Need For Long-term Care Research Articles

Relationship between the subjective age, higher-life function, and new certification as needing long-term care in community-dwelling older adults: The KAGUYA project longitudinal survey of older adults

To determine the relationship between the subjective age, higher-life function, and new certification for the need for long-term care among older adults in the community. A mail survey was conducted in 2016 among community-dwelling older adults, and the 2,323 participants who were available for follow-up in 2019 were included in the analysis. Subjective age was evaluated using the following three items in response to the question "Please answer how old you feel you are": "Same as actual age," "Feel younger," and "Feel older." Other assessments included an evaluation of the higher-life function, Geriatric Depression Scale scores, general self-efficacy, and exercise adherence. In addition, at follow-up, we investigated whether or not participants required new certification for the need for long-term care. At baseline, participants who felt "older than their actual age" had a significantly lower life function and general self-efficacy and were less likely to exercise at least once a week than the other groups. Furthermore, those who felt "older than their actual age" was more likely than the other groups to be newly certified as needing long-term care, while those who felt "younger than their actual age" were less likely to receive new certification. A logistic regression analysis revealed that "feeling older" was a risk factor for being certified as needing long-term care, even after adjusting for other factors (odds ratio= 3.33, 95% confidence interval: 1.02-10.94, p=0.047). Among community-dwelling older adults, those with a subjective age exceeding their chronological age were expected to show a decreased life function in the future and an increased risk of needing long-term care.

All you need to know about sarcopenia: a short guide for an internal medicine physician in questions and answers

Sarcopenia is associated with social, economic, and individual burdens, including loss of independence, poor quality of life, and disability. In a short period of time, ideas about sarcopenia transformed from geriatric syndrome to disease. Initially, sarcopenia was considered in the context of gradual age-related deterioration in the functioning of all physiological systems. Over the years, it became clear that it can develop a second time, as a consequence of various diseases and pathological conditions.To date, there have been no generally accepted diagnostic criteria for sarcopenia. There are several tests and tools available for screening sarcopenia, the choice of which depends on physical capabilities of the patient, capabilities of the medical institution, and the purpose for which it is detected (research or clinical practice).From the point of view of human health, sarcopenia increases the risk of falls and fractures; impairs the ability to perform daily activities; is associated with the progression of major diseases and cognitive impairments; leads to movement disorders; contributes to a decrease in the quality of life, loss of independence or a need for long-term care. The presence of sarcopenia increases both the risk of hospitalization and hospitalization costs.The aim of the literature review is to provide an analysis of up-to-date information on the causes, pathogenesis, screening, diagnosis, treatment, and consequences of sarcopenia, myosteatosis, and sarcopenic obesity. The search for literature containing information on relevant studies was conducted in PubMed and Google Scholar by the following keywords: sarcopenia, dynapenia, myosteatosis, sarcopenic obesity, nutritional status, malnutrition.

Analysis of Factors and the Role of Posyandu Elderly in Influencing the Elderly to Come to Health Services

The increase in the elderly population presents many challenges in the field of health services. The elderly population influences so many aspects of people's lives, one of which is the need for acute and long-term health care. Posyandu for the elderly is a forum for activities from the community and for the community which is supported by cross-sectoral collaboration, and the community health center provides technical support and guidance. Activities at the posyandu include preventive, promotive, curative, and rehabilitative activities. The success of health services for the elderly in the form of promotive, preventive, and curative efforts through means and facilities such as posyandu for the elderly and community health centers is determined to a large extent by the behavior and perspective of the elderly themselves which shape their attitudes and actions in selecting services. So there will be many factors that influence elderly people coming to health services. This research aims to obtain information about the factors and role of elderly posyandu in influencing elderly visits to health service centers. This article method uses a literature review design, namely the researcher reviews, summarizes, and writes down thoughts on several pieces of literature such as articles. The results of this literature review show that factors such as elderly posyandu, finances, social support, knowledge, and physical accessibility influence elderly visits to health services. Understanding these factors can help in designing interventions aimed at improving older adults' access to necessary health services.

Oral Anticoagulant Therapy and Risk of Admission to Long-Term Care in patients With Atrial Fibrillation: A Nationwide Cohort Study.

