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1
Pruksapong, Matana. "Development of a model for assessing the quality of an oral health program in long-term care facilities". Thesis, University of British Columbia, 2008. http://hdl.handle.net/2429/1529.
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Background: There is little information on how the quality of oral health services in long-term care (LTC) facilities is conceptualized or assessed.
Objectives: This study aims to develop a model for assessing the quality of oral healthcare services in LTC facilities.
Methods: This study is divided into four main steps. Firstly, I examined literature for existing concepts relating to program evaluation and quality assessment in healthcare to build a theoretical framework appropriate to dental geriatrics. Secondly, I explored as an ethnographic case study a comprehensive oral healthcare program within a single administrative group of 5 LTC facilities in a large metropolis by interviewing 33 participants, including residents and their families, nursing staff, administrators and dental personnel. I also examined policy documents and made site visits to identify other attributes influencing the quality of the program. Thirdly, I drafted the assessment model combining a theoretical framework with empirical information from the case study. And lastly, I tested the feasibility and usability of the model in another dental geriatric program in northern British Columbia. I applied the assessment model by conducting 15 interviews with participants in the program, made site-visits to the 5 facilities, and reviewed documents on the development and operation of the program.
Results: A combination of theory-based evaluation and quality assurance provided six sequential and iterative steps for quality assessment of oral health services in LTC. The empirical information supported the theoretical framework that a program of oral healthcare in a LTC context should be assessed for quality from multiple perspectives; it should be comprehensive; and it should include the three main attributes of quality - capacity, performance, and outcomes. Participants revealed 20 quality indicators along with suggested program objectives which encompass eight quality dimensions such as effectiveness, efficiency, and patient-centered.
Conclusion: The model provides a unique system for assessing the quality of dental services in LTC facilities that seems to meet the needs of dental and non-dental personnel in LTC.
2
Presley, Ann Frances Cullen. "Nurses' recognition and identification of elder abuse by caregivers". Diss., The University of Arizona, 1993. http://hdl.handle.net/10150/186445.
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The purposes of this secondary study were to explore the case detection phenomena of elder abuse by determining the congruence between nurses' assessments of abuse and elders' self-reports of abuse; to identify factors that may account for differences between abusive situations and nonabusive situations; then to describe differences between abused elders correctly identified and abused elders incorrectly identified by nurses. Both quantitative and qualitative data were used. The theory of attribution directed this research. The conceptual framework consisted of four concepts: structural factors, relationship factors, elder factors, and caregiver factors. A descriptive-comparison design was used to address the research questions. The sample included 48 elder-caregiver dyads, of whom 24 were self-reported abused elders and 24 self-reported nonabused elders. Descriptive analysis was used, including chi-square and t-tests. Results indicated that the nurses' assessments of elder abuse and elders' self reports of abuse were congruent in only one-fifth (N = 5) of the abused cases (N = 24). The findings confirmed allegations that nurses have difficulty identifying elder abuse unless outright battering is observed. Five variables were significant between abused and nonabused elders, and 10 variables were significant between abused elders correctly identified by nurses and abused elders incorrectly identified by nurses.
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McCormick, Christine Viola. "Cognitive coping and depression in elderly long-term care residents". CSUSB ScholarWorks, 2007. https://scholarworks.lib.csusb.edu/etd-project/3194.
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The purpose of this research was to examine specific coping methods used by the elderly as they adjust to the environment of a long-term care facility, and to examine the correlations between these coping methods and levels of depressive symptomatology.
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Lee, Feng-Ping. "The relationship of comfort and spirituality to quality of life among long-term care facility residents in southern Taiwan /". Thesis, Connect to this title online; UW restricted, 2005. http://hdl.handle.net/1773/7328.
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Stuckless, Susan N. "Inter-regional comparisons in the pattern of use and needs for institutional care". Thesis, National Library of Canada = Bibliothèque nationale du Canada, 2001. http://www.collectionscanada.ca/obj/s4/f2/dsk1/tape4/PQDD_0032/MQ62431.pdf.
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Lam, Mei-yee. "Community support facilities planning for an aging population in Hong Kong /". Hong Kong : University of Hong Kong, 1998. http://sunzi.lib.hku.hk/hkuto/record.jsp?B19906481.
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Russell, Cynthia Kay. "Care seeking and elders' dependency work: "My time is occupied trying to live"". Diss., The University of Arizona, 1993. http://hdl.handle.net/10150/186486.
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Even though a plethora of research is devoted to explicating caregivers' experiences, comparatively there is a dearth of information about care recipients. The purpose of this study was to further theoretical and empirical understanding of care recipients' experiences within care relationships. Specifically, this study was concerned with identifying the strategies elders use to seek care and how the processes and characteristics of individual, interpersonal, and structural levels interact to affect elders' care seeking. A synthesized symbolic interactionist and life span developmental framework informed the research. Multiple qualitative field work methods (semi-structured interviews, participant observation, focus group) were utilized to collect information about care recipients who were representative of the variety of care relationships within a life care retirement community. The care seeking process emerged as a sequence of activities engaged in as elders elicited care from others and negotiated care with others. Of most conceptual interest, however, was elders' dependency work: The work elders engaged in as they not only sought care for a specific need but also situated each care occasion within past experiences of care and future possibilities for care. Dependency work was agency in action, serving to define the everyday lives of elders involved in care relationships. The findings of this study suggest the need for viewing care recipients as agents, actively being with others in their delicate dance of dependency.
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Bell, Valarie A. "Perceptions of HIV/AIDS in West Virginia nursing facilities". Morgantown, W. Va. : [West Virginia University Libraries], 1999. http://etd.wvu.edu/templates/showETD.cfm?recnum=1171.
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Thesis (M.S.)--West Virginia University, 1999.Title from document title page. Document formatted into pages; contains v, 66 p. : map. Includes abstract. Includes bibliographical references (p. 55-56).
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Chuang, Yeu-Hui. "Exploration of elderly residents' care needs in a Taiwanese nursing home : an ethnographic study". Thesis, Queensland University of Technology, 2007. https://eprints.qut.edu.au/16470/1/Yeu-Hui_Chuang_Thesis.pdf.
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This study has explored the culture of nursing home life as experienced by elderly nursing home residents in Taiwan in order to understand, describe and interpret their care needs. In December 2006, the elderly represented 10% of the total population of Taiwan, and this proportion is predicted to increase steadily. In turn, this increase suggested that Taiwan would see ever greater numbers of elderly people with chronic illnesses and physical and mental disabilities. To care for these people, nursing homes have expanded rapidly throughout Taiwan. However, the quality of care provided in these nursing homes has become an urgent matter of concern. Though meeting the residents' care needs is essential for the provision of the best quality care, a review of the available literature shows that the care needs of the elderly residents within the nursing home context are poorly understood, both in Taiwan and internationally.
To address this gap in present understanding, a focused ethnographic approach, using participant observation, in-depth interviews and a review of documents, was undertaken between July 2005 and February 2006. The key participants were sixteen elderly residents who were 65 years old and over, had no cognitive impairment and had lived in the nursing home selected for the present study for at least six months.
Eight nurses, six nursing assistants, one private nursing assistant, one orderly, one physician's assistant and four family members were also interviewed, with questions put to them being based on the data generated from the observation and in-depth interviews with the elderly residents. All interviews were recorded on a digital recorder and transcribed verbatim. Following this, the data gathered from the in-depth interviews, the participant observation and the review of documents was sorted and indexed using the qualitative software program, NVivo7. A five-step analytic process, based on concepts discussed in previous literature, was used to trace the emerging themes.
Nine major care needs were identified by the elderly residents. These included basic functional care needs, emotional support care needs, economic care needs, psychological care needs, environmental care needs, social support care needs, professional care needs, religious care needs and preparation for death care needs.
Three themes of nursing home culture were generated; these were collective life, care rituals and embedded beliefs. The findings of the study indicate that the structure and culture of the nursing home contribute to several care needs remaining unmet. In addition, the results reveal that it is necessary to satisfy economic care needs before other care needs can be resolved.
