Search Results (23)

This study focuses on the current service/care difficulties and challenges that social institutions in Hungary are facing during their daily operations; how they can react to them utilizing their internal resources, mechanisms, and capacities; and what concrete, tangible needs and demands are emerging in terms of methodological professional support, potential forms, interventions, and direction for professional development. A total of 24 general and 55 specific service and operational problems were identified and assessed in eight different service areas (family and child welfare services, family and child welfare centers, respite care for children, care for the homeless, addiction intervention, care for people with disabilities, care for psychiatric patients, specialized care for the elderly, and basic services for the elderly). The empirical base of the study uses a database of 201 online questionnaires completed by a professional target group working for social service providers in two counties (Győr-Moson-Sopron and Veszprém), representing 166 social service providers. The questionnaires were completed between November and December of 2022. The findings will be used to develop a professional support and development problem map. Social institutions face complex and serious service/care difficulties and challenges in their daily operations. Three distinctive basic problems clearly stand out in both severity and significance from the complex set of factors assessed. The biggest problem in the social care system is clearly the complex challenge of low wages, followed by the administrative burdens in the ranking of operational difficulties, and the third key factor was the psycho-mental workload of staff. Full article

Background: With the increase in the elderly population, institution-based care has become another option for elderly people. In Changhua, Taiwan, the number of long-term institutions has doubled in the past decade, and more families are choosing to send their elders to institutions for care. However, there is stress induced by having to care for these elders when they come back to their family members when hospitalized. Therefore, this study aimed to understand the stress and coping behaviors of family members in regard to hospitalized long-term care facility residents and identify relevant factors that affect and predict the stress and coping behaviors exhibited by these family members. Method: In this study, a quantitative and cross-sectional survey was conducted using the convenience-sampling method; family members of long-term care facility residents hospitalized in a regional hospital in central Taiwan were selected as the research participants and a total of 162 family members were admitted. The data were collected in the form of questionnaires including basic information and data on the stress and coping behaviors of the family members. The data were collected and coded by using SPSS 22.0 to perform descriptive and inferential statistical analysis. Results: The standard average score of total stress for family members was 57.03 points, which corresponds to a moderate level. The four perceptions of stress by family members were, in order, physiological, life, psychological, and economic. Furthermore, family income, work status, and the relationship between residents of the family members and physiological, psychological, and economic factors had predictive power for their problem-oriented coping behaviors, with an explanatory power of 59.6%. Life aspects, gender, marital status, and the number of hospitalizations in half a year had significant predictive power for the family members’ emotion-oriented coping behaviors, with an explanatory power of 19.0%. Conclusions: The family members had high levels of stress, especially physical stress, and the total scores of stress perception were higher for those who were younger than 39 years old and had no rotating family members. Additionally, the coping behavior of the main caregiver was mainly problem-oriented. The results of this study may serve as a reference that can help nursing staff in clinical or long-term care facilities to provide or develop effective and individualized services for family members of facility residents. Full article

As the aging population in China increases, home-based elderly care is set to become the main mode of elderly care in the future. The construction of community elderly care service facilities is receiving more and more attention from society. Currently, residential area design standards in China lack clear guidance on the spatial planning of facilities, which will lead to unreasonable facility layout planning and insufficient convenience in the utilization of facilities by the elderly. Fully considering the distribution characteristics of community elderly care service facilities and the needs of the community life circle when planning residential areas can effectively solve this problem. This study takes Xi’an City as the research object, based on the theory of life circle, through questionnaire surveys and cluster analysis, analyzes the current situation of the construction of elderly care service facilities and the characteristics of the use by the elderly. Combined with the community life circle model, the study scope is divided into community life circle levels, and put forward the planning strategies of coverage rate, number, richness, and spatial layout of the facilities, respectively. These strategies are designed to enhance the quality of life for seniors, ensuring that they have access to essential support and resources within their communities. It demonstrated that middle-aged elderly prefer community canteens and activity centers, while those with limited mobility and multiple chronic diseases have a higher demand for health service centers and community canteens. The utilization weight analysis shows that vegetable markets and supermarkets are most frequently used, whereas health service centers are the least utilized. The research proposes strategic planning enhancements, including full coverage of basic facilities, targeted increases in high-demand facilities, and tailored facilities for elderly characteristics. It recommends cross-community layouts to ensure service radius coverage, development reservations for future needs, and quality improvements to address the low satisfaction rates of existing facilities. The study concludes that a targeted approach to facility planning, considering the elderly’s diverse needs, can enhance the community elderly care service system’s sustainability and effectiveness. Full article

