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Information and Communication Technologies in Long-term and Palliative Care

Reis, Andreia; Araújo Pedrosa, Anabela; Dourado, Marília; Reis, Catarina
Fonte: Elsevier Publicador: Elsevier
Tipo: Artigo de Revista Científica
ENG
Relevância na Pesquisa
75.7%
In the beginning of the 21st century we experienced a paradigm shift between the acute and infectious diseases to the chronic conditions, sustained by the aging of the population. Nevertheless, the education system for health professionals kept the traditional educational models. The main idea of the work here presented is to provide a literature review of the state of the art of information and communication technology (ICT) applied to Long-term and Palliative Care. We conducted an exhaustive investigation from Pubmed and Google Scholar using the Medical Subject Headings (MeSH) terms “information and communication technologies”, “e-Health”, “m-Health” and “long-term care”, “palliative care”. Currently, the existence of a critical mass of Internet users allows quickly diffusion of electronic communication in the medical practice, which translates as a new way to look at the doctor-patient relationship. It is important to define the various ways in which one can establish a doctor-patient communication, ensure the security and confidentiality of the information, create practical and "user friendly" interfaces that can be easily used by patients and ensure universal access to new technologies. Despite the existence of some literature on new information technologies applied to the health context...

 Envelhecimento ativo: uma contribuição para o desenvolvimento de instituições  de longa permanência amigas da pessoa idosa; Active ageing: a contribution to the development of Age-friendly long-term care institutions.

Kanashiro, Miriam Masako
Fonte: Biblioteca Digitais de Teses e Dissertações da USP Publicador: Biblioteca Digitais de Teses e Dissertações da USP
Tipo: Dissertação de Mestrado Formato: application/pdf
Publicado em 20/03/2012 PT
Relevância na Pesquisa
75.68%
Introdução - Um ambiente favorável ao envelhecimento ativo deve promover a manutenção da autonomia, da independência e a qualidade de vida à medida que se envelhece. Na realidade brasileira o cuidado de longa duração a idosos ocorre, principalmente, no ambiente familiar. Entretanto, o cuidado institucional tem aumentado o que requer serviços de qualidade. Objetivo - Identificar as características essenciais para que uma Instituição de Longa Permanência para Idosos (ILPI) possa ser definida como amigável à pessoa idosa. Método - Pesquisa qualitativa realizada através de observação participante, pesquisa documental e entrevista individual semi-estruturada, a 20 residentes, 10 familiares de residentes e 1 cuidador de idosos de 2 ILPI, utilizando-se uma versão adaptada do protocolo metodológico de Vancouver da OMS. Através da análise do material empírico obteve-se aspectos considerados relevantes para idosos e familiares para o estabelecimento de ILPI amiga do idoso. Resultados - As instituições necessitam fazer adaptações na estrutura física para o atendimento às normas vigentes. Para os entrevistados, o mobiliário é insuficiente para a guarda de pertences pessoais e alguns são ergonomicamente inadequados. Os residentes gostariam de ser tratados com mais afeto e respeito quanto às suas individualidades. A comunicação entre as instituições e os idosos pode ser mais eficiente. As atividades de ocupação do tempo livre ofertadas dependem das habilidades dos voluntários e envolvem poucos idosos. Reuniões da equipe técnica com residentes para discussão de assuntos relacionados ao lazer...

Micro Data Analysis of Medical and Long-Term Care Utilization Among the Elderly in Japan

Hashimoto, Hideki; Horiguchi, Hiromasa; Matsuda, Shinya
Fonte: Molecular Diversity Preservation International (MDPI) Publicador: Molecular Diversity Preservation International (MDPI)
Tipo: Artigo de Revista Científica
EN
Relevância na Pesquisa
85.75%
Japan is currently experiencing the most rapid population aging among all OECD countries. Increasing expenditures on medical care in Japan have been attributed to the aging of the population. Authors in the recent debate on end-of-life care and long-term care (LTC) cost in the United States and Europe have attributed time to death and non-medical care cost for the aged as a source of rising expenditures. In this study, we analyzed a large sample of local public insurance claim data to investigate medical and LTC expenditures in Japan. We examined the impact of aging, time to death, survivorship, and use of LTC on medical care expenditure for people aged 65 and above. On the basis of these findings, we conclude that age is a contributing factor to the rising expenditures on LTC, and that the contribution of aging to rising medical care expenditures should be distinguished according to survivorship.

