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Obayashi K, Kodate N, Ishii Y, Masuyama S. Assistive technologies and aging in place for people with dementia and disabilities: a proof-of-concept study with in-home passive remote monitoring with interactive communication functions. Disabil Rehabil Assist Technol 2023:1-14. [PMID: 38143315 DOI: 10.1080/17483107.2023.2287148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 11/19/2023] [Indexed: 12/26/2023]
Abstract
PURPOSE Can assistive technologies (ATs) support aging in place for people with dementia and disability? In seeking to go beyond the persistent institutional care delivery paradigm, this proof-of-concept study tested the feasibility of home care delivery using sensors and remote communication devices. This article reports the collaborative efforts among care professionals, care recipients and family caregivers in their private home environment and the impact of in-home passive remote monitoring (PRM) system on the users. The purpose of this study was to investigate the usability and impact of a PRM system combining in-house passive remote monitoring and an interactive communication function. METHODS In order to realize AT-supported, person-centered aging in place, a new care delivery model was designed, developed and tested for the duration of 12 weeks. The study was conducted with 5 older people (1 with severe disability and 4 with dementia), their primary family carers with 15 care professionals as users. RESULTS The findings indicate that there were some technical issues. However, the overall assessment of the system performance was positive, and the users expressed favorable views regarding its preventive and interactive nature. The importance of team-based care delivery, adjusted to fit the PRM equipment, was also highlighted. Faced with the challenge of meeting the increasing demand for person-centered care with limited resources, there will be a greater need for better integration of improved ATs. The study indicates ATs' potential for enhancing the quality of life for those involved in caregiving, while stressing the significance of stakeholders' engagement, skills and teamwork.IMPLICATIONS FOR REHABILITATIONThis proof-of-concept study tested the feasibility of a home care delivery system using sensors and remote communication device for those with dementia and disabilities.A home care delivery system was successfully created for 12 weeks by collaborative efforts among care professionals, care recipients and family caregivers in their private home environment.The introduction of in-home passive remote monitoring system increased the possibility of the older adults being able to live independently, and enabled rehabilitation at home.The users had favourable views regarding the system's preventive and interactive nature and highlighted a greater need for better integration of improved assistive technology in long-term care and rehabilitation.
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Affiliation(s)
- Kazuko Obayashi
- Faculty of Healthcare Management, Nihon Fukushi University, Mihama, Aichi, Japan
- Social Welfare Corporation Tokyo Seishin-kai, Nishitokyo, Tokyo, Japan
- Universal Accessibility & Ageing Research Centre, Nishitokyo, Tokyo, Japan
| | - Naonori Kodate
- Universal Accessibility & Ageing Research Centre, Nishitokyo, Tokyo, Japan
- School of Social Policy, Social Work and Social Justice, University College Dublin, Dublin, Ireland
- Public Policy Research Center, Hokkaido University, Sapporo, Hokkaido, Japan
- Fondation France Japon, L'École des hautes études en sciences sociales, Paris, France
- Institute for Future Initiatives, University of Tokyo, Bunkyo, Tokyo, Japan
| | - Yoko Ishii
- Universal Accessibility & Ageing Research Centre, Nishitokyo, Tokyo, Japan
| | - Shigeru Masuyama
- Universal Accessibility & Ageing Research Centre, Nishitokyo, Tokyo, Japan
- Traveler's Medical Center, Tokyo Medical University, Shinjuku, Tokyo, Japan
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Carson A. A Pressure Release Valve: South Korean Long-Term Care Policy as Supplemental to Family Elder Care. J Aging Soc Policy 2023; 35:756-779. [PMID: 36242768 DOI: 10.1080/08959420.2022.2133318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Accepted: 06/21/2022] [Indexed: 10/17/2022]
Abstract
South Korea's National Long-term Care Insurance (NLTCI) has received international acclaim for its universal continuum-of-care model. Based on 25 qualitative interviews with family caregivers, this research explores the relationship between NLTCI policies and experiences of family caregiving for older people. Caregivers who share care responsibilities or are supported by other family are coping well with minor to moderate policy recommendations. Lone caregivers without support from other family are struggling and express desire for expanded services. These findings highlight a need for more consideration of the influence of family dynamics on informal caregiver burdens. Despite many strengths, NLTCI policy functions as a pressure release valve, supplementing family care for seniors - not replacing it - with minimal gender equity contributions.
