Home or foster home care versus institutional long-term care for functionally dependent older people

Young, Camilla; Hall, Amanda; Gonçalves‐Bradley, Daniela C; Quinn, Terry; Hooft, Lotty; Munster, Barbara C. Van; Stott, David J.

doi:10.1002/14651858.cd009844.pub2

Cited by 36 publications

(31 citation statements)

References 36 publications

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“…A recent Cochrane review called for more evidence on health care use and economic analyses focused on home-based care programs. 34 This study adds to the existing literature by exploring patterns of hospital costs and use in a sample facing real-world decisions about enrollment in participant-directed programs. Moreover, our comparison groups allowed us to control for within- and across-site differences in care for chronically ill people.…”

Section: Discussionmentioning

confidence: 99%

Users Of Veteran-Directed Care And Other Purchased Care Have Similar Hospital Use And Costs Over Time

et al. 2019

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The Veteran-Directed Care (VDC) program facilitates independent community living among adults with multiple chronic conditions and functional limitations. Family caregivers value the choice and flexibility afforded by VDC, but rigorous evidence to support its impact on health care costs and use is needed. We identified veterans enrolled in VDC in fiscal year 2017 and investigated differences in hospital admissions and costs after initial receipt of VDC services. We compared VDC service recipients to a matched comparison group of veterans receiving homemaker or home health aide, home respite, and adult day health care services and found similar decreases in hospital use and costs from before to after enrollment in the groups. Further investigation into trends of nursing home use, identification of veterans most likely to benefit from VDC, and relative costs of operating VDC versus other purchased care programs is needed, but our results suggest that VDC remains a valuable option for supporting veterans and caregivers.

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Section: Discussionmentioning

confidence: 99%

Users Of Veteran-Directed Care And Other Purchased Care Have Similar Hospital Use And Costs Over Time

et al. 2019

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“…The impact of both the care models on mortality, healthcare utilization, economic correlations, and caregiver burden needs further research. 17 A meta-synthesis of ten studies from USA, Europe, and Asia found that culture impacts the decision making for a residential care facility, adjustment process, and eventual adaptation there. 18 In the South Asian cultural context, home is the preferred residential setting.…”

Section: History Of Residential Homes For Older Adults In Indiamentioning

confidence: 99%

Regulation of Long-Term Care Homes for Older Adults in India

Harbishettar¹,

Gowda²,

Tenagi

et al. 2021

Indian Journal of Psychological Medicine

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The rising aging population in India has led to an increased caregiving burden, and accordingly, the number of residential care facilities is also burgeoning. There is no regulatory framework or registration authority specifically for residential care homes in India. The article’s objective is to understand the need for a regulatory framework in India in the context of historic and global experiences in the UK, USA, and Europe. Although there is a lack of literature comparing the community home-based care and residential care, one study reported a preference for home-based care in the South Asian context. Elder abuse and deprivation of rights of seniors are common, and there is a need to bring in more safeguards to prevent these from the perspective of the older adults, their family members, the care providers, and the state. While the main priority of meeting care needs in long-term care is a challenge given the lack of trained care staff, the quality control mechanisms also need to evolve. A review of adverse incidents, complaints, and litigations also highlights the need for regulation to improve the standards and quality of care. The article explores lacunae of residential care facilities in the Indian context and provides recommendatory parameters for evaluating the quality of care provided. Relevant sections of the statutory new Mental Healthcare Act of 2017 in India could provide a regulatory framework ensuring rights and liberties of the residents are upheld. The authors propose a state-run model for elderly care homes and commencement of framing regulations appropriate to the Indian context.

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“…Most studies have focused on validating instruments to identify and describe the characteristics of frail older individuals [ 11 ] whilst other authors have established the determinants of HC and NH use [ 21 – 23 ]. The aim of this study is to characterize the factors that will lead to the future inclusion of older, community-dwelling subjects into HC programmes/NH institutionalization, and to develop the corresponding risk prediction models.…”

Section: Introductionmentioning

confidence: 99%

The impact of frailty on admission to home care services and nursing homes: eight-year follow-up of a community-dwelling, older adult, Spanish cohort

et al. 2020

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Background: Frailty in older adults is a common multidimensional clinical entity, a state of vulnerability to stressors that increases the risk of adverse outcomes such as functional decline, institutionalization or death. The aim of this study is to identify the factors that anticipate the future inclusion of community-dwelling individuals aged ≥70 years in home care programmes (HC) and nursing homes (NH), and to develop the corresponding prediction models. Methods: A prospective cohort study was conducted in 23 primary healthcare centers located in Catalonia, Spain, with an eight-year follow-up (2005-2013). The cohort was made up of 616 individuals. Data collection included a baseline multidimensional assessment carried out by primary health care professionals. Outcome variables were collected during follow-up by consulting electronic healthcare records, and the Central Registry of Catalonia for mortality. A prognostic index for a HC and NH at 8 years was estimated for each patient. Death prior to these events was considered a competing risk event, and Fine-Gray regression models were used. Results: At baseline, mean age was 76.4 years and 55.5% were women. During follow-up, 19.2% entered a HC program, 8.2% a NH, and 15.4% died without presenting an event. Of those who entered a NH, 31.5% had previously been in a HC program. Multivariate models for a HC and NH showed that the risk of a HC entry was associated with older age, dependence on the Instrumental Activities of Daily Living, and slow gait measured by Timed-up-and-go test. An increased risk of being admitted to a NH was associated with older age, dependence on the Instrumental Activities of Daily Living, number of prescriptions, and the presence of social risk.

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Home or foster home care versus institutional long-term care for functionally dependent older people

Cited by 36 publications

References 36 publications

Users Of Veteran-Directed Care And Other Purchased Care Have Similar Hospital Use And Costs Over Time

Users Of Veteran-Directed Care And Other Purchased Care Have Similar Hospital Use And Costs Over Time

Regulation of Long-Term Care Homes for Older Adults in India

The impact of frailty on admission to home care services and nursing homes: eight-year follow-up of a community-dwelling, older adult, Spanish cohort

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