Sexuality and Physical Intimacy in Long Term Care: Sexuality, long term care, capacity assessment

Lichtenberg, Peter A.
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
Publicado em /01/2014 EN
Relevância na Pesquisa
75.71%
Sexuality and sexual needs in older adults remains a neglected area of clinical intervention, particularly so in long term care settings. Because older adults in medical rehabilitation and long term care beds present with significant frailties, and often significant neurocognitive disorders it makes it difficult for occupational therapists and other staff to evaluate the capacity of an older adult resident to participate in sexual relationships. The current paper reviews the current literature on sexuality and aging, examines some of the clinical practices and guidelines regarding sexual expression in long term care and presents two case examples. A semi-structured interview and decision tree is presented to assist therapists in making careful and informed decisions and thereby balancing needs for protection with needs for autonomy.

Long-Term Care Policies for Older Populations in New EU Member States and Croatia : Challenges and Opportunities

World Bank
Fonte: Washington, DC Publicador: Washington, DC
EN_US
Relevância na Pesquisa
95.7%
The objective of this summary report is to highlight the main lessons learned from Organization for Economic Development and Co-operation (OECD) countries with advanced Long Term Care (LTC) policies and the implications for LTC policymaking in new European Union (EU) member states and Croatia. The first section examines the main findings from the framework report on the financing, provision and regulation of LTC services. The next section presents comparative findings from the four case study countries, including the demographic context for LTC services, the main features of the financing, provision and regulation of LTC services and the strengths and weaknesses of current LTC systems there. The last section identifies policy directions for the four case study countries. In terms of LTC benefits, none of the case study countries have a universal entitlement system combining home, community and institutional care. Rather, LTC benefits, both cash and in-kind, are limited and largely associated with the social assistance system. The lack of data on LTC expenditures mainly stems from the undefined position of LTC between the health and social sectors...

Some Economic Consequences of Global Aging : A Discussion Note for the World Bank

Lee, Ronald; Mason, Andrew; Cotlear, Daniel
Fonte: World Bank, Washington, DC Publicador: World Bank, Washington, DC
EN_US
Relevância na Pesquisa
75.81%
The note describes the importance of population aging world-wide, clarifying its prevalence among middle- and low-income countries, which suggests that many developing countries are getting old before they are growing rich. The note then asks in what way population aging is an economic problem and what are the specific challenges facing developing countries in this process. The note argues against the common, time-bomb perception?, and clarifies how a simplistic extrapolation from the impact of aging on single programs such as public pensions gives a misleading impression about the more general macroeconomic consequences of population aging, where numerous elements contribute to a more nuanced result. The note briefly discusses various topics of importance in the population aging debate, including: intergenerational flows, social contracts, the risk management element of old-age policies, and the impact of aging on health care costs. The note seeks to share a number of counterintuitive or simply non-intuitive facts...

Fiscal Policy Issues in the Aging Societies

Bogetic, Zeljko; Onder, Harun; Onal, Anil; Skrok, Emilia; Schwartz, Anita; Winkler, Hernan
Fonte: Banco Mundial Publicador: Banco Mundial
Tipo: Trabalho em Andamento
EN_US
Relevância na Pesquisa
75.86%
Aging may be one of the most far-reaching processes defining the economic, fiscal, and social changes societies are likely to experience over the next 40 years. The demographic consequences of aging will have a dramatic impact on labor markets, economic growth, social structures--and government budgets. These issues have gained urgency after the second largest global recession in the past 100 years. Based on a broad comparative analysis of countries that include the EU and non-EU European and Central Asian countries, as well as several case studies and model simulations, the paper seeks to provide broad answers--tailored in part to distinct groups of countries according to their aging-fiscal profiles--to major questions facing governments budgets in aging societies: What are the fiscal-aging profiles of Western European, emerging European, and Central Asian countries? In other words, how good or bad is their fiscal situation--"initial conditions"--in view of their emerging aging-related problems? What kind of public spending pressures are likely to emerge in the coming decades...