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Affiliation(s)
- Alexa Carson
- PhD Candidate, Department of Sociology, University of Toronto, Toronto, Ontario, Canada
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Qi C, Wang Y, Qi X, Jiao Y, Que C, Chen Y. Barriers to providing internet-based home care services for urban older adults in China: a qualitative study of the service providers. BMC Geriatr 2023; 23:320. [PMID: 37221471 DOI: 10.1186/s12877-023-04028-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 05/08/2023] [Indexed: 05/25/2023] Open
Abstract
BACKGROUND Due to the increasingly aging population in China and the changes in social and family structure, older adults' care problems are becoming more and more prominent. To meet the home care needs of urban older adults, the Chinese government has launched Internet-Based Home Care Services (IBHCS). Although this model innovation can significantly relieve care problems, more and more evidence shows that there are many barriers in the process of IBHCS supply. The current literature is mostly from the perspective of the service users, and there are very few studies on the experience of service providers. METHODS In this study, we took a qualitative phenomenological approach and used semi-structured interviews to investigate service providers' daily experiences and the barriers they encounter. A total of 34 staff from 14 Home Care Service Centers (HCSCs) were included. Interviews were transcribed and analyzed using thematic analysis. RESULTS We identified the barriers that service providers encounter in IBHCS supply: (1) bureaucratic repression: unreasonable policy plans, harsh assessment, excessive paperwork, different preferences of government leaders, and obstacles caused by COVID-19 control lead to a shift of focus in their work; (2) profitability crisis in the market: high service costs, dampened effective demand, government intervention in setting prices, and parent companies' excessively high sales targets hinder the service supply process; (3) client-related challenges: the crisis of confidence, the dilemma of popularizing new technology, and communication barriers lead to rejection by older adults; (4) job dissatisfaction: low and unstable salary, heavy tasks, poor social acceptance of occupations, and lack of professional value reduce work enthusiasm. CONCLUSION We have investigated the barriers faced by service providers when providing IBHCS for urban older adults in China, providing empirical evidence in the Chinese context for the relevant literature. In order to provide IBHCS better, it is necessary to improve the institutional environment and market environment, strengthen publicity and communication, target customer needs, and adjust the working conditions of front-line workers.
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Affiliation(s)
- Caiyun Qi
- Department of social work, Shandong University, Jinan, China
| | - Yuan Wang
- Department of labor and social security, Jilin University, Qianjin Street 2699, Changchun, China.
| | - Xiaonan Qi
- Department of management, School of applied technology and health industries, Anshan Normal University, Anshan, China
| | - Yunhe Jiao
- Department of labor and social security, Jilin University, Qianjin Street 2699, Changchun, China
| | - Chuanqi Que
- department of social work, The Chinese University of Hong Kong, Hong Kong, China
| | - Yufei Chen
- Department of labor and social security, Jilin University, Qianjin Street 2699, Changchun, China
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Lestari MD, Stephens C, Morison T. Local knowledge and unliveable narratives: How insights from family caregiving narratives can inform locally relevant ageing policy. J Aging Stud 2023; 64:101102. [PMID: 36868615 DOI: 10.1016/j.jaging.2023.101102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2021] [Revised: 01/10/2023] [Accepted: 01/11/2023] [Indexed: 01/19/2023]
Abstract
BACKGROUND AND OBJECTIVES Accommodating local knowledge in national ageing policy demonstrates a country's intention to preserve local values, including cultural values of older adults' care. However, including local knowledge must provide space for nuanced and adaptive responses to it so that ageing policies can support families in adapting to changes and challenges around caregiving. RESEARCH DESIGN AND METHODS This study interviewed members of 11 multigenerational households in Bali to understand the ways family carers use and resist local knowledge about multigenerational caregiving for older adults. RESULTS Using qualitative analysis of the interplay between personal and public narratives, we found that narratives of local knowledge provide moral imperatives related to care, which shape expectations and a standard for evaluating the younger generations' behaviour. While most of the participants' accounts fit comfortably with these local narratives, some described challenges in which their life circumstances prevented them from identifying themselves as a virtuous carer. DISCUSSION AND IMPLICATIONS Findings provide insight into the role of local knowledge in constructing caregiving function, carers' identities, family relationships, families' adaptation, and the influence of social structure (e.g., poverty and gender) on caregiving issues in Bali. These local narratives both confirm and dispute findings from other locations.