These findings fill an important gap in nursing knowledge regarding the delivery of better quality care in nursing homes. They also provide relevant information to nursing practice, nursing education and Taiwanese long-term care policy-making, and provide a sound basis for future residential care research.
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Chuang, Yeu-Hui. "Exploration of elderly residents' care needs in a Taiwanese nursing home : an ethnographic study". Queensland University of Technology, 2007. http://eprints.qut.edu.au/16470/.
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This study has explored the culture of nursing home life as experienced by elderly nursing home residents in Taiwan in order to understand, describe and interpret their care needs. In December 2006, the elderly represented 10% of the total population of Taiwan, and this proportion is predicted to increase steadily. In turn, this increase suggested that Taiwan would see ever greater numbers of elderly people with chronic illnesses and physical and mental disabilities. To care for these people, nursing homes have expanded rapidly throughout Taiwan. However, the quality of care provided in these nursing homes has become an urgent matter of concern. Though meeting the residents' care needs is essential for the provision of the best quality care, a review of the available literature shows that the care needs of the elderly residents within the nursing home context are poorly understood, both in Taiwan and internationally. To address this gap in present understanding, a focused ethnographic approach, using participant observation, in-depth interviews and a review of documents, was undertaken between July 2005 and February 2006. The key participants were sixteen elderly residents who were 65 years old and over, had no cognitive impairment and had lived in the nursing home selected for the present study for at least six months. Eight nurses, six nursing assistants, one private nursing assistant, one orderly, one physician's assistant and four family members were also interviewed, with questions put to them being based on the data generated from the observation and in-depth interviews with the elderly residents. All interviews were recorded on a digital recorder and transcribed verbatim. Following this, the data gathered from the in-depth interviews, the participant observation and the review of documents was sorted and indexed using the qualitative software program, NVivo7. A five-step analytic process, based on concepts discussed in previous literature, was used to trace the emerging themes. Nine major care needs were identified by the elderly residents. These included basic functional care needs, emotional support care needs, economic care needs, psychological care needs, environmental care needs, social support care needs, professional care needs, religious care needs and preparation for death care needs. Three themes of nursing home culture were generated; these were collective life, care rituals and embedded beliefs. The findings of the study indicate that the structure and culture of the nursing home contribute to several care needs remaining unmet. In addition, the results reveal that it is necessary to satisfy economic care needs before other care needs can be resolved. These findings fill an important gap in nursing knowledge regarding the delivery of better quality care in nursing homes. They also provide relevant information to nursing practice, nursing education and Taiwanese long-term care policy-making, and provide a sound basis for future residential care research.
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Lavoie, Cora Emily Marie. "Situational control and well-being in the institutionalized elderly". Thesis, University of British Columbia, 1988. http://hdl.handle.net/2429/27719.
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This descriptive correlational study was designed to examine the relationship between situational control, and both psychological and physical well-being, in the institutionalized elderly. A convenience sample of 52 elderly institutionalized subjects was selected from two intermediate care facilities. The subjects completed the Perceived Weil-Being Scale, the Situational Control Of Daily Activities Scale, and the Subject Information Sheet. All residents were found to have an overall perception of situational control. However, residents perceived a lack of control for the daily activities of eating and grooming. The majority of residents obtained a moderately high score on the psychological well-being and physical well-being scales. No significant relationship was found between situational control and psychological well-being, or situational control and physical well-being. A significant positive relationship was found between psychological well-being and physical well-being.Applied Science, Faculty of
Nursing, School of
Graduate
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Renom, Guiteras Anna. "Quality issues in caring for older people: Appropriateness of transition from long-term care facilities to acute hospital care. Potentially inappropriate medication: development of a European list". Doctoral thesis, Universitat Autònoma de Barcelona, 2015. http://hdl.handle.net/10803/330370.
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Aquesta tesi doctoral és una tesi per compendi de publicacions que engloba dos aspectes de qualitat de l’atenció a l’ancià. El primer aspecte és l’adequació del trasllat des de centres residencials a hospitals d’aguts. Les persones que viuen en centres residencials sovint presenten diferents graus de comorbiditat, estat cognitiu i funcional i estadis de les patologies. La seva derivació o admissió a urgències o a hospital d’aguts pot ser beneficiosa en algunes ocasions, però en altres ocasions pot representar una discontinuïtat en l’atenció poc favorable. En aquest primer article, els autors van dur a terme una revisió sistemàtica de la literatura per identificar els estudis realitzats internacionalment que han avaluat el concepte d’adequació del trasllat des de centres residencials a hospitals d’aguts. Van identificar vint-i-nou articles, els quals foren heterogenis respecte els seus dissenys, els entorns estudiats, els instruments utilitzats per determinar adequació dels trasllats, i els resultats obtinguts. La proporció d’admissions considerades inadequades varià del 2% al 77%. Entre els estudis, els autors van identificar setze instruments els quals variaren quant als conceptes estudiats, el seu format i la seva administració. L’equip investigador va aïllar els sis aspectes més prominents avaluats pels instruments: diagnòstics mèdics específics, agudesa/severitat dels símptomes, característiques dels residents prèvies al trasllat, desitjos dels residents o de les famílies, existència d’un pla d’atenció, i disponibilitat o requeriment de recursos. Cinc dels instruments avaluaren adequació tenint en compte només un d’aquests aspectes. Únicament sis instruments tingueren en compte quatre o més dels aspectes. Només tres instruments avaluaren els desitjos dels pacients o de les famílies, i sis instruments avaluaren les característiques dels residents prèvies al trasllat. Els autors conclouen que la majoria dels instruments no són globals i no tenen en compte els aspectes individuals dels residents. També conclouen que calen més estudis per desenvolupar un instrument que estigui basat en evidència, i que sigui global i generalitzable a diferents regions o països per tal d’avaluar l’adequació de l’admissió hospitalària dels ancians que viuen en centres residencials.
El segon aspecte és la prescripció de medicaments potencialment inadequats (PIM) per a l’ancià. PIM són els medicaments que no s’hauria de prescriure a aquesta població perquè el seu risc de reaccions adverses supera els seus beneficis clínics, particularment quan existeix evidència a favor d’un tractament alternatiu per la mateixa condició més segur o efectiu. Diversos autors han desenvolupat llistes PIM per ajudar a identificar i reduir la prescripció de PIM als seus països. Aquest article descriu la preparació d’una llista PIM que incorpora medicaments dels mercats de set països europeus. En primer lloc, es preparà una llista PIM preliminar a partir de quatre llistes PIM internacionals. A continuació, trenta experts en prescripció geriàtrica d’Estònia, Finlàndia, França, Holanda, Espanya i Suècia participaren ampliant la llista preliminar amb nous medicaments i avaluant l’adequació dels medicaments mitjançant el mètode Delphi en dues voltes. Els experts també suggeriren ajustaments de dosi i alternatives terapèutiques. Finalment, un grup reduït d’experts respongueren un breu qüestionari final per obtenir un acord sobre alguns aspectes. Els experts arribaren al consens de que 282 substàncies químiques o classes de medicaments són considerats PIM pels ancians. Alguns dels PIM es refereixen a una dosi o duració d’ús específiques. Els autors presenten la llista anomenada “European Union (EU)(7)-PIM list” i conclouen que es tracta d’una eina de cribatge que permet la identificació de PIM i comparació de patrons de prescripció entre països europeus, i que també pot ser utilitzada com a guia per a la pràctica clínica. Conclouen també que calen més estudis que investiguin la factibilitat i aplicabilitat de la llista així com els beneficis clínics del seu ús.This doctoral thesis is a cumulative thesis and covers two quality issues in the care of older people, each of which is approached in an individual article. The first issue is the appropriateness of transferring older people from long-term care facilities to acute hospital care. Residents in long-term care facilities often differ in terms of comorbidity, cognitive and functional status, and stage of disease. Their referral or admission to an emergency department or acute hospital may be beneficial on some occasions, but on others it may represent an unfavourable discontinuity of care. In this first article, the authors performed a systematic review of the literature to identify those international studies that have evaluated the concept of appropriateness of transition from long-term care facilities to hospital care. They identified twenty-nine articles, which were heterogeneous regarding their study designs, the settings investigated, the assessment tools used to determine appropriateness of transition, and the results obtained. The proportion of admissions considered as inappropriate ranged from 2% to 77%. Throughout the studies, the authors identified sixteen different assessment tools, which varied regarding the concepts studied, their format and application. The research team isolated the six most prominent aspects considered by the assessment tools: specific medical diagnoses, acuteness/severity of symptoms, residents’ characteristics prior to admission, residents’ or families’ wishes, existence of a care plan, and availability or requirement of resources. Five tools assessed appropriateness taking only one of these aspects into consideration. Only six tools took four or more aspects into consideration. Only three of the tools assessed residents’ or families’ wishes, and six tools assessed the residents’ characteristics prior to admission. The authors conclude that most assessment tools are not comprehensive and do not take the individual aspects of the residents into account. They also conclude that further research is needed to develop a tool that is evidence-based, comprehensive and generalizable to different regions or countries in order to assess the appropriateness of hospital admissions among long-term care residents. The second issue is the prescription of potentially inappropriate medication (PIM) to older people. PIM are those drugs that should not be prescribed for this population because the risk of adverse events outweighs the clinical benefit, particularly when there is evidence in favour of a safer or more effective alternative therapy for the same condition. Several authors have developed country-specific PIM lists to help identifying and improving prescription in their country. This article describes the development of a PIM list that covers the drug markets of seven European countries. First, a preliminary PIM list was prepared which contained PIM from four international lists. Next, thirty experts on geriatric prescribing from Estonia, Finland, France, the Netherlands, Spain and Sweden participated in the development process by first expanding the preliminary list with further medications, and then assessing the appropriateness of the drugs and suggesting dose adjustments and therapeutic alternatives in a two-round Delphi survey. Finally, a reduced number of experts participated in a last brief survey to agree on last discussion issues. Experts reached the consensus that 282 chemical substances or drug classes are PIM for older people, with some PIM being restricted to a certain dose or duration of use. The authors present the European Union (EU)(7)-PIM list and conclude that this is a screening tool that allows identification and comparison of PIM prescribing patterns for older people across European countries, and that it can also be used as a guide in clinical practice. They conclude also that further research is needed to investigate the feasibility and applicability of the list and the clinical benefits of its application.