New perspectives in health care for older Americans (recommendations and policy directions of the Subcommittee on Health and Long-Term Care)

United States -- Congress. -- House. -- Select Committee on Aging. -- Subcommittee on Health and Long-Term Care
Fonte: U.S. Govt. Print. Off.; U.S. Govt. Print. Off. ( Washington ) Publicador: U.S. Govt. Print. Off.; U.S. Govt. Print. Off. ( Washington )
Tipo: Artigo de Revista Científica Formato: x, 92 p. : ; 24 cm.
Publicado em //1976 ENGLISH
Relevância na Pesquisa
135.74%
(Bibliography) Includes bibliographical references.; At head of title: Committee print.; (Statement of Responsibility) by the Subcommittee on Health and Long-Term Care of the Select Committee on Aging, House of Representatives, Ninety-fourth Congress, second session, January 1976.

Discharge-planning for long-term care needs: the values and priorities of older people, their younger relatives and health professionals

Denson, L.; Winefield, H.; Beilby, J.
Fonte: Taylor & Francis As Publicador: Taylor & Francis As
Tipo: Artigo de Revista Científica
Publicado em //2013 EN
Relevância na Pesquisa
75.65%
Discharge-planning decisions about long-term care (LTC) can be difficult and distressing for older people, families and discharge-planning health professionals. Retrospective research suggests that despite good intentions and a shared focus on the best interests of the older person, stakeholders may hold very different values about good outcomes and how to decide them. We aimed to compare the opinions and values of frail elders living at home, younger relatives and health professionals experienced in discharge-planning, prospectively: before, not after, a LTC decision. We interviewed three types of stakeholders (10 older people, 8 relatives and 18 health professionals) using a hypothetical vignette about a frail elder leaving hospital. In a mixed methods design, we quantitatively compared the discharge plans and decision-makers that stakeholders suggested, and qualitatively analysed the 36 interview transcripts for participants' articulation of underlying values during these discussions. Older participants often suggested safe restrictive options (residential care, proxy decision-making) for the hypothetical frail elder, while advocating autonomy for themselves. Younger people generally endorsed autonomous decision-making and less restrictive discharge options especially if the elder was mentally competent...

Values and long-term care decision-making for frail elderly people

Denson, Linley Alice
Fonte: Universidade de Adelaide Publicador: Universidade de Adelaide
Tipo: Tese de Doutorado Formato: 1524594 bytes; 51122 bytes; application/pdf; application/pdf
Publicado em //2006 EN
Relevância na Pesquisa
105.82%
This project explored the values considered by elderly people, their younger relatives, and health professionals in decisions about residential long - term care, aiming to contribute to the literature on prospectively held values. The mixed methods design utilised a medical record review of 60 frail elderly hospital patients, a stratified survey of 3,015 adults in the South Australian community, and interviews with 36 stakeholders ( 10 elderly people, 10 younger relatives, and 18 health professionals ). The medical record review confirmed that the hospital patients and their outcomes resembled those described internationally. It was used to develop a hypothetical vignette, used in the later studies. Survey responses suggested that when considering a hypothetical long - term care decision, community members put the elderly person ' s physical health and safety first. Situational variables ( the elderly person ' s autonomy, environmental adaptation, and caregiver burden ) appeared secondary, albeit less so with increasing age of the respondent. Thematic analysis of the interviews demonstrated that elderly stakeholders considering a hypothetical decision were more likely to mention autonomy values, and less likely to mention safety values...

