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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)
Black and minority ethnic elderly: perspectives on long-term care
- Author:
- PATEL Nina
- Publisher:
- Policy Research Institute on Ageing and Ethnicity
- Publication year:
- 2010
- Pagination:
- 48p.
- Place of publication:
- Bolton
Based on a series of seminars held in Leeds, London and Edinburgh in 1998, this paper presents the perspectives of black and minority ethnic elders, carers and managers of minority ethnic elders' organisations about long-term care for the elderly. The paper introduces the general context of care for black and minority ethnic older people, including an overview of demographic, socio-economic and health aspects. It considers the views and experiences of the seminar delegates and makes recommendations for the Royal Commission on Long-Term Care for the Elderly. The recommendations cover appropriateness of current models of care, accessing services, planning and paying for long-term care, reducing dependency and alternative models of care, and the future model of care.
Priorities for long-term care resource allocation in England: actual allocation versus the views of directors of service and older citizens
- Authors:
- CLARKSON Paul, et al
- Journal article citation:
- Journal of Long-Term Care, September 2018, pp.13-23. Online only
- Publisher:
- King's College London
- Place of publication:
- London
Context: Decisions about resource allocation in long-term care are a perennial issue. The basis for deciding between different needs in prioritising allocation is contested. In England, this debate has crystallised with the advent of selfdirected support, where individuals’ expressed preferences drive resources. Objectives: To compare perceptions of the priority given to needs for resource allocation in long-term care of older people by two stakeholder groups, compared with actual resource allocation. Methods: Survey data, eliciting perspectives of senior service managers and older citizens, were used to rank the perceived importance of eight needs-related outcomes. Actual resource allocation from 17 local authorities was also modelled against these outcomes. A variable importance metric was used to rank the importance of these outcomes in determining actual resource allocation. Findings from each data collection were compared. Findings: Differences in prioritisation of needs emerged between stakeholders compared with actual allocation. Older citizens and actual allocation prioritised basic and instrumental activities of daily living (ADLs). Directors’ rankings were more distinct, still prioritising basic ADLs, but ranking psychological well-being higher and instrumental ADLs lower. Limitations: The model of actual allocation could not account for political and bureaucratic factors influencing resource allocation, nor the complexity of certain needs that might incur greater resources. Implications: Discretion continues to influence resource allocation, which remains a contested area. Directors must account for overall spend and other extrinsic factors to maintain sustainability, whereas older citizens prioritise instrumental ADLs, despite these being considered lower priority in eligibility decisions. Overall, ADLs remain important drivers of allocation. (Edited publisher abstract)
Supporting residents moving into long-term care: multiple layers shape residents’ experiencei
- Authors:
- SUSSMAN Tamara, DUPUIS Sherry L.
- Journal article citation:
- Journal of Gerontological Social Work, 57(5), 2014, pp.438-459.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
This interpretive grounded theory study explores 10 residents’ retrospective accounts of the relocation process, including the decision to move into a long-term care home, the pre-move preparations, the moving day circumstances, and the initial adjustment period following the move. Analysis of the data revealed a complex intersection of conditions at multiple layers that shaped residents’ experiences of the transitional process. Recommendations to enhance circumstances at individual, interpersonal, and systemic layers, for each temporal stage of the relocation process are proposed. Implications for social work practice across the continuum of care are also discussed. (Publisher abstract)
A Fair deal for older people: public views on the funding of long-term care
- Author:
- DEEMING Chris
- Publisher:
- King's Fund
- Publication year:
- 2001
- Pagination:
- 42p.,bibliog.
- Place of publication:
- London
This report publishes the results of an opinion poll comissioned by the King's Fund to look at the public's views of current and proposed policies regarding the funding of long-term care. The poll was carried out six months after the government had published its response to the recommendations of the Royal Commission on Long-Term Care and were introducing a Health and Social Care Bill which included recommendations on the funding of long-term personal care. The two main recommendations of the Commission were that both nursing care and personal care should be free for all who need it. The first of these recommendations was accepted by the Government but the second was rejected. The opinion poll reports that two thirds of people questioned supported the Governments decision on nursing care but that three out of five people disagreed with the Government's decision to continue means-testing people for personal care. This result marks a change in public attitudes towards the funding of long-term care. Earlier surveys showed that only 25 percent of people in england and Wales supported the idea of free nursing and personal care. This number has now more than doubled and suggests that people are unhappy with the Government's policies and that a rethink may be needed.
I spy...
