Journal articles: 'Life care communities'

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Winklevoss, Howard A. "Continuing Care Retirement Communities:." Journal of Housing For the Elderly 3, no. 1-2 (January 20, 1986): 57–64. http://dx.doi.org/10.1300/j081v03n01_06.

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Simson, Sharon. "Educational Affiliations of Life Care Communities." Gerontology & Geriatrics Education 7, no. 2 (November 13, 1987): 9–20. http://dx.doi.org/10.1300/j021v07n02_02.

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Schaffer, Talia. "Care Communities." South Atlantic Quarterly 118, no. 3 (July 1, 2019): 521–42. http://dx.doi.org/10.1215/00382876-7616139.

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The feminist philosophy of “ethics of care” has been important for disability studies inasmuch as it helps us see caregiving as widespread and admirable, rather than as a failure of autonomy. Care ethicists usually imagine care as either an institutional situation or an intimate dyad. However, in “Critical Care,” I add a third case in a midrange scale: the care community. The care community is a voluntary social formation, composed of friends, family, and neighbors, that coalesces around someone in need. It is my contention that by exploring the care community, we can make important aspects of care visible and rethink care relationships. What we see in care communities is a process, rather than a preset care structure, and that fluidity allows us to interrogate the conditions under which care can develop and the dynamics of extended care. I use Victorian fiction to showcase care communities, since novels of this period are marked by ubiquitous spontaneous small groups forming around people who are ill or hurt, but I also make a case that care communities continue to exist today, particularly among queer communities and people of color, performing a vital function in our ordinary lives. Finally, I argue that care communities can help us fundamentally rethink disability as a need like any other need rather than an inherent identity. Eva Feder Kittay has argued that care relations are the foundation of civic society; in that case, disability and the care community that arises in response to it are not marginalized cases but are what, profoundly, makes social life possible.

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Abel, Julian. "Compassionate communities and end-of-life care." Clinical Medicine 18, no. 1 (February 2018): 6–8. http://dx.doi.org/10.7861/clinmedicine.18-1-6.

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Anonymous. "Life Care Communities Offer an Array of Alternatives." Journal of Gerontological Nursing 16, no. 5 (May 1990): 44. http://dx.doi.org/10.3928/0098-9134-19900501-18.

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Benner, P. "Breathing new life into practice communities." American Journal of Critical Care 10, no. 3 (May 1, 2001): 188–90. http://dx.doi.org/10.4037/ajcc2001.10.3.188.

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Holmes, Sarah, and Kirsten Corazzini. "PROVIDING DEMENTIA CARE ACROSS LOW-RESOURCE COMMUNITIES." Innovation in Aging 7, Supplement_1 (December 1, 2023): 580. http://dx.doi.org/10.1093/geroni/igad104.1897.

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Abstract The growing number of persons living with dementia (PLWD) require ongoing care and supportive services, but dementia care access and quality are more limited in communities with fewer health resources and these limitations are exacerbated by current dementia care workforce shortages. Across low-resource communities—including poorer urban and rural settings—health resources tend to be limited and PLWD are predominantly socioeconomically disadvantaged and have few personal financial resources to contribute to care provision. Although there is growing evidence about the consequences of care inequities for PLWD, less is known about key issues and opportunities for improving dementia care in low-resource communities. This symposium features presentations that highlight unique social and economic challenges and opportunities for providing dementia care in low-resource communities. The first presenter reports results from a community-based, participatory research study in four long-term care settings in federally designated medically underserved areas (two rural, two urban) that highlights strategies used by long-term care providers to recruit and retain dementia care staff and describes their perspectives on quality dementia care. The second presenter shares findings from an innovative pilot program of case management services to address challenges of PLWD who are living alone in the community through collaboration with local paramedicine services. The third presenter provides an overview of the Person-Centered Options Counseling Certification program with a discussion on strategies for implementing person-centered dementia care initiatives in low-resource communities. This symposium reveals complexities in providing care for PLWD in diverse low-resource communities and generates directions for addressing dementia care inequities.

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Bishop, Christine E. "Features of Lower-Cost Continuing Care Retirement Communities." Journal of Housing For the Elderly 7, no. 1 (January 11, 1991): 55–78. http://dx.doi.org/10.1300/j081v07n01_05.

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Koltz, Daniel, and Rebecca Koltz. "SUCCESSFUL TRANSITIONS TO LONG-TERM CARE COMMUNITIES." Innovation in Aging 6, Supplement_1 (November 1, 2022): 701. http://dx.doi.org/10.1093/geroni/igac059.2566.

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Abstract Older adults who transition to independent and assisted-living communities perceive their transition experience differently. This research focused on understanding what factors were predominant for a successful transition from a long-time home to a dependent living community. A constructivist grounded theory method was used to explore the experiences of 18 older adults who had relocated within the past year. The participants of this study were aged 65-95 years and are equally represented by gender. Equal numbers of respondents transitioned into independent and assisted-living accommodations. Five factors related to a central concept of behavioral attitude were found to be key for a successful transition. When an older adult reported a successful transition, their behavioral attitude was positive about their new living environment. The five factors that contributed to their positive attitude are creating a new place, increased community integration, sense of safety and security, independence while dependent, and accepting a new life stage. The theory that emerged from the research emphasizes that when an older adult has increased awareness about the five factors associated with adapting to a dependent living community, this awareness will promote a positive behavioral attitude and increase the opportunity for success during and after a transition. Family members, LTC community administrators and social workers could all benefit from understanding these factors for a successful transition. Enhancing a positive experience for an older adult and improving their behavioral attitude toward the new transition.

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Nyman, John A. "Continuing Care Retirement Communities and Efficiency in the Financing of Long-Term Care." Journal of Aging & Social Policy 11, no. 2-3 (September 11, 2000): 89–98. http://dx.doi.org/10.1300/j031v11n02_10.

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Kellehear, A. "Compassionate communities: end-of-life care as everyone's responsibility." QJM 106, no. 12 (September 30, 2013): 1071–75. http://dx.doi.org/10.1093/qjmed/hct200.