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Affiliation(s)
- Made Diah Lestari
- School of Psychology, College of Humanities and Social Sciences, Massey University, Palmerston North, New Zealand; Department of Psychology, Medical Faculty, Udayana University, Bali, Indonesia.
| | - Christine Stephens
- School of Psychology, College of Humanities and Social Sciences, Massey University, Palmerston North, New Zealand
| | - Tracy Morison
- School of Psychology, College of Humanities and Social Sciences, Massey University, Palmerston North, New Zealand
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Aung MN, Moolphate S, Aung TNN, Koyanagi Y, Kurusattra A, Chantaraksa S, Supakankunti S, Yuasa M. Effectiveness of a community-integrated intermediary care (CIIC) service model to enhance family-based long-term care for Thai older adults in Chiang Mai, Thailand: a cluster-randomized controlled trial TCTR20190412004. Health Res Policy Syst 2022; 20:110. [PMID: 36443788 PMCID: PMC9706835 DOI: 10.1186/s12961-022-00911-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 09/16/2022] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Populations around the world are ageing faster, with the majority living in low- and middle-income countries where health and social care are yet to be universal and inclusive for the ageing population. This community-integrated intermediary care (CIIC) model is a novel prevention-based, long-term care model enhancing the family-based care system traditionally practised in Thailand and neighbouring Asian countries, and many low-and middle-income countries globally. This study assessed the effectiveness of the CIIC model in Chiang Mai, Thailand. METHODS The two-arm parallel intervention study was designed as a cluster-randomized controlled trial. The study population at randomization and analysis was 2788 participants: 1509 in six intervention clusters and 1279 in six control clusters. The research protocol was approved by the WHO Research Ethics Review Committee (WHO/ERC ID; ERC.0003064). The CIIC service intervention model is a combination of formal care and informal care in a subdistrict setting consisting of three components: (1) care prevention delivered as community group exercise and home exercise; (2) care capacity-building of the family caregiver; and (3) community respite service. The primary outcome was family caregivers' burden at 6-month follow-up, and secondary outcome was activities of daily living. Analysis applied the intention-to-treat approach using cluster-level analysis via STATA 16 SE. RESULTS Baseline characteristics did not differ between the two arms. Loss of follow up was 3.7%. Mean age of the participants was 69.53 years. Women constituted 60%. The COVID-19 pandemic caused delayed implementation. The proportion of families with reduced caregiver burden at 6-month follow-up was higher among the intervention clusters (mean 39.4%) than control clusters (mean 28.62%). The intervention clusters experienced less functional decline and fewer people with depression. CONCLUSIONS When communities are integrated for preventing care, and families are empowered for giving care, it is possible to secure universal access to health and social care for the older persons, with basic resources mobilized from communities. This study had shown the CIIC model as an effective and potential step to the realization of universal health and long-term care coverage being inclusive of ageing populations in Thailand and globally. TRIAL REGISTRATION This trial was registered at the Thailand Clinical Trial Registry-Trial registration number TCTR20190412004, https://www.thaiclinicaltrials.org/.