Objectively assessing the impact of various basic public service facilities on social–spatial differentiation has become a prerequisite for promoting urban social integration and development. However, in practice, the configuration of basic public service facilities is not always conducive to social integration, especially at the microscale. Effectively measuring the inhibitory or aggravating effects of various basic public service facility configurations on social–spatial differentiation has become a challenge. Based on the assumption that the configuration of basic public service facilities has inhibitory and aggravating effects on social–spatial differentiation, this study selected two types of objects: social space and basic public service facilities to refine the research elements. Using spatial and statistical analysis methods such as ecological factors, clustering, correlation, mediation, and superposition analysis, a framework was constructed to evaluate the impact of basic public service facility configuration on social–spatial differentiation and take the Zhaomushan area in Chongqing, China, as a typical case for verification. The study found that registered residence, income, employment location, and residential density are still the main factors of social–spatial differentiation in the study area. The main factors contributing to the differentiation of basic public service facilities are elderly care and housing security, public transportation and green space access, education and employment security, and small-scale medical and health facilities in the study area. In the eight principal factor pairs after the superposition of two differentiation spaces, six pairs showed weakened spatial differentiation, while two pairs showed intensified spatial differentiation. This indicates that the allocation of basic public service facilities will simultaneously inhibit and exacerbate social–spatial differentiation, but the inhibitory effect is significantly stronger than the exacerbating effect. Among them, public transportation and green parks are the main types of facilities that mainly exacerbate social–spatial differentiation. This dual effect is specifically reflected in the change in the spatial adaptation position of social space and basic public services, the weakening of the original social space differentiation boundary and the emergence of new differentiation boundaries simultaneously, and the multicenter composite form of social space. In the future, quantitative evaluation based on research frameworks can provide scientific basis for constructing spatial adaptability strategies for the supply of basic public service facilities and social production and life, such as adjusting the distribution, scale, and spatiotemporal relationship between basic public service facilities and residential communities in a reasonable manner. This is crucial for promoting social integration. Full article

The senior life circle is the basic unit space for building a high quality of senior living in the city, and the service level of the community senior facilities within it is directly related to the daily quality of life of the elderly residents. From the perspective of daily life needs, this study constructs a community senior living facility system consisting of “three levels, six categories and fourteen items”. Taking the main urban area of Shanghai as an example, the relationship between the supply and demand of community senior facilities and senior residents is studied from two perspectives: facility coverage and facility accessibility. The results show that: (1) the community senior living facilities system needs to be improved; (2) there are large gaps in the configuration of care facilities and living facilities; (3) the number of facilities served per capita shows the characteristics of “high value concentration in the center, middle value concentration in the transition area, and peripheral mixed”. The study recommends improving the construction of the facility system, broadening the service supply channels, enhancing the accessibility of facilities by grading and zoning, and promoting the sharing of facilities across administrative boundaries. Full article

Background: Elderly population is particularly vulnerable to socioeconomic disparities. This study assessed inequalities in health care utilization among the elderly in China and identified contributing factors. Methods: This study used data from the 2018 China Health and Retirement Longitudinal Study survey. A non-linear probit regression model based on the Andersen Health Care Utilization Model was used to identify determinants of health care utilization among the elderly. The concentration index (CI) and the decomposition of the CI were calculated to evaluate inequalities in health care utilization among the elderly and identify related contributors. Results: The CI for actual and standardized outpatient visits was 0.0889 and 0.0945, respectively, and the corresponding values for inpatient service utilization were 0.1134 and 0.1176, respectively. Factors that contributed to greater inequalities in the utilization of outpatient and inpatient service included income (73.68% for outpatient service; 85.20% for inpatient service), Urban Employee Basic Medical Insurance (UEBMI) (40.75% for outpatient service; 32.03% for inpatient service) and non-agricultural Hukou status (12.63% for outpatient service; 18.73% for inpatient service). New Rural Cooperative Medical Scheme (NRCMS) (−34.30% for outpatient service; −33.18% for inpatient service) and poor health status (−7.36% for outpatient service; −8.30% for inpatient service) reduced inequalities in outpatient and inpatient utilization. Conclusions: This study found that a key contributor to these inequalities was income, followed by UEBMI coverage. Meanwhile, health care coverage through NRCMS was associated with fewer disparities in health care utilization. Full article

