scholarly journals Housing Choices of Older People: Staying or Moving in the Case of High Care Needs

2020 ◽  
Vol 12 (7) ◽  
pp. 2888
Author(s):  
Maša Filipovič Hrast ◽  
Richard Sendi ◽  
Boštjan Kerbler
Keyword(s):  
Home Care ◽  
Older People ◽  
Care Home ◽  
Supported Housing ◽  
Three Dimensions ◽  
Care Needs ◽  
Daycare Centre ◽  
High Care ◽  
Staying At Home ◽  
At Home

Despite the development of various housing options across Europe, older people often face the choice of staying at home with the support of family and/or formal services or moving to a care home, but how people vary regarding these preferences and how newer cohorts will be different is under-researched. This study explores the housing choices of older people under the condition of liminality, which is defined as the hypothetical condition of high care needs. The most common choices available are compared; that is, staying at home (with social home-care support or visits to a daycare centre) or moving to supported housing or a care home. Cluster analysis revealed five distinct groups of older people that were differentiated in their choices between various options of moving versus staying at home, either by using home care or daycare. Differences between the clusters along three dimensions that influence decisions to move or stay, namely levels of attachment, satisfaction with housing and availability of support, which often function as limits on the options that are preferred, were explored. The results present the complexity of the decision-making process under imagined conditions of liminality and show a great diversity among people’s preferences. They also indicate that a significant share of older people have a strong preference for only one option (two of the cluster groups).

scholarly journals Older and ‘staying at home’ during lockdown: informal care receipt during the COVID-19 pandemic amongst people aged 70 and over in the UK

2020 ◽  
Author(s):  
Maria Evamdrou ◽  
Jane Falkingham ◽  
Min Qin ◽  
Athina Vlachantoni
Keyword(s):  
Older People ◽  
Daily Living ◽  
Community Action ◽  
Living Alone ◽  
Care Needs ◽  
Different Types ◽  
Household Members ◽  
The Uk ◽  
Staying At Home ◽  
At Home

On 23 March 2020 the UK went into lockdown in an unprecedented step to attempt to limitthe spread of coronavirus. Government advice at that time was that all older people aged 70and over should stay at home and avoid any contact with non-household members. This studyuses new data from the Understanding Society COVID 19 survey collected in April 2020,linked to Understanding Society Wave 9 data collected in 2018/19, in order to examine theextent of support received by individuals aged 70 and over in the first four weeks oflockdown from family, neighbours or friends not living in the same household, and how thatsupport had changed prior to the outbreak of the coronavirus pandemic. The researchdistinguishes between different types of households as, given with guidance not to leavehome and not to let others into the household, those older people living alone or living onlywith a partner also aged 70 and above are more likely to be particularly vulnerable. Theresults highlight both positive news alongside causes for concern. The receipt of assistancewith Instrumental Activities of Daily Living (IADLs), especially shopping, has increasedparticularly among those living alone or with an older partner, reflecting the rise ofvolunteering and community action during this period. However, not all older people reporteda rise, and the majority reported ‘no change’, in the support received. Moreover, amongstthose older people reporting that they required support with at least one Activity of DailyLiving (ADL) task prior to the pandemic, around one-quarter reported receiving no care fromoutside the household and one-in-ten of those with two or more ADL care needs reportedreceiving less help than previously. Although formal home care visits have continued duringthe pandemic to those who have been assessed by the local government to be in need, it isimportant to acknowledge that some older people risk not having the support they need.

scholarly journals In-home monitoring evaluation by home-dwelling older adults, caregivers and healthcare providers

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
B Pais ◽  
P Buluschek ◽  
T Nef ◽  
N Schütz ◽  
H Saner ◽  
...  
Keyword(s):  
Older Adults ◽  
Home Care ◽  
Older People ◽  
Healthcare Providers ◽  
Home Monitoring ◽  
Daily Activities ◽  
Healthcare Needs ◽  
Monitoring Technologies ◽  
The Impact ◽  
At Home