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Jervis, Lori L., and Derrell W. Cox. "END-OF-LIFE SERVICES IN TRIBAL COMMUNITIES." Innovation in Aging 3, Supplement_1 (November 2019): S667—S668. http://dx.doi.org/10.1093/geroni/igz038.2469.

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Abstract Terminally ill American Indians/Alaska Natives (AI/ANs) are less likely to receive hospice and palliative care than other racial/ethnic groups, with fewer than 1/3 receiving these services compared to over 45% of EuroAmericans (Johnson, 2013; NHPCO, 2017). While some AI/ANs believe that End of Life (EoL) services will hasten their deaths (Colclough & Brown, 2014), claims that Natives reject EoL services due to death taboos are likely overgeneralizations. Rather, extant studies point to barriers to access resulting from lack of financial resources and inadequate service infrastructure, especially in rural areas (Jervis, Jackson, & Manson, 2002; Kitzes & Berger, 2004; Kitzes & Domer, 2004; Weech-Maldonado et al., 2003). While these factors undoubtedly play a role in underutilization, our preliminary research suggests that other factors—such as a lack of tribally based EoL programs and the cultural mismatches that occur when non-Native programs attempt to deliver hospice services to Native clients—may discourage AIANs from seeking and/or retaining these services. In this presentation, we report on results from a nationwide telephone survey of the availability of EoL care across AIAN tribes. We also present findings from in-depth interviews with local service providers on the challenges and successes they experienced in providing EoL care to their AI clients in one tribal community. Together, these findings will add to our growing understanding of the factors that inhibit and facilitate EoL service utilization, and suggest possibilities for improving access.

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Sambol, Daniel, Craig Duncan, and Melvin Katz. "Programmatic and Operational Issues of Continuing Care Retirement Communities." Journal of Housing For the Elderly 3, no. 1-2 (January 20, 1986): 123–30. http://dx.doi.org/10.1300/j081v03n01_15.

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Nichols, Sarah W. "Examining the Impact of Spiritual Care in Long-Term Care." OMEGA - Journal of Death and Dying 67, no. 1-2 (August 2013): 175–84. http://dx.doi.org/10.2190/om.67.1-2.u.

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This project examines the effects of spiritual care on chronically ill and aging populations and those who care for them by studying the development of a comprehensive Pastoral Care Program at Episcopal Communities & Services (ECS), a nonprofit that owns two Continuing Care Retirement Communities (CCRC) in Southern California (in 2010 ECS operated three communities). The study includes the vision, methodology, and specific steps taken to implement this spiritual care program and methods to measure its efficacy. Data is analyzed from satisfaction surveys conducted the year before the program's introduction and surveys taken 2 and 4 years after the institution of the Pastoral Care Program, along with anecdotal findings. Results indicated that spiritual awareness and satisfaction increased throughout the resident population after the Pastoral Care Program's establishment and that satisfaction levels continued to improve as the program developed over time. This study suggests that spiritual support (both religious and nonreligious) is a vital factor in well-being and quality of life at the end of life and that transdisciplinary palliative care is needed in long-term care settings to address spiritual and psychosocial needs.

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Abken, Elise, Molly Perkins, and Alexis Bender. "Assisted Living Administrators' Views of Palliative Care." Innovation in Aging 5, Supplement_1 (December 1, 2021): 899. http://dx.doi.org/10.1093/geroni/igab046.3264.

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Abstract As many older adults with progressive chronic conditions choose to age-in-place in assisted living (AL) communities, external healthcare workers (e.g., those who provide palliative care) increasingly support AL staff in caring for residents with complex health needs. Palliative care is a branch of healthcare dedicated to preserving quality of life by attending to the physical, mental, and spiritual needs of individuals with chronic, life-threatening diseases and is well suited to manage AL residents’ progressive medical conditions. However, AL residents and their care partners often face barriers to accessing palliative care. Using data from a larger 5-year NIA-funded study, we examined AL administrator knowledge and use of palliative care in seven AL communities around the Atlanta metropolitan area that were racially, ethnically, and socioeconomically diverse. Findings from thematic analysis of semi-structured interviews with 16 administrators indicated that 15 of 16 administrators were familiar with palliative care. A minority of administrators clearly distinguished palliative care from hospice services and conceptualized it as a “bridge” to hospice services. Administrators emphasized how palliative care assists communities in caring for health concerns in-house rather than having to send residents to the hospital. Despite their positive view of palliative care, administrators described infrequent use of palliative services in their communities. Findings show that although none of the AL communities integrate palliative care with their service offerings, AL administrators see value in palliative care for their residents. We provide recommendations for improving palliative care access and quality of life for AL residents at end of life.

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Prophater, Lorna, Boeun Kim, Basia Belza, Sarah Cameron, and Sam Fazio. "Dementia Care Coaching: A Pilot to Evaluate Acceptability and Feasibility in Care Communities." Innovation in Aging 5, Supplement_1 (December 1, 2021): 847. http://dx.doi.org/10.1093/geroni/igab046.3098.

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Abstract The Alzheimer’s Association (AA) Dementia Care Practice Recommendations (DCPR) outline ten recommendations to achieve quality care with a person-centered focus. The AA has developed tools to assist care communities (CC) to evaluate their status within the recommendations by working with a trained coach to maximize adoption and implementation of these recommendations. The purpose of this pilot was to evaluate the acceptability and feasibility of pairing trained DCPR coaches with CC teams to implement the DCPR tools. Seven CCs were recruited and four received the DCPR overview and self-assessment. Of the four CC, one withdrew and did not receive the intervention. The remaining three were located in a suburban area, nonprofit, and with memory care units. Data was collected from November 2019 through March 2020. Nine CC staff participated with a mean age 35.8 years and had worked for 11.8 years. Baseline mean scores on the Organizational Readiness to Implementing Change (ORIC) scale were 4.6 for the commitment domain and 4.4 for the efficacy domain. Mean scores on the Nursing Home Employee Satisfaction Survey were high. Sixty-nine percent of CC participants were satisfied with their jobs (greater than 4). Findings from mid-project interviews with the coaches revealed difficulty with scheduling appointments, significant efforts needed to get the “right” people at the table and need for the DCPR tools to be more user-friendly. No post-intervention results were collected due to closing of the CCs to visitors due to COVID. The DCPR tools shows promise and are being evaluated in additional CCs.