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Affiliation(s)
- Myo Nyein Aung
- Department of Global Health Research, Juntendo University Graduate School of Medicine, Tokyo, 113-8421, Japan. .,Advanced Research Institute for Health Sciences, Juntendo University, Tokyo, 113-8421, Japan. .,Faculty of International Liberal Arts, Juntendo University, Tokyo, 113-8421, Japan. .,Department of Public Health, Faculty of Science and Technology, Chiang Mai Rajabhat University, Chiang Mai, 50300, Thailand.
| | - Saiyud Moolphate
- Department of Public Health, Faculty of Science and Technology, Chiang Mai Rajabhat University, Chiang Mai, 50300, Thailand
| | - Thin Nyein Nyein Aung
- Department of Family Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Yuka Koyanagi
- Department of Judo Therapy, Faculty of Medical and Health Sciences, Tokyo Ariake University of Medical and Health Sciences, Tokyo, 135-0063, Japan
| | - Akrapon Kurusattra
- Department of Health Service Support, Ministry of Public Health, Nonthaburi, 11000, Thailand
| | - Sutatip Chantaraksa
- Department of Health Service Support, Ministry of Public Health, Nonthaburi, 11000, Thailand
| | - Siripen Supakankunti
- Department of Global Health Research, Juntendo University Graduate School of Medicine, Tokyo, 113-8421, Japan.,Faculty of International Liberal Arts, Juntendo University, Tokyo, 113-8421, Japan.,Centre of Excellence for Health Economics, Faculty of Economics, Chulalongkorn University, Bangkok, 10330, Thailand
| | - Motoyuki Yuasa
- Department of Global Health Research, Juntendo University Graduate School of Medicine, Tokyo, 113-8421, Japan.,Faculty of International Liberal Arts, Juntendo University, Tokyo, 113-8421, Japan
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Kodate N, Donnelly S, Suwa S, Tsujimura M, Kitinoja H, Hallila J, Toivonen M, Ide H, Yu W. Home-care robots - Attitudes and perceptions among older people, carers and care professionals in Ireland: A questionnaire study. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:1086-1096. [PMID: 33970511 DOI: 10.1111/hsc.13327] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 01/16/2021] [Accepted: 02/01/2021] [Indexed: 06/12/2023]
Abstract
Many countries face major challenges to ensure that their health and social care systems are ready for the growing numbers of older people (OP). As a way of realising ageing in place, assistive technologies such as home-care robots are expected to play a greater role in the future. In Asia and Europe, robots are gradually being adopted as a public policy solution to the workforce shortage. Yet, there is still a strongly held belief that such technologies should not be part of human and personal care services such as OP's care. However, there has been little research into attitudes and perceptions of potential users regarding home-care robots which can provide companionship and support with activities of daily living. To explore these in more detail, a questionnaire study was carried out in Finland, Ireland and Japan. This study reports findings from the Irish cohort (114 older people [OP], 8 family carers and 56 Health and Social Care Professionals [HSCPs]). Seventy per cent of the total respondents (N = 178) reported being open to the use of home-care robots, and only one quarter had a negative image of robots. People with care responsibilities in their private capacity expressed more interest in, and readiness to use, home-care robots, while stressing the importance of 'privacy protection' and 'guaranteed access to human care'. Both OP and HSCPs identified observation and recording of OP's mental and physical condition as desirable functions of such robots, whereas practical functions such as fall prevention and mobility support were also deemed desirable by HSCPs. There is generally positive interest in home-care robots among Irish respondents. Findings strongly suggest that the interest is generated partly by great need among people who deliver care. Should such robots be developed, then careful consideration must be given to user-centred design, ethical aspects and national care policy.
