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Providing high-quality and cost-efficient care of older people is an important development priority for many health and social care systems in the world. This paper suggests a shift from acute, episodic and reactive hospital-centered care toward longitudinal, person-centered and proactive home-centered care. The purpose of this paper is to contribute to the knowledge of a comprehensive development strategy for designing and providing home-centered care of older people.

The study design is based on qualitative research with an inductive approach. The authors study development initiatives at the national, regional and local levels of the Swedish health and social care system. The data collection methods included interviews (n = 54), meeting observations (n = 25) and document studies (n = 59).

The authors describe findings related to policy actions and system changes, attempts to achieve collaboration, integration and coordination, new forms of care offerings, characteristics of work settings at home and differences in patients' roles and participation at home and in the hospital.

The authors suggest home-centered care as a solution for providing person-centered and integrated care of older people and give examples of how this can be achieved.

The authors outline five propositions for research and development related to national policies, service modularity as a solution for customized and coordinated care, developing human resources and infrastructure for home settings, expanding services that enable older people living at home and patient co-creation.

Demand for care at home is growing because of the increase in life expectancy, an ageing population and the chronic conditions that often accompany longevity. Daytime care at home services have been widely reported on, but less is known about overnight care at home. This paper aims to gather evidence about overnight social care for older adults in their homes.

Recent studies were identified through searches in three electronic databases. Studies published in English between January 2016 and June 2022 exploring overnight care at home for older adults were eligible for inclusion. An additional Google search identified home care services within the UK currently providing overnight support.

The review retrieved five relevant papers, highlighting the paucity of research in this area. A narrative review of the literature identified common themes that suggested domiciliary night care staff play an integral role in meeting the overnight care and support needs of older adults who wish to be cared for at home. Despite the limited evidence base in this area, the Google search for UK domiciliary services who provide overnight support identified several active programmes.

To the best of our knowledge, this is the first scoping review exploring the provision of overnight social care to older adults in their own homes. The review highlights the need for further research to inform commissioning and practice development.

At the outset of the COVID-19 pandemic the United Kingdom Government implemented a policy to rapid discharge hospital patients into care homes. This study aimed to examine how the media in the United Kingdom portrayed hospital discharge to care homes during the COVID-19 pandemic.

This study was a qualitative document analysis. Four sources (Daily Mail, The Independent, The Guardian and BBC News) were selected to represent political orientations encompassing right-wing, centrist and left-wing perspectives, and were searched for mention of hospital discharge, care homes and Covid-19 pandemic between 1st January 2020 and 24th February 2022. Article text was copied verbatim into Microsoft Word documents prior to analysis. Data were thematically analysed, followed by coding the sentiment in the included articles as well as coding the sentiment of themes and sub-themes.

Of 722 identified articles, 133 were eligible for inclusion as the final corpus. Data represented a moralistic narrative consisting of four themes: (1) Government as villain, (2) care homes as antiheroes, (3) patients as ideal victims and (4) moral outcomes. Most of the corpus had a negative sentiment (78.1%). One theme, moral outcomes, had considerably more positive sentiment (32.4%) than others (range 15.1%–21.9%).

A moralistic argument for improving cross-boundary interactions between health and social care services is provided, and the media can play a role pushing cross-boundary working higher up the policy agenda. Future work should examine how direct stakeholders, including those working in healthcare and care home settings, perceived the discharge policy.

The purpose of this paper is to compare home care workers' views of their employment conditions by provider type – private for-profit vs public and non-profit – using the case study of Ireland.

An online survey was distributed to care workers (n = 350) employed by private for-profit, public and non-profit home care providers in Ireland. Returned questionnaires were analysed statistically in R using chi-squared tests to systematically compare key aspects of employment conditions.

Analysis shows that conditions are perceived to be significantly worse for those employed by private for-profit providers (and to a lesser extent non-profit organisations) compared to the public provider. There are wide disparities between public and private sector conditions in terms of contracts, pensions, unsocial hours pay and travel time allowances. The main area of convergence is in relation to employer support, where although the public sector performed better, the difference between the three provider types is smaller.

Relatively little research compares working conditions in private for-profit providers vs public and non-profit providers in Ireland and other countries. The findings can be understood in the context of marketisation reforms and may partly be explained by a lack of regulation in Ireland's home care sector and low unionisation rates amongst care workers employed by private for-profit providers.

This study aims to explore nursing home and home care managers’ strategies in handling the COVID-19 pandemic.

This study has a qualitative design with semistructured individual interviews conducted digitally by videophone (Zoom). Eight managers from nursing homes and five managers from home care services located in a large urban municipality in eastern Norway participated. Systematic text condensation methodology was used for the analysis.

The managers used several strategies to handle challenges related to the COVID-19 pandemic, including being proactive and thinking ahead in terms of possible scenarios that might occur, continuously training of staff in new procedures and routines and systematic information sharing at all levels, as well as providing different ways of disseminating information for staff, service users and next-of-kins. To handle staffing challenges, managers used strategies such as hiring short-term staff that were temporary laid off from other industries and bringing in students.

The COVID-19 pandemic heavily affected health-care systems worldwide, which has led to many health-care studies. The situation in nursing homes and home care services, which were strongly impacted by the pandemic and in charge of a vulnerable group of people, has not yet received enough attention in research. This study, therefore, seeks to contribute to this research gap by investigating how managers in nursing homes and home care services used different strategies to handle the COVID-19 pandemic.

The demand for long-term home care services has been increasing in Taiwan due to the significant growth of the older population. In order to understand the crucial roles that language and communication play in providing better long-term home care services in Taiwan, this study aims to adopt a gerontological sociolinguistic perspective to investigate how professional care workers communicate with older people in this context.