To reduce the burden caused by an increased elderly population and to provide efficient service resources, scholars worldwide have proposed and applied smart elderly care. This paper summarizes the hotspots of the existing literature and explores the research frontiers to ignite future research. CiteSpace software was used to conduct a scientometric analysis of high-quality literature collected from both the China National Knowledge Infrastructure (CNKI) and the Web of Science (WOS). Based on the results of the basic situation description, this article highlights six research hotspots in CNKI and 11 research themes in WOS. In addition, it offers three major evolution stages and three future research directions for smart elderly care research. This paper provides a holistic overview of the smart elderly care literature from two major global databases. The results will contribute to healthcare policy designers, practitioners, and developers by giving them comprehensive knowledge and generating strategies to enhance elderly people’s quality of life. Full article

Introduction: Patient opinion surveys have become a widely used method for assessing key aspects of the functioning of medical facilities and, thus, of the functioning of the entire health care system. They are a prerequisite for developing patient-centered care and an essential component of quality improvement programs. In many countries, including Poland, patient opinion surveys are written into the accreditation standards of medical institutions. Patient’s readiness to recommend a hospital is a recognized indicator of the quality of patient-centered care. In a report on strategies for improving the quality of health care in Europe published in 2019 by WHO and the OECD (Organisation for Economic Cooperation and Development), patient’s readiness to recommend a hospital was cited as one of the basic indicators of ‘patient centeredness’ along with patient satisfaction. Therefore, as well consideration of the quality of medical care, a patient recommendation index was also used in the study presented in this paper. The index was based on the answers to questions about the patient’s readiness to recommend a hospital ward to family and friends. Aim: The aim of the study was to investigate patients’ opinions on the quality of services in particular hospital wards. A patient opinion survey can be used to improve the quality of services and monitor the effects of health-related activities, identify areas that need improvement, motivate medical staff and prevent their burnout, build a trusting relationship with patients, and compare the quality of health care in various facilities. Material and methods: The study was carried out in March 2022. The patient opinion survey was conducted using the CAWI (Computer-Assisted Web Interview). The sample selection was purposive. The respondents were patients with a history of hospitalization. The sample selection used an algorithm for the random selection of patients who met the criteria for the sample. The inclusion criterion was hospitalization in the 12 months prior to the study. A standardized questionnaire was used that was aimed at the assessment of the quality of medical care and the patient’s rights to information. Additionally, the survey contained questions about the demographic characteristics of the respondents. Results: A total of 38% of patients with a history of hospitalization expressed criticisms. The majority of statistically significant differences were observed when differentiating respondents according to age. Elderly persons significantly more often declared having been treated with respect and interest. They also rated more highly the meals served in the hospital, effective pain treatment, and respect for the patient’s dignity and intimacy during diagnosis and treatment. Younger persons assessed all these aspects of hospitalization less favorably. Conclusions: Variables including age and the level of income had a statistically significant influence on the opinion of the respondents. Elderly persons assessed most aspects of the quality of care in a hospital ward more favorably. There were a similar number of “promoters” (36%) and “detractors” (38%) of the quality of hospital services. Detractors mainly pointed to long waiting times for hospital admission, the poor quality of medical and nursing care, and unappealing meals. The promoters emphasized the high quality of medical and nursing care and the favorable conditions of the accommodation. Regular patient satisfaction surveys are helpful in identifying areas in which the functioning of a medical entity requires changes. Full article

With population ageing being a notable demographic phenomenon, aging in place is an efficient model to accommodate the mounting aging needs. Based on the community scale, this study takes the 15-min community-life circle as the basic research unit to investigate the imbalanced distribution of pension resources and its influencing factors in downtown Shanghai. We obtained six types of elderly care facilities data from the Shanghai elderly care service platform and utilized the Gaussian 2-step Floating Catchment Area method to calculate the accessibility of 6-type elderly care facilities. Then, we used the Entropy Weight Method to calculate the comprehensive accessibility of elderly care facilities. The Getis–Ord Gi* method was adopted to analyze the overall distribution, identifying the well-developed and the under-developed areas. To explore the influencing factors of the distribution, this paper obtained multi-source data to construct a total of 17 indicators and established a Random Forest model to identify the feature importance. With the selected eight factors, the Geographically Weighted Regression (GWR) model was applied to study the spatial heterogeneity of influencing factors, and the model showed a good performance with the AdjR² being 0.8364. The findings of this research reveal the following: (1) The distribution of six types of elderly care facilities is extremely uneven, with obvious spatial aggregation characteristics. Amongst the seven administrative regions, Huangpu District has the best accessibility to pension resources, while the resources in the other six regions are highly inadequate. (2) Essential influencing factors of the comprehensive accessibility of community-based elderly care facilities are accessibility of nursing institutions (positive), hotel density (positive), catering density (negative), education density (positive) and medical density (negative), while “rents”, “plot ratio” and “building density” have little impact on comprehensive accessibility. (3) The results of GWR revealed that the eight indicators are heterogeneous in space, all of which have bidirectional effects on comprehensive accessibility. By investigating the spatial distribution patterns and influencing factors of pension resources in Shanghai, this research could further contribute to establishing a sound community-based elderly care service system that improves older adults’ quality of life and promotes social fairness and justice. Full article

