Quality of Life in Nursing Homes

Abstract

The Nursing Home Reform Act (NHRA) of 1987 established nursing home requirements and dually emphasized quality of care and quality of life outcomes. We researched elders' perceptions of quality of life in nursing homes using focus groups. Analysis revealed four major themes important to residents: generativity, spiritual well-being, homelike environment, and privacy. Themes were used to analyze the disparity between NHRA's goal of dual emphasis and the dominance of quality of care in the treatment of frail elders living in nursing homes. Policies and procedures must be developed that promote decisional control in everyday matters of an older person's life.     

Issues of Elder Care and Elder Abuse in the Indian Context

Summary

With 7% of the population of India being elderly, two-thirds of whom live in villages and nearly a half of them in poor conditions, the care of the elderly is a difficult problem to be tackled. The dwindling of the joint family, the rise of dual-career families, a possible shift in filial piety values, the increasing life expectancy with greater chances of a prolonged old age characterized by poverty, degeneration, more empty-nest years, and dependency, have all added to the seriousness of the problem and made the elderly more susceptible than ever to abusive treatment. This paper examines these issues as well as the issue of elder abuse in light of available data and suggests some strategies to meet the problem. Also discussed are the problems, stresses, and strains of caregivers of the elderly. A greater role is envisaged for Non-Governmental Organizations (NGOs) than the state in the care of the elderly, particularly in providing support services to family caregivers.     

Improving Australian Residential Aged Care Facilities: A Review of Minor Refurbishment Elements

The objective of this study is to identify elements pertaining to minor refurbishments of residential aged care facilities. A narrative review of relevant publications was conducted. Inductive content analysis was used to categorize coded data into major or minor refurbishment or staff practices. Further analysis identified minor refurbishment domains. There were 14 major refurbishment, seven minor refurbishment and two staff practices domains established. The minor refurbishment elements (n?=?7) identified were lighting, furniture, color and contrast, wayfinding, noise, signage, and flooring. Assessing these elements would assist residential aged care providers to prioritize the provision of minor improvements to the environment for residents.     

The Economic and Psychological Burden to Hospitals and Care Facilities of Accepting EPA Candidates in Japan

The Japanese government has encouraged the opening of the domestic market to foreign workers under the Economic Partnership Agreement (EPA) as a “special case” in order “to promote the trade relationship between Japan and the countries that sign the agreement” since 2008. According to the literature, the introduction of nurses and care workers is not at all economical. Many empirical studies indicate that the costs of accepting EPA candidates is crucial for accepting institutions. In this study, the authors developed a multiple regression model for the economic and psychological burden of EPA and evaluated the goodness of fit of the model by comparing hospitals and care facilities. The multiple regression analysis indicated a good fit model for hospitals, but not for care facilities. The authors speculate that there are some differences in management between hospitals and care facilities that should be considered in interpreting this phenomenon.     

To Empower with Meaningful Data: Lessons Learned in Building an Alliance Between Researchers and Long-Term Care Ombudsmen

Abstract

This is the story of how a research team formed an alliance with state long-term care ombudsmen to develop a national database of resident complaints. Beginning with background information on problem identification and analysis, the article focuses on lessons learned in building alliances between practitioners and researchers, in recognizing individual site needs, in advocating for credible dissemination of findings, and in acknowledging philosophical and political differences. The article stresses the importance of tenacity in seeking funding for projects that empower practitioners to truly advocate for the needs of vulnerable populations.     

Old Age Care Preferences Among Chinese Middle-Aged Single-Child Parents and the Related Policy Implications

We contrast rural and urban single-child parents’ old age care preferences and factors determining their preferences. The results show that single-child parents are more likely to report specific old age preferences than parents with multiple children; urban single-child parents are also more likely to have specific old age care preferences than their rural counterparts. Pension/social insurance is most preferred by urban single-child parents; whereas the preferences of rural single-child parents are more diverse. The most significant rural and urban differences lie in the effects of social and medical insurance on the respondents’ selection of care sources. Policy implications are discussed in the end.     

Quality of Life of the Elderly Receiving Old Age Pension in Lesotho

The southern African country of Lesotho introduced an old age pension scheme in 2004 with the aim of enhancing the quality of life (QoL) of the nation’s elderly population. This study is the first to assess the physical, psychological, social, and environmental aspects of the health-related QoL of the elderly in Lesotho since the pension scheme was adopted. Data for this study were gathered using the World Health Organization QoL-BREF questionnaire. Mean QoL scores were compared across demographic, socioeconomic, and clinical variables using analysis of variance, t test, and regression analysis. Findings indicate that respondents were least satisfied with the environmental and physical domains of QoL. They also indicate that the overall QoL of the elderly in Lesotho was mainly affected by marital status, level of education, type of housing, source of income, and level of satisfaction with income. These factors should thus be taken into account when developing interventions aimed at improving the QoL of the elderly in Lesotho.     

Penny for Your Thoughts: Beggars and the Exercise of Morality in Daily Life1

Urban sociology has tended to study interactions between passersby and “street persons” with an emphasis on the ways street persons become bothersome, harassing, or dangerous. This article moves away from the focus on the ways interactions in public go awry and focuses on how individuals account for the mundane, everyday exchanges they have with strangers who seek their help. Based on interview data (N = 31) and qualitative analysis of data from an Internet survey (N = 110), this article suggests that the presence of beggars does not inherently symbolize urban decay to passersby and does not necessarily elicit anxiety, but instead provides a valuable texture of urban life. Further, the article argues that individuals, when justifying their responses to requests for help from needy persons (beggars) in urban spaces, use a variety of cultural strategies to maintain their perception of themselves as moral persons, both when they choose to help and when they refuse. Drawing from these findings, the article suggests that urban sociology and the sociology of risk would benefit from sensitizing their studies of public interactions to the diverse meanings individuals assign to them, rather than presupposing annoyance, anxiety, or fear as their predominant characteristic.     