Russian Federation : The Demographic Transition and Its Implications for Adult Learning and Long-Term Care Policies

World Bank
Fonte: Washington, DC Publicador: Washington, DC
Tipo: Economic & Sector Work :: Policy Note; Economic & Sector Work
ENGLISH; EN_US
Relevância na Pesquisa
115.82%
This report describes the demographic transition in the Russian Federation and its implications for adult learning and long-term care policies. The population of Russia is aging and declining rapidly compared to other European nations. Russia's current age structure results from decades of complex demographic trends that have created a population structure with increasingly fewer young people. Women are having fewer children and are waiting longer to have children. Russia's mortality remains higher than in other developed societies. This high mortality is due to an unusually high incidence of non-communicable diseases (NCDs) and injuries among adult men. Two key challenges face Russia. The first challenge is whether public expenditure on pensions and health care will become unsustainable as the size of the elderly population increases. The second challenge is whether declining population sizes will reduce the size of the labor force and hence reduce economic growth.

Aging with intellectual and developmental disabilities: the effect of frailty and health instability in home care users on admission to long-term care

McKenzie, KATHERINE
Fonte: Quens University Publicador: Quens University
Tipo: Tese de Doutorado
EN; EN
Relevância na Pesquisa
75.81%
BACKGROUND: An increasingly large proportion of adults with intellectual and developmental disabilities are frail. Measuring frailty is challenging, and generic measures of frailty inaccurately identify frailty in this population. In the general population, frailty reflects an increased risk of outcomes, including admission to long-term care. Institutionalization of adults with intellectual and developmental disabilities may be a reflection of high levels of frailty. OBJECTIVES: 1) To develop a frailty index for home care users with intellectual and developmental disabilities using Ontario standardized clinical assessment data, 2) to describe the prevalence of frailty among these adults, and 3) to determine the association between frailty and admission to long-term care. METHODS: A frailty index was developed using published criteria to select items from the Resident Assessment Instrument-Home Care. Assessments of 7,863 individuals with intellectual and developmental disabilities in Ontario (aged 18-99 years) provided the data. A comparison measure of health instability, the Changes in Health, End-stage disease, Signs and Symptoms scale, identified individuals as stable or unstable. Using a subset of this sample (n=3,034) retrospectively followed over four years...

Ontario’s Home First Approach, Care Transitions, and the Provision of Care: The Perspectives of Home First Clients and Their Family Caregivers

English, Christine
Fonte: Quens University Publicador: Quens University
Tipo: Tese de Doutorado
EN; EN
Relevância na Pesquisa
85.77%
Home First is an Ontario transition management approach that attempts to reduce the pressure on hospital and Long Term Care (LTC) beds through early discharge planning, the provision of timely and appropriate home care, and the delay of LTC placement. The purpose of this qualitative descriptive study was to obtain descriptions from South Eastern Ontario Home First clients and their family caregivers of their experiences with and thoughts about care transitions, the provision of care, and the Home First approach. The goal was to enable insight into the Home First approach, care transitions, and the provision of care through access to the perspectives of study participants. Nine semi structured interviews (and one or more follow-up calls for each interview) with Home First clients discharged from hospitals in South East Ontario and their family caregivers were conducted and their content analyzed. All participating Home First clients were pleased to be home from hospital and did not consider LTC placement a positive option. All had family involved with their care and used a mix of formal and informal services to meet their care needs. Four general themes were identified: (a) maintaining independence while responding (or not) to risks...

Non-invasive wearable sensing systems for continuous health monitoring and long-term behavior modeling

Sung, Michael, 1975-
Fonte: Massachusetts Institute of Technology Publicador: Massachusetts Institute of Technology
Tipo: Tese de Doutorado Formato: 228 leaves
ENG
Relevância na Pesquisa
75.69%
Deploying new healthcare technologies for proactive health and elder care will become a major priority over the next decade, as medical care systems worldwide become strained by the aging populations. This thesis presents LiveNet, a distributed mobile system based on low-cost commodity hardware that can be deployed for a variety of healthcare applications. LiveNet embodies a flexible infrastructure platform intended for long-term ambulatory health monitoring with real-time data streaming and context classification capabilities. Using LiveNet, we are able to continuously monitor a wide range of physiological signals together with the user's activity and context, to develop a personalized, data-rich health profile of a user over time. Most clinical sensing technologies that exist have focused on accuracy and reliability, at the expense of cost-effectiveness, burden on the patient, and portability. Future proactive health technologies, on the other hand, must be affordable, unobtrusive, and non-invasive if the general population is going to adopt them.; (cont.) In this thesis, we focus on the potential of using features derived from minimally invasive physiological and contextual sensors such as motion, speech, heart rate, skin conductance...

