Long-term Care For Older People Research Articles

Older people initiative.

Interlinks is a Europe-wide project to create a resource aimed at improving long-term care for older people. The project has developed.

Patient‐centeredness in long‐term care of older patients – a structured interview

The aim of this study was to describe assessments of older people about patient-centeredness in the long-term care of Estonian hospitals, and to determine correlations between patients' assessments and their socio-demographic characters. Patient-centeredness increases patients' satisfaction and enhances their recovery. Still, patients' opinions are not always taken into account. A cross-sectional study included 111 older people in long-term care of 14 Estonian hospitals. Data were collected in 2008 by means of structured interviews. What patients agreed most was that they were given enough opportunity to carry out activities they were capable of performing themselves. Two thirds of participants had not been sufficiently consulted on who would be providing their care. Half of the participants were not given sufficient opportunity to decide what kind of care was needed and how they would receive it. The more assistance patients needed in daily living activities, the less they considered the care as patient-centred. From the perspective of older people, the patient-centeredness in Estonian long-term care is above average. Providing patient-centred long-term care in Estonian hospitals deserves more attention. Older people should be more involved in decision-making, especially those who need more assistance in daily living activities.

The staff's view on dementia and the care in three cultures: A qualitative study in France, Portugal and Sweden

This article discusses the staff's view on dementia and its impact on the care delivered arising out of a qualitative comparative study focusing on long-term care of older people in France, Portugal and Sweden. The aim was to explore the staff's view on the illness dementia; on older people suffering from dementia; the care provided and the impact of various views on the care. The care was studied through observations at 22 care settings in the three countries and the staff's attitudes were explored by means of interviews with 79 people. A relation-oriented phenomenological approach was used. Great differences appeared regarding the various staff groups’ views. The findings also indicated that the staff's view; the cultural context and the organizational environment might have an impact on the care provided. However the impact of professional affiliation and the way of collaborating seemed to be of greater significance than other similarities or differences. An interdisciplinary based starting point, with close collaboration between medical based health care and social care of older people suffering from dementia in integrative care models, is therefore of vital importance.

Nurses’ assessments of individualised care in long‐term care institutions

The aims of this study were to explore nurses' assessments of individualised care in long-term care wards and to examine how their sociodemographic variables were associated with their views of such care. Although the importance of individualised care is highlighted both by nurses and by older people, there is a limited amount of research about individualised care, especially in the long-term care of older people. An exploratory design was employed. Data were collected using questionnaires [Individualised Care Scale (ICS)-Nurse] from nurses (n = 283, n = 215, response rate 76%) working in the long-term care wards (n = 19) of four institutions in 2009. Data were analysed statistically. Overall, nurses perceived that they supported patient individuality during nursing activities but the care they provided was not so individualised. Nurses perceived that they supported older peoples' individuality in the clinical situation and in decisional control over care well but supported older peoples' individual life situation to a lesser extent. The higher the nurses' age, the longer the working experience in health care or experience in the current ward, the more positive views they had about the support of individuality. This study identified some shortcomings in the realisation of individuality in the care of older people. Nurses seem to think they generally provide individualised care but this was not necessarily realised in the current evaluations of the care they delivered. There is need to identify issues that may help in developing individualised care in clinical practice. Nurses' attitude to older people in the geriatric care settings needs exploration. Nurses may focus on physiological needs that may hinder the recognition of older patient's individuality.

Health systems and long-term care for older people in Europe. Modelling the interfaces between prevention, rehabilitation, quality of services and informal care—an action research project

The International Journal of Integrated Care (IJIC) is an online, open-access, peer-reviewed scientific journal that publishes original articles in the field of integrated care on a continuous basis.IJIC has an Impact Factor of 2.913 (2021 JCR, received in June 2022)The IJIC 20th Anniversary Issue was published in 2021.

