Respite Care For People Research Articles

Distributional Effects of Alternative Strategies for Financing Long-Term Services and Supports and Assisting Family Caregivers

We use two historical data sources – the Health and Retirement Study and the Medicare Current Beneficiary Study – to consider the patterns in older Americans’ severe disability and their use of long-term services and supports (LTSS) by age and socioeconomic status. We then use a dynamic microsimulation model to project how the effects of various interventions to support those with severe disabilities and their caregivers would be distributed across the income distribution. The interventions that we examine fall into three broad classes: tax credits for caregiving expenses, respite care for people in the community with family caregivers, and new social insurance programs. Within each broad class of policies, we examine how sensitive outcomes are to changes in policy details (such as, in the case of tax credits, deductible levels, refundability, and income phase-outs). This paper found that: • Older adults with less education and less wealth are more likely to report disabilities and service use than their more educated and wealthier counterparts. • This pattern persists when we look at people at a point in time but also, more robustly, when we look at their disabilities prospectively. In a sample of older adults who do not report disabilities at baseline, we find that those with fewer economic resources earlier in life are generally more likely to develop disabilities and use paid LTSS over the next two decades, but the differences narrow when we restrict the sample to people who do not develop disabilities until their late 70s. The policy implications of this paper are: • The uneven distribution of disability risks across the population poses challenges for developing effective LTSS policies. Those most likely to need LTSS often lack enough resources to contribute to LTSS programs, and programs that try to contain costs by using underwriting or imposing work requirements often disqualify those who most need coverage. • Certain classes of policies, such as respite care benefits, tend to direct much of their benefits to those in lower income quintiles, according to our projections. Caregiver tax credits and social insurance programs generally distribute benefits more proportionally, although impacts vary depending on how the policies are specified. • Policy design details can significantly affect distributional outcomes. Provisions’ effects can be sensitive to the stacking order in which they are implemented. • It can be useful to examine trends and proposals not only cross-sectionally but also over longer time periods. For example, the distributional effects of social insurance programs depend on the relatively high early-life mortality of those with less education and lower earnings and wealth.

Handover between home and respite care concerning people with dementia: An online survey

Respite care for people with dementia is increasingly promoted. However, little is known about the safety-relevant aspects of handover between home and respite care facilities for people with dementia. We thus focus on the safety-relevant information exchange taking place at the admission to and the discharge from respite care and discuss the need for improvement. A pilot online survey with staff in management positions in different types of respite care facilities in Germany was conducted between April and June 2014. The questionnaire contained 65 (open and closed) questions. The answers were submitted to explorative data analysis using descriptive statistics and qualitative content analysis. 50 respite care facility management staff participated. Nearly half of them reported involving external healthcare professionals (e.g., physicians). The results showed that early identification of informal caregivers or people with dementia in need of support (e.g., so-called red flags) is poorly addressed. Often, there are no medical, medication- and handover-related documents. Information delivery deadlines are not clearly defined. Only 38% of the participating respite care facilities reported regular measurement of the information exchange quality, and only 15% of the management staff reported that they conducted follow-up calls. Most participants reported having standardized procedures. Handover between home and respite care facilities for people with dementia needs to be improved. Information delivery deadlines must be clearly defined. Communication training for respite care staff, including narrative intake methods, could enhance data collection at admission. Overall improved coordination between the parties involved would have a positive impact on safety-relevant aspects of information exchange.

Respite care for people with dementia and their carers

QuestionFor people with dementia and their carers, will respite care (as compared with no respite care or polarity therapy) affect rates of institutionalization?Relevance to nursing careRespite care can be defined as a service or group of services designed to provide temporary periods of relief or r

P128 Does respite care address the needs of palliative care service users and carers?

Research aimsTo explore the perspectives and experience of respite care of married or bereaved palliative care service users and carers and to establish in what ways respite care addresses their...

Menschen mit Demenz zwischen Häuslichkeit und Kurzzeitpflege: Qualitätssicherung settingübergreifender Kommunikation, ein systematischer Review

To identify safety-relevant communication structures and processes considering the handover between home and respite care for people with dementia (PwD). In a systematic review, MEDLINE, -EMBASE, Cochrane Library, CINAHL, PsycINFO and GeroLit were searched for publications indexed until April 2011 including a search via Google and Google scholar. An update for publications indexed between May 2011 and December 2012 was added. A total of 1 832 search results were identified and one relevant publication of a project for PwD to improve the handover between settings was included. With regard to that project, additional literature was identified. The practice-based project identified through the literature search could be suitable to improve handover communication between home and respite care for PwD after further validation. A large gap in the evidence with regard to the research question was identified.

Respite care for people with dementia and their carers.

Caring for someone with dementia can be emotionally and physically demanding. Respite care is any intervention designed to give rest or relief to caregivers. It is not clear what positive and negative effects the provision of respite care may have on people with dementia and their caregivers. To assess the effects of respite care for people with dementia and their caregivers, in particular the effect of respite care on rates of institutionalization. The trials were identified from a last updated search of the Cochrane Dementia and Cognitive Improvement Group's Specialized Register on 2 July 2003 using the terms respite* and "day care". This Register contains up to date records from all major health care databases and many ongoing trial databases. Randomized controlled trials comparing respite care with a control intervention for people with dementia. Both reviewers carried out study selection independently and reached a consensus through discussion. Data was extracted by a single reviewer. The reviewers contacted all investigators for methodological details not reported in the text and for additional data. Three trials were included in the review. They were different in many ways including intervention, duration and outcomes so pooling of data was not possible. Re-analysis of outcomes using data from the published studies found no significant effects of respite care on any variable. Current evidence does not demonstrate any benefits or adverse effects from the use of respite care for people with dementia or their caregivers. These results should be treated with caution, however, as they may reflect the lack of high quality research in this area rather than an actual lack of benefit. Given the frequency with which respite care is advocated and provided, well-designed trials in this area are needed.

Night respite care: relieving the burden on people caring for relatives with dementia.

There are few published reports of night-time respite care for people with dementia. We review the literature on effectiveness of respite care and report on an audit of the Bexley ACE Night Centre. Nighttime respite care is well received by carers who say that it helps them cope better and for longer with relatives who have dementia. Many carers say they would be willing to pay for the service if it were not free. We argue that models of very brief night-time respite should be developed further and researched more fully as they meet an important need of carers.

More and better services for people with learning disabilities

A prevalence study of disability, use of and need for services was undertaken to estimate the need for NHS and other forms of residential, day and respite care for people with severe learning disabilities. Subjects aged 20 or more were drawn from the Leicestershire Learning Disabilities Register (n = 1887). Information was collected by interview with a professional career. The age-specific prevalence was 2.9 per 1000 and the response rate was 88 per cent. A disability rating predicted consultant opinion on need for NHS residential care with a sensitivity and specificity of 82 per cent. Predictive disability factors included problems with behaviour, toileting, speech, epilepsy, postural deformity and use of a wheelchair. Planning targets per 100,000 population aged 20 or more were estimated as follows: NHS residential care--47 places; other residential care--103 places; respite care--36 people; day care--224 places. The need for residential care and medical support remains eminently predictable within the new philosophical framework of provision. Since 1971 the need for NHS residential places has decreased but remains important for people with high dependence. Day care targets have increased and diversified.