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Bowers, Barbara J. "Continuing Care Retirement Communities' Response to Residents Aging in Place:." Journal of Housing For the Elderly 5, no. 2 (May 11, 1989): 65–77. http://dx.doi.org/10.1300/j081v05n02_06.

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Hua, Cassandra. "Comparing Loneliness Among Individuals in Long-Term Care Settings and the Community." Innovation in Aging 5, Supplement_1 (December 1, 2021): 577. http://dx.doi.org/10.1093/geroni/igab046.2214.

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Abstract We used the NHATS COVID-19 module to examine whether individuals in long-term care communities were lonelier than individuals in the community during the pandemic. Additionally, we examined whether individuals in long-term care communities with more restrictive policies concerning visitors and communal activities were more likely to experience loneliness than individuals in communities with less restrictive policies. Approximately 45% of individuals in long-term care communities (n=134) felt at least a moderate amount of loneliness during COVID-19 when compared to 34% of individuals in the community (n= 2,666) (p<.05). However, the association was no longer statistically significant after adjusting for age, race, and sex. Among individuals in long-term care communities with the most restrictive policies, 48% experienced loneliness compared to 44% individuals in less restrictive communities. However, this finding was not statistically significant. Discussion will focus on similarities and differences within these populations that could have led to these results.

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Kartupelis, Jenny. "Exploring the Dynamics of Spiritual Life in Residential Care Communities." Journal for the Study of Spirituality 5, no. 2 (July 3, 2015): 170–77. http://dx.doi.org/10.1179/2044024315z.00000000049.

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Netting, F. Ellen. "The Meaning of Church Affiliation for Continuum of Care Retirement Communities." Journal of Religious Gerontology 8, no. 2 (April 20, 1992): 79–99. http://dx.doi.org/10.1300/j078v08n02_06.

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Coonan-Byrom, Anna. "Connections and care: newborn life transitions." Practising midwife Australia 1, no. 1 (September 1, 2022): 19. http://dx.doi.org/10.55975/ghnb3308.

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The birth of a new life holds significance across all cultures, communities, families and parents. Human newborns, like many infant mammals, are born sentient, learning and expectant of love, nourishment and nurturing relationships.1 Healthy infants are born with unique adaptations that optimise their survival, prompting care-giving behaviours in their mothers and/or parents.2 Understanding what neonates need is important to midwives and those caring for families, at birth and in the weeks and months that follow. In this topic highlight, we look at the newborn’s sensory needs with a focus on human consciousness, connections and care.

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Lampe, Nik, Harry Barbee, Nathaniel Tran, and Tara McKay. "FAITH, SOCIAL SUPPORT, AND END-OF-LIFE CARE PREPARATION AMONG LGBTQ+ OLDER ADULTS." Innovation in Aging 7, Supplement_1 (December 1, 2023): 412. http://dx.doi.org/10.1093/geroni/igad104.1363.

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Abstract Faith communities can provide older adults support as they plan for end-of-life care, but how this support unfolds for lesbian, gay, bisexual, transgender, and queer (LGBTQ+) people is uncertain. Although many LGBTQ+ people experience marginalization within faith communities, they also report experiences of acceptance and affirmation. This mixed-methods study investigates how LGBTQ+ older adults’ involvement in faith communities shape their end-of-life care perceptions and preparation. First, we analyze panel data from the Vanderbilt University Social Networks, Aging, and Policy Study (N=1,256) to assess the relationship between faith community involvement and levels of social support. We find that 63% of older LGBTQ+ respondents identify with a religious affiliation, and 31% attend religious services several times a year or more. Attending religious services several times a year are more is associated with having a spouse in the household (11.4 vs 7.1%, p<.05) and reporting larger personal networks (11.7 vs 9.9 individuals; p<.001). Service attendance is also associated with having support when seeking advice about important decisions and having social support from friends. In the second portion of our study, we analyze data from in-depth interviews with 47 LGBTQ+ older adults to understand how faith communities influence preparation for end-of-life care. Many interviewees described their faith communities as guides that help them select reliable healthcare providers and formulate their end-of-life care plans. Overall, these findings reveal important ways that faith communities can foster social support and promote optimal end-of-life care among older LGBTQ+ adults.

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Jennings, Lee, Teri Round, Diana Sturdevant, and Keith Kleszynski. "AN AGE-FRIENDLY NURSING HOME PROJECT ECHO IN RURAL COMMUNITIES." Innovation in Aging 6, Supplement_1 (November 1, 2022): 755. http://dx.doi.org/10.1093/geroni/igac059.2743.

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Abstract We launched an Age-Friendly Nursing Home Project ECHO in October 2021 focused on the 4Ms (mobility, medications, mentation, what matters most) with emphasis on dementia and QI in long-term care. One-hour virtual sessions included a short expert presentation and case discussion, were offered twice weekly, and recordings were posted online. Topics included person-centered care, advance care planning, LGBTQIA+ care, fall prevention, medication reduction, dementia resident activities, oral health, skin integrity, staff retention, COVID-19, PDSA cycles, root cause analysis, team huddles, among others. 235 individuals from 80 nursing homes, 19 ALFs, 6 continuing care communities, and 10 VA-affiliated sites in 5 states (OK, AR, KS, MO, CO) participated in the first four 6-week ECHO series; 27% attended ≥2 series. Most attendees were nursing home administrators (46%), directors of nursing (20%), nursing assistants (12%), or activity directors (11%). Most were female (91%) and worked in rural settings (77%). 237 attended an additional COVID-19 update session. 152 participants (65%) completed an evaluation. 91% rated the program as valuable (score≥8/10); 99% would recommend to others; 57% discussed topics with colleagues; 59% reviewed materials after sessions; 25% implemented new QI processes; and 25% made a change to resident care. Suggestions for future sessions included: active shooter training, antibiotic stewardship, team building, staff-resident communication, dementia training for non-clinical staff, weight loss, capacity determination, and family caregiver support. An age-friendly nursing home Project ECHO was well-received by health professionals in long-term care. ECHO can successfully expand the reach of training in long-term care, especially in rural areas.