Residential aged care in Auckland, New Zealand 1988-2008: do real trends over time match predictions?

in Auckland, New Zealand in 1988, 7.7% of those aged over 65 years lived in licenced residential aged care. Age-specific rates approximately doubled for each 5-year age group after the age of 65 years. Even with changes in policies and market forces since 1988, population increases are forecast to drive large growth in demand. This study shows previously unrecognised 20-year trends in rates of care in a geographically defined population. four cross-sectional surveys of all facilities (rest homes and hospitals) licenced for long-term care of older people were conducted in Auckland, New Zealand in 1988, 1993, 1998 and 2008. Facility staff completed survey forms for each resident. Numbers of licenced and occupied beds and trends in age-specific and age-standardised rates in residential aged care are reported. over the 20-year period, Auckland's population aged over 65 years increased by 43% (from 91,000 to 130,000) but actual numbers in care reduced slightly. Among those aged over 65 years, the proportion living in care facilities reduced from 1 in 13 to 1 in 18. Age-standardised rates in rest-home level care reduced from 65 to 33 per thousand, and in hospital level care, from 29 to 23 per thousand. Had rates remained stable, over 13,200 people, 74% more than observed, would have been in care in 2008. growth predicted in the residential aged care sector is not yet evident. The introduction of standardised needs assessments before entry, increased availability of home-based services, and growth in retirement villages may have led to reduced utilisation.

Prescribing for older people in nursing homes: challenges for the future

As the population continues to age, long-term care for older people will be required, although the setting and method of delivery may differ depending on people's needs. We anticipate that nursing homes will continue to be part of the overall long-term care delivery model, but will face a number of challenges if they are to be considered as much sought-after places. This paper highlights three issues in relation to prescribing that have been largely ignored to date, but which need to be considered by practitioners, policy makers and researchers alike: culture; resident-centred decision-making and care at the end of life. There has been growing interest in culture within organisations and how this may influence behaviour and performance. In this paper, we will consider how culture may influence prescribing. Culture is important in how it contributes to resident-centred care and this leads to a consideration on how residents may be involved in decision-making, specifically in the area of medicines. Finally, care at the end of life in nursing homes, particularly in those with dementia, has been shown to be poor in quality, and this also encompasses the medicines that are prescribed. Palliative services need to be developed to meet the requirements of some of the most vulnerable residents in this care setting.

Physical and Emotional Status of Nursing Home Residents: Long-term Care of Older People via Incheon Nursing Home Network (LOVE) Study

Results: Hypertension was the most common ailment at 58.6% of the total followed by dementia (50.6%), stroke (28.7%), and diabetes (24.2%). Prevalence of diabetes (p<0.001) and stroke (p<0.001) were relatively low in the older age groups but that of osteoarthritis (p<0.001) and dementia (p=0.001) were relatively high. After adjusting for age and sex, limited physical activity was more frequent in those with strokes (odds ratio [OR], 3.7 [2.1-6.2], p<0.001) and fractures (OR, 2.1 [1.1-4.1], p=0.023). Unstable emotion was more frequent in residents with dementia (OR, 1.9 [1.3-2.8], p=0.001). Conclusion: The most common diseases among nursing home residents, in decreasing order, were hypertension, dementia, stroke, and diabetes. Diseases related to the need for physical aids were strokes and fractures. Effective strategies for the management of unstable emotional status in the elderly with dementia are needed.

Dental care of frail older people and those caring for them

To describe oral health utilisation patterns of frail older people and contrast these with attitudes and utilisation patterns of nursing staff who are caring for them. In view of widespread poor oral health of frail older people in long-term care, staff attitudes have been identified as an area of interest. In addition to data on attitudes, the current study contributes a description of aspects of oral health related behaviour of staff and clients. Cross-sectional study. Structured interviews of a random selection of long-term care staff (n=320) and frail older people (n=172), within the two groups of home-care services (HCS) and long-term care facilities (LTCF). Of staff members, 55·3% attach the same importance to their own oral health compared to that of clients and 35·7% regard their own oral health as more important; 98·4% of staff attended two or more dental examinations per year; 3·4% of HCS and 37·1% of LTCF routinely arranged oral examinations. In 81·4% HCS and in 34·4% of LTCF, there was no routine dental service available. Patterns of oral health service attendance greatly differ between staff and clients. The oral health awareness of the majority of long-term care staff did not translate into adequate oral health care for clients. A gap exists between attitudes supportive of oral health, adequate and prevention driven own oral health related behaviour of staff and actual oral health care delivered to clients. To bridge the gap identified, a concept is suggested for nursing educators and managers of LTCF targeting educational measures while taking into account individual attitudes.

