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Five costed reforms to long-term care funding

Author:
HIRSCH Donald
Publisher:
Joseph Rowntree Foundation
Publication year:
2006
Pagination:
8p.
Place of publication:
York

As part of its Policy and Practice Development Programme on Long-term Care, the Joseph Rowntree Foundation asked William Laing of Laing and Buisson to estimate the cost of a range of policy changes. This document gives a summary of these costings and how to interpret them. The data behind these calculations is reproduced in a spreadsheet available alongside this paper. The context of these costings is given in JRF’s Foundations document, Paying for long-term care: moving forward, published in April 2006, which presents the programme conclusions and options for reform. These costings are all illustrative rather than precise calculations of what a particular policy would cost. The main objective is to show the order of magnitude of the cost of various changes, in order to open up discussion of the desirability of these options.

Journal article

Free to choose?

Author:
ROYSON Claire
Journal article citation:
Community Care, 6.7.02, 2002, pp.32-33.
Publisher:
Reed Business Information

The author argues that the major difference between long-term care and long-term caring for older people is the understanding of consent, capacity and autonomy.

Journal article

Revaluating aging in place: from traditional definitions to the continuum of care

Authors:
WEIL Joyce, SMITH Elizabeth
Journal article citation:
Working with Older People, 20(4), 2016, pp.223-230.
Publisher:
Emerald

Purpose: Traditional definitions of ageing in place often define ageing in place specifically as the ability to remain in one’s own home or community setting in later life. The purpose of this paper is to reframe ageing in place and show how narrowly defined ageing in place models can be potentially negative constructs that limit options for older adults. The authors propose a paradigm shift, or a re-framing of, the popularised idea of ageing in place. The authors challenge mainstream and literature-based beliefs that are deeply rooted to the idea that ageing in place ideally happens in the home in which a person has lived for many years. Design/methodology/approach: The paper reviews common concepts and constructs associated with ageing in place as well as gaps or exclusions, and US-based ageing in place policy initiatives favouring the ageing in place model. Findings: An expanded definition of ageing in place embraces heterogeneity in residence types and living options. A realistic assessment of person-environment fit, matching an older person’s capabilities to his or her environmental demands, allows for the development of additional ageing in place options for those living across the continuum of care. Social implications: Ageing in place should be moved from the personal “success” or “failure” of an older individual to include the role of society and societal views and policies in facilitating or hindering ageing in place options. The authors demonstrate that these options, in facilities within the continuum of care, can be thought of as appealing for older persons of all levels of physical and cognitive functioning. (Edited publisher abstract)

Journal article

Exploring the personal and environmental factors related to length of stay in assisted living

Author:
FIELDS Noelle L.
Journal article citation:
Journal of Gerontological Social Work, 59(3), 2016, pp.205-221.
Publisher:
Taylor and Francis
Place of publication:
Philadelphia, USA

This study explored to what extent personal and environmental factors, as defined by the ecological model of aging, help us to understand length of stay in assisted living (AL). A convenience sample (N = 218) of administrative records of AL residents admitted between the years 2006 and 2011 was collected and included AL residents' demographic and healthcare information as well as dates of admission and discharge. Cox regression was used to determine which personal and environmental factors influenced length of stay in three AL programs. Number of medical diagnoses, level of care score, and facility were found to be significant predictors of length of stay. The analyses identified a median survival time of 32 months as well as critical periods for discharge from AL. Implications for future research and social work practice are presented. (Publisher abstract)

Journal article

Drivers of change: learning from the lived experiences of nursing home social workers

Authors:
LEE Ahyoung Anna, LEE Sharon Narae, ARMOUR Marilyn
Journal article citation:
Social Work in Health Care, 55(3), 2016, pp.247-264.
Publisher:
Taylor and Francis
Place of publication:
Philadelphia, USA

In response to the growing attention to integrated health care and the cultural change movement in nursing homes, this study examines the lived experiences of nursing home social workers to better understand their role perceptions, job satisfaction, and relationship with other staff members. Hermeneutic phenomenology was used in order to understand the lived experience of being a nursing home social worker. Ten nursing home social workers were recruited from a southern state and individual interviews were conducted. From the interviews, four themes emerged: challenge, coping, mattering, and rewarding. Guided by identity negotiation theory and social identity theory, these findings are discussed. Also, implications for social work education, nursing home administration, and policy is discussed. (Edited publisher abstract)

Journal article

The barriers to sustaining and scaling-up housing experiments in community-care: the Dutch experience

Authors:
CRAMER Hendrik, VOORDIJK Hans, DEWULF Geert
Journal article citation:
Housing Care and Support, 18(3/4), 2015, pp.69-79.
Publisher:
Emerald