Healthy ageing refers to the development and maintenance of the functional ability of ageing individuals. Aged care nurses provide nursing care to elderly individuals and usually work in aged care residential facilities, nursing homes, home care services, and/or hospital departments. The registered nurse working in the aged care sector has several important roles. Key roles cover both therapeutic and preventative paradigms, as discussed in this paper. The aged care nurse is also “tasked with” holistic patient-centred care and the promotion of healthy ageing via advocacy and sociocultural roles. This paper examined, described, and analysed the multifaceted role of an aged care nurse from an Australian perspective. We conducted meticulous searches using PubMed, Google Scholar, government guidelines, authoritative body regulations, quality control guidelines, and government portals pertaining to aged care nursing in Australia. This paper relied upon the information garnered from publications, reports, and guidelines resulting from these searches and analyses. Multiple aspects of healthy ageing and holistic aged care nursing are discussed. The key roles of the aged care nurse are enumerated next, in accordance with the code of conduct from the Nursing and Midwifery Board of Australia (NMBA). The NMBA promotes evidence-based, culturally sensitive, consultative, holistic aged care clinical practice that includes input from care recipients, their decision makers, and/or their health care providers. The difficult issue of loneliness is discussed with strategies to ameliorate aspects of this. Good social networks, community interactions, meaningful friendships, and participation in personalised spiritual/religious practices improve the quality of aged care. The key topic of elder abuse and its forms are discussed apropos of aged care nursing. Healthy ageing is promoted by identifying and reporting elder abuse at the earliest. Current Australian law and recent federal legislation changes pertaining to aged care nursing are discussed next. As a result of these legislation changes, several new quality control imperatives (for aged care organisations/facilities) under the Aged Care Quality and Safety Commission (ACQSC) have been implemented. Residential and flexible aged care providers should now have robust ongoing documentation and a well-developed behaviour support plan (BSP) for each care recipient who currently requires or may require restrictive practices, which must be reported under the new serious incident reporting scheme (SIRS). Various strategies to promote healthy ageing and approaches to communicate effectively with aged care recipients are also discussed. Healthy ageing is promoted when age care recipients are empowered with making their own autonomous choices in “major and minor” aspects of life. Finally, approaches to optimise quality aged care nursing care are discussed. The Roper–Logan–Tierney model is one of the models used to assess and optimise nursing care. This is premised on the capability of an ageing individual to accomplish 12 basic activities of daily living. Full article

This paper explores the composite of elderly immigrants, self-appointed helpers (selvudpegede hjælpere) and care managers (visitatorer) in Danish municipalities. Free elderly care is a common good in the Danish welfare state. Instead of using the homecare service provided by the municipality, many elderly citizens with a Muslim immigrant background prefer to have a family member contracted as their self-appointed helper. The self-appointed helper is often a spouse, daughter or daughter-in-law, who ends up having the dual role as both a caring, loving family member and a professional care worker. Due to the special setup with self-appointed helpers working in their private homes, it is difficult for the care managers to follow standard rules and procedures. Instead, it seems to be a public secret that there is a gap between what we are supposed to do (according to the law) and what we actually do. We suggest seeing this gap as a silence agreement, where care managers, self-appointed helpers and elderly citizens refrain from asking all the critical questions (regarding the provision of care, the quality of care, working conditions, etc.) that no one wants to know the answers to. However, when the silence agreement from time to time breaks down, the relationship between the self-appointed helper and the care manager is haunted by a widespread phantasm where Muslim immigrants are cast as welfare scroungers. Basically, we argue that care managers and self-appointed helpers share a silent agreement but when it is neglected or violated, the latter end up in a vulnerable and marginalized position. The dynamic highlights the ambiguous intimate belonging of Muslim immigrant families and questions to what extent they were seen as legitimate subjects under the state in the first place. Full article

Until the 1980s, institutional elder care was virtually unknown in China. In a few decades, China had to construct a universal social safety net and assure basic elderly care. China’s government has been facing several challenges: the eroding traditional family care, the funding to assure care services for the older population, as well as the shortage of care delivery services and nursing staff. This paper examines China’s Five-Year Policy Plans from 1994 to 2020. Our narrative review analysis focuses on six main topics revealed in these policies: care infrastructure, community involvement, home-based care, filial piety, active aging and elder industry. Based on this analysis, we identified several successive and often simultaneously strategic steps that China introduced to contend with the aging challenge. In Western countries, elder care policies have been shifting to the home care approach. China introduced home care as the elder care cornerstone and encouraged the revival of the filial piety tradition. Although China has a unique approach, the care policies for the aged population in China and Western countries are converging by emphasizing home-based care, informal care and healthy aging. Full article