Role of Healthcare in Korean Long-Term Care Insurance

Kang, Im-Oak; Park, Chong Yon; Lee, Yunhwan
Fonte: The Korean Academy of Medical Sciences Publicador: The Korean Academy of Medical Sciences
Tipo: Artigo de Revista Científica
EN
Relevância na Pesquisa
75.76%
With the rapid aging of the population, Korea introduced public long-term care insurance for older people in 2008. The long-term care insurance was designed as a separate scheme from the national health insurance, with eligibility qualifications and the certification process based on functional disability, benefits and coverage of community-based and institutional care, and a financing structure through multi-party contributions. Delivering appropriate health services to long-term care beneficiaries who manifest a high prevalence of comorbid chronic conditions with rising healthcare costs, however, presents a particular challenge. The lack of coordination between the health and long-term care sectors, limited consideration of physicians' assessments in the certification process, inadequate provision of health services in long-term care facilities, and overlapping and inefficient use of care resources act as barriers to providing comprehensive healthcare for older beneficiaries. Through active participation in the long-term care system, health professionals can help older patients navigate through the complex long-term care terrain to obtain quality healthcare.

Live Long and Prosper; Aging in East Asia and Pacific

World Bank
Fonte: Washington, DC Publicador: Washington, DC
Tipo: Book; Publications & Research :: Publication; Publications & Research
EN_US
Relevância na Pesquisa
85.66%
This book discusses the societal and public policy challenges and reform options for the East Asia and Pacific countries as they address aging. The book aims to strike a balance between optimism and pessimism over aging. On the one hand, the impacts of aging on growth, labor markets, and public spending need not represent the unavoidable catastrophe sometimes feared. On the other hand, minimizing the downside risks of aging and ensuring healthy and productive aging will require proactive public policy, political leadership, and new mindsets across society.

Understanding the Context for Long-Term Care Planning.

Broyles, IH; Sperber, NR; Voils, CI; Konetzka, RT; Coe, NB; Van Houtven, CH
Fonte: Universidade Duke Publicador: Universidade Duke
Tipo: Artigo de Revista Científica
Publicado em 09/11/2015 ENG
Relevância na Pesquisa
95.71%
Evolving family structure and economic conditions may affect individuals' ability and willingness to plan for future long-term care (LTC) needs. We applied life course constructs to analyze focus group data from a study of family decision making about LTC insurance. Participants described how past exposure to caregiving motivated them to engage in LTC planning; in contrast, child rearing discouraged LTC planning. Perceived institutional and economic instability drove individuals to regard financial LTC planning as either a wise precaution or another risk. Perceived economic instability also shaped opinions that adult children are ill-equipped to support parents' LTC. Despite concerns about viability of social insurance programs, some participants described strategies to maximize gains from them. Changing norms around aging and family roles also affected expectations of an active older age, innovative LTC options, and limitations to adult children's involvement. Understanding life course context can inform policy efforts to encourage LTC planning.

An Assessment of Information & Assistance Services For Seniors Needing Long-term Care in North Carolina: What has changed and what comes next for the Aging Network?

Hayes, Ariel
Fonte: Universidade Duke Publicador: Universidade Duke
Tipo: Masters' project
Publicado em 22/04/2011 EN_US
Relevância na Pesquisa
75.93%
Policy Question: How should North Carolina’s Aging Network provide information and assistance services so that all older adults (and their caregivers) looking for long-term care receive appropriate guidance? Introduction: Information and Assistance (I&A) programs inform, counsel and connect people seeking long-term care with services that could meet their needs. The Older Americans Act mandated that every Area Agency on Aging (of which there are 17 in North Carolina) establish I&A programs in their region. North Carolina has 42 I&A programs registered with the Division of Aging and Adult Services; more counties offer these services without OAA funds. As the population ages, more people will need a well-informed, local agency is critical to help them navigate the long-term care system and access services. Older adults and their families face such a complicated array of choices and decisions – about not only health care, but also housing, finances, and basic household tasks. Ten years ago, the North Carolina Institute of Medicine (NCIOM) delivered its report, “A Long-Term Care Plan for North Carolina: Final Report” to the North Carolina Department of Health and Human Services (DHHS). Early in its deliberations, the Task Force concluded “one of its goals would be to propose a system that would allow consumers to find their way into and through the system with ease.” Once the state was awarded a Real Choice Systems Grant...