Purpose: The purpose of this paper is to provide new insights into barriers to sustaining and scaling-up housing and community-care innovations related to changing the long-term care (LTC) system. Design/methodology/approach: Two housing and community-care experiments were studied. The 11 barriers and four core themes identified to the scaling-up of these experiments were analysed using the three theoretical concepts from the transitions literature: shielding, nurturing, and empowering innovations. Findings: The barriers included shielding through subsidies without having organizational or political commitment, nurturing networks that underestimated the size of the housing and community-care innovations, and a failed empowerment because of regulatory uncertainty – not knowing the rules of tomorrow and ignoring the reality that it takes time to spread the lessons learnt in experiments. Research limitations/implications: Housing and community-care innovations need to pay less attention to subsidies and focus more on learning from the experiments, spreading the ideas, and creating commitment from policymakers so that the innovations become empowered. (Edited publisher abstract)

Book Full text available online for free

Review of care products: key messages

Author:
GREAT BRITAIN. Department of Health
Publisher:
Department of Health
Publication year:
2014
Pagination:
4
Place of publication:
London

The Department of Health invited representatives of the financial services industry to conduct a review of the market of products to fund care. These reports have identified opportunities for development of financial care products and the problems they might face. This short report presents key messages from the financial services industry, which briefly outlines the types of plans those entering care (mainly aged 75+), the ‘semi-retired’, and those of working age should make. It suggests the sorts of “products” that could help with care costs, e.g. Equity Release; and that certain conditions are also needed to create consumer demand for such products to make provision for care, for example helping people to access good financial advice. The review was supported by 3 industry-led working groups that looked a: consumers and the marketplace, housing and equity, and pensions and insurance. (Edited publisher abstract)

Journal article

The relevance of Marjory Warren’s writings today

Authors:
ST. JOHN Philip D., HOGAN David B.
Journal article citation:
Gerontologist, 54(1), 2014, pp.21-29.
Publisher:
Gerontological Society of America

Marjory Warren was one of the initial geriatricians in the United Kingdom. She established specialised geriatric units, held important administrative positions, and wrote influential papers where she argued for the need of the specialty of geriatric medicine and outlined principles for inpatient care of older adults with chronic illness. The authors compare and contrast Warren’s early papers describing these principles with contemporary models for improving inpatient care of older adults and the need for the specialty of geriatrics. Warren’s writings on the inpatient care of older adults presage the principles of both Hospital Elder Life Programs and Acute Care of the Elderly units. The importance of multidisciplinary teams, the physical environment, attention to diverse issues (medical, social, functional), early ambulation, and the active involvement of the older person in their daily routine are present in Warren’s writings and in contemporary approaches. Warren’s arguments for both the specialty of geriatric medicine and increased training of nonspecialist physicians and other health professionals are remarkably similar to those made in a recent Institute of Medicine report. Across time and place, there has been consistency in the general principles perceived as required for the effective cares of older persons, but challenges persist in implementing and sustaining them. (Publisher abstract)

Book Full text available online for free

Failing to care: NHS continuing care in England

Author:
ALL PARTY PARLIAMENTARY GROUP ON PARKINSON'S
Publisher:
All Party Parliamentary Group on Parkinson's
Publication year:
2013
Pagination:
37
Place of publication:
London

NHS continuing care is defined as ‘free care outside of hospital that is arranged and funded by the NHS’ and can be provided in any setting. This inquiry into NHS continuing care has uncovered huge failings in a system which leaves people with Parkinson's no choice but to pick up the cost of care they cannot survive without. The All-Party parliamentary Group on Parkinson's found that 59% of NHS continuing care assessments do not involve a professional with specialist expertise or knowledge in the applicant's condition. This leads to inaccurate and incorrect decisions on funding. Furthermore, 40% of people going through the assessment process reported a lack of empathy and transparency from professionals. The report makes robust recommendations for the Department of Health and NHS England to overcome these issues, to help people who are eligible for NHS continuing care to be awarded this funding as promptly as possible, so that they can receive the care and support they need without worrying about the costs. (Edited publisher abstract)

Journal article

Specifying long-term care provider responsiveness to LGBT older adults

Author:
JIHANIAN Lila J.
Journal article citation:
Journal of Gay and Lesbian Social Services, 25(2), 2013, pp.210-231.
Publisher:
Taylor and Francis
Place of publication:
Philadelphia, USA

In-depth interviews and focus groups with lesbian, gay, and transgender older adults addressed the question “What does it mean for long-term care providers to be responsive to lesbian, gay, bisexual, and transgender (LGBT) older adults?” Sixteen domains of long-term care provider responsiveness to LGBT older adults were identified, including awareness of centrality of partners, knowledge of importance of preferred gender expression, openness to welcoming LGBT older adults, and ability to create LGBT-safe environments. Future research should include LGBT elders who belong to ethnic minority groups, bisexual elders, and LGBT older adults who do not identify with LGBT labels. (Publisher abstract)

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