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Affiliation(s)
- Naonori Kodate
- School of Social Policy, Social Work and Social Justice, University College Dublin, Dublin, Ireland
- Public Policy Research Center, Hokkaido University, Sapporo, Japan
- Institute for Future Initiatives, The University of Tokyo, Tokyo, Japan
- L'École des hautes études en sciences sociales, La Fondation France-Japon, Paris, France
| | - Sarah Donnelly
- School of Social Policy, Social Work and Social Justice, University College Dublin, Dublin, Ireland
| | - Sayuri Suwa
- Division of Visiting Nursing, Graduate School of Nursing, Chiba University, Chiba, Japan
| | - Mayuko Tsujimura
- Division of Visiting Nursing, Graduate School of Nursing, Chiba University, Chiba, Japan
| | - Helli Kitinoja
- Seinäjoki University of Applied Sciences, Seinäjoki, Finland
| | - Jaakko Hallila
- Seinäjoki University of Applied Sciences, Seinäjoki, Finland
| | - Marika Toivonen
- Seinäjoki University of Applied Sciences, Seinäjoki, Finland
| | - Hiroo Ide
- Institute for Future Initiatives, The University of Tokyo, Tokyo, Japan
| | - Wenwei Yu
- Center for Frontier Medical Engineering, Chiba University, Chiba, Japan
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7
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Lestari MD, Stephens C, Morison T. The Role of Local Knowledge in Multigenerational Caregiving for Older People. JOURNAL OF INTERGENERATIONAL RELATIONSHIPS 2022. [DOI: 10.1080/15350770.2022.2059606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Made Diah Lestari
- School of Psychology, College of Humanities and Social Sciences, Massey University, Palmerston North, New Zealand
- School of Psychology, Medical Faculty, Udayana University, Bali, Indonesia
| | - Christine Stephens
- School of Psychology, College of Humanities and Social Sciences, Massey University, Palmerston North, New Zealand
| | - Tracy Morison
- School of Psychology, College of Humanities and Social Sciences, Massey University, Palmerston North, New Zealand
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8
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Lu Q, Mårtensson J, Zhao Y, Johansson L. Needs of family members caring for stroke survivors in china: A deductive qualitative content analysis study by using the caregiver task inventory-25. BMC Geriatr 2022; 22:96. [PMID: 35114940 PMCID: PMC8812361 DOI: 10.1186/s12877-022-02774-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Accepted: 01/07/2022] [Indexed: 11/12/2022] Open
Abstract
Background In China, family caregivers are usually the main carers of relatives after stroke due to traditional Chinese culture and the limited development of the primary healthcare system. This responsibility often results in burdens and negative health outcomes. However, family caregivers seldom receive support. To improve informal care, as well as the health and well-being of family caregivers, it is important to identify their needs. Objective This study aimed to deductively explore the needs of family members caring for stroke survivors in China. Methods Twenty-six semi-structured interviews were performed with family caregivers of stroke survivors who were selected from one city and three communities by purposive sampling. A deductive qualitative content analysis method was performed by using the Caregiver Task Inventory-25 (CTI-25), an instrument measuring the needs of family caregivers, as a framework. Results All subscales, as well as all belonging items in the CTI-25, were identified in the present study, meaning that the family caregivers had needs related to learning to cope with new role, providing care according to care-receiver’s needs, managing own emotional needs, appraising supportive resources, and balancing caregiving needs and one’s own needs. Moreover, needs related to financial support, both direct and indirect, were identified but not part of the CTI-25. Conclusion These findings identified that family caregivers of stroke survivors in China had various needs, which is important knowledge when assessing needs and improving health care for family caregivers. Cultural adjustments and modifications should be made if CTI-25 is used in mainland China. This study also indicated a comprehensive and holistic perspective (individual, community, and social level) when identifying, assessing needs or implementing interventions to support family caregivers.
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Affiliation(s)
- Qi Lu
- School of Health and Welfare, Jönköping University, Jönköping, Sweden. .,School of Nursing, Tianjin Medical University, Tianjin, China.
| | - Jan Mårtensson
- School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Yue Zhao
- School of Nursing, Tianjin Medical University, Tianjin, China
| | - Linda Johansson
- School of Health and Welfare, Jönköping University, Jönköping, Sweden
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A research framework for the United Nations Decade of Healthy Ageing (2021-2030). Eur J Ageing 2022; 19:775-787. [PMID: 35035341 PMCID: PMC8753942 DOI: 10.1007/s10433-021-00679-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/22/2021] [Indexed: 12/13/2022] Open
Abstract
The mission of UN Decade of Healthy Ageing (2020–2030) is to improve the lives of older people, their families and their communities. In this paper, we create a conceptual framework and research agenda for researchers to knowledge to address the Decade action items. The framework builds on the main components of healthy ageing: Environments (highlighting society and community) across life courses (of work and family) toward wellbeing (of individuals, family members and communities). Knowledge gaps are identified within each area as priority research actions. Within societal environments, interrogating beliefs about ageism and about familism are proposed as a way to illustrate how macro approaches to older people influence their experiences. We need to interrogate the extent to which communities are good places to grow old; and whether they have sufficient resources to be supportive to older residents. Further articulation of trajectories and turning points across the full span of work and of family life courses is proposed to better understand their diversities and the extent to which they lead to adequate financial and social resources in later life. Components of wellbeing are proposed to monitor improvement in the lives of older people, their families and communities. Researcher priorities can be informed by regional and national strategies reflecting Decade actions.