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Orsulic-Jeras, Silvia, Ashlee Cordell, Sara Powers, Farida Ejaz, and Lisbeth Sanders. "RECRUITING AND RETAINING RESIDENTIAL CARE COMMUNITIES DURING THE COVID-19 PANDEMIC: LESSONS LEARNED." Innovation in Aging 7, Supplement_1 (December 1, 2023): 801. http://dx.doi.org/10.1093/geroni/igad104.2586.

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Abstract Demands within residential care communities have escalated throughout the Covid-19 pandemic as meeting basic care needs has become more critical. Non-pharmacological interventions that aim to alleviate care strain and promote person-centered care are even more important now, as residents have been significantly impacted by social isolation and loss. This presentation highlights successes and challenges faced by researchers and residential care communities related to study recruitment and retainment efforts during the Covid-19 pandemic while conducting a fidelity trial of LifeBio MemoryTM: a novel app-based product designed to collect life story information from persons living with dementia (PLWD). The target sample is comprised of residential care staff (n=60) and PLWD (n=242) across ten residential care communities in the state of Ohio. Successes presented include: 1) high enthusiasm for the study and 2) strong relationships built between researchers and site liaisons. Significant challenges faced include: 1) organization-wide staff shortages, 2) low overall resident census, and 3) Covid-19 outbreaks and quarantines. Key lessons learned include: 1) researchers and residential care communities face competing demands as a result of the Covid-19 pandemic and 2) the Covid-19 pandemic has changed the landscape of residential care and research. The importance of efficient field operations, supportive training resources, and contingency plans when conducting studies in residential care will be discussed.

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Thompson, Katherine, and Angela Catic. "GWEP Successes and Lessons Learned From Making Communities Age Friendly." Innovation in Aging 5, Supplement_1 (December 1, 2021): 493–94. http://dx.doi.org/10.1093/geroni/igab046.1905.

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Abstract Geriatrics Workforce Enhancement Programs (GWEPs), funded by the Health Resources and Services Administration have a strong focus on age friendly care and community engagement. With a wide range of populations, locales, and health systems served, GWEPs have significant experience working with a wide variety of communities to implement age friendly care. In this symposium, we present successes and lessons learned from GWEP projects representing diverse populations and approaches to achieving age friendly communities. For instance, one GWEP is utilizing Patient Priorities Care to lay the framework for What Matters in clinical decision-making. Another GWEP is focusing on What Matters by uniquely embedding Area Agencies on Aging care coordinators within primary care settings to invite the participation of aging patients in advance care planning, among other health interventions. A third GWEP is using the 4Ms to educate patients and caregivers in geriatric psychiatry clinics in a population of veterans. Another GWEP is pairing Age Friendly Health System efforts within a health system with community-based efforts to become an age friendly and dementia friendly city. A final GWEP is using multiple educational modalities to create Age-Friendly Communities and assure that health systems, community-based organizations, and older adults and families are educated about the 4Ms. By exploring successes and lessons learned in making communities age friendly, we can improve existing and future programs centered on age friendly care for older adults.

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Proffitt, Mark A., and Andrew Lee Alden. "A Review of: “Senior Living Communities: Operations Management and Marketing for Assisted Living, Congregate, and Continuing Care Retirement Communities”." Journal of Housing For the Elderly 22, no. 4 (November 17, 2008): 423–27. http://dx.doi.org/10.1080/02763890802458536.

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Davis, Rebecca, and Margaret Calkins. "WAYFINDING DESIGN IN LONG-TERM-CARE COMMUNITIES: EVALUATION OF COMPLEXITY." Innovation in Aging 6, Supplement_1 (November 1, 2022): 699. http://dx.doi.org/10.1093/geroni/igac059.2560.

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Abstract Wayfinding, the ability to find one’s way, is a significant problem for many older adults; especially those with cognitive impairment. Long term care communities (LTCC) are often fraught with challenges for wayfinding. Those who cannot find their way are at risk for decreased engagement and loss of independence. A critical need is to assess architectural and design features that promote effective wayfinding in an objective way. This study describes the results of a wayfinding design evaluation of 12 LTCC (4 Assisted living; 2 Independent Living; and 6 mixed residency). We measured space syntax axial integration (SSAI; a measure of the visual connectedness) and a Revised Wayfinding Checklist. The results showed low integration values in all communities, ranging from an R3 of 1.43-2.03, indicating low connectedness (and increased wayfinding complexity). The Checklist score totals ranged from 23 – 34 (M = 27.45) out of a possible total of 17 – 51. Results showed that the buildings were overall complex, all had long corridors (>100 feet), over half used multiple elevators to get to common areas; and over 60% had complex, multi-building layouts. Design wise, visibly accessible restrooms were not present; over half of the LTCC had insufficient lighting; and signage color/contrast and letter size was less than recommended. All sites had few directional signs at decision points. Thus, the review of these LTCC showed that most buildings were very complex, with low connectedness, and had room to improve design features like signage and lighting to support wayfinding ability for the residents.

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Caffrey, Christine, Jessica Lendon, and Sengupta Manisha. "COMORBIDITIES AMONG RESIDENTS DIAGNOSED WITH DEMENTIA IN RESIDENTIAL CARE COMMUNITIES." Innovation in Aging 6, Supplement_1 (November 1, 2022): 637. http://dx.doi.org/10.1093/geroni/igac059.2360.