The impact of oral anticoagulants (OACs) on the need of long-term care (LTC) in the aging and multimorbid population of patients with atrial fibrillation (AF) is unknown. We conducted a nationwide cohort study to evaluate the effect of OACs on the need of LTC. Retrospective nationwide cohort study. The registry-based FinACAF cohort study covers all patients with incident AF from all levels of care in Finland from 2007 to 2018, as well as all their OAC purchases, LTC admissions, and information on previous home care acuity. Incidence rate ratios (IRRs) of LTC admission were calculated using Poisson regression models with a Lexis-type data structure based on 3 time scales: follow-up time from AF diagnosis, calendar year, and age. We identified 188,752 patients (49.0% female; mean age 71.4years; mean follow-up 3.6years) with incident AF without prior LTC, of whom 143,534 (76.0 %) initiated OAC therapy and 11,775 (6.2 %) were admitted to LTC. OAC therapy was associated with lower rates of LTC admission (adjusted IRR 0.79, 95% CI 0.76-0.82). When compared to warfarin, direct oral anticoagulants (DOACs) were associated with lower LTC admission rate (adjusted IRR 0.69, 95% CI 0.61-0.79). No significant disparities were observed between different DOACs. OAC therapy, particularly with DOACs, is associated with a substantially lower risk of admission to LTC in patients with AF. Increasing guideline-based OAC coverage among patients with AF may prevent the need of LTC, lengthen survival at home, and potentially decrease health care costs.

Evaluation of the efficiency of the program of combined psychocorrection of the persons performing the function of caring for patients with dementia

The purpose of this work was to evaluate the effectiveness of the step-by-step psychocorrection program for caregivers of patients with dementia by studying the dynamics of clinicalpsychopathological manifestations and the level of social functioning. With the help of sociodemographic, clinical-psychopathological, psychodiagnostic and statistical examination methods, 104 caregivers (100 women, 4 men) and 104 patients with dementia were examined on the basis of the PI “Regional institution for the provision of psychiatric care of the Poltava Regional Council”. Caregiver inclusion criteria were: signed informed consent, age of caregivers 25 years or older, caring for one patient with dementia and being with him at least 5 times a week, at least 4 hours a day. According to modern clinical interpretations, dementia is a clinical syndrome, usually chronic or prone to progression, characterized by a complex of manifestations in the form of disorders of memory, attention, thinking, gnosis, praxis, speech, psyche, behavior, social functioning and a pronounced decrease in the quality of life. The lack of formed pro-social networks and the lack of social support, both from the family and from friends, makes caregivers more vulnerable to stress factors. The obtained data were used as a basis for the development of a programs of complex phased psychocorrection. In a situation of deterioration of the patient's condition, the burden on the caregiver also increases. The fact of maladjustment of patients with dementia is a very relevant issue, because this disease not only reduces the quality of life of patients, but also leads to large non-material and material costs due to the need for long-term and constant care for a sick relative with a severe or moderate course of dementia. Key words: rehabilitation, anxiety, psycho-emotional stress, comprehensive therapy, dementia, psychosocial maladaptation

The Moderating Role of Psychological Safety in the Relationship between Job Embeddedness, Organizational Commitment, and Retention Intention among Home Care Attendants in Taiwan.

As Taiwan's population ages, the need for long-term care, such as home care, is increasing due to improved medical services and longer life expectancy; however, the current coverage rate for home care services is only 50%, highlighting the importance of retaining home care workers. This study applies job embeddedness, organizational commitment, and psychological safety as variables to explore the retention intention of Taiwan's home care workers. A questionnaire survey was distributed among home care workers using convenience sampling, resulting in 547 collected questionnaires, of which 458 were valid. Data analysis was conducted with SPSS 22.0 and AMOS 22.0, and a structural equation model (SEM) was used to test the hypotheses. Our findings suggest that job embeddedness has a positive impact on organizational commitment (γ = 0.649, γ = 0.607, and γ = 0.628; p < 0.001) and retention intention (γ = 0.253, γ = 0.242, γ = 0.271; p < 0.001), similar to organizational commitment (γ = 0.721, p < 0.001). Additionally, organizational commitment mediates job embeddedness and retention intention, while psychological safety moderated organizational commitment and retention intention (β = 0.639; p < 0.001). This study aims to provide information for the development of more effective human resource policies and contribute to practical advancements in the home care service environment and management structure of home care organizations. By analyzing and exploring the main factors contributing to home care workers' retention intention, we hope to enhance the overall benefits of home service organizations and the industry.