Administrators and Quality of Care in Long-Term Care Facilities

This exploratory study investigated administrator and facility-related predictors of quality of care in long-term care facilities. Quality was measured using several unmet standards of care identified in the last inspection report of the Ontario Ministry of Health and Long-Term Care (2007). Supplemental data were gathered from surveys mailed to all 602 long-term care administrators in Ontario, Canada, 302 of whom completed the questionnaire. Multiple regression analyses were conducted to test sets of hypotheses linking characteristics of administrators and those of the long-term care facility to quality of care. Education and experience as an administrator in a participant's current position had a moderate positive influence on quality of care; however, negative associations were found between administrator salary and effort devoted to resident care problems and quality of care. In addition, smaller facilities, being located in less populated communities, and administrators with a nursing background significantly affected quality of care in a positive manner.     

Demography of Indian Aging, 2001-2051

Summary

India is the second largest country in the world, with 72 million elderly persons above 60 years of age as of 2001, compared to China's 127 million. One of the objectives of this paper is to assess the emerging scenario of elderly for the first half of the 21st century. According to projections, the elderly in the age group 60 and above is expected to increase from 71 million in 2001 to 179 million in 2031, and further to 301 million in 2051; in the case of those 70 years and older, they are projected to increase from 27 million in 2001 to 132 million in 2051. Among the elderly persons 80 and above, they are likely to improve their numbers from 5.4 million in 2021 to 32.0 million in 2051. The increasing number and proportion of elderly will have a direct impact on the demand for health services and pension and social security payments. Mobilizing resources for geriatric care and providing sufficient maintenance for the elderly will emerge as a major responsibility for heath-care providers and pension economists.     

Enhancing the Quality of Care in Residential and Nursing Homes: More than Just a Professional Responsibility

ABSTRACT

This article highlights a range of issues considered essential to improving the quality of care received by older people in residential and nursing home settings. It is argued that improving such care represents a societal as well as a professional responsibility and that remedial action is needed at a number of levels. Five ‘routes’ to achieving quality are outlined, and it is suggested that these are not simply alternatives but that each requires attention if genuine progress is to be made.     

Reconfigured Reciprocity: How Aging Taiwanese Immigrants Transform Cultural Logics of Elder Care

Drawing on 55 interviews with older Taiwanese immigrants who relocated to the United States at an earlier life stage, the author argues that changing contextual features involved in the processes of international migration encourage and even demand aging immigrants to reconstruct cultural logics of aging and geriatric care. He develops the concept of reconfigured reciprocity to demonstrate how aging migrant populations transform cultural logics of intergenerational responsibility, obligation, and entitlement to reconcile the tension between ethnic tradition and modernity. First, he reveals how many of the respondents' lack of caregiving for their own parents undermines their sense of entitlement to receive care from younger generations. Furthermore, he highlights how the structural squeeze among work, family, and caregiving with which the younger generation struggles further discourages the respondents from relying on their children. Finally, the author underscores how aging immigrants evoke the concept of Americanization to reconstruct expectations of how they should be taken care of in their twilight years.     

The Power of Silver: Age and Identity Politics in the 21st Century

Pensioner political movements emerged in the interwar years in America and Europe. Documentary and empirical analyses confirm the influential role such movements played in helping shape the postwar social security systems of Western societies. Pensioner movements, qua pensioner movements, have failed to retain their influence, despite that “old age” and its demographic significance have become more salient. We propose three explanations for this: the first concerns the failure of old age to connect with the generational ethos of identity politics; the second reflects the nature of the actors now involved in the governance of old age; and the third concerns the individualization of retirement as a phase of life.     

Long-Term Care Administrators' Perceptions of the Ombudsman Program in the State of Missouri

The presence of a long-term care ombudsman in a long-term care or nursing facility helps prevent abusive or neglectful situations before they start. Almost all Missouri long-term care facility administrators responding to the survey reported that they were aware of the ombudsman program; however, only half currently house an ombudsman in their facility. Respondents aware of the program were significantly more likely to currently accommodate an ombudsman in their facility, and those managing larger facilities were significantly more likely to currently have an ombudsman present. Given the numerous changes in the long-term care system, the need for more ombudsman advocates in this setting is crucial.     

Policymaking for Diversity Among the Aged in India

Abstract

Population aging is occurring rapidly in India, and the implications of an aging society are likely to be experienced in an adverse manner unless immediate steps are taken to provide social security for all of India's older population. Current provision by central and state governments is grossly inadequate. This article analyzes the major Indian states across three income groups and describes the differences and inequalities across states and rural/urban areas with regard to income, living arrangements, pension benefits, etc. The efforts by central and state governments to meet the needs of older persons are outlined and critiqued. Suggestions are made for the establishment of more equitable income security, and health and social services schemes.     

Health Care of American Indian Elderly: Determinants of the Perceived Difficulty Obtaining Access to Health Care

This study examines the perceived areas of difficulty in obtaining access to health care and the factors influencing that difficulty among elderly American Indians in a rural environment. One hundred thirty-seven elderly Indians in the Ponca and Pawnee tribes of Oklahoma were interviewed. Four major difficulties are reported: a long waiting period at Indian health centers, difficulty in making appointments to see physicians, language and cultural barriers to communication with the health care providers, and lack of available transportation. The long waiting period is the most serious problem, and lack of transportation is the least serious. The results of probit analysis show that physical health, automobile ownership, education, employment, and the presence of an informal caregiver are related to difficulty obtaining access to health care. Ways to minimize this difficulty are discussed.     

Programmatic and Operational Issues of Continuing Care Retirement Communities

No abstract available for this article.