- Author:
- IVORY Mark
- Journal article citation:
- Community Care, 11.6.98, 1998, pp.18-19.
- Publisher:
- Reed Business Information
The author takes a fly-on-the-wall look at the work of Claire Rayner, agony aunt and a member of the Royal Commission on Long-Term Care, when she visited a care home in West Sussex.
Being disconnected from life: meanings of existential loneliness as narrated by frail older people
- Authors:
- SJOBERG Marina, et al
- Journal article citation:
- Aging and Mental Health, 22(10), 2018, pp.1357-1364.
- Publisher:
- Taylor and Francis
Objectives: This study illuminated the meanings of existential loneliness (EL) as narrated by frail older people. Method: Data were collected through individual narrative interviews with 23 people 76–101 years old receiving long-term care and services. A phenomenological hermeneutical analysis was performed, including a naïve reading and two structural analyses as a basis for a comprehensive understanding of EL. Result: Four themes were identified related to meanings of EL: (1) being trapped in a frail and deteriorating body; (2) being met with indifference; (3) having nobody to share life with; and (4) lacking purpose and meaning. These intertwined themes were synthesized into a comprehensive understanding of EL as ‘being disconnected from life’. Conclusion: Illness and physical limitation affects access to the world. When being met with indifference and being unable to share one's thoughts and experiences of life with others, a sense of worthlessness is reinforced, triggering an experience of meaninglessness and EL, i.e. disconnection from life. It is urgent to develop support strategies that can be used by health care professionals to address older people in vulnerable situations, thereby facilitating connectedness. (Publisher abstract)
Dying in long-term care: perspectives from sexual and gender minority older adults about their fears and hopes for end of life
- Authors:
- KORTES-MILLER Katherine, et al
- Journal article citation:
- Journal of Social Work in End-of-Life and Palliative Care, 14(2-3), 2018, pp.209-224.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia
As lesbian, gay, bisexual, transgender, and queer (LGBTQ+) communities age, many individuals expect a need to enter the long-term care system toward the end of life. Not unlike most ageing Canadians, this anticipation is met with concern and fear. However, previous research suggests that older LGBTQ + individuals have unique fears often related to personal safety and discrimination. This qualitative study examined the hopes and fears of older LGBTQ + adults considering long-term care as they face end of life. Data were collected from three focus groups in Ontario, Canada, and analysed using inductive thematic analysis. Specific and frequent reference to fear of entering long-term care homes was common across all focus groups, as participants anticipated: social isolation, decreased independence and capacity for decision-making, increased vulnerability to LGBTQ+-related stigma as well as exposure to unsafe social and physical environments. The results from this study, therefore, emphasise the need for palliative care specialists and long-term care home staff to address the unique health needs of older LGBTQ + adults nearing the end of life in order to work toward allaying fears and creating supportive and inclusive long-term care environments. (Edited publisher abstract)
Culture and language discordance in the workplace: evidence from the National Home Health Aide Survey
- Authors:
- WENG Suzie S., LANDES Scott D.
- Journal article citation:
- Gerontologist, 57(5), 2017, pp.900-909.
- Publisher:
- Oxford University Press
Purpose of the study: Home health aides (HHAs) provide valuable resources to address existing and predicted needs for taking care of the ageing population. Both the older adult and healthcare provider populations in the United States are becoming increasingly diverse. The study examined the effect of culture and language discordance between HHAs and their patients or coworkers on worker outcomes. Design and methods: Data from this study were from the 2007 National Home Health Aide Survey. T Tests and ordinary least squares regression were used to analyse the relationships between cultural discordance and worker outcomes. Results: Cultural discordance with patients was associated with lower levels of job satisfaction among HHAs. Cultural discordance with coworkers was associated with lower levels of job satisfaction and, increased intent to leave one’s job. Implications: The current study suggests that cultural discordance does affect worker outcomes. However, home healthcare workers appear to differentiate between cultural discordance with patients and with coworkers. This article concludes with strategies for all involved in the care of older adults to improve the experience of HHAs and to ensure patients receive the best possible care. (Edited publisher abstract)
Choosing a nursing home: families need more support
- Authors:
- ASHTON Susan, ROE Brenda, JACK Barbara
- Journal article citation:
- Journal of Dementia Care, 24(4), 2016, pp.22-24.
- Publisher:
- Hawker
Nursing homes are sometimes the best option for people with advanced dementia, but the authors ask what is it like choosing one. In their study the authors focused on the challenges and experiences of family carers of people with advanced dementia, who are at the end of life.. (Edited publisher abstract)