Aging in South Asia: Attitudes/Beliefs of Elders in Southern India and Long-Term Care of the Elderly in Southern Sri Lanka

Beaudry, Lauren Jeanette
Fonte: Universidade Duke Publicador: Universidade Duke
Tipo: Tese de Doutorado
Publicado em //2013
Relevância na Pesquisa
105.85%

Developing nations in Asia are posed to experience a significant increase in the population of older adults living in their respective societies. Over the coming decades, India, the second most populous country in the entire world, is poised to experience a significant increase in its elder population. India's population of adults 60 years of age or older is projected to increase from 8% to 19% of the countries total population by the year 2050. Figures predict that by mid-century, 323 million people in India will be aged 60 years or older, more than the total current U.S. population. As the demographic structure of India is making a dramatic shift, concerns regarding the health and wellbeing of the growing Indian elder population are emerging, as is the growing concern for social policy. In addition, Sri Lanka is the fastest aging nation in South Asia. Multiple factors, including an increase in the number of people considered to be the "oldest old" (80+ years of age), a decrease in the number of working age adults, and increases in disability amongst the elderly, could necessitate an increased need for institutionalization of elderly Sri Lankans into long-term care facilities.

This project aims to study aging in south Asia from two different perspectives. An analysis of existing data from Southern India was done to examine the attitudes and beliefs of Indian elders towards aging and support systems for the elderly. Mental health of Indian elders was assessed and logistic regression analysis was conducted to examine possible correlations between attitudes and beliefs of the elderly and elder mental health. In addition...

Idosos asilados em hospitais gerais; Long-term care elderly residents in general hospitals

Gorzoni, Milton Luiz; Pires, Sueli Luciano
Fonte: Universidade de São Paulo. Faculdade de Saúde Pública Publicador: Universidade de São Paulo. Faculdade de Saúde Pública
Tipo: info:eu-repo/semantics/article; info:eu-repo/semantics/publishedVersion; ; ; ; ; Formato: application/pdf; application/pdf
Publicado em 01/12/2006 POR; ENG
Relevância na Pesquisa
75.64%
Instituições de longa permanência para idosos interagem periodicamente com hospitais gerais para internações de casos agudos ou dos que necessitam de métodos diagnósticos complexos e da atenção de várias especialidades simultaneamente. A decisão de indicar hospitalização é multifatorial, sendo influenciada por circunstâncias como a gravidade do quadro clínico e a infra-estrutura das instituições de longa permanência para idosos. Internações hospitalares apresentam benefícios e riscos, como o desenvolvimento de iatrogenias, delirium e declínios funcionais, podendo resultar em piora do estado geral e da qualidade de vida do idoso asilado durante e/ou após a hospitalização. O objetivo do estudo foi abordar aspectos peculiares na avaliação, tratamento e manejo de idosos asilados em internações hospitalares, particularmente quanto a cuidados que os auxiliem efetivamente nessas circunstâncias. Discutiram-se situações freqüentes como delirium, iatrogenias, desnutrição, declínio funcional e cuidados paliativos e características próprias de residentes em instituições para idosos durante internações em hospitais gerais.; Long-term care facilities for the elderly have regularly to work together with general hospitals to provide care to acutely ill residents or when they require all together more complex diagnostic procedures and multi-specialty care. The decision to hospitalize a nursing home elderly resident is multifactorial and it is based on factors such as illness severity and care facility infrastructure. Hospitalizations have benefits and risks such developing iatrogenic diseases...