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Baer, Shannon L. "Efficacy of complementary and alternative medicine on perceived well-being in geriatric long-term care residents". [Denver, Colo.] : Regis University, 2008. http://165.236.235.140/lib/SBaer2008.pdf.
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Mandville-Anstey, Sue Ann. ""Adjustment to life in a nursing home", the process of relocation : a grounded theory study /". St. John's, NF : [s.n.], 2002.
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Chui, Kam-chor. "Participating leisure and recreational activities and depressive symptoms among Chinese elder people residing in institutions /". View the Table of Contents & Abstract, 2006. http://sunzi.lib.hku.hk/hkuto/record/B36783407.
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Muge, Lydiah Joyce C. "Experiences of caregivers around the final decision-making process of transferring an older person living with dementia to long-term care: A grounded theory study". Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 2022. https://ro.ecu.edu.au/theses/2510.
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The decision to transfer an older person living with dementia to long-term residential care is challenging for family caregivers. The experiences of family caregivers leading up to the transfer have been previously explored; however, no study has explicitly focused on family experiences related to making the final decision to transfer. This study presents a constructivist grounded theory of the experiences of 12 family caregivers of older adults living with dementia. Caregivers of these older people were recruited through a residential aged care facility in the metropolitan area, Western Australia. Data collection was conducted using face to face interviews with the participants and guided by the interview questions. Data collection and analysis followed the steps and fundamentals of a grounded theory approach which included concurrent data collection and analysis, constant comparison and memo-writing. Data was analysed using Charmaz’s coding technique to include initial coding, focused coding and theoretical coding (Charmaz, 2006).
This thesis presents a substantive constructivist theory of: “The journey of uncertainty punctuated by key moments.” The journey of uncertainty in the context of this study includes the unpredictable experiences of family caregivers before, during and post transfer of an older person living with dementia to long-term residential care. The key moments were the major changes that older people living with dementia, or the family caregiver, experienced. Four core categories exemplified the journey of uncertainty: “cascade of events triggering the final decision.” which illuminated the burden of care to family caregivers, the gradual deterioration and the unpredictable acute care needs of the older person living with dementia. “Responsibility for decision-making and living with the decision” captured the experiences of family caregiver on decision-making to transfer and life post decision. The complex transfer process to residential aged care was perceived as “Navigating the maze of the complex transfer process” punctuated by bureaucracy and lack of knowledge and support. “Life after transfer to long-term residential care” depicted continuity of the journey with ongoing uncertainties among family caregivers about the need to partner and build relationships with long-term residential staff and the support they needed post transfer. The substantive grounded theory suggests that there is need to increase support provided to family caregivers. The study highlights implications for professional practice, future policy and residential aged care providers and identifies areas for further research.
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Heresi, Davila Gustavo Adolfo. "Choice of Initial Oral Therapy for Pulmonary Arterial Hypertension, Age and Long-Term Survival: A Propensity Score Analysis". Case Western Reserve University School of Graduate Studies / OhioLINK, 2017. http://rave.ohiolink.edu/etdc/view?acc_num=case1491430607305639.
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Wagner, Kay. "Nursing homes' organizational factors and resident mistreatment /". Connect to full text via ProQuest. Limited to UCD Anschutz Medical Campus, 2008.
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Thesis (Ph.D. in Nursing) -- University of Colorado Denver, 2008.Typescript. Includes bibliographical references (leaves 209-220). Free to UCD Anschutz Medical Campus. Online version available via ProQuest Digital Dissertations;
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Tyler, Katherine. "Levers and barriers to patient-centred care with school-age children living with long-term illness in multi-cultural settings". Thesis, City University London, 2009. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.509117.
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Vrabec, Nancy Joan 1955. "THE EFFECTIVENESS OF MODELED BEHAVIOR VERSUS DIDACTIC INFORMATION ON COGNITIVE ACQUISITION OF KNOWLEDGE BY EMPLOYEES OF ADULT CARE HOMES (ELDERLY, VIDEOTAPE, COMMUNITY HEALTH, BOARDING HOMES)". Thesis, The University of Arizona, 1986. http://hdl.handle.net/10150/275521.
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Marquis, Ruth. "The meaning of quality in living service environments: An analysis of the experiences of people with disabilities, elderly people and service workers". Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 1998. https://ro.ecu.edu.au/theses/976.
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The purpose of the study was to examine the experiences of both people with disabilities and elderly people and to identify their perceptions of quality as it relates to living in a service or being supported by a service to live in the community. The study was naturalistic in design and used a phenomenological approach and inductive analysis. It involved immersion in living services for a two year period, in-depth interviews with people living and working in services and participant observation. Fifty service users between the ages of twenty-one and ninety-six, and twenty-six service workers between the ages of twenty-six and fifty-four were informants in the study. The study comprised of three phases, the first phase involved repeated in-depth interviews with service users in two disability and two aged care living services to examine the experiences of people living in services and their perceptions of quality. As a result of the consistency with which relationships with key staff members emerged in the context of quality experiences, selected service workers who were named by service users were also interviewed. The findings in this phase indicated that relationships experienced by service users in their encounters with service workers were more significant in service users' evaluation of quality than tangible acts of physical and environmental care. Relational experiences of people living in services were variable. Some informants experienced consistent validation and socio-emotional support, whilst others experienced role distancing and negative communication experiences. Service workers who were interviewed as a result of being identified by service users in the context of quality, attached importance to the relational domain in the acts and behaviours of providing a service. They also attached personal meaning to their roles as service workers and shared the view that their role as service worker was underpinned by an ethos of communality. The second phase of the study involved accessing another five disability and five aged care services to collect further data to support or refute the findings from phase one. As a result a large data bank was established to confirm the consistency with which relational experiences in living services were linked to perceptions of quality by both service users and service providers. Acts and behaviours which were consistently present in the context of quality were also identified and the need for emotional support in the living context was further confirmed. The third phase of the study involved an in-depth analysis and identification of commonly experienced categories of relationships between service users and workers. Relationships were categorised into ethical and technical living service experiences and exemplars used to illustrate findings. Data analysis indicated that service experiences lie on a continuum, with mutually supportive relationships between service users and workers at one end, and physical and psychological abuse at the other. Experiences were variable in singular service contexts. This highlighted the individual nature of service relationships between service users and workers and the need to articulate human service as relationship. It also highlighted the inadequacies of using standard measures to evaluate quality in living services.