The primary healthcare facilities are among the most basic needs of the residents, huge in quantity and widespread. Their distributions are directly related to people’s health, which affects the sustainable development of cities. The accessibility calculation of primary level healthcare facilities and the equity evaluation of accessibility from the perspective of medical service category and urban population is very important for the decision-making of layout and configuration but has been ignored for a long time. This study took the primary healthcare facilities of Fukuoka city in Japan as research objects; it first used the variable two-step floating catchment area (V2SFCA) method to calculate the healthcare catchment areas (HCAs) of medical service providers and the population catchment area (PCAs) of medical demand locations, and then obtained the accessibility to primary healthcare facilities. Finally, the spatial disparities of accessibility were evaluated from three aspects: overall space distribution by using Global and Local Moran’s I, service quality, and the population to be served. The results showed that HCAs were from 500 m to 6400 m, PCAs ranged from 500 m to 3000 m, the use of variable catchments can improve the accuracy of accessibility assessment results; the accessibility of primary healthcare facilities was clustered and had significant spatial differences, which were high in urban center and low in suburban area; the obvious differences in the accessibility distribution characteristics of clinics in differential diagnosis and treatment departments led to different degrees of unsaturation in the types of medical services obtained by residents; although the elderly’s demand for basic medical care was many times higher than that of other age groups, the accessibility in high-demand areas was generally low, and the situation in severely high-demand areas was more serious. This work puts forward a multi-dimensional realistic evaluation system for equality accessibility of primary healthcare facilities, providing the data support for the medical resources and facilities’ allocation and the intensive land use. Full article

Population aging has become more and more severe in many countries. As a result, the demand for basic elderly care services has risen. The establishment of an evaluation index system for basic elderly care services can provide guidelines for governments to improve the quality of such services. Based on the “5A” theoretical analysis framework of Penchansky and Thomas, this paper introduces the concept of “accessibility” into evaluation. The “accessibility” model of services, through a literature review, field research, and three rounds of expert correspondence, consists of three first-level indicators, including the accessibility of home-based community elderly care services, the accessibility of institutional elderly care services, and the accessibility of administrative services. The evaluation index system of 15 s-level indicators and 70 third-level indicators, using AHP to determine the weight value of each indicator, provides a quantitative basis for the quality evaluation and improvement of basic elderly care services. Based on our quantitative results, policy recommendations are put forward: strengthen the support for the human and financial resources of community home-based elderly care services; improve the affordability of basic elderly care services; increase the types and numbers of institutional elderly care service projects; improve the availability and adaptability of institutional elderly care services; improve the accessibility of administrative services so that elderly care service institutions and elderly care administrative agencies can establish an effective communication and feedback mechanism. Full article

(1) Background: Because of the rapid expansion of the aging population in China, their health status transition and future medical expenditure have received increasing attention. This paper analyzes the health transition of the elderly and how their health transition impacts medical expenditures. At the same time, feasible policy suggestions are provided to respond to the rising medical expenditure and the demand for social care. (2) Methods: The data were obtained from the China Health and Retirement Longitudinal Study (CHARLS) from 2011 to 2015 and analyzed using the Markov model and the Two-Part model (TPM) to forecast the size of the elderly population and their medical expenditures for the period 2020–2060. (3) Results: The study indicates that: (1) for the elderly with a mild disability, the probability of their health improvement is high; in contrast, for the elderly with a moderate or severe disability, their health deterioration is almost certain; (2) the frequency of the diagnosis and treatments of the elderly is closely related to their health status and medical expenditure; alternatively, as the health status deteriorates, the intensity of the elderly individuals’ acceptance of their diagnosis and treatment increases, and so does the medical expense; (3) the population of the elderly with mild and moderate disability demonstrates an inverted “U”-shape, which reaches a peak around 2048, whereas the elderly with severe disability show linear growth, being the target group for health care; (4) with the population increase of the elderly who have severe disability, the medical expenditure increases significantly and poses a huge threat to medical service supply. Conclusions: It is necessary to provide classified and targeted health care according to the health status of the elderly. In addition, improving the level of medical insurance, establishing a mechanism for sharing medical expenditure, and adjusting the basic demographic structure are all important policy choices. Full article