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Measurement features of a long-term care quality of life (LTC-QoL) assessment scale
- Author:
- McDONALD Tracey
- Journal article citation:
- Journal of Care Services Management, 7(3), 2013, pp.76-86.
- Publisher:
- Taylor and Francis
The issue of life quality for older people admitted for long-term care is of concern to those keen to provide services that support an acceptable quality of life. This study investigates measurement characteristics of the long-term care quality of life (LTC-QoL) assessment scale developed to address a gap in quality in life assessment in such contexts, i.e. an easy to use single scale generating summary information on the life quality experienced by all older adults in care, indicating aspects requiring attention from direct care personnel and providing management information on individual and care unit outcomes in supporting residents' experiences of life quality. Analysis of repeated LTC-QoL data for 62 long-term residents in an Australian aged care facility establishes the instrument as having good reliability and validity. Exploratory factor analysis of nine items revealed high internal consistency, good test–retest reliability, and validity across age, gender, and cognitive capacity of participants. Findings establish that the LTC-QoL has adequate reliability and dimensionality. Content validity and management utility were verified by experts using and refining the scale over 7 years in long-term care contexts, resulting in an easy to use and reliable assessment tool for long-term care recipients. (Publisher abstract)
Prevalence, presentation and prognosis of delirium in older people in the population, at home and in long term care: a review
- Authors:
- DE LANGE E., VERHAAK P.F.M., VAN DER MEER K.
- Journal article citation:
- International Journal of Geriatric Psychiatry, 28(2), 2013, pp.127-134.
- Publisher:
- Wiley
Although delirium is relatively common in hospitals, especially in intensive, post-operative and palliative care, its prevalence in the general population is only about 1-2%. The aim of this systematic review was to provide an overview, with the GP in mind, of prevalence, symptoms, risk factors and prognosis of delirium in primary care and institutionalised long-term care. The evidence confirms that the prevalence of delirium among the elderly aged 65+ years is 1–2%. It rises with age, reaching about 10% among a “general” population aged 85+ years. In populations with higher proportions of demented elders prevalence can be 22%. In long-term care, it ranges between 1.4% and 70%, depending on diagnostic criteria and on the prevalence of dementia. Age and cognitive decline are significant risk factors for delirium in all groups. In terms of prognosis, most studies agree that older people who previously experienced delirium have a higher risk of dementia and a higher mortality rate. Population and long-term care studies confirm this tendency. The authors conclude that although delirium in a non-selected population aged over 65 years is uncommon, prevalence rises quickly in selected older groups. They emphasise the need for primary care doctors to be aware of a relatively high risk of delirium among the elderly in long-term care, those over 85 years and those with dementia.
Analysis of the UK long term care market
- Author:
- FROST AND SULLIVAN
- Publisher:
- Technology Strategy Board
- Publication year:
- 2013
- Pagination:
- 38
- Place of publication:
- Swindon
Examines the economic research in the current care market and makes some analyses and extrapolations of future market potential. The report looks at the public and private long term care provision in the UK and makes some comparisons with global markets. It argues that the residential sector will continue to see higher growth compared to the non-residential sector. The total residential market will see a compound annual growth rate of 4.3 per cent between 2030 and 2040, with the private sector growing faster than the public sector. The report also examines how demand factors impact on the market, focusing in particular on changing demographics, the source of funding and expenditure, the consumer trends and the role of technology, and provides a brief outline of the current political and regulatory context. (Edited publisher abstract)
Caring for an ageing population: points to consider from reform in Japan
- Authors:
- CURRY Natasha, PATTERSON Linda, HOLDER Holly
- Publisher:
- Nuffield Foundation
- Publication year:
- 2013
- Pagination:
- 42
- Place of publication:
- London
Japan has the world’s oldest population, 23% being aged 65+. In order to relieve the pressure on its health and social care system, the country introduced Long Term Care Insurance (LTCI) in 2000, a compulsory scheme for those aged over 40, which offers access to social care for those aged over 65 on the basis of need alone. At the heart of the LTCI system is the care manager who is responsible for developing a package of care and advising individuals of their options. While quality of provision was not initially built into the system, it became a central focus in 2005. The authors describe two models of provision: integrated delivery systems; and dementia group homes. In many ways, the LTCI scheme has been a success, but it has not achieved all that was intended. It has also not been without controversy; and its greatest test is yet to come as it grapples with an older population that already accounts for nearly one quarter of its population. It will be useful for England to reflect on the Japanese experience, for its challenges and difficulties are as valuable as its successes in helping shed light on options for social care in England. This report is from a project part funded by the Great Britain Sasakawa Foundation, ‘Universal access and low costs? Health and social care the Japanese way’, which included a study visit to Japan in 2012, during which a variety of organisations, policy-makers, clinicians and academics were visited. (Edited publisher abstract)
Understanding contextual factors in falls in long-term care facilities
- Authors:
- SIXSMITH Andrew, et al
- Journal article citation:
- Quality in Ageing and Older Adults, 14(3), 2013, pp.160-166.