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Chui, Kam-chor y 徐錦初. "Participating leisure and recreational activities and depressive symptoms among Chinese elder people residing in institutions". Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2006. http://hub.hku.hk/bib/B45014449.
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Locatelli, Patrícia Augusta Pospichil Chaves. "As representações sociais sobre a velhice e os reflexos nos processos de gestão de pessoas de uma instituição de longa permanência de Porto Alegre". reponame:Biblioteca Digital de Teses e Dissertações da UFRGS, 2012. http://hdl.handle.net/10183/49412.
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Nas últimas décadas, o envelhecimento da população brasileira tem demandado atenção, principalmente, no que tange ao cuidado para com o público idoso. Apesar de a legislação brasileira estabelecer que o principal responsável pelo cuidado ao idoso é a família, a dinamicidade do contexto social e a atual fluidez dos relacionamentos familiares tem reconfigurado essa prerrogativa. Neste contexto, com a finalidade de suprir essa demanda oferecendo ao público longevo serviços de assistência social e à saúde, principalmente, em casos em que o idoso não possui família ou esta não apresenta condições para assumir a responsabilidade pelo seu cuidado, surgem as denominadas Instituições de Longa Permanência para Idosos – ILPIs, objeto deste estudo. Partindo-se do entendimento de que a forma como os funcionários de uma ILPI são geridos e a prestação de serviços conduzida está diretamente relacionada às representações sociais de gestores, funcionários e dos próprios idosos sobre a velhice, este estudo objetivou identificar e analisar como as representações sociais sobre a velhice na ótica dos usuários e daqueles que trabalham em uma instituição de longa permanência para idosos se refletem nos processos de movimentação e desenvolvimento de pessoas dessa instituição. Para isso, esta pesquisa, de abordagem qualitativa e natureza exploratório-descritiva, adotou como estratégia o estudo de caso e como técnicas de coleta de dados: observação simples e participante, realizadas de setembro de 2011 a fevereiro de 2012; entrevistas semiestruturadas com 18 indivíduos, sendo quatro gerentes, nove funcionários e cinco idosos; classificação de fotos; pesquisa documental. Os resultados deste estudo apontaram para a heterogeneidade das representações sociais de gestores, funcionários e usuários da instituição pesquisada a respeito da velhice, que perpassaram não apenas o contexto de institucionalização, mas também os dois modelos predominantes de velhice, um com foco nas perdas e outro com foco nos ganhos. A análise dessas representações sociais permitiu ainda o desvelamento de questões pertinentes à dinâmica organizacional como as relacionadas a gênero, relações de poder, mecanismos de controle da velhice e mecanismos de resistência. Quanto aos processos de movimentação e desenvolvimento de pessoas, identificouse que as representações sociais a respeito da velhice influenciam na condução das ações relacionadas aos processos de captação, internalização e desenvolvimento de pessoas, se desdobrando na filosofia de atendimento da ILPI pesquisada e no comportamento de seus gestores e funcionários.In recent decades, the aging of the Brazilian population has been attracting more and more attention, mainly in what regards elderly care. Despite Brazilian legislation provisioning that it its mainly the family's role to take care of their elderly, the dynamics of the social context and the present fluidity of family relations has reshaped this claim. Therefore, the Long Term Care Institutions for Elders – LCIF, the focus of this study, appear in order to meet this demand, by offering social welfare and health services to this long-living public – mainly when the elder has no family or they do not offer the conditions to take on the responsibility for such care. Assuming that the way LCIF employees are managed and the services they provide are directly connected with the social representation perceived by managers, employees and the very elders in regards to old age, this study aimed at identifying and analyzing how such social representations, as perceived by the users of and those who work at these institutions, impact on their movement and development processes. In order to accomplish that, this qualitative and exploratory-descriptive research employed the strategy of case study; for acquiring data, it employed the following procedures: simple and engaged observations, taken place over the period of September, 2011, through February, 2012; semi-structured interviews with 18 individuals (four managers, nine employees, and five elders); classification of photographs; and document research. Results revealed a heterogeneity in the social representations perceived by managers, employees and users of the institution studied in regards to old age. These perceptions involved not only the institutionalization context, but ranged between two predominant models, one focusing on loss, and the other on gain. The analysis of these social representations also allowed for the unveiling of issues regarding the organizational dynamics, such as those related to gender, power relations, mechanisms of old age control, and resistance mechanisms. Concerning the processes of movement and development of people, there could be identified that the social representations on old age influence the decisions related to the processes of reception, internalization and development of people, unfolding into the philosophy of service at the LCIF studied here, as well as in its managers' and employees' behavior.
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Newman, Nicole Rae. "Cognitively impaired elderly individuals and durable powers of attorney for healthcare". CSUSB ScholarWorks, 1999. https://scholarworks.lib.csusb.edu/etd-project/1795.
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Erickson-Taube, Christina Marie. "Special care units: Recreational activities for patients with Alzheimer's disease". CSUSB ScholarWorks, 2005. https://scholarworks.lib.csusb.edu/etd-project/2843.
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The purpose of this study was to evaluate the recreational activities provided in special care units located in the Inland Empire. The population that this study sought to assist was patients diagnosed with Alzheimer's disease and living in an Alzheimer's special care unit.
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Holt, Jim. "Navigating Long-Term Care". Digital Commons @ East Tennessee State University, 2017. https://dc.etsu.edu/etsu-works/6474.
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Americans over age 65 constitute a larger percentage of the population each year: from 14% in 2010 (40 million elderly) to possibly 20% in 2030 (70 million elderly). In 2015, an estimated 66 million people provided care to the ill, disabled, and elderly in the United States. In 2000, according to the Centers for Disease Control and Prevention (CDC), 15 million Americans used some form of long-term care: adult day care, home health, nursing home, or hospice. In all, 13% of people over 85 years old, compared with 1% of those ages 65 to 74, live in nursing homes in the United States. Transitions of care, among these various levels of care, are common: Nursing home to hospital transfer, one of the best-studied transitions, occurs in more than 25% of nursing home residents per year. This article follows one patient through several levels of care.
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Hernández-Pizarro, Helena M. "Essays on long-term care". Doctoral thesis, Universitat Pompeu Fabra, 2017. http://hdl.handle.net/10803/456565.
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This thesis analyses the effects of expanding public Long-Term Care (LTC) benefits
in Spain, using three different approaches. In the first chapter, I estimate
the impact of public LTC allowances on the mortality of the beneficiaries. My
results suggest that providing care prevents a deterioration in health, such that
death is postponed when the level of needs is low or moderate. In the second
chapter –with Garc´ıa-G´omez, L´opez-Casasnovas and Vidiella-Martin–, we assess
the equity of the access of public LTC. We show that the system is particularly
inequitable regarding the form of provision of benefits. This translates into a
pro-poor concentration of longer waiting time to access care. Finally, in the last
chapter –with L´opez-Casasnovas and Nicodemo–, we investigate the unintended
consequences of a non-linear scheme of benefits. We identify that around 3% of
the claimants are upgraded to the next level of benefits, increasing the cost for the
system. Instead, the proposed linear system of benefits could make the system
more egalitarian and minimise the unintended incentives.Aquesta tesi analitza els efectes de l’expansió de les prestacions públiques en dependència a l’estat espanyol, des de tres perspectives diferents. En el primer capítol, estimo l’impacte de les prestacions públiques en la mortalitat dels beneficiaris. Els resultats suggereixen que la provisió d’atenció prevé el deteriorament de la salut, fins al punt de posposar la mort quan el nivell de dependència és baix o moderat. En el segon capítol –amb García-Gómez, López-Casasnovas i Vidiella- Martin–, avaluem l’equitat en l’accés als diversos serveis públics per a l’atenció a la dependència. Mostrem que el sistema públic de dependència és especialment inequitatiu en la forma de provisió de beneficis. Això es tradueix en major concentració entre els més pobres del temps d’espera per accedir als recursos públics. Al darrer capítol –amb López-Casasnovas i Nicodemo–, investiguem les conseqüèencies inintencionades d’un sistema de beneficis no lineal. Identifiquem que entorn el 3% de la gent que sol.licita les prestacions són classificats en nivells de necessitat per sobre dels que els pertoca, fet que incrementa el cost del sistema. És per això, que proposem un sistema lineal de prestacions, que esdevingui més igualitari i minimitzi els incentius perversos.
