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Long-term care quality assurance policies in European countries
- Authors:
- DANDI Roberto, et al
- Publisher:
- European Network of Economic Policy Research Institutes
- Publication year:
- 2012
- Pagination:
- 89p.
- Place of publication:
- Brussels
This report present the findings and conclusions of research undertaken in the context of research projects carried out by a consortium of ENEPRI member institutes. This report is a contribution to Work Package 5 of the ANCIEN project, which focuses on the future of long-term care for the elderly in Europe. This report analyses the quality assurance policies for long-term care (LTC) in the following countries: Austria, Estonia, Finland, France, Germany, Hungary, Italy, Latvia, Poland, Slovakia, Slovenia, Spain, Sweden, the Netherlands, and the United Kingdom. First, it discusses quality assurance in LTC by analysing: the dimensions of quality, the policy frameworks for quality in LTC, the different levels of development of LTC quality policies at the international, national, organisational, and individual levels. Second, it describes the methodology for collecting and analysing data on quality policies in the selected countries. Finally, it discusses the results, identifying four clusters of countries based on quality policies and indicators for LTC. These clusters are compared to the clusters identified in Work Package 1 of the ANCIEN project. Policy recommendations are proposed.
Quality assurance indicators of long-term care in European countries
- Authors:
- DANDI Roberto, CASANOVA Georgia
- Publisher:
- European Network of Economic Policy Research Institutes
- Publication year:
- 2012
- Pagination:
- 128p.
- Place of publication:
- Brussels
This report present the findings and conclusions of research undertaken in the context of research projects carried out by a consortium of ENEPRI member institutes. This report is a contribution to Work Package 5 of the ANCIEN project, which focuses on the future of long-term care for the elderly in Europe. The report presents the quality indicators that were collected by the ANCIEN project partners in each country. The main contribution of this report is a classification of the quality assurance indicators in different European countries according to three dimensions: organisation type; quality dimensions; and system dimensions. The countries that provided quality indicators, which are used at a national level or are recommended to be used at a local level by a national authority, are: Estonia, Finland, France, Germany, Hungary, Italy, Latvia, the Netherlands, Spain, Sweden and the United Kingdom. In total, 390 quality indicators were collected. Each quality indicator has been assigned to one or more options in each dimension.
Physical restraints and associations with neuropsychiatric symptoms and personal characteristics in residential care: a cross-sectional study
- Authors:
- KURONEN Marja, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 32(12), 2017, pp.1418-1424.
- Publisher:
- Wiley
Background: Physical restraints are widely used in residential care. The objective was to investigate restraint use and its associations with neuropsychiatric symptoms and personal characteristics in residential care. Methods: Data were collected in the South Savo Hospital District from 66 of 68 public or private institutions providing long-term residential care. Nurses assessed the use of physical restraints and neuropsychiatric symptoms (NPS) included in the symptom list of the Neuropsychiatric Inventory (NPI). Drug use was obtained from medical records, and activities of daily living (ADL) were assessed by the nurses according to the Barthel Index. Results: The total number of persons in residential care was 1386. Any restraint was used for 721 patients (52%) in the preceding 24 h. Bedrails were the most common restraints. In the multivariate analysis, psychotic symptoms (OR 1.94, 95% CI 1.14–3.31) and use of benzodiazepines (OR 1.69, 95% CI 1.18–2.41) were positively associated with restraint use, whereas antipsychotic (OR 0.62, 95% CI 0.44–0.87) and antidepressant drug use (OR 0.64, 95% CI 0.45–0.90) and higher ADL score (OR 0.9, 95% CI 0.92–0.93) were negatively associated. Concomitant use of at least two restraints was associated with high prevalence of hyperactivity NPS symptoms. Conclusions: More than half of the residents were exposed to some physical restraint, most frequently bedrails, within the last 24 h. Psychotic symptoms and benzodiazepine use increased while good ADL and antipsychotic or antidepressant use decreased the risk of restraint use. Bedridden persons were the most frequently restrained which may pose an ethical problem. (Publisher abstract)
Facing the challenges in the development of long-term care for older people in Europe in the context of an economic crisis
- Authors:
- DEUSDAD Blanca A., PACE Charles, ANTTONEN Anneli
- Journal article citation:
- Journal of Social Service Research, 42(2), 2016, pp.144-150.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
This article introduces the content of this special issue, which incorporates eight articles in which authors evaluate recent changes and developments in long term conditions (LTCs) for older people in European countries, most particularly from the perspective of restructuring taking place in the LTC for older people. The economic and state financial crises are the most important drivers behind widespread overall restructuring processes. (Edited publisher abstract)
Regulating long-term care quality: an international comparison
- Editors:
- MOR Vincent, LEONE Tiziana, MARESSO Anna
- Publisher:
- Cambridge University Press
- Publication year:
- 2014
- Pagination:
- 519
- Place of publication:
- Cambridge
This edited book provides a comprehensive international survey of long-term care provision and regulation, built around a series of case studies from Europe, North America and Asia. The analytical framework allows the different approaches that countries have adopted to be compared side by side and readers are encouraged to consider which quality assurance approaches might best meet their own country's needs. Wider issues underpinning the need to regulate the quality of long-term care are also discussed. The book is aimed at policymakers working in the health care sector, researchers and students taking graduate courses on health policy and management. (Edited publisher abstract)
Trends in severe disability among elderly people: assessing the evidence in 12 OECD countries and the future implications
- Authors:
- LAFORTUNE Gaetan, et al
- Publisher:
- Organisation for Economic Co-operation and Development
- Publication year:
- 2007
- Pagination:
- 78p., bibliog.
