Services and Support
Factors Influencing Senior Care: Two Generations’ Perspectives, Providing Support and Supported
Paper Presentation in a Themed Session Zofia Szweda Lewandowska
The process of population aging implies an increased need for assistance to the elderly. Disabilities or chronic illnesses may further impair one’s ability to live on one’s own, perform household chores, and take care of one’s needs. Other factors determining the possibility of obtaining care include: family status, informal non-family support networks, services offered by private companies, and the capacity of local authorities to supply care (in the form of personal household services or institutional care). The aim of the conducted research was to identify demand for care among the seniors aged seventy-five plus and to diagnose how do they function in atomized families. The analytical approach is to examine the care of elderly from the perspective of two generations, supported (seniors) and supporting (the family caregivers), and to identify the implications of an aging population and family network verticalization for elderly care system. This was achieved by pursuing the following specific objectives: Diagnosis of the situation of the needs of the oldest seniors in care. The degree of care to meet the needs of the family (reconciliation of professional and caring by those providing support); Indication of possibilities to improve the efficiency of support to the oldest seniors through the analysis of potential care needs of the family, the local government and the health care system; and Estimation of the future growth of demand for assistance provided not only by family and close friends, but also by care services and through institutional support (especially when the senior has no family or the family cannot provide adequate care).
Factors Affecting Discharge to Home of Geriatric Health Services Users: An Analysis of Physical Conditions and the Contents of Care Received
Paper Presentation in a Themed Session Kazutoshi Furukawa
Japan’s long-term care insurance system, which was put in place in 2000, is roughly divided into at-home care services and facility services. Facility services comprise three types: special nursing homes, geriatric health service facilities, and medical care facilities. To obtain useful findings for the promotion of discharge to home, this study analyzes the discharge-related data of a geriatric health services facility promoting home care. On examining the 52-month data (from 2012) of 541 users discharged from the facility, the energy intake was shown to most markedly influence the feasibility of discharge to home, followed by the duration of the time spent out of bed and nocturnal incontinence rate. The importance of mealtime assistance and necessity of prolonging the duration of the time spent out of bed by supporting diurnal arousal and independent urination during the night-time were also suggested as effective approaches to promote discharge to home.
The Role of Successful Aging and Service Quality in Quality of Life in Assisted Living and Long Term Care Residences
Paper Presentation in a Themed Session Helen Kelley, Carla Carnaghan
Traditional long term care and assisted living represent two distinct care models with differing costs for the elderly who can no longer live independently. With increasing numbers of frail seniors needing supportive care given increasing life expectancy, it becomes important to understand how these two models affect quality of life, as well as the role of service quality in quality of life. We survey seniors and their families in long-term care and assisted living residences using Raphael et al’s (1995) Quality of Life Profile – Seniors Version. This instrument reflects a holistic quality of life definition incorporating health, functional, social, environmental, and psychological dimensions. Respondents also completed Linn and Linn’s (1984) self-evaluation of life function instrument, as well as questions capturing service quality and demographic information. We create a proxy for successful aging as a cumulative index of individual health capabilities, using Mejia et al’s (2017) proxy. Our proxy for service quality has the same dimensions as the Quality of Life Profile, and incorporates questions from existing resident satisfaction surveys. We find that on a univariate basis, respondents in assisted living generally report higher quality of life at each level of health capabilities. On a multivariate basis, controlling for age, gender, education and respondent type, the most important determinant of the quality of life proxy is service quality, followed by health resources then the care model. Results suggest that assisted living may represent a viable care model from a quality of life perspective even for residents with fewer health capabilities.
