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Commercial, non-profit and governmental residential elderly care in Flanders: differences in client selection and efficiency?
- Authors:
- VERSCHUERE Bram, MORAY Nathalie, DECRAMER Adelien
- Journal article citation:
- International Journal of Social Welfare, 21(4), October 2012, pp.384-392.
- Publisher:
- Wiley
Public services which were initially delivered by public organisations have increasingly been transferred to the market. This has led to debate about the commercialisation of public service delivery and its consequences for the nature of service delivery. In the care of the elderly, there has been a substantial increase in commercial provision. This study aimed to explore differences in the performance of public, private non-profit and private commercial elderly care organisations. The data were collected in 2007 by the Flemish Inspection Agency, which is responsible for monitoring the quality of elderly care facilities. Of the 727 facilities in the sample, 227 were public, 372 were private non-profit, and 128 were private commercial. Quantitative indicators were used to measure client selection (the percentage of residents with dementia or high care needs) and input efficiency (the ratio between the number of staff and residents). The findings show that commercial elderly care facilities tend to be more input-efficient while non-profit and public elderly care facilities tend to be more attentive to recruiting and housing residents with high care needs. However, these results need to be interpreted in light of the regulatory framework in which the different types of elderly care facilities operate.
Inter-organisational collaboration in palliative care trajectories for nursing home residents: a nation-wide mixed methods study among key persons
- Authors:
- HERMANS Sofie, et al
- Journal article citation:
- International Journal of Care Coordination, 22(2), 2019, pp.69-80.
- Publisher:
- Sage
Introduction: Multiple care organisations, such as home care services, nursing homes and hospitals, are responsible for providing an appropriate response to the palliative care needs of older people admitted into long-term care facilities. Integrated palliative care aims to provide seamless and continuous care. A possible organisational strategy to help realise integrated palliative care for this population is to create a network in which these organisations collaborate. The aim is to analyse the collaboration processes of the various organisations involved in providing palliative care to nursing home residents. Method: A sequential mixed-methods study, including a survey sent to 502 participants to evaluate the collaboration between home and residential care, and between hospital and residential care, and additionally three focus group interviews involving a purposive selection among the survey participants. Participants are key persons from the nursing homes, hospitals and home care organisations that are part of the 15 Flemish palliative care networks dispersed throughout the region of Flanders, Belgium. Results: Survey data were gathered from 308 key persons (response rate: 61%), and 16 people participated in three focus group interviews. Interpersonal dimensions of collaboration are rated higher than structural dimensions. This effect is statistically significant. Qualitative analyses identified guidelines, education, and information-transfer as structural challenges. Additionally, for further development, members should become acquainted and the network should prioritise the establishment of a communication infrastructure, shared leadership support and formalisation. Discussion: The insights of key persons suggest the need for further structuration and can serve as a guideline for interventions directed at improving inter-organisational collaboration in palliative care trajectories for nursing home residents. (Edited publisher abstract)
Enabling meaningful activities and quality of life in long-term care facilities: the stepwise development of a participatory client-centred approach in Flanders
- Authors:
- DE VRIENDT Patricia, et al
- Journal article citation:
- British Journal of Occupational Therapy, 82(1), 2019, pp.15-26.
- Publisher:
- Sage
Introduction: Meaningful activities of daily living promote the quality of life of residents of long-term care facilities. This project aimed to develop an approach to enable meaningful activities of daily living and to guide long-term care facilities in a creative and innovative attitude towards residents' meaningful activities of daily living. Method: The approach was developed in six steps: (1) in-depth-interviews with 14 residents; (2) a survey with 171 residents; (3) a systematic map and synthesis review on interventions enriching meaningful activities of daily living; (4) qualitative analysis of 24 ‘good examples’ and, to support future implementation, (5) focus groups with staff (n = 69). Results determined the components of the new approach which was (6) pilot-tested in one long-term care facility. Quantitative and qualitative data were gathered concerning benefits for the residents and feasibility for the staff. Results: A client- and activity-oriented approach was developed, characterised by an active participatory attitude of residents and staff and a systematic iterative process. Significant positive effects were found for the number of activities, the satisfaction with the leisure offered, the social network, medication use, but not for quality of life. The approach appeared to be feasible. Conclusion: This approach stimulates residents' meaningful activities of daily living and social life. Further investigation is needed to evaluate its outcome and implementation potentials.
Cognitive functioning and quality of life: Diverging views of older adults with Alzheimer and professional care staff
- Authors:
- DEWITTE Laura, VANDENBULCKE Mathieu, DEZUTTER Jessie
- Journal article citation:
- International Journal of Geriatric Psychiatry, 33(8), 2018, pp.1074-1081.