- Place of publication:
- Paris
As the population aged 65 and over will continue to grow steadily in OECD countries over the next decades, improvements in the functional status of elderly people could help mitigate the rise in the demand for, and hence expenditure on, long-term care. This paper assesses the most recent evidence on trends in disability among the population aged 65 and over in 12 OECD countries: Australia, Belgium, Canada, Denmark, Finland, France, Italy, Japan, the Netherlands, Sweden, the United Kingdom and the United States. One of the principal findings from this review is that there is clear evidence of a decline in disability among elderly people in only five of the twelve countries studied (Denmark, Finland, Italy, the Netherlands and the United States). Three countries (Belgium, Japan and Sweden) report an increasing rate of severe disability among people aged 65 and over during the past five to ten years, and two countries (Australia, Canada) report a stable rate. In France and the United Kingdom, data from different surveys show different trends in ADL disability rates among elderly people, making it impossible to reach any definitive conclusion on the direction of the trend. One of the main policy implications that can be drawn from the findings of this study is that it would not be prudent for policymakers to count on future reductions in the prevalence of severe disability among elderly people to offset completely the rising demand for long-term care that will result from population ageing.
Transformation by stealth: the retargeting of home care services in Finland
- Authors:
- KRÖGER Teppo, LEINONEN Anu
- Journal article citation:
- Health and Social Care in the Community, 20(3), May 2012, pp.319-327.
- Publisher:
- Wiley
This article explores changes that Finish home care services for older people have undergone during the last two decades. Data drawn from national social care statistics, 1990–2010, suggest, in contrast to many other European nations, the coverage levels in Finland have dropped dramatically during this period. Those with the highest needs do receive increased amounts of support, but others have become excluded from publicly funded home care provisions. Overall, the changes represent weakening defamilisation, that is, decreasing public responsibility for the needs of many older people and, correspondingly, an increasing reliance on family carers. This full-scale transformation of home care has taken place without any real policy debate or major modification of legislation. No actual decision was ever made to thoroughly alter the character of home care in Finland: the transformation happened by stealth.
Care-related quality of life in old age: concepts, models and empirical findings
- Editors:
- VAARAMA Marja, PIEPER Richard, SIXSMITH Andrew, (eds.)
- Publisher:
- Springer
- Publication year:
- 2008
- Pagination:
- 96p.
- Place of publication:
- Heidelberg
While best-practice data exist for long-term care, quality of life as a concept, measure and standard for care outcomes remains elusive. This book, which includes new instruments for evaluating care, brings together the findings of a European research initiative, the Care Keys Project. This addressed quality of life issues among frail, care-dependent older people, taking their social as well as health needs into account. It covered Finland, Estonia, Germany, Sweden and the United Kingdom. The writers explain the theory behind Care Keys, its methodology, empirical findings, and practical considerations in promoting effective, efficient elder care aimed at social and emotional well-being and including disabled and cognitively impaired patients. The book brings together gerontological knowledge from medical, psychology, nursing, sociology, economics, and health care systems perspectives. It introduces an integrated theory of care-related quality of life that emphasises social, emotional and mental aspects as well as physical longevity. The editors present a practice oriented framework for quality management of long-term care toward improving elders’ quality of life. They examine quality of life in home and long-term care settings across the five European member countries of Care Keys and describe the Care Keys Toolkit, featuring innovative measures for monitoring and evaluating care and troubleshooting for problem areas.
Factors associated with non-use of antipsychotics among older residents with schizophrenia in long-term institutional care
- Authors:
- ALANEN Hanna-Mari, FINNE-SOVERI Harriet, LEINONEN Esa
- Journal article citation:
- International Journal of Geriatric Psychiatry, 23(12), December 2008, pp.1261-1265.
- Publisher:
- Wiley
This study aimed to investigate factors associated with non-use of antipsychotics among older schizophrenia residents in long-term institutional care. A retrospective study was designed using cross-sectional data gathered between 1 January and 30 June 2006 in Finland. Data were extracted from the Resident Assessment Instrument (RAI) database, based on Minimum Data Set for long-term care facilities (MDS-LC) assessments. Residents with schizophrenia 65 years or older were included, giving a total of 356 patient assessments. The prevalence of older schizophrenia residents not receiving any antipsychotic medication was 18.5%. Factors independently associated with non-use of antipsychotics in the logistic regression model were: severe degree of functional impairment, severely impaired vision, any diagnosis of dementia and severe underweight. There was a negative association between non-use of antipsychotics and a factor had arrived from a psychiatric hospital. Severe degree of functional impairment and dementia were the main findings associated with non-use of antipsychotics in this resident group.
A place for support: new policies for informal carers in long-term programmes
- Author:
- SCHUNK Michaela
- Journal article citation:
- Benefits, 28, April 2000, pp.22-25.
- Publisher:
- Policy Press
Reviews policy trends for informal carers which have been implemented in various countries between 1996 - 1998. The article focuses on respite care and direct payments for carers of older ill and disabled adults.