Abstract Background In Europe, population ageing is increasing the healthcare needs and costs. Both frailty and chronic diseases affecting older people reduce their ability to live independently. However, most older people prefer to age in their own homes. New development of in-home monitoring can play a role in staying independent, active and healthy. Our objective was to evaluate a new in-home monitoring system among home-dwelling older adults (OA), their family caregivers (FC), and their healthcare providers (HCP) for the support of home care. Methods The system continuously monitored OA’s daily activities (e.g., mobility, sleep habits, fridge visits, door events) at home by ambient sensor system (DomoCare®) and health-related events by wearable sensors (Fitbit®, ECG). In case of deviations in daily activities (e.g., changes in mobility), alerts were transmitted to HCP via email. Using specific questionnaires, the opinion of 13 OA, 13 FC, and 20 HCP were collected at the end of 12-month of follow-up focusing on their user experience and the impact of in-home monitoring on home care services. Results These preliminary results underlined that the majority of OA, FC, and HCP consider that in-home sensors can help staying at home, improving home care, reducing family stress, and preventing domestic accidents. The opinion tended to be more favourable toward ambient sensors (80%) than toward Fitbit® (67%) and ECG (64%). On average, OA (80%) and FC (73%) tended to be more enthusiast than HCP (63%). Some barriers reported by HCP were a fear of weakening of the relationship with OA and an excessive surveillance. Conclusions Overall, the opinion of OA, FC and HCP were positive related to in-home sensors, with HCP being more mixed about their use in clinical practice. Key messages In-home monitoring technologies seem to be generally well accepted. In-home monitoring technologies could be help facilitating home care of older people.

scholarly journals Unmet care needs are common among community-dwelling older people with memory problems in Finland

2019 ◽  
pp. 140349481989080 ◽  
Author(s):  
Mari S. Aaltonen ◽  
Lina H. Van Aerschot
Keyword(s):  
Home Care ◽  
Older People ◽  
Home Care Services ◽  
Community Dwelling ◽  
Care Needs ◽  
Care Services ◽  
Memory Problems ◽  
More Care ◽  
Community Dwelling Older People ◽  
With Memory

Aims: Ageing in place has become a policy priority. Consequently, residential care has been reduced, and more older people with multiple care needs reside at home with the help of informal care and home care services. An increasing share of these people has memory disorders. We examined the extent to which memory problems, in addition to other individual characteristics, are associated with unmet care needs among community-dwelling older people. Methods: The study employed cross-sectional survey data from community-dwelling people aged 75+ collected in 2010 and 2015, analysed using binary logistic regression analysis. The study population consisted of people who had long-term illnesses or disabilities that limited their everyday activities ( N = 1928). Nine per cent reported substantial memory problems. Of these, 35.7% had a proxy respondent. Results: People with memory problems have more care needs than those with other types of disability or illness. They receive more care but still have more unmet needs than others. About a quarter of people with memory problems reported that they did not receive enough help. This result did not change significantly when the proxy responses were excluded. Even a combination of informal and formal home care was insufficient to meet their needs. Conclusions: Insufficient care for people with memory problems implies a serious demand for further development of home care services. The care needs of this population are often complex. Unmet needs represent a serious risk to the well-being of people with memory disorders, and may also create an extensive burden on their informal caregivers.

scholarly journals Comprehensive assessment of older people with complex care needs: the multi-disciplinarity of the Single Assessment Process in England

2010 ◽  
Vol 30 (7) ◽  
pp. 1115-1134 ◽  
Author(s):  
DAVID CHALLIS ◽  
MICHELE ABENDSTERN ◽  
PAUL CLARKSON ◽  
JANE HUGHES ◽  
CAROLINE SUTCLIFFE
Keyword(s):  
Older People ◽  
Social Care ◽  
Local Authority ◽  
Care Home ◽  
Comprehensive Assessment ◽  
Assessment Process ◽  
Care Plan ◽  
Assessment Practice ◽  
Care Needs ◽  
Health And Social Care

ABSTRACTThe quality of assessment of older people with health and social care needs has for some time been a concern of policy makers, practitioners, older people and carers in the United Kingdom and internationally. This article seeks to address a key aspect of these concerns, namely whether sufficient expertise is deployed when, as a basis for a care plan and service allocation, an older person's eligibility for local authority adult social-care services requires a comprehensive needs assessment of their usually complex and multiple problems. Is an adequate range of professionals engaged, and is a multi-disciplinary approach applied? The Single Assessment Process (SAP) was introduced in England in 2004 to promote a multi-disciplinary model of service delivery. After its introduction, a survey in 2005–06 was conducted to establish the prevalence and patterns of comprehensive assessment practice across England. The reported arrangements for multi-disciplinary working among local authority areas in England were categorised and reviewed. The findings suggest, first, that the provision of comprehensive assessments of older people that require the expertise of multiple professionals is limited, except where the possibility arose of placement in a care-home-with-nursing, and second that by and large a systematic multi-disciplinary approach was absent. Policy initiatives to address the difficulties in assessment need to be more prescriptive if they are to produce the intended outcomes.

scholarly journals When Frail Older People Relocate in Very Old Age, Who Makes the Decision?