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Abstract Residential care communities (RCCs) are an important source of care for older adults, particularly those with dementia. Nationally in 2018, 34% of RCC residents had been diagnosed with dementia. Other common chronic conditions among RCC residents were high blood pressure (55%), depression (27%), arthritis (20%), diabetes (20%), and heart disease (17%). RCC residents with dementia who have comorbidities could present greater challenges when managing their care. This report presents national estimates of comorbidities among RCC residents with dementia and compares these estimates by selected characteristics. Estimates are from the 2018 National Post-acute and Long-term Care Study conducted by the National Center for Health Statistics. Among RCC residents with dementia, 62% had also been diagnosed with high blood pressure, 28% with depression, 23% with arthritis, 16% with diabetes, and 16% with heart disease. Among RCC residents with dementia, 17% were diagnosed with only dementia, 38% were diagnosed with dementia and one other common condition, 31% were diagnosed with dementia and two other conditions, and 14% were diagnosed with dementia and three to five other conditions. A greater percentage of RCC residents with dementia and two or more common conditions compared to only dementia or dementia and one other condition were aged 85 years and older (69% vs 62%), needed help with three or more activities of daily living (82% vs 73%), were hospitalized (34% vs 28%), and were taking more than 10 medications (48% vs 32%). Results may benefit efforts focused on implementing long-term care practices to manage dementia and comorbidities.

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Jonkman, Harrie B., Josine Junger-Tas, and Bram van Dijk. "From behind dikes and dunes: communities that care in the Netherlands." Children & Society 19, no. 2 (2005): 105–16. http://dx.doi.org/10.1002/chi.865.

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Winston, Carole A., Paula Leshner, Jennifer Kramer, and Gillian Allen. "Overcoming Barriers to Access and Utilization of Hospice and Palliative Care Services in African-American Communities." OMEGA - Journal of Death and Dying 50, no. 2 (March 2005): 151–63. http://dx.doi.org/10.2190/qqkg-epfa-a2fn-ghvl.

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While there is ample evidence to support the need for hospice and palliative care services for African Americans, only 8% of patients who utilize those services are from African-American communities. The underutilization of end-of-life and palliative care can be attributed to several barriers to service access including incompatibility between hospice philosophy and African-American religious, spiritual, and cultural beliefs; health care disparities; distrust of the medical establishment; physician influence; financial disincentives, and hospice admission criteria. Suggestions for dismantling barriers to care access include developing culturally competent professionals in the health and human services, expanding the philosophy of hospice to include spiritual advisors from client communities, and funding national initiatives to promote improved access to health care at all stages in the life cycle of members of all underserved communities.

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Sloan, Danetta, Deirdre Johnston, Chanee Fabius, Inga Antonsdottir, Morgan Spliedt, Tabitha Pyatt, Melissa Reuland, and Quincy Samus. "Transcending Inequities in Dementia Care in Black Communities: Lessons From the MIND Care Coordination Program." Innovation in Aging 5, Supplement_1 (December 1, 2021): 516–17. http://dx.doi.org/10.1093/geroni/igab046.1997.

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Abstract Resolution of ongoing inequities in dementia care requires careful examination of how care is delivered to ensure we are aware of, and meeting needs for all people affected, especially those most vulnerable and in under-resourced communities. Maximizing Independence at Home (MIND) is a multicomponent, home-based dementia care program designed to provide high quality, wholistic care coordination for to persons and families living with dementia. Program goals are to delay transition from home, improve life quality, and reduce unmet care needs. We completed three focus groups (n = 25) with Black (e.g., African American) dementia caregivers who received the intervention to understand (1) the unique dementia related needs of Black dementia caregivers and barriers and challenges to caregiving experienced within the Black community , (2) perceived benefits of MIND, and (3) ways to improve the MIND intervention. Participants noted three overarching themes related to needs and challenges in dementia care in the Black community: difficulty finding and accessing dementia information, help, and related services; familial conflict/lack of sibling and familial support; and lack of effective communication about dementia within Black Communities. Regarding benefits of the program, four themes emerged including that the program helped find resources (formal and informal); provided caregivers an opportunity for socialization and interaction; included comprehensive assessments and helpful linked information; and resulted in a “much needed break.” Increased diversity of MIND personnel and greater clarity and consistency in MIND program promotion and communications were themes for how the program could be improved.

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Hartig, Jeanne, and Judah Viola. "Online Grief Support Communities." OMEGA - Journal of Death and Dying 73, no. 1 (March 6, 2015): 29–41. http://dx.doi.org/10.1177/0030222815575698.

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Online grief support communities have become popular in recent years for those seeking information and empathetic others following the death of someone close to them. Hundreds of Facebook pages and Web sites are now devoted to bereavement—and health-care professionals need to assess what therapeutic benefits virtual communities might offer to help people manage grief and integrate death into their lives. In the current study of online grief support networks ( N = 185), individuals report less psychological distress as a result of joining these groups—and this psychosocial benefit increased over time. Individuals who were members for a year or more characterized their grief as less severe compared with those who had a shorter tenure in the community. Additional findings and implications are discussed.

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Brewer, Kathleen Pearl, and Robert E. Hurley. "Managing Life Care Communities: New Integration of Skills for Hospitality Managers." Hospitality Research Journal 14, no. 2 (May 1990): 285–94. http://dx.doi.org/10.1177/109634809001400231.

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Adams, Diana, and Gavin Marx. "Daily Life As an Australian Medical Oncologist." Journal of Oncology Practice 6, no. 3 (May 2010): 146–48. http://dx.doi.org/10.1200/jop.878901.

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Cornell, Portia. "Racial Disparities in Use of Memory Care and Prevalence of Duals in Assisted Living." Innovation in Aging 5, Supplement_1 (December 1, 2021): 526. http://dx.doi.org/10.1093/geroni/igab046.2029.

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Abstract Assisted living (AL) communities with memory care licenses are disproportionately located in affluent and predominantly White communities and Black older adults are underrepresented in AL. But little is known about characteristics of AL that care for Black residents. We estimated the association of facility-level characteristics as proxy measures for AL resources, such as memory care designations and percentage of dual-eligible residents, across low (0-5%), medium (5-10%) and high (>10%) percentages of Black residents. We found broad differences among communities in the three levels of Black-resident prevalence. High percentage of Black residents was associated with large differences in the percentage of Medicaid-enrolled residents (high 54% duals [s.d.=34], med 28% [31], low=13% [22], p<0.001). ALs with high Black populations were less likely to have a memory-care designation than ALs with medium and low percentages of Black residents (high 4.7% memory care, med 11%, low 17%).

