Balancing Institutional and Community-Based Care: Why Some Older Persons Can Age Successfully at Home While Others Require Residential Long-Term Care

Williams, A. Paul; Challis, David; Deber, Raisa; Watkins, Jillian; Kuluski, Kerry; Lum, Janet; Daub, Stacey

doi:10.12927/hcq.2009.3974

Cited by 56 publications

(73 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Similar to Challis' s study, most of the individuals who were deemed fit to be taken off the wait list had low levels of cognitive and functional impairments. Access to an informal caregiver in the home varied and became increasingly important when functional and cognitive impairments increased (Williams, Challis et al 2009). …”

Section: Facility-based Long-term Care: Definition and Risk Factorsmentioning

confidence: 99%

“…What is more, community support agencies in Ontario lack a central access point, making it difficult for individuals to navigate services and mobilize care (denton et al 2008). While CCAC care managers can recommend clients to community support agencies, there is no mechanism to coordinate services between CCACs and the myriad community support agencies, even though many older persons with multiple morbidities require both (Williams, Challis et al 2009). …”

Section: The Case Of Ontariomentioning

confidence: 99%

“…Nevertheless, in jurisdictions like Ontario, Canada' s most populous province, facilitybased LTC wait lists persist. While wait lists have been seen as evidence of too few facility-based LTC beds to meet the needs of an aging population, wait lists may also show that there are insufficient community-based care options (Challis and Hughes 2002;Williams, Challis et al 2009). …”

mentioning

confidence: 99%

See 2 more Smart Citations

The Role of Community-Based Care Capacity in Shaping Risk of Long-Term Care Facility Placement

Kuluski

Williams²,

Laporte³

et al. 2012

hcpol

Self Cite

View full text Add to dashboard Cite

The Role of Community-Based Care Capacity in Shaping Risk of Long-Term Care Facility Placement AbstractObjectives: Across the developed world, wait lists for facility-based long-term care (LTC) beds continue to grow. Wait lists are primarily driven by the needs of aging populations (demandside factors). Less attention has been given to system capacity to provide community alternatives to LTC (supply-side factors). We examine the role of both demand-and supply-side factors by comparing the characteristics of individuals who have been assessed and deemed eligible for LTC in urban and rural/underserviced parts of northwestern Ontario, Canada.Methods: Home care assessment data were analyzed for all individuals waiting for LTC in northwestern Ontario as of march 2008 (n=858). for the analysis, the sample was separated into urban and rural groups to account for geographical differences in wait list location. Characteristics between these two groups were compared. Results: Individuals on LTC wait lists in the rural areas were significantly less impaired in activities of daily living and cognition than their counterparts in the urban area. However, in both areas, impairments in lighter-care activities appeared to be a key wait list driver, and few people had an informal caregiver living in the home. Conclusions: Our data suggest that LTC wait lists reflect, at least to some extent, insufficient community capacity, not just need for LTC.

show abstract

Section: Facility-based Long-term Care: Definition and Risk Factorsmentioning

confidence: 99%

Section: The Case Of Ontariomentioning

confidence: 99%

mentioning

confidence: 99%

See 1 more Smart Citation

The Role of Community-Based Care Capacity in Shaping Risk of Long-Term Care Facility Placement

Kuluski

Williams²,

Laporte³

et al. 2012

hcpol

Self Cite

View full text Add to dashboard Cite

show abstract

“…In Ontario, public funds may pay for certain professional services (particularly for clients in the acute care substitution category, where policy makers can defend these services as cost-effective by speeding discharge from hospital), while clients and their families, private insurance and sometimes charities pay for most non-professional services. HCC services are available to clients through a variety of different access points, which may vary in their eligibility requirements and costs, and are funded in a variety of ways (Williams et al 2009). …”

Section: Home and Community Care In Ontariomentioning

confidence: 99%

“…CCACs, in turn, purchase professional home care services for eligible clients on a competitive basis under capped budgets set by the province. Services are allocated to individuals, but there is a ceiling on the amount or units of services that individuals may receive (Williams et al 2009). The LHINs also fund some community care services through multi-service accountability agreements (MSAAs), a multi-year agreement for service delivery between LHINs and health service providers (HSPs).…”

Section: Home and Community Care In Ontariomentioning

confidence: 99%

Home and Community Care Sector Accountability

Gray

Berta²,

Deber³

et al. 2014

hcpol

Self Cite

View full text Add to dashboard Cite

Home and Community Care Sector Accountability stakeholders tend to rely on regulatory and expenditure instruments to hold organizations to account for service delivery. Semi-structured key informant interview respondents reported that the expenditure-based accountability tools being used carried a number of unintended consequences, both positive and negative. These include an increased organizational focus on quality, shifting care time away from clients (particularly problematic for small agencies), dissuading innovation, and reliance on performance indicators that do not adequately support the delivery of high-quality care. RésuméCet article porte sur l' obligation de rendre compte dans le secteur des soins à domicile et en milieu communautaire (SDC) en Ontario. Ce secteur est très hétérogène étant donné les divers types de prestation de services, de méthodes de financement et d' organisations qui offrent de tels services. Les conclusions d'une analyse du secteur font voir que les organisations qui offrent des services de SDC font face à de nombreuses exigences, provenant d'une vaste gamme d'intervenants, quant à l' obligation de rendre compte. Les représentants du gouvernement sont plus enclins à compter sur les instruments réglementaires et de dépenses pour tenir les organisations responsables de la prestation de services. Les personnes interrogées dans le cadre d' entrevues semi-dirigées indiquent que les outils de responsabilisation axés sur les dépenses ont des répercussions non intentionnelles, qu' elles soient positives ou négatives. Cela comprend l' accroissement des efforts visant la qualité, le déplacement du temps consacré aux clients (un effet particulièrement problématique pour les petites organisations), l' entrave à l'innovation et l'utilisation d'indicateurs de rendement qui n' appuient pas adéquatement la prestation de soins de qualité supérieure.

show abstract

Service utilisation and family support of people with dementia: a cohort study in England

Gage

Cheynel

Williams

et al. 2014

Int J Geriatr Psychiatry

View full text Add to dashboard Cite

show abstract

Balancing Institutional and Community-Based Care: Why Some Older Persons Can Age Successfully at Home While Others Require Residential Long-Term Care

Abstract: Longwoods Review Longwoods Review is an integrated section of Healthcare Quarterly featuring peer-reviewed, applied research.

Cited by 56 publications

References 9 publications

The Role of Community-Based Care Capacity in Shaping Risk of Long-Term Care Facility Placement

The Role of Community-Based Care Capacity in Shaping Risk of Long-Term Care Facility Placement

Home and Community Care Sector Accountability

Service utilisation and family support of people with dementia: a cohort study in England

Contact Info

Product

Resources

About