2019 ◽  
Vol 3 (4) ◽  
Author(s):  
Fiona Scheibl ◽  
Morag Farquhar ◽  
Jackie Buck ◽  
Stephen Barclay ◽  
Carol Brayne ◽  
...  
Keyword(s):  
Decision Making ◽  
Older People ◽  
Old Age ◽  
Residential Care ◽  
Care Home ◽  
Later Life ◽  
Old People ◽  
Care Needs ◽  
Health Crisis ◽  
Age In Place

Abstract Background and Objectives Older people are likely to transition to a new home closer to family who can provide assistance or to long-term residential care as their health declines and their care needs increase. A minority choose to move to “age-friendly” housing before the onset of disability, but the majority prefer to “age in place” and defer moving until health crises compel a transition. Older people living with dementia are likely to move into residential care, but not much is known about the role they play in decision making around these moves. This qualitative study addresses this gap in knowledge by examining how a rare cohort of “older old” people, most with some level of cognitive impairment, were involved in decisions surrounding assistance seeking and moving to a care home. Research Design and Methods Thematic analysis of qualitative interview data from Cambridge City over-75s Cohort (CC75C) study participants aged 95 years and older, who had moved in later life, and their proxy informants (n = 26). Results Moves at such an old age were made due to a complexity of push and pull factors which had layered dynamics of decision making. In most cases (n = 22), decision making involved other people with varying degrees of decision ownership. Only four older people, who moved voluntarily, had full ownership of the decision to move. Many relatives reported being traumatized by events leading up to the move. Discussion and Implications “Older old” people are sometimes unable to make their own decisions about moving due to the urgency of health crisis and cognitive decline. There is a need to support relatives to discuss moving and housing options at timely junctures before health crises intervene in an effort to optimize older people’s participation in decision making.

scholarly journals Involuntary Treatment in Dementia Care at Home: Results From the Netherlands and Belgium

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 664-665
Author(s):  
Vincent Moermans ◽  
Angela Mengelers ◽  
Michel Bleijlevens ◽  
Hilde Verbeek ◽  
Frans Tan ◽  
...  
Keyword(s):  
The Netherlands ◽  
Home Care ◽  
Secondary Data ◽  
Involuntary Treatment ◽  
Care Needs ◽  
Cross Sectional ◽  
Term Care ◽  
Systems Research ◽  
Increased Risk ◽  
At Home

Abstract Most PwD remain living at home. Due to complex care needs this can result in an increased risk for care provided against the wishes of the client and/or to which the client resists, referred to as involuntary treatment. This study explores the use and factors associated with involuntary treatment in PwD receiving home care in the Netherlands and Belgium. A secondary data analysis of two cross-sectional surveys (n=844 persons) showed that more than half of the PwD (51%) living at home received involuntary treatment (Belgium 68% and the Netherlands 45%). Non-consensual care (83%) was the most common, followed by psychotropic medication (41%) and physical restraints (18%). Involuntary treatment was associated with living alone, greater ADL dependency, lower cognitive ability, higher family caregiver burden and receiving home care in Belgium versus the Netherlands. In order to provide person-centered care, it is important to study ways to prevent involuntary treatment in PwD. Part of a symposium sponsored by Systems Research in Long-Term Care Interest Group.

Evaluating automated goals for home care support

2016 ◽  
Vol 10 (2) ◽  
pp. 79-91 ◽  
Author(s):  
Julia S Clark ◽  
Kenneth J. Turner
Keyword(s):  
Home Care ◽  
Social Care ◽  
Research Question ◽  
End Users ◽  
Informal Carer ◽  
Care Needs ◽  
Content Type ◽  
Care At Home ◽  
Care System ◽  
At Home

