak intergovernmental relations, is highlighted and in section 2 Scottish attendance allowances and Welsh domiciliary care charges are contrasted. Section 3 details demand for care varies more within countries than between them, while section 4 highlights divergence in older people’s ability to pay. A current snapshot of care provision across the UK in section 5, is followed by a focus on free personal care, personalisation and charging in Section 6. Section 7 reiterates that policies can be constrained as well as enhanced by devolution. Other reports, in this series, detail area based regeneration, indicators of poverty and social exclusion, employment and employability and housing and homelessness.
Older people's vision for long-term care
- Authors:
- BOWERS Helen, et al
- Publisher:
- Joseph Rowntree Foundation
- Publication year:
- 2009
- Pagination:
- 56p., bibliog.
- Place of publication:
- York
The research project explored the voice, choice and control of older people living with high support needs. The research involved a scoping study exploring the current role of long term care; a series of discussions with older people, their families and professionals; synthesis of key messages with a diverse advisory group; local feedback; and a national ‘sounding board’ event to identify the key messages to be shared. Those involved in the study emphasised the need for all sectors to work to ensure that older people's vision for their own future is widely owned and used to move from the current default model of residential care towards a range of more flexible options.
Willingness to use formal long-term care services by Korean elders and their primary caregivers
- Authors:
- KIM Hyungsoo, CHOI Won-Young
- Journal article citation:
- Journal of Aging and Social Policy, 20(4), 2008, pp.474-492.
- Publisher:
- Routledge
- Place of publication:
- Philadelphia, USA
Logistic regression models were estimated using 2001 national survey data on 1,168 Korean adults aged 65 or older, and their primary caregivers. More than 70% of the older people were female, mostly with very low levels of formal education, and the majority lived with adult children or spouses. The attitudes of both older people and primary caregivers towards care responsibility were the dominant predictor of willingness to use formal long term care services. These attitudes need to be taken into account as policy makers attempt to normalise the use of formal care (home-based or institutional) and reduce the burden on informal carers. (Copies of this article are available from: Haworth Document Delivery Centre, Haworth Press Inc., 10 Alice Street, Binghamton, NY 13904-1580).
Autonomy in long-term care: a need, a right or a luxury?
- Author:
- BOYLE Geraldine
- Journal article citation:
- Disability and Society, 23(4), June 2008, pp.299-310.
- Publisher:
- Taylor and Francis
Doyal and Gough's theory of human need highlighted that personal autonomy is a universal need and human right, essential for well-being. In applying their theory to older disabled people in the UK the author suggests that their "minimally autonomous" threshold would exclude some older people in long-term care who still have a fundamental need for autonomy or, alternatively, extant autonomy. The disability movement has highlighted that independent living is fundamental to achieving self-determination for disabled people and debate on equality and caregiving emphasises the autonomy of carers. However, there is a lack of recognition in both academic research and government policy of autonomy as a need and right of older disabled people. The author argues that autonomy is a human right of older people living in long-term care settings, but that social rights are necessary to facilitate their autonomy.
A panel multinomial logit analysis of elderly living arrangements: evidence from aging in Manitoba longitudinal data, Canada
- Authors:
- SARMA Sisira, SIMPSON Wally
- Journal article citation:
- Social Science and Medicine, 65(12), December 2007, pp.2539-2552.
- Publisher:
- Elsevier
Utilizing a unique longitudinal survey linked with home care use data, this paper analyzes the determinants of elderly living arrangements in Manitoba, Canada using a random effects multinomial logit model that accounts for unobserved individual heterogeneity. Because current home ownership is potentially endogenous in a living arrangements choice model, prior home ownership as an instrument is used as an instrument. Prior home care use is also used as an instrument for home care and use a random coefficient framework to account for unobserved health status. After controlling for relevant socio-demographic factors and accounting for unobserved individual heterogeneity, it was found that home care and home ownership reduce the probability of living in a nursing home. Consistent with previous studies, age was also found to be a strong predictor of nursing home entry. Married people, those who have lived longer in the same community, and those who are healthy are more likely to live independently and less likely to be institutionalized or to cohabit with individuals other than their spouse.
Funding long-term care for older people: lessons from other countries
- Authors:
- GLENDINNING Caroline, et al
- Publisher:
- Joseph Rowntree Foundation
- Publication year:
- 2004
- Pagination:
- 35p., bibliog.
- Place of publication:
- York
An evaluation of how other countries are devising fair and sustainable ways of funding long-term care for older people. Like the UK, many other countries are facing challenges in devising fair and sustainable ways of funding the long-term care needed by new generations of older people. While the challenges are similar, their responses are sometimes very different from our own. Nevertheless, their experiences can provide valuable lessons for the UK. This report draws on the experiences of long-term care funding – both the raising of revenue and the mechanisms by which it is allocated to services and allowances – in Australia, Austria, Denmark, France, Germany, Japan, Netherlands, Scotland and the United States.
The cross-Atlantic exchange to advance long-term care: background paper prepared for the European Commission and AARP joint conference on long-term care 13 September 2006, Brussels
- Authors:
- TSOLOVA Svetla, MORTENSEN Jorgen
- Publisher:
- Centre for European Policy Studies
- Publication year:
- 2006
- Pagination:
- 26p., bibliog.
- Place of publication:
- Brussels
This background paper begins with a discussion of the overall goal of promoting healthy and active ageing. It highlights the fact that the world’s population is ageing rapidly and with the exception of Japan, the world’s 25 oldest countries are all in Europe. However, the need for long-term care (LTC) services is not dependent on age alone; people with limitations in self-care or mobility, seniors living alone and on low income are also important indicators. Taking this into account, the overall proportion of older people in need of LTC is found to be approximately the same in the US and the EU.
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.