Search results for ‘Subject term:"older people"’ Sort:
Results 1 - 10 of 25
Access to long-term care: perceptions and experiences of older Dutch people
- Authors:
- SCHIPPER Lisette, et al
- Journal article citation:
- Quality in Ageing and Older Adults, 16(2), 2015, pp.83-93.
- Publisher:
- Emerald
Purpose: Despite the current focus on demand-based care, little is known about what clients consider important when they have a request for formal long-term care services. The paper aims to discuss this issue. Design/methodology/approach: Questions about the access process to care services were added to the “Senior Barometer”, a Dutch web-based questionnaire that assesses the opinion of older people about different aspects in life. The questionnaire surveyed both people who already requested care services (“users”), and people that did not (“future clients”). Findings: The results show a significant difference in what people expect to be the first step from what users actually did, when requesting formal care services. In addition, there was a significant difference on how “users” and “future clients” rated several access service aspects. Research limitations/implications:The results give valuable information on how both “users” and “future clients” value the access process. The findings also provide valuable input for organisations providing long-term care for older clients about the important issues that have to be considered when organising the access process. Originality/value: This study shows what older people in the Netherlands find important during the access process to care and this has not been explored before. The difference between what “users” and “future clients” find of importance in the care access process suggests that it is difficult for people to foresee what will be important once the need for care arrives, or where they will turn to with a request for care services. (Edited publisher abstract)
Not all that glitters is gold: long-term care reforms in the last two decades in Europe
- Authors:
- RANCI Costanzo, PAVOLINI Emmanuele
- Journal article citation:
- Journal of European Social Policy, 25(3), 2015, pp.270-285.
- Publisher:
- Sage
This article explores changes that took place in long-term care (LTC) policies during the last two decades in six European welfare states. It addresses three issues: (1) why reforms took place, (2) the main actors and coalitions driving this process and the institutional mechanisms at work and (3) the main outcomes of reform processes. In order to analyse the development of LTC policies, the article applies theoretical concepts of historical institutionalism. The interpretation is that institutional change in LTC policy has taken place through a protracted institutional dynamic in which continuity and discontinuity are inextricably linked and where tensions and contradictions have played a crucial role. With regard to outcomes, the article analyses coverage and citizens’ social rights, working conditions in the care sector and trajectories of de-/re-familization of care. The final impact is that the level of universalism has generally increased in Europe, but that in part it has adopted a new form of ‘restricted universalism’, characterized by universal entitlements to LTC benefits constrained by limitations in provision due to financial constraints and budget ceilings. (Edited publisher abstract)
Using video capture to investigate the causes of falls in long-term care
- Authors:
- WOOLRYCH Ryan, et al
- Journal article citation:
- Gerontologist, 55(3), 2015, pp.483-494.
- Publisher:
- Oxford University Press
Purpose: Falls and their associated injuries represent a significant cost and care burden in long-term care (LTC) settings. The evidence base for how and why falls occur in LTC, and for the design of effective interventions, is weakened by the absence of objective data collected on falls. Design and Methods: This article reflects on the potential use of video footage in fall investigations. In particular, it reports on findings from a Canadian Institute for Health Research-funded research project entitled “Technology for Injury Prevention in Seniors,” detailing four distinct methodological approaches where video footage of real-life falls was used to assist in identifying the circumstances and contributory factors of fall events in (LTC) settings: questionnaire-driven observational group analysis; video-stimulated recall interviews and focus groups; video observations of the resident 24hr before the fall; and video incorporated within a comprehensive systemic falls investigative method. Results and Implications: The various ways in which video footage offers potential for both care providers and researchers to help understand the cause and prevention of falls in LTC are described. The limitations of using video in fall investigations, including the logistical, practical, and ethical concerns arising from such an approach are also discussed. (Edited publisher abstract)
The emotional wellbeing of older carers
- Authors:
- SCRUTTON Jonathan, CREIGHTON Helen, INTERNATIONAL LONGEVITY CENTRE UK
- Publisher:
- University College London
- Publication year:
- 2015
- Pagination:
- 20
- Place of publication:
- London
This report, the second in a two part series summarising research from the Department of Epidemiology and Public Health at University College London (UCL), focuses on the subjective wellbeing of older carers. The research finds that: long term caregiving was associated with declines in quality of life and life satisfaction for carers, and an increased risk of depression; and giving up caregiving was associated with increased depression amongst both male and female carers. The report addresses the wider context of these findings, highlighting how the ageing population could potentially lead to large increases in the number of older carers, with the number of carers over 65 already having risen by 35 per cent since 2001. It also highlights the day-to-day realities faced by many older carers, including a high risk of emotional distress; the loss of friends, either because of a lack of time to socialise or because friends were unable to properly understand the constraints and strains of caring; and potential health risks. The report explores the policy implications of the research, highlighting that few policies and support services are aimed at older carers specifically. The report suggests that more could be done to protect the emotional wellbeing and mental health of older carers, through appropriate support being provided at all stages of the caregiving cycle. (Edited publisher abstract)
An exploratory qualitative study on relationships between older people and home care workers in South Korea: the view from family carers and service providers
- Author:
- CHON Yongho
- Journal article citation:
- Ageing and Society, 35(3), 2015, pp.629-652.
