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The strategy for older people in Wales
- Author:
- WALES. National Assembly
- Publisher:
- Wales. National Assembly
- Publication year:
- 2003
- Pagination:
- 39p.
- Place of publication:
- Cardiff
This Strategy is the product of extensive consultation, research and expert views about the lives of older people in Wales both now and in the future. The aims, objectives and more detailed programmes and projects reflect the findings of the report of the Advisory Group ‘When I’m 64…..and more’ published in May 2002 and over 100 responses to it. The Strategy recognises that: over the next 20 years demographic changes will significantly change the balance of the population and mean that future policies and programmes in Wales must reflect the needs of an ageing society; and there is a need to improve the quality, quantity and responsiveness of services for older people.
Gauging quality in constructivist research: the Aldre Vaste Sjuharad model revisited
- Authors:
- NOLAN Mike, et al
- Journal article citation:
- Quality in Ageing, 4(2), August 2003, pp.22-27.
- Publisher:
- Pier Professional
- Place of publication:
- Brighton
The Aldre Vaste Sjuharad Centre in West Sweden has as its main goal the promotion of partnerships between older people and their families. In pursing these goals the Centre adopts a broadly constructivist method to research that is 'authentic and meaningful' to those that take part. This paper assesses the quality of the resultant research.
The quality of quality measurement in U.S. nursing homes
- Authors:
- MOR Vincent, et al
- Journal article citation:
- Gerontologist, 43(Special Issue II), April 2003, pp.37-46.
- Publisher:
- Oxford University Press
This article examines various technical challenges inherent in the design, implementation, and dissemination of health care quality performance measures. Using national and state-specific Minimum Data Set data from 1999, the authors examined sample size, measure stability, creation of ordinal ranks, and risk adjustment as applied to aggregated facility quality indicators. Nursing home Quality Indicators now in use are multidimensional and quarterly estimates of incidence-based measures can be relatively unstable, suggesting the need for some averaging of measures over time. Current public reports benchmarking nursing homes' performances may require additional technical modifications to avoid compromising the fairness of comparisons.
Quality of care for elderly residents in nursing homes and elderly people living at home: controlled observational study
- Authors:
- FAHEY Tom, et al
- Journal article citation:
- British Medical Journal, 15.3.03, 2003, pp.580-583.
- Publisher:
- British Medical Association
Reports on the results of a research study which examined three general practices with registered patients resident in four Bristol nursing homes. In each practice four patients who lived in their own homes were also selected to act as controls. The study compared and evaluated the quality of clinical care given to patients in both settings. The results of the study suggested that the quality of medical care that patients received in the study was inadequate, particularly in the nursing homes. Suggests that better coordinated care would avoid the problems of overuse of unnecessary drugs, underuse of beneficial drugs, and poor monitoring of chronic disease.
Improving nursing home quality of care through outcomes data: the MDS quality indicators
- Author:
- ZIMMERMAN David R.
- Journal article citation:
- International Journal of Geriatric Psychiatry, 18(3), March 2003, pp.250-257.
- Publisher:
- Wiley
The quality of care provided to nursing home residents is a continuing source of concern throughout the world. In the United States, the Health Care Financing Administration mandated the use of a standardised resident assessment instrument, called the Minimum Data Set (MDS) which facilitated the development of a set of nursing home quality of care indicators. The MDS Quality Indicators were developed by a team of researchers and covered 12 domains, as well as associated risk factors. This initial set of indicators then went through an iterative process of review by national clinical panels, further empirical analysis, validation studies, and pilot tests, to confirm whether they were accurate, reliable and useful tools for identifying quality problems. The final set of MDS Quality Indicators includes 24 variables that include both processes and outcomes of care and prevalence and incidence measures. They are defined at both the resident and facility level. Four of the indicators are risk-adjusted. The indicators have several possible applications: a source of consumer information; to help guide policy makers; and to assist providers in conducting quality improvement initiatives and to evaluate the impact of these efforts.
Consumer satisfaction in long-term care: state initiatives in nursing homes and assisted living facilities
- Authors:
- LOWE Timothy J., et al
- Journal article citation:
- Gerontologist, 43(6), December 2003, pp.883-896.
- Publisher:
- Oxford University Press
The authors report the results of a survey of state initiatives that measure resident satisfaction in nursing homes and assisted living facilities, and we describe several model programmes for legislators and public administrators contemplating the initiation of their own state programmes. Data on state initiatives and programmes were collected during March and April 2000 through a mailed questionnaire and follow-up telephone interviews and were current as of September 2002. Of the 50 states surveyed, 50 responses were received (response rate = 100%); 12 states (24%) reported the use of consumer satisfaction measures, and 7 (Florida, Iowa, Ohio, Oregon, Texas, Vermont, and Wisconsin) reported using resident satisfaction data within their consumer information systems for nursing homes or assisted living facilities. Additionally, 2 states (Iowa and Wisconsin) use resident satisfaction data for facility licensing and recertification. The design of the instruments and collection methods vary in these states, as do the reported response rates, per-resident cost, and the purpose for satisfaction data collection. State satisfaction efforts are in an early stage of development. Well-produced, easily understandable reports on nursing home and assisted living quality could provide information and guidance for patients and families contemplating the utilization of long-term care services. Dissemination of quality information may also facilitate sustained quality and efficiency improvements in long-term care facilities and thus enhance the quality of care for and quality of life of long-term care residents.