Rehabilitation for older people in long-term care (2009)

Australasian Journal on AgeingVolume 29, Issue 2 p. 98-98 Rehabilitation for older people in long-term care (2009) First published: 08 June 2010 https://doi.org/10.1111/j.1741-6612.2010.00435_2.xRead the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article. Volume29, Issue2June 2010Pages 98-98 RelatedInformation

Is physical rehabilitation for older people in long-term care effective? Findings from a systematic review

to determine the effects of physical rehabilitation for older people resident in long-term care. systematic review of randomised controlled trials. The Cochrane Central Register of Controlled Trials, Medline, EMBASE, AMED, CINAHL, PEDro, British Nursing Index, ASSIA, IBSS, PsychINFO, DARE, HMIC, NHS EED, HTA, Web of Science, AsLib Index to UK Theses and Dissertation Abstracts, the National Research Register, Medical Research Council Register, CRIB, Current Controlled Trials and HSRPRoj. all randomised trials investigating physical rehabilitation for people permanently resident in long-term care aged > or = 60 years. The primary outcome was measures of activity restriction. 49 trials were identified involving 3,611 subjects with an average age of 82 years. Intervention duration was typically 12 weeks with a treatment intensity of three 30-min sessions per week. Exercise was the main component of the interventions. The mean attendance rate for 17 studies was 84% (range 71-97%). Thirty-three trials, including the nine trials recruiting over 100 subjects, reported positive findings, mostly improvement in mobility but also strength, flexibility and balance. physical rehabilitation for older people in long-term care is acceptable and potentially effective. Larger scale studies are needed to confirm the findings and should include longer term follow-up and assessment for possible harms.

The Changing Process of the Mix in the Long-term Care for Older People : An Analysis of Reformist Policies after the Introduction of the Long-term Care Insurance

The Changing Process of the Mix in the Long-term Care for Older People : An Analysis of Reformist Policies after the Introduction of the Long-term Care Insurance

Health care, social care or both? A qualitative explorative study of different focuses in long-term care of older people in France, Portugal and Sweden

Challenges with an ageing population are increasingly becoming a reality in the Western world. Since cognitive impairment increases with age, we can expect an increasing number of older people in need of care. The aim of this article is to describe, analyse and compare different focuses on care of older people with dementia, using examples from France, Portugal and Sweden. The questions are principally focused on the participants’ view about their tasks, the organisation of work, the professional role and cooperation with other professions. Everyday care was studied through observations and participant observations and the staff's opinion was explored by means of interviews. Twenty-two care settings for older people were included. The findings showed that France provided mainly ‘health care’, Sweden ‘social care’ and Portugal an integrated ‘health care and social care’. In a comparative perspective the Portuguese general care of older people, which focuses on integration of health care, social care and social work, also seems to provide care for older people suffering from dementia which best corresponds to the previously developed group living model.

Using talking therapies in the treatment of depression

Depression is prevalent in older people in longterm care, however, it should not be considered a normal part of ageing. Dawn Weaver discusses depression in older people and the role of cognitive behavioural therapy in treating the condition.

Older people actively reconstruct their life in a care home

The research reported here aimed to present the stories of care home residents through an interpretative study that was informed by a biographical approach and narrative method. Eight older people who lived in four different care homes in England participated in a sequence of up to eight narrative interviews over a six month period. The findings revealed how the older people tried to live as active biographical agents who were instrumental in shaping their own life in a care home. They were able to do this to a greater or lesser extent through the implementation of a range of resident-led strategies. The understanding of care home life that was developed through this study offers an alternative biography for living in care homes that is not only possible but achievable. This is a biography of frail older people who are active in reconstructing their life following the move to a care home, and living lives that are meaningful, purposeful and enjoyable. This sits in contrast to the standard biography that dominates current understanding of care home life that of older people merely 'existing' for the most part of their days. This image provides a vision for long-term care for older people, which is grounded in the views and aspirations of older people.