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Sunding, Brooke Abrams. "Gratitude in long term care". Thesis, Spalding University, 2014. http://pqdtopen.proquest.com/#viewpdf?dispub=3621800.
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An exploratory study was conducted to examine the effectiveness of a group gratitude intervention with 29 permanent residents at a long term care/ skilled nursing facility in improving elder mood, behavior, and well- being over a 3 week time period. The sample included individuals diagnosed with dementia, other cognitive impairment, major depressive disorder, insomnia, and generalized anxiety disorder. The gratitude intervention consisted of asking elders to share what they are thankful for at the dinner table each day. Measures included the Elder Well Being Scale and The Dinner Rating Scale. On both measures, higher scores indicated better functioning. To test the hypothesis that post treatment elder well-being will be significantly higher than pretreatment elder well-being ratings, a one-way ANOVA was conducted. Post-hoc tests revealed a statistically significant increase in Elder Well Being Scale scores. An ANOVA of comparing Dinner Ratings demonstrated a nonsignificant increase over the 3 week experiment. Implications are discussed.
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Yauk, Jessica Ann. "Planning for Long-Term Care". Miami University / OhioLINK, 2020. http://rave.ohiolink.edu/etdc/view?acc_num=miami1605102319925788.
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Coe, Norma B. "Long-term care and the elderly". Thesis, Massachusetts Institute of Technology, 2005. http://hdl.handle.net/1721.1/33837.
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Thesis (Ph. D.)--Massachusetts Institute of Technology, Dept. of Economics, 2005."September 2005."
Includes bibliographical references.
Long-term care expenditures represent one of the largest uninsured financial risks facing the elderly. Medicaid provides incomplete insurance against these costs: unlimited nursing home benefits with a deductible equal to the savings and income above the means-testing limits. While private insurance is available, fewer than 10 percent of the elderly are currently covered. This thesis explores how the elderly prepare for future nursing home use and the interactions between the private and public insurance systems. Chapter one exploits the state-variation in Medicaid generosity to study the financial response of the elderly to perceived future nursing home needs. I find that the elderly shift their consumption and savings decisions in response to Medicaid. Single households have lower net worth through the median of the distribution due to Medicaid policy. On the other hand, I find that married households do not lower total net worth, but they change their relative holdings of protected and non-protected assets. Chapter two explores the crowd-out effect of the public Medicaid program on demand for private long-term care insurance coverage. We estimate the impact of Medicaid program rules on private long-term care insurance coverage for the elderly. We find small but statistically significant marginal crowd-out effects.
(cont.) Our estimates imply that even a $67,000 decrease in the asset disregard for couples would only increase private long-term care insurance ownership among the elderly by 1.9 percentage points. These findings underscore that marginal reforms to the existing Medicaid program are unlikely to be an effective way of increasing private long-term care insurance coverage among the elderly. Chapter three explores individuals' expectations for future nursing home use. I compare self-reported probabilities to the statistical probability computed with a state-of-the-art model used by the long-term care insurance industry. I find that respondents tend to overestimate unlikely outcomes and underestimate likely outcomes. On average, though, the expectations are very accurate. I find that expectations for nursing home use evolve with health conditions in similar ways as the statistical probability. While I find that expectations include private information, they do not account for all information available to the individual, especially the individual's demographic characteristics.
by Norma B. Coe.
Ph.D.
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Sheffer, Nathan D. "Memory Care Units in Ohio Long-Term Care Facilities". Miami University / OhioLINK, 2017. http://rave.ohiolink.edu/etdc/view?acc_num=miami149339984336246.
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Lu, Chen-Hua y 盧振華. "Study of the aged long-term care organization relation between Strategic Alliance and service quality---For example Wuan, Wuti the aged long-term care organization". Thesis, 2003. http://ndltd.ncl.edu.tw/handle/88148496843697649437.
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碩士國立中山大學
高階經營碩士班
91
THESIS ABSTRACT For the past few years, the development of social welfare has a tendency of leading the managing concept of business administration, which emphasizes the connection between service and cost, and the requirement of efficiency. However, in spite of the increasing demand of long-term care, the nursing system has come across many difficulties. The competition from the related occupations, the increasing pressure, and the higher demand of nursing quality have seriously affected the maintenance of nursing organization, which also have obliged the manager of nursing organization to consider the possibility of cooperation of the same line. The intention of Strategic Alliance between the aged long-term care organization and some medical organizations has been promoted. In the near future, the manager of medical and long-term care enterprises will be up against the challenges and competitions from these organizations. And they are forced to unite and share their resources by Strategic Alliance. The manager must realize the changes inside and outside of their organizations. And it is the most important to adopt the prompt policy, management and control of their resources. Through this research, I hope there will be better understanding for the main managers on their long-term care services and evaluation of satisfaction. Also, I wish to study the elements that influence the quality of service. Therefore, the resources of long-term care might be efficiently used, and the quality will be improved as well. In experimental research, I make use of contrast of Strategic Alliance which influences the quality of service by analysis of 84 questionnaires investigation reports from Won-An and Won-Tai Nursing Centers. The experiments are independent and circuitous. . The result of this study indicates that Strategic-Alliance makes influence on either service quality or customers’ satisfaction. Customers gave Won-An Nursing Center a higher appreciation because which practice Strategic-Alliance. At the end, this study offers concrete suggestions for management. Hopefully this will provide the government authorities a consultation of policy as well as a new direction of the long-term care organizations.
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Hong, Hong y 洪宏. "LGBTQ friendly long-term care：The Attitude of Long-term Care Services on the Middle-aged gay male". Thesis, 2018. http://ndltd.ncl.edu.tw/handle/e8q694.
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碩士高雄醫學大學
高齡長期照護碩士學位學程
106
The study adopts in-depth interviews method of qualitative research. We interviewed 6 middle-aged gay males, at the age of from 40-53, by semi-structured interview outline, to explore their attitude toward long-term care service, inclusive of cognition, demand, and willingness of utilize. The research outcome showed as the following: 1. Because of contact experience of respondents, their attitudes to the long-term care service are different, and most of the respondents were not able to understand the information of long-term care services, and do not know much about its’ content. 2. Their demand of long-term care services includes physiological, psychological, social, spiritual, and others kinds of satisfaction. My study showed that respondents pay more attention to LGBTQ-friendly services than devices. The study found that the demand for long term care services between homosexuals and heterosexual people seems to be the same, but the details are different. In particular, their life experience and social situation of the two were completely different, and most homosexuals have no children for long-term care support. They are self-defended because of the lack of basic social security and the atmosphere of homophobia of the society. They therefore feel that their care service need will be rejected or procrastinating, and concealing their sexual orientation. The orientation. The results also suggest that public policymakers must understand that the elderly in different ethnic groups face various barriers to receiving health care and long-term care in our society. 3. Respondents feel that there is a need for long-term care services in the future, and those who help long-term care services in the future are friends and partners, especially friends, the research result showed that social support from significant others is a very important factor to quality of life for long-term care receiver. Respondents also felt that their willingness to use long-term care services was high. They preferred long service model was home-based services. The second choice was community-based services, and the third one was institutional Services residential services. 4. The factors affecting the long-term care service of the respondents were: contact experience, aging attitudes, economic capacity, LGBTQ-friendly structure, condition of health and information knowing.