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Disability in Older People and Socio-Economic Deprivation in Italy: Effects on the Care Burden and System Resources. SUSTAINABILITY 2021. [DOI: 10.3390/su14010205] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The sustainability of European Long-Term Care systems faces the demographic and socio-economic circumstances, mainly the increasing ageing of the population, with its chronic disease conditions, and the simultaneous economic general crises, exacerbated by the recent COVID-19 pandemic. Beyond the increase in general rate of relative poverty, there is a higher risk of poverty among elderly and families in a high demand of care, especially if situations of Activities Daily Living (ADL) disability are present. Italian welfare, which is based on family care regimes and regional strategies, and is oriented to private or public care, is a relevant case study with which to analyze such a relationship. This paper aims to study the relationship between ADL disability and the socio-economic deprivation of families, that is, household poverty. Variables came from the ISTAT Health for All Italian Database and the INAIL Disability Allowance Database. A pool of statistical methods, based on bivariate and multivariate analyses, from bivariate correlation, through multiple linear regression to principal component factor analysis, were used to reduce the number of the variables and compute the indicators. The multivariate analysis underlines how ADL disability impacts on a household’s poverty, confirming the existence of statistical correlation between them. Moreover, the study identifies and measures two answer capability models to cope with household poverty. The answer capability of the formal system is the main tool for reducing poverty due to one family member’s ADL disability. Integration and collaboration between the formal system and family capabilities remains the main solution.
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Bell JF, Whitney RL, Keeton V, Young HM. Caregiver Characteristics and Outcomes Associated With Level of Care Complexity for Older Adults. Res Gerontol Nurs 2021; 14:117-125. [PMID: 34039151 DOI: 10.3928/19404921-20210427-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Care in the home is increasingly complex, with family caregivers now expected to take on aspects of care previously managed by nurses and other health professionals. In a national sample of caregivers of older adults, we examined predictors and outcomes of level of care (low, medium, high) based on caregiving hours and counts of activities of daily living (ADLs) and instrumental ADLs supported. Characteristics associated with high level of care include Hispanic or "other" race/ethnicity, being unemployed, and specific care recipient conditions (e.g., Alzheimer's disease/dementia, cancer, mobility limitations). High compared to low level of care is also associated with caregiving difficulty and unmet needs. These findings underscore the need for targeted interventions and nursing research to further understand the features and dynamics of care complexity. Such research can inform family-centered interventions, health care system redesign, and health policies to support family caregivers of older adults engaged in complex care. [Research in Gerontological Nursing, 14(3), 117-125.].
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Aung MN, Moolphate S, Yuasa M, Aung TNN, Koyanagi Y, Supakankunti S, Ahmad I, Kayano R, Ong P. Community-Integrated Intermediary Care (CIIC) Service Model to Enhance Family-Based, Long-Term Care for Older People: Protocol for a Cluster Randomized Controlled Trial in Thailand. JMIR Res Protoc 2021; 10:e20196. [PMID: 33759787 PMCID: PMC8088866 DOI: 10.2196/20196] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 10/02/2020] [Accepted: 02/24/2021] [Indexed: 01/22/2023] Open
Abstract
Background Thailand is one of the most rapidly aging countries in Asia. Traditional family-based care, which has been the basis of most care for older people, is becoming unsustainable as families become smaller. In addition, women tend to be adversely affected as they still form the bulk of caregivers for older people, and many are likely to exit the labor market in order to provide care. Many family caregivers also have no or minimal training, and they may be called upon to provide quite complex care, increasing the proportion of older people receiving suboptimal care if they rely only on informal care that is provided by families and friends. Facing the increasing burden of noncommunicable diseases and age-related morbidity, Thai communities are increasingly in need of community-integrated care models for older persons that can link existing health systems and reduce the burden upon caring families. This need is common to many countries in the Association of Southeast Asian Nations (ASEAN). Objective In this study, we aimed to assess the effectiveness of a community-integrated intermediary care (CIIC) model to enhance family-based care for older people. Methods This paper describes a cluster randomized controlled trial comprised of 6 intervention clusters and 6 control clusters