Distinct effects of community-based activities on long-term care needs: A study using zero-inflated Poisson regression

Social isolation among older adults is a major concern in countries where the need for long-term care (LTC) has increased. However, no previous observational study has identified which community-based activities can reduce the LTC needs of older adults. Our study fills the gap between interventional and observational studies. Data were drawn from a survey of LTC insurance needs in A city in Fukuoka Prefecture, Japan. A city is one of the municipalities participating in the longevity improvement and fair evidence (LIFE) study that provides data from government-administered LTC insurance enrollees and public assistance recipients. To measure the precise impact of self-assessed poor health (SAPH) on the needs of LTC by living arrangements, we adopted the two-stage residual inclusion approach and estimated zero-inflated Poisson (ZIP) models. We uncovered two major findings. First, the results of ZIP models showed that the magnitude of the impact of SAPH on the LTC needs of older adults living alone was five times that of older adults living with other family members. Second, participation in community-based care prevention can reduce LTC needs among older adults living alone. The same effect was not observed in older adults cohabiting with family members. Although older adults tend to refrain from going out when their subjective health is poor, the top strategy for reduction of LTC needs is the promotion of participation in community-based care prevention for older adults living alone.

A holistic approach to assessing an individual with urinary incontinence.

Urinary incontinence can have an overwhelmingly negative impact on an individual's quality of life. The personal, physical, psychosocial and sexual implications of urinary incontinence can affect health and well-being. This can increase the risk of falls, depression, anxiety, social isolation alongside a greater need for long-term care from a individual's own home. Statically, the prevalence rates of urinary incontinence increases with age; however, incontinence is not an inevitable or acceptable part of ageing-symptoms can be improved and managed effectively for suffers of this common condition. Urinary incontinence can be challenging to assess, address and overcome for individuals. However health professionals need to have the expertise and experience to undertake a comprehensive continence assessment. When assessment is completed evidence-based interventions can be recommended, implemented and subsequently evaluated.

How do South Asian seniors in a large Canadian city perceive long-term care?

To understand how community-dwelling South Asian older adults understand and envision long-term care (LTC). Descriptive qualitative study. The Region of Waterloo in Ontario. Participants included 3 key informants (geriatrician, social worker, and medical translator, all South Asian), 1 family caregiver, and 15 community-dwelling South Asian adults aged 65 and older. In-depth interviews and focus groups were recorded, transcribed verbatim, and analyzed using a framework analysis approach. High-level themes included the emotional impacts of failure to provide culturally competent care, such as fear and isolation; a desire for a model of culturally competent care with an emphasis on food and language; and the need for LTC to be more integrated with the broader community and connected to families. As the delivery of LTC is rethought in this country, there is the potential to deliver on the promise of culturally competent care for this growing population. These findings are among the first to communicate the LTC care needs of South Asian older adults in their own words.

The Need for Long-Term Physiotherapeutic Care in Patients with Multiple Sclerosis

The Need for Long-Term Physiotherapeutic Care in Patients with Multiple Sclerosis

COVID-19 or threat of a nuclear war in Europe? A cross-sectional study of anxiety levels in adults living in Portugal.