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Pan, Yi-Jing y 潘怡靜. "Exploring on Long-term Care Service in Aged Society-Analysis of Care Robot Demand". Thesis, 2019. http://ndltd.ncl.edu.tw/handle/28t2p2.
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碩士朝陽科技大學
保險金融管理系
107
The world is facing three major issues: aging, declining birth, and human aging. The elderly population is increasing rapidly, and the demand for care workers has increased significantly. At present, the world is investing in the development and research of various types of robots, aiming at the development of services, care, and medical care, and reducing the need for a large amount of human resources. This study focuses on the needs of long-term care services for the elderly, the care robot. This study used qualitative and quantitative research methods, in-depth interviews in qualitative and quantitative questionnaires. The results of this study show that aging life is highly dependent on robot companionship and assistedness, and that care robots have a high degree of preference. It is highly feasible for long-term care institutions to introduce care robots. The development market for care robots lies in home care services.
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Kim, YongKyang. "Strategies for enhancing food intake of the elderly in long-term care facilities". Thesis, 1999. http://hdl.handle.net/1957/27655.
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Chu, Chiao-Wei y 朱喬尉. "Using Data Mining Techniques to Construct Aged Long-Term Care Decision Model". Thesis, 2011. http://ndltd.ncl.edu.tw/handle/r256va.
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碩士國立臺北科技大學
工業工程與管理研究所
99
According to the statistics report of the Ministry of Interior, Taiwan’s people amounts is 23,162,123 at the end of December, 2010. Age above 65 years old is 2,487,893 and occupy whole population 10.74%, the population structure has already reached the old-age population ratio that the World Health Organization defines as the aging society standard of 7%. Executive Yuan passes "long-term care bill" drafted plan in March, 2011. Accompany with by responding aged population''s surging and produce of long-term care need. If the "long-term care bill" approve by the Legislative Yuan in the future, more aged populations will accupt subsidy by government. This research uses data mining techniques to analyze the aged people''s ADL measuring form and IADL measuring form. Find out which people is match subsidy condition''s causing by avoiding the waste of resource and the public funds. This research finds that BPN-LR-CBR model and BPN-SVM-CBR model have better classification ability.
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Carpenter, Patricia A. "The development, practice and education of kinlein associates". Thesis, 1997. http://hdl.handle.net/1957/33882.
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This study documented the history of the development and practice of the
kinlein associate. Consumer dissatisfaction with health care, nursing unrest, and
increased demand for long-term care-givers were the antecedents for a paradigm shift
to "caring with" persons based upon the theory of esca developed by
M. Lucille Kinlein. Interested people wanted to learn how to offer care from this
perspective, and informal classes were held in several locations across the nation.
The study focused on identifying the teaching methods used by the founder,
Miss Kinlein. The methodology was deemed important in an attempt to assure that
future kinlein associate teachers reflect the original educational processes and style
when Miss Kinlein is no longer teaching. Her methods were considered important for
kinlein associate teachers to prepare kinlein associates for practice.
To determine Miss Kinlein's teaching methodology, qualitative research was
conducted by observing her teaching, face to face interviews with students and
kinleiners interested in teaching, and material gathered from the founder, Institute of
Esca/Practice of Kinlein, and the Detente Homer, Alaska. Modeling, coaching, and
directed inquiry were the primary methods used by Miss Kinlein and Mrs. Raymond,
kinleiner of reference at the Homer Detente, in teaching kinlein associates. It was
important to ground their teaching in educational theory and the contemporary
interest in constructivism philosophy. Principles were extracted from several articles
regarding constructivist philosophy/theory and were aligned with principles from the
theory of esca used by Miss Kinlein. The parallels between the theory of esca and
constructivism were striking.
The study concluded by recommending Miss Kinlein and her student teachers
examine the constructivism philosophy relative to the kinlein philosophy and theory of
esca. The result of this examination may open kinleiner interest to explore similar,
new ideas and serve as a spark for an intellectual/philosophical interchange among
professional kinleiners and educators. Specific recommendations were given
regarding immediate attention to kinlein associate curriculum, videotaping Miss
Kinlein teaching various levels of courses, and developing a course on assisting
students in moving in esca in learning.Graduation date: 1998
38
Denson, Linley Alice. "Values and long-term care decision-making for frail elderly people". 2006. http://hdl.handle.net/2440/37794.
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This project explored the values considered by elderly people, their younger relatives, and health professionals in decisions about residential long - term care, aiming to contribute to the literature on prospectively held values. The mixed methods design utilised a medical record review of 60 frail elderly hospital patients, a stratified survey of 3,015 adults in the South Australian community, and interviews with 36 stakeholders ( 10 elderly people, 10 younger relatives, and 18 health professionals ). The medical record review confirmed that the hospital patients and their outcomes resembled those described internationally. It was used to develop a hypothetical vignette, used in the later studies. Survey responses suggested that when considering a hypothetical long - term care decision, community members put the elderly person ' s physical health and safety first. Situational variables ( the elderly person ' s autonomy, environmental adaptation, and caregiver burden ) appeared secondary, albeit less so with increasing age of the respondent. Thematic analysis of the interviews demonstrated that elderly stakeholders considering a hypothetical decision were more likely to mention autonomy values, and less likely to mention safety values, than were relatives or health professionals. However, elderly stakeholders were also more likely to suggest restrictive solutions, such as residential placement and proxy decision - making. This finding raised methodological issues concerning ' third person ' vignettes, in that respondents might be responding as proxy decision - makers, rather than as if the hypothetical decision applied to themselves. The project confirmed that, in this context, prospectively held values resembled the retrospectively described values identified by McCullough, Wilson, Teasdale, Kolpakchi and Shelly ( 1993 ). Hence, the retrospective literature could be applied. The project supported the importance and complexity of psychosocial predisposing factors when applying the Andersen Behavioral Model ( Andersen, 1995 ) to long - term care decisions. Additionally, the Ecological Theory of Aging ( Nahemow, 2000 ) and the MacArthur Model of Successful Aging ( Andrews, Clark, & Luszcz, 2002 ) were found to be relevant to long - term care decisions for individuals and populations. It was concluded that both clinically, and at a policy level, discussions of long - term care could be more effective if they focussed on maintenance of elderly people ' s autonomy and control, rather than on their physical health and safety.Thesis (Ph.D.) -- University of Adelaide, School of Psychology, 2006.
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Cho, Gwilae. "Development of care standards for South Korean residential aged care facilities". Thesis, 2014. http://hdl.handle.net/1959.13/1057609.
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Research Doctorate - Doctor of Philosophy (PhD)The world’s ageing population means that many older people in developed countries now live out the latter parts of their lives in Long-Term Care (LTC) settings such as Residential Aged Care Facilities (RACFs). The majority of the older people in LTC settings have problems with cognition and a range of debilitating chronic conditions associated with frailty which means they are dependent on others for the needs of everyday living. South Korea has one of the world’s fastest growing ageing populations. The catalyst for this study was the instigation of a national government LTC insurance system in South Korea in 2008 and issues and concerns about the Quality of Care (QOC) in RACFs. The introduction of the LTC system highlighted the absence of care standards for care provision in RACFs in South Korea. The research study reported in this thesis used modified Delphi methodology for the development of care standards for RACFs in South Korea. Methods included; 1) Document analysis of international care standards from Australia, the United Kingdom and the United States, 2) qualitative descriptive analysis of the transcriptions of focus group meetings held with residents, their families and older people within the community, and 3) Analysis of the assessment data relating to the health and functional status of Korean residents. A pilot study was conducted of the Delphi method which was followed by three rounds of Delphi to complete the data collection, analysis and development of standards. Donabedian’s framework was used to inform the quality care elements of the care standards. A suite of standards for care in RACFs, underpinned by international principles of care for older people, comprising 15 statements of standards and 155 criteria, were developed. International, cultural, social and individual requirements for care are reflected in the standards. Of importance is that the care standards may assist the South Korean Government’s National Health Insurance Service (NHIS) policy makers to ensure the provision of culturally appropriate care in RACFs. In addition, they may guide Quality Assurance (QA) activities for private and public service providers. Finally, the findings from this research provide nurses with an opportunity to play a central role in the emergence of the gerontological nursing specialty in South Korea. It also serves as a reference point for nurses from other countries in the Asia Pacific that are also facing rapidly ageing populations.