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Davies, Bishop Geoff. "SAFCEI (Southern African Faith Communities’ Environment Institute)." ANVIL 29, no. 1 (September 1, 2013): 87–91. http://dx.doi.org/10.2478/anv-2013-0007.

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Abstract The Southern African Faith Communities’ Environment Institute (SAFCEI) grew out of a life-long conviction that the Christian church had failed in its responsibility to care for God’s world. Surely we who worship the God who ‘in the beginning created’ all that exists, should take a lead in its care?

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Wilk, Christa, Ashlee Cordell, Silvia Orsulic-Jeras, Sara Powers, Farida Ejaz, and Lisbeth Sanders. "Using Life Story Techniques with Diverse Communities: Lessons Learned from a Focus Group Study." Innovation in Aging 5, Supplement_1 (December 1, 2021): 838. http://dx.doi.org/10.1093/geroni/igab046.3068.

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Abstract Providing high quality, cost-effective dementia care remains a major health challenge. Life story work, used in residential care settings, helps engage persons living with dementia (PWD) at a low cost with minimal staff burden. LifeBio, one such intervention, is designed to elicit life history data and care preference information through comprehensive life story interviews. LifeBio Memory, an adaptation of LifeBio, utilizes novel speech-to-text technology to process life story data more efficiently. Seven focus groups were conducted to evaluate the acceptability and feasibility of LifeBio Memory. Three types of focus groups were held (n=35) and audio recorded: 1) One group of early-stage PWDs (n=5); 2) Two groups of current and former users of original LifeBio (n = 12); and 3) Four groups of residential care staff and directors (n=18). Sessions were transcribed and thematic analyses were conducted. Findings indicated high levels of acceptability and feasibility of LifeBio Memory. Further, a secondary theme emerged signaling the need to prioritize the emotional safety of PWDs participating in life story work. This poster will discuss: 1) the life story interview process, 2) identifying PWDs who would most benefit from a life story program, 3) involving family and staff care partners to identify sensitive topics, 4) interview question design, selection and order, and 5) expanding life story work across diverse communities. Discussion will highlight the importance of protecting the emotional well-being of marginalized communities by identifying potential underlying traumas that could impact the safe delivery of otherwise effective life story interventions.

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Gao, Xiang. "Associates of Perceived Quality of Life in Chinese Older Adults Living With Cognitive Impairment." Innovation in Aging 5, Supplement_1 (December 1, 2021): 243. http://dx.doi.org/10.1093/geroni/igab046.941.

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Abstract This study examined perceived quality of life in Chinese older adults living with cognitive impairment in a group of urban Chinese older adults and explore its associations with caregivers’ characteristics. Questionnaires were administered in person to 300 caregiver-care recipient dyads from three urban communities in mainland China in 2019. The 40-item Alzheimer’s Disease-related Quality of Life tool asked caregiver respondents to indicate care recipients’ life conditions. Higher levels of caregiving burden (β = -0.19, p < 0.01) and more depressive symptoms (β = -0.19, p < 0.01) amongst caregivers were significantly associated with lower quality of life of care recipients. The results suggested that reducing caregivers’ burden and depressive symptoms are essential to promote quality of life of care recipients. Formal support from health professionals, service organizations, and communities are urgently called for to promote the wellbeing of Chinese families affected by cognitive impairment.

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Gill, Amy, Stacey M. Page, and Melissa Hairston. "Communities of Support for Care-Experienced Mothers." British Journal of Social Work 53, no. 3 (April 1, 2023): 1775–83. http://dx.doi.org/10.1093/bjsw/bcad032.

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Abstract A genuinely supportive social network is crucial to health and well-being in motherhood. Feeling supported during challenging times can help to shield the impact of adversity and distress. Mutual support networks resulting from authentic, caring connections with others can be particularly beneficial to people with histories of fractured family relationships and/or out-of-home care (OOHC). As three women with lived experience of OOHC, we describe how we have built communities of support to sustain us as we raise our families, reflect on our childhoods, and strive to provide loving environments for our children. Our narratives highlight the value of informal support during the joys and challenges of motherhood, and the need for strength-based and trauma-informed practices within health and social work. Drawing on the theory of social support, we argue that professionals should aim to support care-experienced young people to empower themselves by building autonomous and authentic social connections to promote their well-being, particularly during life transitions such as exiting care and becoming parents.

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Liu, Chia-Jen, Sheng-Jean Huang, and Samuel Shih-Chih Wang. "Implementation of Compassionate Communities: The Taipei Experience." Healthcare 10, no. 1 (January 17, 2022): 177. http://dx.doi.org/10.3390/healthcare10010177.

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A worldwide movement to empower communities to support their members to care for each other at the end of life (EoL) has emerged since Kellehear published the Compassionate City Charter. This current report discusses the implementation experiences and preliminary outcomes of Compassionate Communities (CC) in Taipei City. Using the guidance of the Charter and international experiences, we have developed and multiplied a culturally sensitive, sustainable, and holistic CC program that composes municipal hospital, social, and other services, partnering with community leaders, non-governmental organizations, university students, and volunteers. Innovative campaigns, such as workshops, conferences, and the Life Issue Café, have been delivered to facilitate engagement, public education, and leadership with reverence to folk beliefs and the use of existing social networks. We have identified a model with strong collaborative leadership, high participation rates, and ongoing commitment. The gaps between asking/accepting and providing help were bridged when social connectedness was strengthened. We also integrated home-based medical care, home-based palliative care, and advance care planning to help the vulnerable who live alone, with poor status, or with limited resource access, and continue to support the community throughout the COVID-19 pandemic.

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Crary, Kate, Melissa Mandrell, and Laura Davie. "A FRAMEWORK OF SUPPORT: THE NURSING HOME PERSON-CENTERED OPTIONS COUNSELING CERTIFICATION PROGRAM." Innovation in Aging 7, Supplement_1 (December 1, 2023): 580–81. http://dx.doi.org/10.1093/geroni/igad104.1899.