Since 2019, Europe has experienced ongoing stressors with the emergence of the COVID-19 pandemic and the Russian-Ukrainian War, which have had social, financial, physical, and psychological impacts. Studies suggest that anxiety, fear, post-traumatic stress disorder, depression, and other psychological disorders are common in such situations, and there is a need for more research on the impact of the war on mental health in Portugal. The main goal of the present study was to assess the impact of the fear of COVID-19 and anxiety related to nuclear war on the general anxiety levels of adult individuals living in Portugal. A cross-sectional study was conducted from May to July 2022 using an online questionnaire built on the Google Forms platform. Portuguese-speaking male and female individuals aged 18 years or older, who provided informed consent and agreed to participate, were included. The outcome variable was defined using the Portuguese version of the GAD-7 scale, while the main predictors were the FCV-19S and the NWA Scale in Portuguese. Linear and logistic regression models were used to test associations between predictors and outcome variable. The study included 1,182 participants, with a mean age of 46.5 (±11.7) years, mostly women (80.6%). The global mean GAD-7 score was 5.8 (±4.5) points, and 17.9% of the participants scored above the 10-point cutoff. Higher scores were found in both the FCV-19S and the NWA scale among participants with anxiety, as measured by both a 10-point cutoff (p < 0.001), and GAD-7 scale mean scores (p < 0.001). The study showed that fear of COVID-19 [OR of 1.133 (95%CI: 1.097-1.170)] and, at a lesser extent, nuclear war anxiety [OR of 1.020 (95%CI, 1.009-1.031)] contribute to anxiety in the general population. This is also true for those with a personal history of anxiety, revealed by multiple regression. This study contributes to the research on COVID-19's impact on anxiety and provides the first comprehensive assessment of nuclear war anxiety in Portugal. Results highlight the need for long-term care for anxiety, as prevalence is expected to increase due to the pandemic and war, even in non-conflict areas like Portugal.

Sporadic Use of Antibiotics in Older Adults and the Risk of Dementia: A Nested Case-Control Study Based on German Health Claims Data.

Antibiotics for systemic use may increase the risk of neurodegeneration, yet antibiotic therapy may be able to halt or mitigate an episode of neurodegenerative decline. To investigate the association of sporadic use of antibiotics and subsequent dementia risk (including Alzheimer's disease). We used data from the largest public health insurance fund in Germany, the Allgemeine Ortskrankenkasse (AOK). Each of the 35,072 dementia cases aged 60 years and older with a new dementia diagnosis during the observation period from 2006 to 2018 was matched with two control-patients by age, sex, and time since 2006. We ran conditional logistic regression models for dementia risk in terms of odds ratios (OR) as a function of antibiotic use for the entire antibiotic group and for each antibiotic subgroup. We controlled for comorbidities, need for long-term care, hospitalizations, and nursing home placement. Antibiotic use was positively associated with dementia (OR = 1.18, 95% confidence interval (95% CI):1.14-1.22), which became negative after adjustment for comorbidities, at least one diagnosis of bacterial infection or disease, and covariates (OR = 0.93, 95% CI:0.90-0.96). Subgroups of antibiotics were also negatively associated with dementia after controlling for covariates: tetracyclines (OR = 0.94, 95% CI:0.90-0.98), beta-lactam antibacterials, penicillins (OR = 0.93, 95% CI:0.90-0.97), other beta-lactam antibacterials (OR = 0.92, 95% CI:0.88-0.95), macrolides, lincosamides, and streptogramins (OR = 0.88, 95% CI:0.85-0.92), and quinolone antibacterials (OR = 0.96, 95% CI:0.92-0.99). Our results suggest that there was a decreased likelihood of dementia for preceding antibiotic use. The benefits of antibiotics in reducing inflammation and thus the risk of dementia need to be carefully weighed against the increase in antibiotic resistance.

Controlling Spending For Health Care And Long-Term Care: Japan's Experience With A Rapidly Aging Society.

As the Japanese population has aged rapidly, Japan's experience has implications for other high-income countries, including the United States. The aging of Japan's population, coupled with the government's decision to implement a public long-term care insurance program in 2000, has increased the nation's expenditures. In acute care, costs have been relatively contained by biennially revising the fee schedule for all physician and hospital services and by lowering pharmaceutical prices. The fee schedule not only sets prices but also controls volume by setting the conditions of billing for each item. This fee schedule is applied to all social health insurance plans (which enroll all permanent residents of Japan) and to virtually all providers. In contrast, despite the use of a similar fee schedule, spending in long-term care insurance has increased more than spending in health care. This is both because long-term care became an entitlement and because aging has had a greater impact on long-term care insurance spending than on health insurance spending. In this article we analyze Japanese expenditure data to provide essential information to the US as the percentage of its population ages sixty-five and older continues to rise. A key lesson that the US can learn from Japan's experience is that as its population ages, the need for long-term care will increase, necessitating better control of acute care spending.