- Publisher:
- Wiley
Objective: Staff ratings of quality of life (QOL) in dementia are often lower and more strongly related to the cognitive functioning of the person with dementia than self‐ratings. However, cognition‐related items in QOL measures and limited cognitive screening measures hamper a clear understanding of the relationship, two issues addressed in the current study. Methods: The authors collected data of 88 pairs of older adults with Alzheimer disease and their professional caregivers in 9 residential care settings. Both self‐report and staff report of the QOL of residents were assessed with the Quality of Life in Alzheimer's Disease. Cognitive functioning was assessed with the Mini‐Mental State Examination and a battery of specific cognitive measures. Results: Intraclass correlations and a paired sample t test confirmed a discrepancy between self‐rating and staff rating, with staff significantly underestimating QOL as experienced by the resident. After removing the possibly confounding memory item of the Quality of Life in Alzheimer's Disease, Mini‐Mental State Examination score remained a significant predictor of staff ratings but not self‐ratings in regression analyses. Exploratory analyses of specific cognitive measures showed a significant contribution of a memory test of intentional visual association learning in the prediction of staff‐rated QOL. Conclusions: Staff reports cannot simply substitute reports of the subjective experience of residents with Alzheimer, so both judgments should be taken into account to form an adequate picture of QOL. Staff might be guided more strongly by a cognitive point of view when evaluating QOL of residents with Alzheimer disease, while the latter might have shifted their evaluation standards to cope adequately with the challenges posed by their disease. (Edited publisher abstract)
How do older adults experience and perceive socially assistive robots in aged care: a systematic review of qualitative evidence
- Authors:
- VANDEMEULEBROUCKE Tijs, DIERCKX De CASTERLE Bernadette, GASTMANS Chris
- Journal article citation:
- Aging and Mental Health, 22(2), 2018, pp.149-167.
- Publisher:
- Taylor and Francis
Objectives: The aim of this review was to gain a better understanding of how older adults experience, perceive, think, and feel about the use of socially assistive robots (SARs) in aged care settings. Method: The authors conducted a literature search for studies that used a qualitative or a mixed-method approach having a significant qualitative element. Pubmed, Cinahl, Embase, Scopus, and Web of Science electronic databases were queried. Candidate articles published in journals and conference proceedings were considered for review. Two independent reviewers assessed the included studies for methodological quality using the Critical Appraisal Skills Program, after which data on subjects’ self-reported opinions and perceptions were extracted and synthesised using thematic analyses. Results: Seventeen studies producing 23 publications were included. Based on the opinions of older adults, four themes emerged in relation to the use of SARS: (1) roles of a SAR; (2) interaction between the older adult and the SAR, which could be further subdivided into (a) the technical aspect of the interaction and (b) the human aspect of the interaction; (3) appearance of the SAR; and (4) normative/ethical issues regarding the use of SARs in aged care. Conclusions: Older adults have clear positive and negative opinions about different aspects of SARs in aged care. Nonetheless, some opinions can be ambiguous and need more attention if SARs are to be considered for use in aged care. Understanding older adults’ lived experiences with SARs creates the possibility of using an approach that embeds technological innovation into the care practice itself. (Edited publisher abstract)
Adaptation of Flemish services to accommodate and support the ageing of people with intellectual disabilities
- Authors:
- MAES Bea, VAN PUYENBROECK Joris
- Journal article citation:
- Journal of Policy and Practice in Intellectual Disabilities, 5(4), December 2008, pp.245-252.
- Publisher:
- Wiley
The authors attempted to find out to what extent and in which ways, in Belgium, have Flemish services for people with intellectual disability adapted to the specific needs of aging people. A study was undertaken and a questionnaire was developed to address the following research topics: (1) accommodations and personnel, (2) staff working methods, and (3) staff views and attitudes. The questionnaire was completed by 66 coordinating staff members in as many facilities. At the time of the study, these services supported 310 (27%) persons with Down syndrome age 40 years and older and 833 (73%) persons with intellectual disability (other than Down syndrome) age 55 years and older. Adaptations in accommodation and personnel management were obvious in the majority of the participating services. The working methods reflected a person-centred philosophy, regardless of the age-factor. An exploratory factor analysis revealed three different staff approaches: an activating/socializing, disengaging, and methodical. Participation in activities and involvement in social relations have a prominent place in the staff's views. In general, the authors found that about two-thirds of the services have started to modify their accommodation and personnel to the needs of aging people with intellectual disability. The authors note also that the results suggest there is still a lot of work to do in improving staff training, introducing specific working methods, and in altering stereotypical staff attitudes to assure a good "aging in place."
Caring for older Europeans: comparative studies in 29 countries
- Author:
- GIARCHI George Giacinto
- Publisher:
- Arena
- Publication year:
- 1996
- Pagination:
- 547p.,bibliog.
- Place of publication:
- Aldershot
Provides a reference source for various modes of care (both formal and informal) for older people throughout Europe. Each chapter follows the same format and covers: demography; socio-political and administrative background; social security and pensions; housing; health care; mental health care; residential care; personal social services; voluntary care agencies and support organisations; leisure pursuits and education; and older people in rural areas.