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PubMed2004

Culture and long-term care: the bath as social service in Japan.

A central feature of Japan's approach to community-based care of the elderly, including long-term home health care, is the emphasis on providing bath facilities. For mobile elders, senior centers typically provide a public bathing facility in which people can enjoy a relaxing soak along with friends who also visit the centers. In terms of in-home long-term care, visiting bath services are provided to assist family care providers with the difflcult task of bathing a frail or disabled elder--a task made more problematic as a result of the Japanese style of bathing. I argue that the bath, as social service, is a culturally shaped solution to a specific problem of elder care that arises in the Japanese context as a result of the importance of the bath in everyday life for Japanese. While the services may be considered specific to Japan, some aspects of bathing services, particularly the mobile bath service, may also have applicability in the United States.

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PubMedDate not supplied

Bridging the gaps in geriatric care. Volunteers help meet the elderly's nonmedical needs.

Concerned about the paucity of services for elderly who need care but prefer to live at home, Our Lady of Lourdes Medical Center, Camden, NJ, embarked on an effort to obtain grant funds while seeking creative ways to meet the elderly's nonmedical needs. One of the first programs developed was a Senior Companion Program. This federally funded program recruits low-income elderly citizens, trains them, and places them in the homes of seniors who need nonmedical services to remain in the community. The program's success led to the establishment of Helping Hands in the Community, which recruits volunteers of all ages and incomes to serve as companions for seniors. An extension of this program, Helping Hands in Business, sought to help employers reduce the costs associated with lost productivity because of employees' responsibilities as care givers for elderly family members. Finally, the Camden Senior Community Support Program uses aggressive case management in the emergency room and the hospital to determine whether the elderly need to be admitted to the hospital or can receive support from family or others to remain in the community.

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PubMed1998

Professionalization of home care aides in The Netherlands.

In The Netherlands, as elsewhere in the world, home care strives to keep patients home as long as possible. Home care aides play a large role in this effort, and the government has begun programs to make their jobs more professional.

Home Care Services↗
PubMed2003

[Consideration of home care for patients with advanced cancer as a surgeon].

There is a tendency to consider that home care is promoted as an alternative to reduce the mean duration of hospital stay. Home care must be carried out according to the wish of both the patient himself and his family. At present, home care has reached a high levels, so that it can be carried out safely. As a surgeon, I think that we must make use of the system of home care established to allow patients to live at home when they wish to do so, and I want to let them stay in the hospital if they prefer so.

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PubMed2003

[Management of home care for the advanced cancer patient from the standpoint of home hospice].

We offer home hospice care to patients with bowel obstruction associated with advanced gastrointestinal cancer, who hope to leave hospital and be cared at home, if they understand their condition and if their families also hope to live with the patients, so that the patients can live at home to the last breath. To master various palliative techniques and nursing care services are indispensable to assure home hospice care. In this case, 1. guidance about HPN, 2. guidance about pain control, 3. arrangement of visiting nurse services and 4. application for the long-term care insurance and procurement of the bed and other nursing goods needed to be completed before the discharge from the hospital, and it is important to complete these preparations rapidly in a short period. The 24-hour communication system and appropriate care for new symptoms are the key for successfully shifting to home hospice care. At the final stage, it is important to support families and repeatedly provide guidance for the peaceful death.

Community Health Nursing↗
PubMed2004

Current and future worldwide prevalence of dependency, its relationship to total population, and dependency ratios.

OBJECTIVE: To estimate the number of people worldwide requiring daily assistance from another person in carrying out health, domestic or personal tasks. METHODS: Data from the Global Burden of Disease Study were used to calculate the prevalence of severe levels of disability, and consequently, to estimate dependency. Population projections were used to forecast changes over the next 50 years. FINDINGS: The greatest burden of dependency currently falls in sub-Saharan Africa, where the "dependency ratio" (ratio of dependent people to the population of working age) is about 10%, compared with 7-8% elsewhere. Large increases in prevalence are predicted in sub-Saharan Africa, the Middle East, Asia and Latin America of up to 5-fold or 6-fold in some cases. These increases will occur in the context of generally increasing populations, and dependency ratios will increase modestly to about 10%. The dependency ratio will increase more in China (14%) and India (12%) than in other areas with large prevalence increases. Established market economies, especially Europe and Japan, will experience modest increases in the prevalence of dependency (30%), and in the dependency ratio (up to 10%). Former Socialist economies of Europe will have static or declining numbers of dependent people, but will have large increases in the dependency ratio (up to 13%). CONCLUSION: Many countries will be greatly affected by the increasing number of dependent people and will need to identify the human and financial resources to support them. Much improved collection of data on disability and on the needs of caregivers is required. The prevention of disability and provision of support for caregivers needs greater priority.

Activities of Daily Living↗
PubMed2006

[Public social health services to demented persons living at home in Norway].

BACKGROUND: About 50% of the 65,000 elderly with dementia in Norway live in their own homes, and are cared for by their families and social and health care personnel in the municipalities. According to governmental documents, the provision of help to demented patients should be predictable, continuous, individually tailored, and carried out by few helpers. The purpose of this study was to examine public social and health services provided to demented patients living at home. MATERIAL AND METHODS: Provision of public care to 460 patients from 24 municipalities, was recorded for seven consecutive days. The average patient age was 82 years (SD 7.1), 74% were women. Degree of dementia was assessed with the Clinical Dementia Rating scale (CDR). Functional status and need of help was assessed with the Rapid Disability Rating Scale-2 (RDRS 2). RESULTS AND INTERPRETATION: . Of the 460 patients, 54% had received a diagnosis by a physician. On average, 8 (SD 4) different people helped for 5.4 ( SD: 6.3) hours a week. Help was most frequently given to; take medicines, prepare food, carry out personal Activity of Daily Living (ADL) and to clean the house. Some did not receive enough help and a few received too much. Patients with a dementia diagnosis did not receive more help than those without. The results indicate that Norwegian municipalities provide a substantial amount of health services, but fail to tailor plans according to individual needs.

Activities of Daily Living↗
PubMed1990

Costs of community care for disabled elderly persons: the policy implications.

This paper presents results from our analysis of the National Long-Term Care Channeling Demonstration Project data. We used this data to estimate the costs of community-based long-term care services for disabled elderly persons. Our results indicate that both costs per community day and the likelihood that any costs would be incurred, would increase noticeably if a program similar to the Channeling project were implemented nationally. To illustrate the effects of disability-based eligibility criteria on total program costs, we present unit costs in conjunction with numbers of persons having different levels of ADL dependency.

Activities of Daily Living↗
PubMed1996

[Effects of technical aids on the utilization of professional care. A study among single 75-year olds].

In this paper we describe the results of a project, in which occupational therapists visited 83 independently living, single, elderly people (clients of organisations providing care) and advised them about technical aids. Subsequently some technical aids were provided. The intervention group received, on average, three out of five advised technical aids. The effect of this intervention was an increase in the use of technical aids (people used, on average, two technical aids more at the end of the project), which means that the provided technical aids were being used. This effect was stronger in the group of the 75-84 old persons than in the above 85 year old ones. This effect led to a change in people's attitudes towards technical aids: at the beginning of the project 80% of the elderly believed technical aids could help them to remain independent and at the end this percentage was 90%. There was a slight, non-significant, decrease in the number of hours home help (from 5,4 to 4,7 hours per week). However, we were unable to ascertain an effect on the percentage of elderly using community care or waiting for institutional care. This may have been due to the heterogeneity of the intervention, the small research population and the relatively short intervention period. Elderly should be assessed as being in need of technical aids at an earlier stage.

Activities of Daily Living↗