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At least 1,063 records · Page 59Linked to original sources
PubMed2004

A national census of care home residents.

BACKGROUND: the medical and dependency characteristics of UK care home residents have not been well described. This undermines care commissioning, development and regulation. Data to inform policy and practice are needed. OBJECTIVE: to survey the dependency and clinical diagnoses of 16,043 people resident in the 244 care homes distributed across the UK managed by the largest provider of care in the UK. RESULTS: (i) Return rate of 97% (15,483 returns suitable for analysis). (ii) 25% were 'residential' and 75% in 'nursing' care. (iii) Medical morbidity and associated disability rather than non-specific frailty and social needs had driven admission in over 90% of residents. (iv) More than 50% of residents had dementia, stroke or other neurodegenerative disease. (v) Overall, 76% of residents required assistance with their mobility or were immobile. 78% had at least one form of mental impairment and 71% were incontinent. 27% of the population were immobile, confused and incontinent. (vi) Considerable overlap in dependency between residential and nursing care observed: only 40% of those in residential care were ambulant without assistance and 46% were incontinent. CONCLUSIONS: the practicality of acquiring information on care home residents has been demonstrated. The care needs of people in care homes are largely determined by progressive chronic diseases. A single assessment and commissioning at the point of entry to care services is unlikely to address changing needs. Alternatives to institutional long-term care should only be considered in the context of current resident profiles, the practicality of providing alternative models and likely projected population needs.

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PubMed2005

American Indian/Alaskan Native grandparents raising grandchildren: findings from the Census 2000 Supplementary Survey.

This article documents the prevalence and national profile of American Indian/Alaskan Native (AI/AN) grandparents who are raising their grandchildren, based on data from the American Community Survey/Census 2000 Supplementary Survey. In 2000 there were estimated to be nearly 53,000 AI/AN grandparent caregivers age 45 and older in the United States. Almost half of the caregiving grandparents had been raising a grandchild for five years or longer. The findings reveal a portrait of grandparents committed to raising their grandchildren despite the fact that many were living in extreme poverty, with ill health, and with limited resources and services. One-third of grandparent caregivers were living below the poverty line, and only one-quarter of these were receiving public assistance. Even when compared with their noncaregiving AI/AN peers, grandparents raising grandchildren were disproportionately female, poor, living with a functional disability, and living in overcrowded conditions. Implications for social work practice are presented and recommendations for policy and research are discussed.

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PubMed2000

Relation between income inequality and mortality in Canada and in the United States: cross sectional assessment using census data and vital statistics.

OBJECTIVE: To compare the relation between mortality and income inequality in Canada with that in the United States. DESIGN: The degree of income inequality, defined as the percentage of total household income received by the less well off 50% of households, was calculated and these measures were examined in relation to all cause mortality, grouped by and adjusted for age. SETTING: The 10 Canadian provinces, the 50 US states, and 53 Canadian and 282 US metropolitan areas. RESULTS: Canadian provinces and metropolitan areas generally had both lower income inequality and lower mortality than US states and metropolitan areas. In age grouped regression models that combined Canadian and US metropolitan areas, income inequality was a significant explanatory variable for all age groupings except for elderly people. The effect was largest for working age populations, in which a hypothetical 1% increase in the share of income to the poorer half of households would reduce mortality by 21 deaths per 100 000. Within Canada, however, income inequality was not significantly associated with mortality. CONCLUSIONS: Canada seems to counter the increasingly noted association at the societal level between income inequality and mortality. The lack of a significant association between income inequality and mortality in Canada may indicate that the effects of income inequality on health are not automatic and may be blunted by the different ways in which social and economic resources are distributed in Canada and in the United States.

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