Abstract
BackgroundAs demand and desire to “age-in-place” grows within an aging population, and new areas of need emerge, governments nationally and internationally are focusing effort and attention on innovative and integrative approaches to health and well-being. Seniors’ Campus Continuums are models of care that seek to broaden access to an array of services and housing options to meet growing health and social needs of aging populations. The objective of this study is to increase understanding of this model and factors that influence their evolution, development, ongoing functioning and capacity to integrate care for older adults wishing to age in their own home and community.MethodsThis research uses a comparative case study approach across six-bounded cases offering four geographically co-located components (mixed housing options, internal and external community supports, and a long-term care home) in various contexts across Ontario, Canada. Onsite in-person and phone interviews with senior campus staff (N = 30), and campus partners (N = 11), enhanced by direct observation at campuses explored historical and current efforts to offer health, housing and social care continuums for older adults.ResultsAnalysis highlighted eight key factors. Enabling factors include i. rich historical legacies of helping people in need; ii. organizational vision and readiness to capitalize on windows of opportunity; iii. leveraging organizational structure and capacity; iv. intentional physical and social design; v. broad services mix, amenities and innovative partnerships. Impeding factors include vi. policy hurdles and rigidities; vii. human resources shortages and inequities; and viii. funding limitations. A number of benefits afforded by campuses at different levels were also observed.ConclusionFindings from this research highlight opportunities to optimize campus potential on many levels. At an individual level, campuses increase local access to a coordinated range of health and social care services, supports and housing options. At an organizational level, campuses offer enhanced collaboration opportunities across providers and partners to improve consistency and coordination of care, and improved access to shared resources, expertise and infrastructure. At a system level, campuses can address a diversity of health, social, financial, and housing needs to help seniors avoid premature or inappropriate use of higher intensity care settings.
Highlights
As demand and desire to “age-in-place” grows within an aging population, and new areas of need emerge, governments nationally and internationally are focusing effort and attention on innovative and integrative approaches to health and well-being
Campus inception and development In describing campus evolution, most case studies developed into a continuum incrementally over time with all six currently offering a broad spectrum of communitybased health and social supports, mixed-income housing options and Long-Term Care Home (LTCH) beds for seniors and older persons with ongoing care needs in one geographic location
To achieve the promise of seniors’ campus care continuums as fully integrated, affordable, accessible and quality care settings it is important to understand how they take root, the opportunities and challenges that they face in bridging the health and social care divide, and prospects to maximize their benefit across varied contexts
Summary
As demand and desire to “age-in-place” grows within an aging population, and new areas of need emerge, governments nationally and internationally are focusing effort and attention on innovative and integrative approaches to health and well-being. These concerns (demand factors) play an important role in determining an individual’s care destination; when, where and how a person receives care is affected by other important “supply” factors including formal system capacity (e.g., state policies, funding priorities, service mix and volume, eligibility criteria, rurality, health human resources) and availability and willingness of informal systems to provide support (e.g., access to caregivers, care mix and volume, caregiver characteristics and resilience, social capital) [1, 11,12,13,14] The dynamism amongst these demand and supply factors with the changing pace of population ageing pose challenges to providing coordinated approaches to equitable and accessible care and services to support “aging-in-place” as safely and independently as possible in communities of choice [1, 15,16,17]. Moving Forward (all respondents): How might one better facilitate the ability of campuses to maximize their benefit for their residents/ tenants and local community? Suggested Probes for exploration (dependent on respondent’s role): Lessons learned from campus development and implementation experience?
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