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Weber, Haley. "Pain Management within the Long-term Care Setting: An Inquiry into Staff-perceived Contemporary Pain Management Practices". Thesis, 2014. http://hdl.handle.net/10012/8422.
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Background: Chronic pain is a frequent and undertreated ailment within the long-term care community (Herman et al, 2009). The likelihood of experiencing pain increases with age and failure to treat this condition may expose individuals to prolonged and unnecessary suffering (Ramage-Morin, 2008). Furthermore, undertreated pain can lead to a life of inactivity and a failure to carry out normal social and vocational roles which in term may result in higher rates of depression, anxiety and sleep disorders (Clark, 2000). The present study aimed to explore staff perceptions on current pain management within long-term care including insights to future needs in optimizing pain management. This work will contribute to the overall awareness surrounding possible reasons that current pain management within long-term care is viewed as suboptimal (Herman et al, 2009).
Methods: A qualitative, post-positivist grounded theory study was carried out in order to investigate staff-perceived strengths, weaknesses and barriers surrounding the topic of pain-management within the long-term care setting. Semi-structured interviews with 17 long-term care staff members from a variety of vocations were conducted with a focus on identifying and clarifying properties surrounding the notion that pain management is currently suboptimal. A focus group session was implemented as a method to further develop the emerging grounded theory.
Results: Nine themes surrounding pain management within the long-term care setting were identified in the present study. These themes gave rise to the core concept of creating an environment supportive of optimal pain management. The nine themes were integrated into the theory of optimization of pain management within long-term care through thematic interpretation. The focus group session further developed and confirmed themes identified throughout the one-on-one interviews as well as expanded the discussed theory.
Discussion: The developed theory of optimization of pain management within the long-term care setting provides a comprehensive overview of the current barriers facing adequate pain management as well as outlines future suggestions for improvement of managing pain within the long-term care setting.
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CHEN, YU y 陳瑜. "Examination of Long-term Care Needs among the Post-Acute Middle-Aged Disabled Persons". Thesis, 2016. http://ndltd.ncl.edu.tw/handle/07832551156182030862.
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碩士國立暨南國際大學
社會政策與社會工作學系
104
Post-acute care is the important concept from acute-care to long-term care, this concept has not received enough attention in our long-term care system, but it is so important for post-acute middle-aged disabled persons’s physical, psychological recovery, and social inclusion. To highlight the importance of post-acute care, this research applies Bradshaw’s demand theory based on both expressive needs and normative needs. By semi-structured in-depth interviews, collecting the data from the selected post-acute middle-aged disabled persons and the care managers from the long-term care management centers. The study revealed that disabled person express diverse needs of long-term care services as far as recovery of daily living function is concered, but the care managers are limited by their professional background and basis for assessment, thus without adequate service, delaying recovery and increase the risk of falling into long-term disability. Our research recommendations are as follows：Our long-term care system should unified financial resources；providing multiple and continuous care services with the concept of prevention grading；the early construction of post-acute care model, and provides complete continuity of care.
42
Liao, Chun-yen y 廖俊彥. "Empirical Research on Service Quality of Long-term Care Facilities under the Aged Society". Thesis, 2016. http://ndltd.ncl.edu.tw/handle/13457104729471609442.
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碩士國立中山大學
企業管理學系研究所
104
The 21st century has seen unprecedented challenges - impact of aged society. Under the advent of aged society, people are beginning to realise to improve the concept of long-term care. In turn, it is necessary for re-think the service quality of long-term care facilities to establish a new social adjustment mechanism to deal with aged problems. In this study, the core is the quality of service. The basic research is according to the revised SERVQUAL model. This study aims to explore the service quality of long-term care, customer satisfaction and the impact of customer loyalty and explore their interactive relations. The subject is Nantou Cing-Yuan Nursing Home (inhabitants, inhabitants’ families and potential inhabitants). There are 108 valid questionnaires, and questionnaires and interview are employed as the main research methods, and at last, using descriptive statistics and regression for data analysis. The study shows: (1) The quality of service of the "tangible", "assurance" and "caring" have a distinct positive effect on customer satisfaction. (2) The structure of the service quality has no significant positive effect on customer loyalty. (3) Customer satisfaction has obvious positive effect on customer loyalty. According to research, recommending the operators of long-term care facility enhance software and hardware equipment and service quality of services (medical) personnel, and how to improve the overall satisfaction of long-term care facilities, as well as a target of continuously efforts in the future.
43
Chow, Celine Yuqi. "Long term residential care for the elderly /". 2004. http://library.smu.edu.sg/apps/edms/checkuser.asp?type=ethesis-rescare.
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Thesis (B.Sc. (Honours) in Economics)--Singapore Management University, 2004.Senior thesis in part fulfillment for the BSc (Honours) in Economics degree presented to the School of Economics and Social Sciences, Singapore Management University 2003-2004. Includes bibliographical references (p. 36-38).
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Chen, Sheue-Shu y 陳雪姝. "Comparisons of Medical Care Utilization in Middle Taiwan between Aged Long-Term Care Residents of Organizations and Communities". Thesis, 2008. http://ndltd.ncl.edu.tw/handle/47834200828876887714.
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碩士東海大學
工業工程與經營資訊學系
96
Objective The purpose of this research is to investigate the differences of medical care utilization between organization residents and community residents. Method This research collected 3,043 aged long-term care organization residents in middle Taiwan as the observation group. Corresponding 2,996 community residents who have identical disease severity and category of serious illness compared with the organization residents were selected from a population of thirty-two thousand elders. We compared with the utilizations of medical services of these two groups in a durance of one year, from July 2006 to June 2007. The medical services included outpatient service, in hospital and emergency medical treatments. Similar approach was taken to compare 721 more ill elder as the control group and 715 elders from the community. Results The medical utilization indexes including the number of outpatient visit, emergency, home care and hospitalization, the costs of outpatient and inpatient, the length of hospitalization days, the frequency of emergency visit and hospitalization per person per year indicate that organization residents are 11%-80% higher than community residents. Additionally, the totally cost of outpatient and inpatient of the organization group is 22% higher than the community group. Surprisingly, the total cost of the more ill residents in the organization is only 15% higher than the community residents. Conclusions This research shows that the medical utilization of long-term care organization residents is 15%-22% higher than that of the community residents. While the population in Taiwan is getting aging and the organization residents getting more, this will make extra financial loading of NHI. The results provide indicating references for the health authorities to plan public or private elder insurances in the future.
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Navarro, Pablo. "Factors influencing the utilization of community long-term care services /". 2004.
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OU, CHANG-CHI y 歐長奇. "Commercial Disability and Long-Term Care Insurance for Senior Citizen Purchase Intention in Aged Society". Thesis, 2019. http://ndltd.ncl.edu.tw/handle/7pta55.
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碩士朝陽科技大學
保險金融管理系
107
Taiwan's aging rate is the highest in the world. In 2025, the number of senior citizens will account for 20% of the total population, crossing the threshold of a super-aged society. In 2060, the proportion of senior citizens will reach 41.6% to signify the official arrival of the "Silver Economy" era. The concern about long-term care for silver-haired senior citizens has gradually become a topic that both the government and all the people must care about. "What kind of life do you want to live after the age of 65?" This problem is not only prevalent in the 60-year-old group, but also existent in the 40-to-50-year-old group, as these people need to shoulder the sweet burden of taking care of their parents and often think about "How can I make my parents live the life they want?” and “Do I have the ability to take care of them when they are ill?" At present, the security programs in Taiwan that aim to take care of the health, life, family and finance of senior citizens are still in its infancy. Thus, the concern about long-term care for the silver-haired senior citizens has gradually become a topic that both the government and all the people must care about. The main purpose of this study is to explore the intentions of senior citizens to purchase commercial insurance policies that aim to take care of them when they are disabled. From the perspective of marketing strategy, this study discusses the purchase intention of commercial insurance and provide relevant suggestions on future operation of the insurance industry and supervision by the government. A total of 110 questionnaires were distributed for this study, and among them 103 valid questionnaires were obtained. Through in-depth interviews, we learned that people have some understanding of disability and long-term care insurance, but most consumers do not want to spend too much money on such insurance. Therefore, this study suggests that the government and insurance companies should promote knowledge of the disability and long-term care insurance, so as to increase the willingness of the public to purchase the disability and long-term care insurance.
