Experiences of Informal Caregivers of Older Adults Transitioned From Nursing Homes to the Community Through the Money Follows the Person Demonstration

This study examined experiences of 156 informal caregivers of older adults who transitioned to the community through the Connecticut Money Follows the Person (MFP) Rebalancing Demonstration after prolonged nursing home stays. Caregiver burden, positive aspects of caregiving, depressive symptoms, anxiety, and comparative subjective stress were examined in relation to caregiver demographics and care receiver characteristics with a cross-sectional survey. Caregivers reported low burden, depressive symptoms, and anxiety, and fairly high levels of positive aspects of caregiving and satisfaction with community services. Most caregivers were less stressed compared to the time the care recipient was in, or before they entered, a nursing home. Live-in caregivers experienced more positive aspects of caregiving, but adult children reported higher burden than other caregivers. Unmet service needs also increased caregiver burden. Programs like MFP are a viable option with broadly positive outcomes from a caregiver’s perspective. Enthusiasm for increasing access to community care is growing for older adults who otherwise would reside in nursing homes for extended periods. Identifying unmet service needs and needs for targeted functional support could further enhance caregiver experiences and contribute to the successful transition of older adults to the community.     

Experiences of a Mass Interinstitutional Relocation for Long-Term Care Staff

This research explored long-term care (LTC) staff perceptions and experiences of working in LTC and providing care to residents following a mass interinstitutional relocation. In-depth, semistructured interviews were conducted with 63 LTC workers. Thematic analyses revealed three overarching themes related to how staff members perceived their relationships with other staff members following relocation. The first theme, post-relocation relationships between staff members, included the subthemes “Staff are segregated from each other” (physical distance) and “We were a family” to “barely say hi” (psychological distance). The second theme, post-relocation stress, has two subthemes: “Staffing is our big issue” and consequences of stress: absenteeism and leave. The third theme is recommendations for improving and managing staff relationships post-relocation. Relationships among staff members are integral to working in LTC and providing care to residents following a mass interinstitutional relocation. Recommendations for improving staff relationships and morale are suggested.     

Old and New Spaces

Abstract

Traditionally, the Mexican domestic interior has been characterized by a propensity to accumulative decoration and solemnity in the public areas of the house. The present study of residents of a central area of Mexico City shows that this situation has changed as forms of urban lifestyles, environmental attitudes and house ownership have developed that affect the use and decoration of the house. Here, I will focus on those changes that affect the public rooms of the house (living room, dining room, kitchen) with the aim of describing new forms of domesticity in the lifestyles, consumption practices, leisure and home life that no longer respond to the model of the traditional bourgeois home, but to life patterns in which the symbolic experience of home suits a particular spatial and economic reality.     

农业科技入户工程的绩效评价与政策建议——基于江西省3个试点县的实证

对江西省农业科技入户工程水稻项目的绩效进行了评估,实证分析结果表明,项目实施两年来,无论在主观绩效还是在增加农民来自农业的收入、提高政府政治信誉租金等客观方面取得了较高的绩效,但结果也表明在降低农户生产成本方面的成效不明显。文章认为,要使农业科技与农民有效对接应当从创新农业推广机制上入手,尽快实现农业技术推广工作通过诱致性为主、强制性为辅的方式来完成。     

Part of the Problem or Part of the Solution? The Role of Care Homes in Tackling Delayed Hospital Discharges

As part of current UK policies to reduce the number of delayedhospital discharges, a number of commentators have identifiedan alleged crisis in the care home market as one of key contributingfactors. With local authorities under pressure to cut costs,it is argued, the number of care homes is reducing, and delaysin hospital can often result. Behind this diagnosis is a seriesof assumptions about the role and nature of care home provision,the appropriateness of this form of service for many older people,and the need for more care homes to reduce the number of hospitaldelays. In order to explore and critique these assumptions,this paper reviews the role of care homes in tackling delayeddischarges, and argues the need for fewer and different carehome placements rather than more of this type of provision.     

Retrospective Temporal and Spatial Mobility of Adult Iowa Women

Human exposure assessments require a linkage between toxicant concentrations in occupied spaces and the receptor's mobility pattern. Databases reporting distinct populations' mobility in various parts of the home, time outside the home, and time in another building are scarce. Temporal longitudinal trends in these mobility patterns for specific age and gender groups are nonexistent. This paper describes subgroup trends in the spatial and temporal mobility patterns within the home, outside the home, and in another building for 619 Iowa females that occupied the same home for at least 20 years. The study found that the mean time spent at home for the participants ranged from a low of 69.4% for the 50-59 year age group to a high of 81.6% for the over 80-year-old age group. Participants who lived in either one- or two- story homes with basements spent the majority of their residential occupancy on the first story. Trends across age varied for other subgroups by number of children, education, and urbadrural status. Since all of these trends were nonlinear, they indicate that error exists when assuming a constant, such as a 75% home occupancy factor, which has been advocated by some researchers and agencies. In addition, while aggregate data, such as presented in this report, are more helpll in deriving risk estimates for population subgroups, they cannot supplant good individual-level data for determining risks.     

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.     

Common areas in group homes: arenas for different interests?

In Sweden, more than 5000 people with intellectual disabilities have moved from institutions into new types of integrated housing areas during the last decade. In order to safeguard the residents’ private lives, the role of the private sphere has been exaggerated and, subsequently, the importance of other more collective spheres has been underrated. This article examines the function, the use and the staffs’ ideas of common areas in various kinds of group accommodations in Sweden. The data consist of qualitative interviews with 34 individuals with intellectual disabilities, interviews with members of staff at the group homes and participant observations. The analysis focuses on the ways in which placement, architecture and decoration of the common areas as well as the staffs’ ideas and approaches influence the residents’ everyday lives. Three types of common areas were consequently identified: the restrictive, the familiar and the neutral room.