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Abstract Person-centered initiatives and approaches are the cornerstone of best practices when it comes to supporting older adults and persons living with dementia. Lack of person-centered care has been associated with higher medical costs and negative health outcomes, particularly in low-resource communities. Implementing person-centered care may help to address disparities and improve care outcomes in these communities, although it is often unclear which approaches are most appropriate. The Person-Centered Options Counseling Certification program attempts to address this gap via a mentoring program and competency framework. Developed and piloted in rural New Hampshire, this framework helps professionals and organizations evaluate the approaches that works best for them, while creating fidelity for ongoing support through a rigorous mentorship program. The framework shows promise of being cost effective, an important consideration for many low-resource communities. Professionals can attain knowledge, skills, and abilities without incurring higher education costs and agencies can utilize pre-developed instructional materials. Pilot data was collected to evaluate the program and demonstrated that professionals found the educational training delivered within the framework was relevant to their community and increased their knowledge about person-centered care, although some expressed hesitancy when applying the skills learned with individuals. Professionals who completed both the training and participated in the mentorship program reported a high level of competency, satisfaction, and confidence in delivering person-centered care. The use of this framework may support staff retention in low-resource communities and approaches can be tailored across different environments to facilitate the delivery of person-centered care.

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Coe, Norma B., and April Yanyuan Wu. "Who Pays for Seniors Housing and Care Communities? Evidence from theResidents Financial Survey." Journal of Housing For the Elderly 28, no. 2 (April 3, 2014): 165–81. http://dx.doi.org/10.1080/02763893.2014.899537.

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Golden, Robyn, Alexander Rackman, Elizabeth Davis, Leticia Santana, and Walter Rosenberg. "Rush@Home: Home-Based Primary Care Focused on Underserved Communities and Health Equity." Innovation in Aging 5, Supplement_1 (December 1, 2021): 267. http://dx.doi.org/10.1093/geroni/igab046.1031.

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Abstract Homebound patients are often medically complex and are among those in greatest need of care and services. This is especially true for those that reside in underserved communities, where they face the added risk stemming from scarce community resources. Often these patients are only able to access health care for emergencies, which is ineffective and high cost. Rush@Home is a home-based primary care program that exemplifies the Age-Friendly Health System mission with a focus on the 4Ms, incorporating navigation and social work. Patients reflect the West Side of Chicago, with 80% of patients identifying as Black and/or Latino. During the first two years, Rush@Home demonstrated better care at a lower cost with readmission rates decreased by 11.8%, hospitalizations by 17.5%, length of stay by 8.7%, ED visits by 17.9%, and missed appointments by 72%. This presentation will highlight outcomes and discuss key issues in home-based primary care.

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Lewis, Jordan, Steffi Kim, Zayla Asquith-Heinz, and Lena Thompson. "ALASKA NATIVE DEMENTIA CAREGIVERS AND THE INCREASING NEED FOR CULTURALLY SAFE RESOURCES." Innovation in Aging 7, Supplement_1 (December 1, 2023): 247. http://dx.doi.org/10.1093/geroni/igad104.0813.

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Abstract With the rate of dementia increasing among Alaska Native people and the tribal health system ill-equipped to meet the challenges associated with dementia care, there is an urgent need to better understand cultural perspectives on dementia caregiving and what states and communities can do to support their caregivers. Despite the fact caring for others is a value and cultural practice for Indigenous communities, and caregivers tend to report fewer challenges and barriers related to care, they still experience barriers and challenges. Guided by Kleinman’s explanatory model of illness, a qualitative, the aim of this study was to gain insight on Alaska Native caregiver experiences in caring for someone living with dementia in communities across Alaska. 21 interviews with Alaska Native dementia caregivers in rural and urban communities were completed. Despite being innovative and resourceful in providing care, caregivers reported the high cost of care, inadequate training of health care providers, and the paucity of culturally safe caregiver training, education, and resources are especially concerning and need to be addressed in a timely fashion. Caregivers in this study recommended the development of basic educational materials to be aware of dementia, its stages, and the available supports, as well as caregiver support and respite services. The recommendations from this study focus on outreach and education for caregivers to improve their access to education, training, and support to reduce isolation, increase their dementia knowledge, expand their awareness of ancillary resources, and inform help-seeking decisions.

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Chirinos, Carlos. "It Takes Another Kind of Village: How Older Husbands in Rural Spanish Communities Experience Caregiving." Anthropology & Aging 44, no. 3 (December 19, 2023): 16–31. http://dx.doi.org/10.5195/aa.2023.441.

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This article explores how older husbands’ caregiving experiences are interwoven with the social representation of ‘the village,’ understood herein as an intimate, local community that actively contributes to long-term care on a daily basis. The concepts of belonging and doing kinship form the analytical basis for illuminating this interaction between care from husbands and daily community care. I use the social representation of the imagined community both as the axis for articulating the singular experiences of care, and the construct of a village that values its collective history, local rituals, natural environment, and ordinary routines. Study data are based on ethnographic observations of the daily long-term care trajectories of five married couples in two villages and one small town in the rural Spanish Mediterranean.

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Podgorski, Carol. "A BIOPSYCHOSOCIAL-ECOLOGICAL, FAMILY-FRAMED APPROACH TO DEMENTIA CARE." Innovation in Aging 6, Supplement_1 (November 1, 2022): 401–2. http://dx.doi.org/10.1093/geroni/igac059.1579.

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Abstract An individual’s experience of cognitive impairment is shaped by biopsychosocial factors, including their own perceptions of illness as well as interactions with family members, healthcare providers, and the communities in which they live. With advancing illness an individual’s dementia care requires the involvement and commitment of others, usually family. Hence, the quality of a person’s illness experience is shaped largely by relationships with family members and others throughout their respective communities. Current models of dementia care recognize family members as an important part of the care team, but fail to consider a patient’s family system and relationships as social determinants that affect care outcomes. This presentation will introduce a biopsychosocial-ecological, family-framed approach to dementia care that addresses factors that influence care considerations at both the individual and relational levels of the social ecological networks that the patient and their family members occupy.

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Haverhals, Leah, and Katie Cherry. "Major Disasters’ Impacts on Long-Term Care Settings, Vulnerable Older Adults, and Care Providers." Innovation in Aging 5, Supplement_1 (December 1, 2021): 200. http://dx.doi.org/10.1093/geroni/igab046.770.