Evaluating the Impact of Workplace Friendship on Social Loafing in Long-Term Care Institutions: An Empirical Study

In light of the aging population and the rapid growth of people with mental and physical disabilities, the demand for long-term care has increased significantly. In order to meet the massive need for long-term care, the government of the Republic of China has accelerated the training of manpower for care services, and the number of qualified staff and institutions in the long-term care industry has increased accordingly. Although the need for long-term care employees has increased, they face problems such as low pay, low levels of decent work feelings, and high work pressure. Moreover, the increase in employee numbers in the organization does not improve the overall efficiency of long-term care workers. Instead, it has a social loafing effect. Not only in Taiwan, but other countries worldwide, such as Japan, Korea, Singapore, Hong Kong, and the United Arab Emirates, are experiencing a staff shortage, a lack of training, and social loafing in long-term care institutions due to the aging of their populations. Therefore, in this study, workplace friendship as the independent variable, organizational commitment and psychological safety as the mediating variables, and service climate as the moderating variable were used to investigate the effects of social loafing on the employees of long-term care institutions in Taiwan. The results showed that workplace friendship between employees positively and significantly affects organizational commitment and psychological safety. Moreover, organizational commitment and psychological safety will negatively and significantly affect their social loafing. Second, organizational commitment and psychological safety have mediating effects between workplace friendship and social loafing. Furthermore, the service climate of employees in long-term care institutions will positively moderate the impact of their workplace friendship on psychological safety. The results will be provided to those in charge of the long-term care service industry, training institutions, long-term care business-related organizations, and government agencies, as well as for reference in subsequent studies.

Equitable, sustainable and acceptable long-term care in Malawi? Unpacking the implied universalism of key terms in international ageing policy discourse

Indications of a care deficit for older adults in Africa and the need for long-term care that is acceptable for recipients and providers is well established, as are calls for its format to be ‘home-grown’. However, there is a discrepancy between the desire for evidenced African solutions, and the framing of both the problem and possible solutions derived from the Global North. This article draws on qualitative data from men and women needing and providing care in rural southern Malawi to challenge the implied universalism of the key terms of reference in the African long-term care discourse: ‘care’ and ‘family’.

Device-Aided Therapies in Parkinson's Disease-Results from the German Care4PD Study.

Data on the use of device-aided therapies (DATs) in people with Parkinson's disease (PwP) are scarce. Analyzing data from the Care4PD patient survey, we (1) evaluated application frequency and type of DAT in a larger, nationwide, cross-sectoral PwP sample in Germany; (2) analyzed the frequency of symptoms indicative for advanced PD (aPD) and need for DAT amongst the remaining patients and (3) compared the most bothersome symptoms and need for professional long-term care (LTC) of patients with and without suspected aPD. Data from 1269 PwP were analyzed. In total, 153 PwP (12%) received DAT, mainly deep brain stimulation (DBS). Of the remaining 1116 PwP without DAT, >50% fulfilled at least one aPD criterion. Akinesia/rigidity and autonomic problems were most bothersome for PwP with and without suspected aPD, with more tremor in the non-aPD and more motor fluctuations and falls in the aPD group. To recapitulate, the German DAT application rate is rather low, although a large proportion of PwP fulfills aPD criteria indicating a need for intensified treatment strategies. Many reported bothersome symptoms could be overcome with DAT with benefits even for LTC patients. Thus, precise and early identification of aPD symptoms (and therapy-resistant tremor) should be implemented in future DAT preselection tools and educational trainings.

Long-term care need, loneliness, and perceived social isolation during the COVID-19 pandemic: evidence from the German Ageing Survey