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Lu, Mei Li y 呂美麗. "Exploring the Behavior Intention of Purchasing Long-term Care Insurance in Young and Middle-aged Population". Thesis, 2018. http://ndltd.ncl.edu.tw/handle/882x75.
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碩士樹德科技大學
金融系碩士班
106
There are urgent needs for long-term care in the aging society in Taiwan. However, Taiwan people''s willingness to buy long-term care insurance is low, which is a serious problem for long-term care. In order to understand the purchase behavior of long-term care insurance in Taiwan, this study integrates the perceived risk and trust by theory of planed behavior to explore the behavior intention of people in young adult population to purchase long-term care insurance. The results indicated that the factors such as attitude, trust, perceptual behavior control and subjective norm have direct positive influence on the behavior intention according to the order of effect size. Among them, trust not only has direct behavioral intention, but also has a positive influence on behavioral intention indirectly through attitude, and has negative influence on perceived risk directly. The results suggested that long-term care insurance practitioners should improve the trust of the target population to reduce their perceived risk and provide services to improve their attitudes and subjective norms to promote the purchase behavior intention. The results of this study can be used as reference for insurance policy formulation and marketing strategy of practitioners.
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Lourenço, Helena Maria Alves. "Fisioterapia e ganhos em Saúde numa Unidade de Cuidados Continuados". Master's thesis, 2014. http://hdl.handle.net/10362/14208.
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RESUMO: Atualmente, toda a envolvência do envelhecimento, desencadeada por um aumento crescente do número de pessoas idosas, incapazes de satisfazer as exigências do autocuidado e de viver autonomamente na comunidade, torna relevante o papel da fisioterapia no suporte ao idoso.
O objetivo geral deste trabalho é caracterizar a evolução do nível de independência nas atividades da vida diária (AVD’s), dos indivíduos que realizam fisioterapia numa unidade de cuidados continuados integrados (UCCI). Trata-se de uma abordagem quantitativa, observacional, longitudinal e descritiva. A população do estudo incide nos indivíduos admitidos na UCCI do Hospital do Mar (HM). Da presente população é retirada uma amostra por conveniência, num período de quatro meses, de acordo com critérios de inclusão e exclusão. Os instrumentos utilizados para a recolha de informação foram: um inquérito por questionário para o levantamento das características sócio-demográficas, de saúde e hábitos de vida; o Método de Avaliação Biopsicossocial (MAB - Classificação) para a avaliação do nível de independência nas AVD’s; e o Timed Up and Go (TUG) para a avaliação da mobilidade funcional.
Os principais resultados mostraram, segundo o MAB - Classificação, diferenças significativas, entre os dois momentos de avaliação (antes da fisioterapia e no momento da alta da fisioterapia), resultando num maior nível de independência funcional nas AVD’s no momento da alta da fisioterapia. Em relação ao TUG, a média da duração do teste diminuiu no momento da alta da fisioterapia, em relação ao momento antes da fisioterapia, traduzindo-se num aumento da mobilidade funcional.
Concluindo, conseguiu-se evidenciar que os indivíduos submetidos a tratamentos de fisioterapia numa UCCI, obtêm um nível de independência funcional mais elevada no momento da alta da fisioterapia, do que antes de serem objetos desta intervenção; o mesmo sucedendo, em relação à mobilidade funcional.---------------ABSTRACT: Currently, the issue aging, triggered by an increasing number of elderly people, unable to meet the demands of self-care and live independently in the community, makes relevant the role of physiotherapy in support to the elderly.
The aim of this work is to characterize the evolution of the level of independence in activities of daily living (ADLs), of individuals who perform physiotherapy in long term care hospital. This is a quantitative, observational, longitudinal and descriptive approach.The population of the study focuses on individuals admitted in long-term care in Hospital do Mar. Of this population is withdrawn a convenience sample within a period of four months, according to the inclusion and exclusion criteria. The instruments used for collecting data were a questionnaire to survey the socio-demographic, health and lifestyle characteristics; Método de Avaliação Biopsicossocial (MAB - Classificação) to assess the level of independence in activities of daily living (ADLs); and the Timed Up and Go (TUG) to assess functional mobility. The main results showed, according to the MAB - Classificação, significant differences between the two time points (before physiotherapy and at discharge from physiotherapy), resulting in a higher level of functional independence in ADLs at discharge from physiotherapy. Regarding the TUG, the average duration of the test decreased at discharge from physiotherapy, relative to the time before physiotherapy, translating into an increase of functional mobility. In conclusion, we were able to show that individuals undergoing physiotherapy treatments in long-term care hospital, obtaining a higher level of functional independence at discharge from physiotherapy than before objects of this intervention; the same applies with respect to functional mobility.
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Chang, Hsing-Chia y 張幸家. "Study on Related Factors of Long-term Care Services among Disabled People Aged 53 and above in Taiwan". Thesis, 2009. http://ndltd.ncl.edu.tw/handle/35171627267467364031.
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碩士亞洲大學
健康產業管理學系長期照護組 在職專班
97
The elderly Taiwanese Profile Report revealed that families members still play the main resources for the care of disabled elderly. On the other hand, The composite forms of family structures are graduate changes, thus the aim of this study was to investigate factors influencing the use of home care and institutional care among the disabled middle-aged and elderly in Taiwan. The longitudinal date with 1824 interviewees was retrieved form the fourth and the fifth” The Longitudinal Sample Survey of Health and Living Status of the Elderly in Taiwan” survey in 1999 and 2003, respectively。Andersen’s behavioral model was borrowed as conceptual structure. In addition, general Estimation Equations（GEE）was adopted as the statistical tool to analyze the date in the study. The result shoved that incontinence and the numbers of difficulties in Activity of Daily Living（ADL）were significantly related to the use of home care. In other words, the disabled middle-aged and elderly with incontinence and more difficulties numbers of ADL were likely to use home care. For the use of institutional care, ethnical groups, the housing owner ship, living arrangement and numbers of difficulties in ADL are significantly correlated. In other wore, those disabled middle aged and elderly who are from Mainland China, without housing owner ship, preferring to live alone or live with other except for children, and with more difficulties numbers of ADL tended to use institutional care. Impact of the above factors should be taken into account in policy making and resource allocating of long term care in the future.
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Wang, Jiun-Yue y 王君月. "The Implementation Evaluation of the Long-Term Care Policy in Aged Society：A Case Study of Home Care Service in New Taipei City". Thesis, 2012. http://ndltd.ncl.edu.tw/handle/00075603900253048888.
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碩士世新大學
行政管理學研究所(含博、碩專班)
100
The problem of aging population is getting more and more serious and has become one of the major global concerns. In order to reduce the impacts caused by aging society, government in Taiwan has proposed many social welfare policies. One of the policies is “Long Term Care”, in which, “home care” is the most commonly used service among the senior and the handicapped. Therefore, our study investigated the current status of “home care service” and subsequently evaluated the government policy through qualitative research, in-depth interview, and literature review. The purpose of this study is to tap into the insight and perception of related staff’s toward “home care service” and to analyze problems and difficulties that staff might face when carrying out the service. I also compared the difference of home care service before and after Taiwan County being promoted to New Taipei City. Based on the research findings, agencies and affiliated institutions responsible for carrying out the service has followed government’s regulations and rules in terms of task procedure, task content, financial management, and manpower allocation. According to the data drawn from interviewing related staff, home care service has indeed provided the senior and the handicapped with great help. Problems and difficulties with home care service mainly come from two major areas, namely “task content and procedure” and “manpower allocation”. After Taipei Country was promoted to New Taipei City, no significant change or difference was found in home care service. Based on the analysis of this study, I advanced some suggestions for future development of home care service and further researches. Hopefully, it will trigger more scholars to conduct more researches in the same field.