Interviews were conducted with 58 long-term home care workers to identify their communication accommodation strategies for older people, considering their health conditions (dementia), personalities (grumpiness), living status (loneliness) and general principles of long-term home care communication.

The study's findings provide practical insights for long-term home care workers to enhance their communication skills while interacting with older people.

The results could contribute to improving the quality of care services provided to older people and address their specific communication needs.

To the best of the author’s knowledge, this paper is the first attempt to identify contextually specific communication accommodations to older people in existing literature of gerontological sociolinguistics that addresses language, communication and older age. The salience of the findings in this study can be further enhanced if they were applied in the development of training programs for future Taiwanese long-term home care workers.

Older people living in nursing homes have complex care needs and frequently need specialists’ advice and support that can be challenging to deliver in a rural setting. The aim of this paper is to describe a model of integrated care in a rural area supported by a nurse case manager.

A real-world evidence study of people living in Ribes de Freser nursing home, was conducted between specific timeframes in 2019 and 2022, comparing the casemix and outcomes of a traditional care model with the integrated interdisciplinary model.

The integrated care model led to a significant reduction in transfers to the emergency department, hospitalisations, outpatient medical visits and a reduction in the number of medicines. In addition, the number of residents receiving end-of-life care at the nursing home showed a substantial increase.

This case study contributes valuable evidence supporting the implementation of an integrated model of nurse case manager support in nursing homes, particularly in the rural contexts, where access to specialist medical staff may be limited. The findings highlight the potential benefits of person-centred integrated care for older adults, addressing their complex needs and improving end-of-life care in nursing home settings.

This paper aims to explore what can be learned from the COVID-19 pandemic about adaptable, functional housing design that supports seniors’ resilience. This paper considers how physical and design features enable seniors to stay safe, develop coping strategies, give and receive care and maintain social connections.

A qualitative research strategy incorporating thematic analysis was used, involving interviews and one focus group with seniors and interviews with housing providers and community organisations supporting seniors. Forty-eight semi-structured interviews were conducted with 54 seniors aged over 60 years living independently, not in aged care. Interviewees were selected to cover a range of ages and housing circumstances. Semi-structured interviews were also conducted with 20 organisations.

The physical, amenity and design aspects of the living environment that support seniors’ well-being and resilience during a pandemic are: the ability to receive essential goods and services in the home; sufficient space and storage; flexible and adaptable living spaces; access to private indoor and outdoor space; ability to garden and grow food; having an outlook or view; functional heating, ventilation and appliances; and dwelling location allowing access to green spaces, food stores and services. The ability of housing to facilitate social connections is a fundamental enabler of seniors’ resilience.

This paper contributes to knowledge about physical and design aspects of the dwelling that enable protection and care in a pandemic and how that can help to future-proof housing. Its focus on enabling seniors’ resilience through housing recognises the growing significance of structural population ageing for housing design and delivery and the central role of housing to ageing-in-place policies that underpin health and welfare provision.

Residents in under-resourced/high-Medicaid (85% or higher) nursing homes on average receive care from relatively lower quality providers and have worse health outcomes, which may increase the risk of higher COVID-19 incidence. This study aims to evaluate if having a culture that encourages employee empowerment results in better quality (lower COVID-19 deaths) in times of crisis, such as the current pandemic. The study combined primary survey data from 391 Directors of Nursing (response rate of 37%), with Centers for Medicare and Medicaid Services’ (CMS) Nursing Home COVID-19 Public File, LTCFocus, Area Health Resource File, and Nursing Home Compare. The dependent variable consisted of the number of COVID-19 death as of November 25, 2021. The independent variables consisted of Likert scale for employee empowerment (Cronbach alpha= 0.82). Control variables consisted of organizational factors (e.g., size, location, and ownership), as well as community factors (e.g., poverty, unemployment, and competition). The results indicated that one unit increase in employee empowerment was associated with 6% lower likelihood of having COVID-19 deaths. Nursing homes, particularly those under-resourced, face difficulty improving the quality of care due to financial constraints. However, the results suggest that adopting a culture that fosters employee empowerment may give nursing homes an edge in improving quality outcomes in crises.

This viewpoint paper focuses on the important role played by hospices in the UK in providing specialised end-of-life care for older people with complex needs – particularly for the growing number who choose to die at home. With demand for such care growing, the paper highlights the funding issues facing the independent hospice sector and the implications for hospices of receiving more state funding. The purpose of this paper is to highlight the challenges that hospices in the UK face in providing home-based palliative and end of life care for older people.

This a viewpoint paper informed by recent reports and research findings, as well as the author’s own work within the hospice sector.

The demand for specialised community-based and home-based palliative and end-of-life care is growing. The Covid-19 pandemic prompted wider discussion about what constitutes both “a good death” and good end-of-life care. This confirmed that most older people would prefer to end their lives free from pain, in familiar surroundings and not in hospital.

The specialised end-of-life care provided by hospices is rated highly by the regulator and the communities which they serve. In recent years, more attention has been given to providing “hospice at home” services, but coverage is limited largely due to lack of funding, the bulk of which comes from charitable fundraising. To provide a more equitable service, the fragility of the hospice funding model needs to be addressed.

If the state expands its funding of hospice care, it is important that charitable fundraising also continues to take place and is encouraged. This will help ensure that the good links between hospices and local stakeholders are maintained.

The funding of the hospice sector in the UK has been the subject of several reports both by governmental and non-governmental bodies, several in the last year. However, it is an issue of growing importance and the whole subject needs a fuller airing in academic circles.