- Publisher:
- Cambridge University Press
This exploratory qualitative study explores the relationships between older people and home care workers under the new Korean long-term care insurance system. Semi-structured in-depth interviews were conducted with 22 family carers and private-sector home care service providers (home care workers and provider managers). The findings show that while the majority of family carers interviewed reported that their relationships were good, the majority of service providers' responses were more negative. Service providers stated that they experienced a number of difficulties that affected their relationships with older clients, including excessive demands or sexual harassment by the older people in their care, exposure to unsafe working environments, and poor treatment in terms of pay and conditions. The findings suggest that stable and good relationships between home care workers and their clients have not been secured in Korea's long-term care system. (Edited publisher abstract)
A growing care gap? The supply of unpaid care for older people by their adult children in England to 2032
- Author:
- PICKARD Linda
- Journal article citation:
- Ageing and Society, 35(1), 2015, pp.96-123.
- Publisher:
- Cambridge University Press
A key feature of population ageing in Europe and other more economically developed countries is the projected unprecedented rise in need for long-term care in the next two decades. There is, however, considerable uncertainty over the future supply of unpaid care for older people by their adult children. The future of family care is particularly important in countries planning to reform their long-term care systems, as is the case in England. This article makes new projections of the supply of intense unpaid care for parents aged 65 and over in England to 2032, and compares these projections with existing projections of demand for unpaid care by older people with disabilities from their children. The results show that the supply of unpaid care to older people with disabilities by their adult children in England is unlikely to keep pace with demand in future. By 2032, there is projected to be a shortfall of 160,000 care-givers in England. Demand for unpaid care will begin to exceed supply by 2017 and the unpaid ‘care gap’ will grow rapidly from then onwards. The article concludes by examining how far this unpaid ‘care gap’ is likely to be met by other sources of unpaid care or by developments in new technology and examines the implications of the findings for long-term care policy (Publisher abstract)
Bedlam or bliss? recognising the emotional self-experience of people with moderate to advanced dementia in residential and nursing care
- Authors:
- GODWIN Beatrice, POLAND Fiona
- Journal article citation:
- Quality in Ageing and Older Adults, 16(4), 2015, pp.235-248.
- Publisher:
- Emerald
Purpose: The purpose of this paper is to examine the self-experience of people with moderate to advanced dementia. While people with dementia are widely assumed to lose their sense of self, emotions are preserved long into dementia and some can still discuss their lives, enabling exploration of respondents’ own self-conceptualisation of experience. Design/methodology/approach: Ten people, purposively sampled, living in long-term residential or nursing care. A mixed methods design with Interpretative Phenomenological Analysis approach used semi-structured empathetic interviews to explore their experience and continuing goals, using supplementary information from family and others to contextualise core data. Data analysis identified emerging themes and superordinate concepts. Findings: Sustained well-being and resistant ill-being emerged as major themes. Findings demonstrated continuity in sense of self, moral awareness and diversity of emotional reactions to living with dementia, associated with their emotional capital. Research limitations/implications: The sample was small and limited to well- and moderately funded care homes. How to provide such support in less-well-funded homes needs further research as do reasons for resistant ill-being in advanced dementia. Practical implications: Findings suggest care provision for people with advanced dementia which acknowledges individual feelings may support their sustained well-being. Psychological assessments should take closer account of multiple factors in individuals’ situations, including their emotional capital. Social implications: Findings suggest everyday care of people with advanced dementia, may sustain their sense of self, well-being and emotional capital. Originality/value: By empathically facilitating in-depth expression of individuals’ feelings and views, this research illuminates the personal self-experience of advanced dementia, hitherto little explored. (Publisher abstract)
Quality of in-home care, long-term care placement, and the survival of persons with dementia
- Authors:
- McCLENDON McKee J., SMYTH Kathleen A.