A national survey of assisted living facilities
- Authors:
- HAWES Catherine, et al
- Journal article citation:
- Gerontologist, 43(6), December 2003, pp.875-882.
- Publisher:
- Oxford University Press
Throughout the 1990s, assisted living was the most rapidly growing form of senior housing. The purpose of this paper is to describe the existing supply of assisted living facilities (ALFs) and examine the extent to which they matched the philosophy of assisted living. The study involved a multistage sample design to produce nationally representative estimates for the ALF industry. Administrators of nearly 1,500 eligible ALFs were interviewed by telephone. As of 1998, there were an estimated 11,459 ALFs nationwide, with 611,300 beds and 521,500 residents. Nearly 60% offered a combination of low services and low or minimal privacy, whereas only 11% offered relatively high services and high privacy. Seventy-three percent of the resident rooms or apartments were private. Aging-in-place was limited by discharge policies in most ALFs for residents who needed help with transfers, had moderate to severe cognitive impairment, had any behavioral symptoms, or needed nursing care. The industry is largely private pay and unaffordable for low- or moderate-income persons aged 75 unless they use assets as well as income to pay. ALFs differed widely in ownership, size, policies, and the degree to which they manifested the philosophy of assisted living. This diversity represents a challenge for consumers in terms of selecting an appropriate facility and for policy makers in terms of deciding what role they want assisted living to play in long-term care.
Adult care
- Author:
- PEACE Sheila
- Journal article citation:
- Research Matters, 16, October 2003, pp.5-10.
- Publisher:
- Community Care
This article draws on research from two studies, the first of which considers the capacity of nursing homes in England to provide rehabilitation and intermediate care; and the second which compares the quality of health care provided for residents by nursing homes with those living at home.
Developing a satisfaction survey for families of Ohio's nursing home residents
- Authors:
- EJAZ Farida, et al
- Journal article citation:
- Gerontologist, 43(4), August 2003, pp.447-458.
- Publisher:
- Oxford University Press
The purpose of this project was to develop a reliable and valid family satisfaction instrument for use in Ohio's nursing homes. Investigators worked with an advisory council to develop the survey. Purposive sampling techniques were largely used to select 12 small, medium, and large for-profit and proprietary facilities in one large county for the pretest. A total of 239 families who were "most involved" in their relative's care completed an instrument with 97 satisfaction items. Results: Factor analyses identified nine factors that explained 59.44% of the variance in satisfaction. Investigator judgment modified some factors and developed scales. The scales had good internal reliability ( and above, except for one), test–retest reliability ranged from.49 to.88, and differences between families of short- and long-stay residents were in expected directions. A final instrument with 62 satisfaction and 17 background items was recommended for statewide implementation. : Findings from the project can be used to further refine the instrument and protocols for use with larger populations in other states and by the federal government.
Factors influencing residents' satisfaction in residential aged care
- Authors:
- CHOU Shu-Chiung, BOLDY Duncan P., LEE Andy H.
- Journal article citation:
- Gerontologist, 43(4), August 2003, pp.459-472.
- Publisher:
- Oxford University Press
The aim of this study was to identify the important factors influencing residents' satisfaction in residential aged care and to provide a better understanding of their interrelationships. A cross-sectional survey design was used to collect the required information, including resident satisfaction, resident dependency levels, and staff satisfaction. A stratified random sampling approach was utilized to select facilities. All residents satisfying the selection criteria (i.e., understand English, be sufficient cognitive competence, have a sufficient energy level to participate in the survey, and live in the facility for more than 4 weeks) and all care staff were invited to participate. A total of 996 residents and 895 staff from 62 facilities (36 hostels and 26 nursing homes) provided the required data. Structural equation modeling was used to examine the interrelationships among three sets of contributing factors, related to the facility, staff and residents, and resident satisfaction components, separately for nursing home and hostel residents. Overall fits of both nursing home and hostel models were satisfactory. This study has revealed that staff satisfaction plays a crucial and central role in determining resident satisfaction in nursing homes, whereas it has less impact in hostels. The provision of more care hours has only a small, yet positive, impact on resident satisfaction. Larger facility size has a negative impact on resident involvement. Older residents were found to be more satisfied with staff care. The results provide a comprehensive understanding of what influences resident satisfaction. By accounting for important factors identified by residents, a resident-focused care model can be developed and implemented, leading to better service for aged care residents.