that aim to recruit 2000 participants in each arm. This research protocol has been approved by the World Health Organization Ethics Review Committee. The intervention clusters will receive an integrated model of care structured around (1) a community respite service, (2) the strengthening of family care capacity, and (3) an exercise program that aims to prevent entry into long-term care for older people. Control group clusters receive usual care (ie, the current system of long-term care common to all provinces in Thailand), consisting principally of a volunteer-assisted home care service. The trial will be conducted over a period of 2 years. The primary outcome is family caregiver burden measured at a 6-month follow-up, as measured by the Caregiver Burden Inventory. Secondary outcomes consist of biopsychosocial indicators including functional ability, as measured using an activity of daily living scale; depression, as measured by the Geriatric Depression Scale; and quality of life of older people, as measured by the EuroQol 5-dimensions 5-levels scale. Intention-to-treat analysis will be followed. Results The CIIC facility has been established. Community care prevention programs have been launched at the intervention clusters. Family caregivers are receiving training and assistance. However, the COVID-19 pandemic delayed the intervention. Conclusions Since ASEAN and many Asian countries share similar traditional family-based, long-term care systems, the proposed CIIC model and the protocol for its implementation and evaluation may benefit other countries wishing to adopt similar community-integrated care models for older people at risk of needing long-term care. Trial Registration Thai Clinical Trials Registry TCTR20190412004; http://www.thaiclinicaltrials.org/# International Registered Report Identifier (IRRID) DERR1-10.2196/20196
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Affiliation(s)
- Myo Nyein Aung
- Advanced Research Institute for Health Sciences and Faculty of International Liberal Arts, Juntendo University, Tokyo, Japan
| | - Saiyud Moolphate
- Department of Public Health, Faculty of Science and Technology, Chiang Mai Rajabhat University, Chiang Mai, Thailand
| | - Motoyuki Yuasa
- Faculty of International Liberal Arts, Juntendo University, Tokyo, Japan.,Department of Public Health, Juntendo University, Tokyo, Japan
| | | | - Yuka Koyanagi
- Tokyo Ariake University of Medical and Health Sciences, Tokyo, Japan
| | | | - Ishtiaq Ahmad
- Department of Public Health, Juntendo University, Tokyo, Japan
| | - Ryoma Kayano
- Centre for Health Development, World Health Organisation, Kobe, Japan
| | - Paul Ong
- Centre for Health Development, World Health Organisation, Kobe, Japan
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Wu SA, Morrison‐Koechl J, Slaughter SE, Middleton LE, Carrier N, McAiney C, Lengyel C, Keller H. Family member eating assistance and food intake in long‐term care: A secondary data analysis of the M3 Study. J Adv Nurs 2020; 76:2933-2944. [DOI: 10.1111/jan.14480] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Revised: 05/15/2020] [Accepted: 06/15/2020] [Indexed: 12/16/2022]
Affiliation(s)
| | | | | | | | | | - Carrie McAiney
- University of Waterloo Waterloo ON Canada
- Schlegel‐University of Waterloo Research Institute for Aging Waterloo ON Canada
| | | | - Heather Keller
- University of Waterloo Waterloo ON Canada
- Schlegel‐University of Waterloo Research Institute for Aging Waterloo ON Canada
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14
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Bell JF, Whitney RL, Young HM. Family Caregiving in Serious Illness in the United States: Recommendations to Support an Invisible Workforce. J Am Geriatr Soc 2020; 67:S451-S456. [PMID: 31074854 DOI: 10.1111/jgs.15820] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Revised: 11/20/2018] [Accepted: 12/26/2018] [Indexed: 11/28/2022]
Abstract
Family caregivers provide the vast majority of care for individuals with serious illness living in the community but are not often viewed as full members of the healthcare team. Family caregivers are increasingly expected to acquire a sophisticated understanding of the care recipient's condition and new skills to execute complex medical or nursing tasks, often without adequate preparation and support, and with little choice in taking on the role. This review draws on peer-reviewed literature, government reports, and other publications to summarize the challenges faced by family caregivers of older adults in the context of serious illness and to identify opportunities to better integrate them into the healthcare workforce. We discuss promising approaches such as inclusion of family caregivers in consensus-based practice guidelines; the "no wrong door" function, directing consumers to needed resources, regardless of where initial contact is made; and caregiver-friendly workplace policies allowing flexible arrangements. We present specific recommendations focusing on research, clinical practice, and policy changes that promote family-centered care and improve outcomes for caregivers as well as persons with serious illness. J Am Geriatr Soc 67:S451-S456, 2019.