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Abstract The COVID-19 pandemic has disproportionately negatively affected older adults, and has specifically devasted older adults who are minorities and those who reside in long-term care (LTC) facilities. For professionals working in LTC facilities, major stressors and challenges due to the pandemic must be navigated, sometimes in parallel with the effect that major disasters like hurricanes can have on LTC facilities. This symposium will focus on the impact major disasters, including the COVID-19 pandemic and Hurricane Irma, had on LTC settings and those who live and work there, as well as older adults who are minorities and their communities. First, Dr. Roma Hanks will present findings from a study of community members and leaders in a majority African-American community in the United States (US) about their experiences with and challenges faced related to the pandemic. Second, Dr. Lisa Brown will share experiences and perceptions of mental health clinicians from across the US who worked in LTC settings before and during the pandemic. Third, Dr. Ella Cohn-Schwartz will describe how the pandemic impacted Holocaust survivors ages 75+ in Israel compared to older adults who did not experience the Holocaust. Fourth, Dr. Lindsay Peterson will present findings from interviews with nursing home and assisted living community representatives in the US regarding vulnerabilities LTC facilities experienced related to Hurricane Irma in 2017. As a whole, these presenters will provide insights into experiences of older adults, care providers, LTC facilities, and communities as they navigated challenges associated with the COVID-19 pandemic and a major hurricane.

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Ciolfi, Mary Lou, Catherine Taylor, Tracy Ericson, David Wihry, Jennifer Crittenden, Angela Hunt, Lenard Kaye, and Paul Nebenzahl. "LONG-TERM CARE RESIDENT PERSPECTIVES ON PERSON-CENTERED CARE: INTERSECTIONS OF PRACTICE AND THEORY." Innovation in Aging 6, Supplement_1 (November 1, 2022): 638. http://dx.doi.org/10.1093/geroni/igac059.2363.

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Abstract The Designation of Excellence in Person-Centered Long-Term Care is a multi-year study to redefine standards of long-term care delivery according to the preferences of residents, family, staff, and leaders. During 2021, as one component of the study, 247 residents from 23 communities across the country engaged in a participatory message board activity inquiring about their lived experiences of receiving care and services in their long-term care communities. Residents commented on their personal care, personal and shared spaces; family, friends, and community; and wishes and feelings. Using a phenomenological approach to data analysis to better understand the universal and the unique aspects of the experience of living in long-term care, key themes centered on the importance of staff (1) knowing, responding, and being attentive to the details of residents’ life history, care needs and preferences; (2) treating residents respectfully and as mature adults; and (3) demonstrating care and connection in resident interactions. These key themes and their related sub-themes intersect with several social science theories that underscore those factors promoting adaptability to changed environments while trying to preserve identity, belief systems, and values. Applying a conceptual lens to resident comments suggests programmatic strategies that long-term care providers can prioritize for promoting and operationalizing person-centered care. The poster will present a graphic representation of the intersections of person-centered care and existing theoretical frameworks using resident remarks to highlight central tenets of continuity theory, person-environment fit theory, and social identity theory.

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Efird-Green, Lea, Philip Sloane, Christine Lathren, Krista Perreira, Karen Bluth, and Sheryl Zimmerman. "STRESS AND COPING AMONG NURSING ASSISTANTS AND PERSONAL CARE AIDES IN LONG-TERM CARE." Innovation in Aging 7, Supplement_1 (December 1, 2023): 330–31. http://dx.doi.org/10.1093/geroni/igad104.1101.

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Abstract Care in nursing homes and assisted living communities is largely provided by direct caregivers (nursing assistants [NAs] and personal care aides [PCAs]), who are >50% minoritized, 20% immigrant, 90% female, 87% without a college degree, and often in poverty. The well-being of direct caregivers is critical to quality of care, but research aimed at improving well-being is hampered because existing measures of stress and coping translate poorly to their backgrounds and work-related experience. To address this gap, we designed and conducted research aimed at describing the range of coping approaches used to address work-related stress, gathering data on a diverse sample of 391 direct caregivers from 9 nursing homes and 4 assisted living communities in 3 states, of which 75% were racially or ethnically minoritized and 21% were immigrant – mirroring the national workforce. Results indicated that 78% of respondents often felt stressed at work, with 30% screening positive for depression and 28% for anxiety, with some caregivers experiencing both (21%). However, working with residents and their families, while stressful (76%), was considered less stressful than workload (90%) and lack of support (83%); in fact, 89% of caregivers said that caring for residents makes them feel appreciated. Coping strategies were diverse, but the most common includedresilient coping (93%), mindfulness (89%), recognizing common humanity (84%), self-kindness (83%), and planning (69%). This presentation will address differences in coping based on demographic characteristics, as well as the relationship between types of coping strategies and reasons for staying in a direct caregiver position.

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Drost, Jennifer, and Margaret Sanders. "Creating Dementia-Inclusive Communities Using a Geriatric Workforce Enhancement Program Framework." Innovation in Aging 5, Supplement_1 (December 1, 2021): 511–12. http://dx.doi.org/10.1093/geroni/igab046.1980.

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Abstract The Geriatric Workforce Enhancement Program (GWEP) sponsored by HRSA provides an organizing framework around which dementia inclusive community initiatives can be successfully implemented and sustained. The overarching goal of all GWEPs is to improve outcomes for older adults by promoting evidence-based education that spans the continuum of care. This includes integration of academic, clinical, and community-based providers. By their very nature, all GWEPs partner across agencies throughout the state to deliver interprofessional education that will impact people living with dementia and their caregivers at the community, primary care, and acute care levels. Dementia inclusive community initiatives must have this kind of high-level interagency coordination. Our GWEP has successfully implemented Dementia Friends sessions across multiple sectors (Veterans, EMS, clergy, libraries, developmentally disabled, living alone) both in-person and virtually due to COVID-19. This symposium will share the methods to organize at the community level to deliver a unified message community-wide.

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Journal articles on the topic 'Life care communities'

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