BackgroundThere is a complete lack of studies focusing on the association between care degree (reflecting the long-term care need) and loneliness or social isolation in Germany.AimsTo investigate the association between care degree and loneliness as well as perceived social isolation during the COVID-19 pandemic.MethodsWe used data from the nationally representative German Ageing Survey, which covers community-dwelling middle-aged and older individuals aged 40 years or over. We used wave 8 of the German Ageing Survey (analytical sample: n = 4334 individuals, mean age was 68.9 years, SD: 10.2 years; range 46–100 years). To assess loneliness, the De Jong Gierveld instrument was used. To assess perceived social isolation, the Bude and Lantermann instrument was used. Moreover, the level of care was used as a key independent variable (absence of care degree (0); care degree 1–5).ResultsAfter adjusting for various covariates, regressions showed that there were no significant differences between individuals without a care degree and individuals with a care degree of 1 or 2 in terms of loneliness and perceived social isolation. In contrast, individuals with a care degree of 3 or 4 had higher loneliness (β = 0.23, p = 0.034) and higher perceived social isolation scores (β = 0.38, p < 0.01) compared to individuals without a care degree.Discussion/conclusionsCare degrees of 3 or 4 are associated with higher levels of both loneliness and perceived social isolation. Longitudinal studies are required to confirm this association.

Screening Risks of Alcohol Abuse, Depressive Symptoms, and Decreased Health-Related Quality of Life in Post-Bariatric Patients and Their Relations to Weight Regain.

Not all patients who underwent bariatric surgery keep their regular medical follow-up. We screened alcohol use, depressive symptoms, and health-related quality of life (HRQoL) in post-bariatric patients who have lost medical follow-up at their first appointment in our healthcare unit. These screened disorders were compared between low vs. high ratios of weight regain (RWR) and correlated with surgical outcomes. Ninety-four post-bariatric patients without medical follow-up (87.2% female, aged 42 ± 9 years, BMI = 32.9 ± 6.5kg/m2) were included. They underwent Roux-en-Y gastric bypass (n = 80) or sleeve gastrectomy (n = 14). They were divided into high RWR (≥ 20%) and low RWR (< 20%) groups. We used Alcohol Use Disorders Inventory Test, Beck Depression Inventory, and 36-Item Short-Form Health Survey. Neck and waist circumferences, diastolic blood pressure, and time since surgery were higher in the high than low RWR group (P≤ 0.05). No differences between groups for alcohol use and depressive symptoms were detected (P≥ 0.07), but those who regained more weight exhibited poorer health scores in physical functioning, physical role limitations, bodily pain, and vitality (P≤ 0.05). In the low RWR group, the RWR was inversely correlated to physical/social functioning and vitality. Positive associations were present between RWR vs. depressive symptoms, while negative ones were noted to physical functioning and general health perception in the high RWR group. HRQoL has deteriorated in those post-bariatric patients without medical follow-up who regained more weight, possibly indicating the need for regular long-term health care.

Public long-term care insurance and consumption of elderly households: Evidence from China

This study investigates the impact of long-term care insurance (LTCI) on the non-health consumption of elderly households. By exploiting a quasi-experiment on the public LTCI pilot program in China, we identify the effect of LTCI using a triple-difference approach. Using longitudinal data from the China Health and Retirement Longitudinal Study, we find that LTCI has led to an increase in the non-health consumption of elderly households by 15.7%, mostly observed in households having no older members with need for long-term care (LTC). Further evidence suggests that the effects are stronger for households with higher expected LTC risks, less wealth or family insurance, and covered by more generous schemes. Finally, LTCI increases the expectation of using formal LTC when disabled and subjective longevity expectations for older adults having no need for LTC. Overall, these findings offer empirical support for the role of LTCI in mitigating precautionary savings against LTC risks.

Integrating Fuzzy AHP and TOPSIS Methods to Evaluate Operation Efficiency of Daycare Centers

As the population ages and families become less able to offer care, the need for long-term care among older people increases. Evaluation of daycare centers, which provide localized long-term care services, is essential for the growth and direction of these institutions. Nevertheless, the present evaluation indexes do not adequately emphasize the significance of each index item or the actual effectiveness of an organization’s operations and management. To solve this issue, the purpose of this research was to develop an evaluation model for the operation and administration of daycare centers. Experts were consulted to collect pertinent criteria, which were further assessed using the Fuzzy Analytic Hierarchy Process (FAHP) and the Technique for Order Preference by Similarity to the Ideal Solution (TOPSIS) techniques. The results indicated that organizational operation management was the top priority, with administrative operation management and service quality management having the largest impact on productivity. Among the 10 daycare services tested, Institution 3 was judged to have the highest score. These findings shed light on the operational management effectiveness of daycare centers and give a novel evaluation methodology for gauging the efficacy of nursing management.