Assessing pressure ulcer risk in long-term care using the Waterlow scale

This article reports on a mixed-methods study examining the use of the Waterlow scale by nurses working in long-term care for older people in Scotland. Eight nurses from four long-term care facilities in two health board regions took part. They were observed carrying out 16 pressure ulcer risk assessments, after which they were interviewed about their assessment and plan of care. Results from the observations and interviews suggest that an assessment of pressure ulcer risk and plan of care went beyond the information that was contained in, or produced by, the Waterlow scale.

Considering the factors affecting nutritional status

Factors affecting the nutritional status of older people in long-term care include communication and eating environment. Rachel Welch discusses the ways that carers and nurses can positively influence their residents' nutritional intake.

Failures in the system: our inability to learn from inquiries

The Rowan report was published in 2003, following an investigation into allegations of abuse on a ward providing longterm care for older people with mental health problems. The factors identified as important were similar to those identified in other inquiries that took place before and after the Rowan inquiry. Why do organisations fail to learn the lessons of the past?This paper examines what happened following publication of the Rowan report and the ensuing publicity. Some positive outcomes are identified but, putting these in context, it seems unlikely that they will prevent further incidents. How do organisations prevent incidents/suspicions of abuse? The author suggests a multi‐level approach and argues that residential and nursing care is at least equally at risk. The fundamental problem lies in society's failure to prioritise and adequately resource the care of older people with dementia and other mental health problems.

Improving Use of Medicines for Older People in Long-Term Care: Contrasting the Policy Approach of Four Countries

The quality of nursing home care for older people, including medication use and related outcomes, has been problematic in a number of developed countries. This paper compares the policy approaches to drug prescribing and administration in nursing homes adopted by four countries. The United States has led the way in terms of regulating and inspecting nursing homes, with strict requirements for prescribing psycho-tropic medications, commonly known as "chemical restraints." These requirements have been facilitated by detailed data collection mandated by the US government. Although regulation has led to marked reductions in the prescribing of these agents, underused medications have received little attention. Despite similar problems with the use of psychotropic drugs, the United Kingdom, Australia and New Zealand have adopted a more generic approach to drug use in the nursing home setting, a situation that may reflect the different organization and ethos of healthcare systems in these countries. Developments in systematic medication data capture, greater collaboration and more educational feedback to prescribers and facilities would represent a major step forward in long-term care policy in these latter three countries, while a broader educational focus would further support improvements in the US setting.

Frequency and appropriateness of antipsychotic medication use in older people in long-term care

Many studies have reported excessive use of antipsychotic medications in long stay institutions in Britain and America. We examined the frequency and appropriateness of antipsychotic prescribing in a variety of extended care settings in the west of Ireland. Clinical details of 345 residents (211 public and 134 private) were obtained from medication sheets and medical notes and by interviewing nursing staff. American prescribing guidelines were applied for those residents taking antipsychotic medications. Of the 345 residents, 80 (23%) were prescribed regular antipsychotic medications of whom 41 (51%) were deemed to be receiving these agents inappropriately. There was no difference in the use of antipsychotic drugs (21.3% vs. 26.1%, Chi-sq = 1.1, p = 0.3) between residents of public and private units. However, inappropriate antipsychotic use was more common among those in private care (23/35 (66%) vs. 18/45 (40%); Chi-sq = 5.2, p = 0.02). Prominent inappropriate indications for antipsychotic use were: restlessness (26/41 (63%) patients); history of very intermittent aggression (23 (56%) patients); and wandering (19 (46%) patients). Inappropriate use of antipsychotic medications, as judged by American legislative guidelines, is common in long-stay units in the west of Ireland.