Consumer Direction in Long-Term Care Policy: Overcoming Barriers to Promoting Older Adults' Opportunity for Self-Direction

Ruggiano, Nicole

doi:10.1080/01634372.2011.638701

Cited by 17 publications

(11 citation statements)

References 46 publications

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“…Investigators need to create opportunities for participants to be engaged in research and planning at the level of their choice [ 38 , 60 ]. Once this level is mutually understood, the engagement of the social support network (family, friends, peers and neighbours) should be considered, as they can provide valuable insight when researching and planning healthcare for older adults [ 38 , 61 ].…”

Section: Reviewmentioning

confidence: 99%

Engaging older adults in healthcare research and planning: a realist synthesis

et al. 2016

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Plain English summaryThe importance of citizen involvement in healthcare research and planning has been widely recognized. There is however, a lack of understanding of how best to engage older adults, Canada's fastest growing segment of the population and biggest users of the healthcare system. We aimed to address this gap by developing an understanding of the engagement of older adults and their caregivers in healthcare research and planning. We conducted a review of available knowledge on engagement in healthcare research and planning with a focus on older adults and their caregivers. A five stage engagement framework emerged from this study that can be used to guide engagement efforts. We are continuing to collaborate with older adults and decision makers to develop and test strategies based on the presented framework.Abstract Background The importance of engaging the community in healthcare research and planning has been widely recognized. Currently however, there is a limited focus on older adults, Canada’s fastest growing segment of the population and biggest users of the healthcare system. Objective This project aimed to develop an understanding of engagement of older adults and their caregivers in healthcare research and planning. Method A realist synthesis was conducted of the available knowledge on engagement in healthcare research and planning. The search methodology was informed by a framework for realist syntheses following five phases, including consultations with older adults. The synthesis included theoretical frameworks, and both peer-reviewed and grey literature. Results The search generated 15,683 articles, with 562 focusing on healthcare research and planning. The review lead to the development of a framework to engage older adults and their caregivers in healthcare research and planning. The 5 stages environment, plan, establish, build, and transition are accompanied with example context, mechanism, and outcomes to guide the use of this framework. Conclusion We have identified a framework that promotes meaningful engagement of older adults and their caregivers. We are continuing to collaborate with our community partners to further develop and evaluate engagement strategies that align with the presented framework.

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Section: Reviewmentioning

confidence: 99%

Engaging older adults in healthcare research and planning: a realist synthesis

et al. 2016

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“…Integrating knowledge on individuals’ preferences into care services goes along with improved care outcomes and wellbeing (Cvengros et al 2009; Rathert, Wyrwich and Boren 2012; Swift and Callahan 2009). Understanding care preferences is a central tenet of patient/person-centred care (Batavia 2002; Keirns and Goold 2009), which is endorsed by health-care and research agencies around the world (Department of Health 2001; OECD 2013 b ; Ruggiano 2012; Salzburg Global 2011). In contrast to the expected value of information on LTC preferences and ongoing research for at least three decades (Kane and Kane 2001), the corresponding literature has never been comprehensively reviewed.…”

Section: Introductionmentioning

confidence: 99%

Stated preferences for long-term care: a literature review

et al. 2018

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Person-centred provision of long-term care (LTC) requires information on how individuals value respective LTC services. The literature on LTC preferences has not been comprehensively reviewed, existing summaries are contradictory. An explorative, scoping review was conducted to provide a thorough methodological description and results synthesis of studies that empirically investigated LTC preference outcomes based on respondents’ statements. A wide search strategy, with 18 key terms relating to ‘LTC’ and 31 to ‘preferences’, was developed. Database searches in PubMed, Ovid and ScienceDirect were conducted in February 2016. The 59 studies meeting the inclusion criteria were grouped and methodically described based on preference elicitation techniques and methods. Despite substantial methodological heterogeneity between studies, certain findings consistently emerged for the investigated LTC preference outcomes. The large majority of respondents preferred to receive LTC in their known physical and social environment when care needs were moderate, but residential care when care needs were extensive. Preferences were found to depend on a variety of personal, environmental, social and cultural aspects. Dependent individuals aspired to preserve their personal and social identity, self-image, independence, autonomy, control and dignity, which suggests that LTC preferences are a function of the perceived ability of a specific LTC arrangement to satisfy peoples’ basic physiological and mental/social needs. Research on LTC preferences would greatly profit from a standardisation of respective concepts and methods.

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“…Case managers or social workers can also act as a safeguard for those with diminished capacity for decision making. An open dialogue between the carers, older persons and case managers could help them gain common knowledge of what the older persons need for care, which could be helpful to overcome the differences in opinions in the level of flexibility and support [ 35 ]. The effectiveness of these measures and relevant assessment tools can be explored in future studies.…”

Section: Discussionmentioning

confidence: 99%

Preference of Older Adults for Flexibility in Service and Providers in Community-Based Social Care: A Discrete Choice Experiment

Wang

Wong

et al. 2022

IJERPH

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Empowerment of control and choice of the service users in health and social care has been incorporated into service provision in various countries. This study aimed to elicit the preference of community-based long-term care (LTC) service users on levels of flexibility in service provision. A discrete choice experiment was performed among older community care service users to measure their preference for attributes of LTC services identified from a prior qualitative study. Each participant was asked to make choices in six choice tasks with two alternatives of hypothetical LTC services that were generated from the attributes. A generalized multinomial logistic model was applied to determine the relative importance and willingness to pay for the attributes. It found that the participants preferred multiple flexible providers, determining services by themselves, meeting case managers every month and social workers as sources of information on service provision. Significant preference heterogeneity was found for flexibility in providers and flexibility in services between those with and without activity of daily living impairment. The findings highlighted the preference of older adults for greater flexibility in LTC, while they rely heavily on social workers in decision making. The enhancement of flexibility in LTC should be supported by policies that allow the older service users to make decisions based on their own preferences or communication with social workers instead of determining the services and providers for them. Options should be offered to users to decide their preferred level of flexibility to better reflect their divided preferences.

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Consumer Direction in Long-Term Care Policy: Overcoming Barriers to Promoting Older Adults' Opportunity for Self-Direction

Cited by 17 publications

References 46 publications

Engaging older adults in healthcare research and planning: a realist synthesis

Engaging older adults in healthcare research and planning: a realist synthesis

Stated preferences for long-term care: a literature review

Preference of Older Adults for Flexibility in Service and Providers in Community-Based Social Care: A Discrete Choice Experiment

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