Purpose – The purpose of this paper is to evaluate an approach to automating goals for supporting home care, with a view to understanding user experience when defining such goals and hence identifying improvements that could be made to the approach. Design/methodology/approach – The study was designed to answer the key research question of whether users can understand, formulate and relate to automated goals for home care. In order to do this, a fictional text-based scenario was used about a couple with care needs. This helped to explore the feasibility, acceptability and usability of goals to manage care at home. Face-to-face qualitative interviews were undertaken with ten participants with a background in social care: four social care professionals; one health care professional; one formal carer; one informal carer; and three end users. Findings – Overall, participants were positive about being able to control the MATCH (Mobilising Advanced Technologies for Care at Home) system through the use of goals. The results from the participant interviews will be used to help guide potential improvements to the home care system. The main issue that emerged from the study is that it would be valuable to think in terms of outcomes as a higher level than goals. A second consideration is that it would be desirable to adopt terminology that can be understood by all stakeholders. Research limitations/implications – The study has demonstrated that automated goals for home care have a useful role to play and can be successfully used by end users and carers. Although the range of participants in the study was limited, it has allowed confidence to be built in the approach and has identified useful pointers for future development. Practical implications – With the evaluation and validation of the goal-based approach, it has encouraged the developers to make automated goals more widely available in future deployment of the home care system. Social implications – The use of automated goals to support home care has been shown to be acceptable to end users and carers. This will allow future home care systems to offer more personal and better customised services to those receiving telecare. Originality/value – The study provides a unique evaluation of the use of automated goals to support home care. Previous use of goals in the literature has been for highly technical applications, so their application to home care is novel and speculative. The study has demonstrated that the approach is viable, useful, and usable by end users and carers.

scholarly journals Personal care and practical support at home: a systematic review of older people’s views and experiences

2019 ◽  
Vol 23 (2) ◽  
pp. 87-106
Author(s):  
Irene Kwan ◽  
Deborah Rutter ◽  
Beth Anderson ◽  
Claire Stansfield
Keyword(s):  
Systematic Review ◽  
Home Care ◽  
Older People ◽  
Bibliographic Databases ◽  
Care Providers ◽  
Personal Care ◽  
Content Type ◽  
Time To Build ◽  
Care And Support ◽  
At Home

Purpose Considering the views of service users is important to identify their needs as this helps providers to develop appropriate and responsive services. For older people receiving home care, recognising their needs is the first step towards supporting them to maintain independence and promote wellbeing. The paper aims to discuss these issues. Design/methodology/approach A systematic review was conducted in 2014 to explore the personal experiences of older people in England about the care and support they received at home. Studies published between 2004 and 2013 were identified from bibliographic databases and websites. A total of 17 studies satisfied the inclusion criteria. Data were extracted using a standardised coding tool and narratively synthesised. Study quality was evaluated. Findings Nine themes were identified. Older people valued an approach that was person centred, flexible and proactive to respond to their changing needs and priorities, focusing on what they can or would like to do to maintain their independence. Allowing time to build trust between older people and their care workers helped to realise older peoples’ aspirations and goals. Practical help to promote choice and reduce social isolation was perceived to be as important as personal care. Practical implications Evidence from this review contributed to the development of a social care guideline on home care, and informed key practice recommendations for care providers in England. Originality/value This review highlighted the value older people place in person-centred care incorporating practical help both inside and outside the realm of personal care.

scholarly journals A qualitative study of older people with minimal care needs experiences of their admission to a nursing home with Registered Nurse care

2015 ◽  
Vol 16 (2) ◽  
pp. 94-105 ◽  
Author(s):  
Alice K. Stevens ◽  
Helen Raphael ◽  
Sue M. Green
Keyword(s):  
Decision Making ◽  
Grounded Theory ◽  
Qualitative Study ◽  
Older People ◽  
Registered Nurse ◽  
Care Home ◽  
Care Homes ◽  
Care Needs ◽  
Content Type ◽  
Health And Social Care

Purpose – Residential care for older people in the UK includes care homes with and without 24-hour Registered Nurse (RN) care. Reduced autonomy and personal wealth can result when people assessed as having minimal care needs, enter and reside in care homes with RN care. The purpose of this paper is to explore the experiences of older people with minimal care needs admission to care homes with RN care. Design/methodology/approach – A qualitative study using a grounded theory method was undertaken. In total, 12 care home with RN care residents assessed as not requiring nursing care were interviewed. Initial sampling was purposive and progressed to theoretical. Interviews were analysed using the grounded theory analysis method of constant comparison and theory development. Findings – Two main categories emerged: “choosing the path”, which concerned the decision to enter the home, and “settling in”, which related to adaptation to the environment. Findings suggested participants who perceived they had greater control over the decision-making process found it easier to settle in the care home. The two categories linked to form an emerging framework of “crossing the bridge” from independent living to care home resident. Research limitations/implications – The findings contribute to the understanding of factors influencing admission of older people with minimal care needs to care homes with RN care and highlight the importance of informed decision making. Practical implications – Health and social care professionals must give informed support and advice to older people seeking care options to ensure their needs are best met. Originality/value – This study enabled older people with minimal care needs admission to care homes with RN care to voice their experiences.

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