- Publisher:
- Emerald
Purpose – Despite the growing area of research involving falls in the residential care setting, the link between contextual and environmental factors in falls is poorly understood. This paper aims to draw upon existing research being undertaken in long-term care (LTC) in Metro Vancouver, Canada, with a particular focus on identifying contextual factors contributing to fall events. Design/methodology/approach – This paper presents the results of a qualitative observational analysis of video-captured data collected through a network of high-quality video systems in two LTC facilities. The research comprised workshops involving experienced researchers who reviewed six video sequences of fall events. The outcome of the workshops was a written narrative summarising the discussion and researchers’ interpretation of fall sequences. Findings – The analysis indicates that there are a broad range of environmental, behavioral and situational factors that contribute to falls in LTC. This suggests that a limited conceptualisation of a fall as an outcome of the person's impairment and environmental hazards fails to convey the complexity of potential contributory factors typical of most fall incidents. Research limitations/implications – Broadening our understanding of falls provides the potential to make recommendations for falls prevention practice across multiple levels, including the individual, social and organisational context. Originality/value – The paper evaluates the potential of video-based data in fall analysis and points to the development of a case study approach to analysing fall incidents to capture the complex nature of contributory factors beyond research that focuses solely on intrinsic and extrinsic risk factors. (Publisher abstract)
Long-term care funding in England: an analysis of the costs and distributional effects of potential reforms
- Authors:
- HANCOCK Ruth, et al
- Publisher:
- University of Kent. Personal Social Services Research Unit
- Publication year:
- 2013
- Pagination:
- 13
- Place of publication:
- Canterbury
This paper examines projected costs and distributional effects of Government plans to reform the systems that determine how much the state contributes to people's long-term care costs compared with the current system. It also contrasts these costs and distributional effects with the central recommendation of the Commission on the Funding of Care and Support (Dilnot Commission) which was set up by the Government and reported in 2011. Two variants on the Government’s plans which would give additional help to recipients of residential care with capital below the proposed higher capital threshold are also considered. (Edited publisher abstract)
A good life in old age? Monitoring and improving quality in long-term care
- Authors:
- ORGANISATION FOR ECONOMIC CO-OPERATION AND DEVELOPMENT, EUROPEAN COMMISSION
- Publisher:
- Organisation for Economic Co-operation and Development
- Publication year:
- 2013
- Pagination:
- 270
- Place of publication:
- Paris
With the ageing populations and growing costs, ensuring and improving the quality of longterm care (LTC) services has become an important policy priority across OECD countries. The share of those aged 80 years and over is expected to increase from 4% in 2010 to nearly 10% in 2050, while in 2010 OECD countries allocated 1.6% of groos domestic product (GDP) to public spending on LTC, on average. The goal of good quality care is to maintain or, when feasible, to improve the functional and health outcomes of frail older people, the chronically ill and the physically disabled, whether they receive care in nursing homes, assisted living facilities, community-based or home care settings. This report is the outcome of a two-year collaboration between the OECD Health Division and the Directorate General for Employment, Social Affairs and Inclusion of the European Commission. The report discusses the importance of developing metrics for measuring safe, effective and responsive long-term care services, and looks at on-going country initiatives to improve the quality of life of frail older people, as well as the technical and broader challenges to measurement and improvement. The report focuses on three aspects generally accepted as critical to quality care: effectiveness and care safety; patient-centredness; and responsiveness and care co-ordination. The report is organised in three parts: measuring quality in long-term care; policies to drive the quality in long-term care; and case studies: Europe and the United States. (Edited publisher abstract)
Nurse's role in care home rehabilitation
- Author:
- O'DOHERTY Elisabeth
- Journal article citation:
- Nursing Times, 109(29), 2013, pp.18-21.
- Publisher:
- Nursing Times
Increasing numbers of older people are living in long-term residential care. due to their often complex physical and medical conditions there is a need for nursing rehabilitation to improve or maintain their functional status. This study was to explores nurses' perceptions of their role in the rehabilitation of older people in long-term care residences. (Edited publisher abstract)
Making integrated care happen at scale and pace: lessons from experience
- Authors:
- HAM Chris, WALSH Nicola
- Publisher:
- Kings Fund
- Publication year:
- 2013
- Pagination:
- 8
- Place of publication:
- London
The current fragmented services in health and social care fail to meet the needs of the population. A shift to an approach that develops integrated models of care for patients, especially older people and those with long-term conditions, can improve the patient experience and the outcomes and efficiency of care. Making integrated care happen at scale and pace: Lessons from experience is intended to support the process of converting policy intentions into meaningful and widespread change on the ground. The authors summarise 16 steps that need to be taken to make integrated care a reality and draw on work by The King’s Fund and others to provide examples of good practice. There are no universal solutions or approaches to integrated care that will work everywhere and there is also no ‘best way’ of integrating care, and the authors emphasise the importance of discovery rather than design and of sharing examples of good practice when developing policy and practice. Finally, the paper acknowledges that changes are needed to national policy and to the regulatory and financial frameworks for local leaders to fully realise a vision of integration. (Publisher abstract)
The INTERLINKS Framework for long-term care of older people in Europe
- Author:
- BILLINGS Jenny
- Journal article citation:
- Journal of Integrated Care, 21(3), 2013, pp.126-138.
- Publisher:
- Emerald
Purpose - This paper describes the methodological approach to and outcomes of a European multi-consortium EU 7th Framework funded project entitled ‘INTERLINKS’. The project sought to develop a concept and method to describe and analyse long-term care and its links with the health and social care systems, and formal and informal care. Design/methodology/approach - Through the development of a template, it accumulated and validated practice examples that described good policy and practice, transferable across EU Member States. Findings - The outcome was to assemble a range of themes, sub-themes and 135 key issues into a web-based Framework for Long Term Care (LTC) that is illustrated by over a hundred examples of validated practice in LTC for older people. Research limitations/implications - Key messages emanating from the project are provided, with an emphasis on the need for greater investment and pluralist evaluation of initiatives that seek to address the interfaces and links between care services. Originality/value - The project is unique in that is provides a comprehensive and accessible interactive European database of policy and projects that directly address the problems of interfaces between service provision for older people, and contributes towards the evidence base in discrete areas of LTC. (Publisher abstract)