- Journal article citation:
- Aging and Mental Health, 19(12), 2015, pp.1093-1102.
- Publisher:
- Taylor and Francis
Purpose of the study: Caregivers of persons with dementia living at home adopt a variety of caregiving styles that vary in quality. Three styles of high-quality care and poor-quality care have been identified. The outcomes, however, of varying styles of caregiving are unknown. The purpose was to investigate the linkage of quality of care to long-term care placement and survival. Design and methods: The authors used a sample of 148 primary caregivers of a relative living at home and needing assistance due to memory or thinking problems. Items from four existing scales and five new items were used to construct measures of high-quality and poor-quality care. Long-term care and survival were determined from two follow-ups. Cox proportional hazards regression was used to estimate the relationship of quality of care to long-term care placement and survival. Results: Poor quality of care increased the risk of long-term care placement, as expected, but high-quality care was not related to placement. Surprisingly, high-quality care increased the risk of death while poor-quality care decreased the risk. Secondary results were: wishful/intrapsychic coping (a dysfunctional type of emotion-focused coping) and long-term care placement shortened the survival; and caregiver personality traits of neuroticism and agreeableness lengthened the survival. Implications: It is premature to recommend caregiver interventions based on our unexpected findings. Further studies are vital and should include care-recipient impairments and the quality of life of the person with dementia as additional outcomes. (Publisher abstract)
Choice, competition and care: developments in English social care and the impacts on providers and older users of home care services
- Authors:
- RODRIGUES Ricardo, GLENDINNING Caroline
- Journal article citation:
- Social Policy and Administration, 49(5), 2015, p.649–664.
- Publisher:
- Wiley
This article critically examines recent changes in markets for home (domiciliary) care services in England. During the 1990s, the introduction of competition between private (for-profit and charitable) organisations and local authority providers of long-term care services aimed to create a ‘mixed economy’ of supply. More recently, care markets have undergone further reforms through the introduction of direct payments and personal budgets. Underpinned by discourses of user choice, these mechanisms aim to offer older people increased control over the public resources for their care, thereby introducing further competitive pressures within local care markets. The article presents early evidence of these changes on: a) The commissioning and contracting of home care services by local authorities and individual older people; b) The experiences and outcomes for individual older people using home care services.. Drawing on evidence from two recent empirical studies, the article describes how the new emphasis on choice and competition is being operationalised within six local care markets. There are suggestions of small increases in user agency and in opportunities for older people to receive more personalised home care, in which the quality of care-giving relationships can also be optimised. However, the article also presents early evidence of increases in risk and costs associated with the expansion of competition and choice, both for organisations providing home care services and for individual older service users. (Edited publisher abstract)
Resident- and facility-level predictors of quality of life in long-term care
- Authors:
- SHIPPEE Tetyana P., et al
- Journal article citation:
- Gerontologist, 55(4), 2015, pp.643-655.
- Publisher:
- Oxford University Press
Purpose: This study assesses multiple domains of quality of life (QOL) for nursing home residents and examines facility- and resident-level correlates for different domains. Design and Methods: Data come from (a) self-reported resident interviews using a multidimensional measure of QOL; (b) resident clinical data from the Minimum Data Set; and (c) facility-level characteristics from Minnesota Department of Human Services. Factor analysis was used to confirm domains of QOL, and then employed cross-sectional hierarchical linear modelling to identify significant resident- and facility-level predictors of each domain. Results: Six unique domains of QOL were examined: environment, personal attention, food, engagement, negative mood, and positive mood. In multilevel models, resident-level characteristics were more reliable correlates of QOL than facility characteristics. Among resident characteristics, gender, age, marital status, activities of daily living, mood disorders, cognitive limitations, and length of stay consistently predicted QOL domains. Among facility characteristics, size, staff hours, quality of care, and percent of residents on Medicaid predicted multiple QOL domains. Implications: Examining separate domains rather than a single summary score makes associations with predictors more accurate. Resident characteristics account for the majority of variability in resident QOL. Helping residents maintain functional abilities, and providing an engaging social environment may be particularly important in improving QOL. (Edited publisher abstract)