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Affiliation(s)
- Janice F Bell
- Family Caregiving Institute, Betty Irene Moore School of Nursing, University of California, Davis, Davis, California
| | - Robin L Whitney
- Hillblom Center on Aging, University of California, San Francisco, Fresno, California
| | - Heather M Young
- Family Caregiving Institute, Betty Irene Moore School of Nursing, University of California, Davis, Davis, California
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15
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Abstract
AbstractIn the midst of a ‘care crisis’, attention has turned again to families who are viewed both as untapped care resources and as disappearing ones. Within this apparent policy/demographic impasse, we test empirically theorised trajectories of family care, creating evidence of diverse patterns of care across the lifecourse. The study sample, drawn from a Statistics Canada national survey of family care, comprised all Canadians aged 65 and older who had ever provided care (N = 3,299). Latent Profile Analysis yielded five distinct care trajectories: compressed generational, broad generational, intensive parent care, career care and serial care. They differed in age of first care experience, number of care episodes, total years of care and amount of overlap among episodes. Trajectories generally corresponded to previously hypothesised patterns but with additional characteristics that added to our understanding of diversity in lifecourse patterns of care. The five trajectories identified provide the basis for further understanding how time and events unfold in various ways across lifecourses of care. A gap remains in understanding how relationships with family and social network members evolve in the context of care. A challenge is presented to policy makers to temper a ‘families by stealth’ policy approach with one that supports family carers who are integral to health and social care systems.
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16
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Shinan-Altman S, Soskolne V, Ayalon L. Becoming a Home Care Worker: Job-Seekers' Push and Pull Factors. Res Aging 2019; 42:62-71. [PMID: 31709907 DOI: 10.1177/0164027519886176] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This study examined "push and pull" factors associated with the decision to become home care workers among job-seekers in Israel. Participants completed measures of ageism, anxiety about aging, attitudes toward the home care profession, and personal relationship with older adults. Of 1,492 participants, 32.0% accepted the offer to become home care workers and were no longer in the job market, 36.7% accepted the offer but worked in the past, and 31.2% refused the offer. Compared to participants currently employed, the odds of being employed in the past were higher for participants who were younger, with poorer health and higher ageism; the odds of refusal were higher for males, Arabs, younger participants, with more education, lower ageism, and fewer personal relationship with older adults. The findings have implications for practice with job-seekers and for retaining current home care workers in the field. This may assist in expanding the home care workforce.
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Affiliation(s)
- Shiri Shinan-Altman
- Louis and Gabi Weisfeld School of Social Work, Bar-Ilan University, Ramat Gan, Israel
| | - Varda Soskolne
- Louis and Gabi Weisfeld School of Social Work, Bar-Ilan University, Ramat Gan, Israel
| | - Liat Ayalon
- Louis and Gabi Weisfeld School of Social Work, Bar-Ilan University, Ramat Gan, Israel
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17
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Obayashi K, Kodate N, Masuyama S. Enhancing older people’s activity and participation with socially assistive robots: a multicentre quasi-experimental study using the ICF framework. Adv Robot 2018. [DOI: 10.1080/01691864.2018.1528176] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Affiliation(s)
| | - Naonori Kodate
- School of Social Policy, Social Work and Social Justice, University College Dublin, Dublin, Ireland
| | - Shigeru Masuyama
- Travellers Medical Centre, Tokyo Medical University Hospital, Tokyo, Japan
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