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1 – 10 of over 9000An increase in life expectancy brings about an aging society, necessitating increasing demand for elderly care services. The purpose of this paper is to present an examination of…
Abstract
Purpose
An increase in life expectancy brings about an aging society, necessitating increasing demand for elderly care services. The purpose of this paper is to present an examination of: how an aging society affects the demand for elderly care services and the labor market for elderly care services; how the labor share and wage inequality between the final goods sector and elderly care sector are determined; and whether the subsidy for elderly care service increases demand for elderly care services or not.
Design/methodology/approach
This paper sets the dynamics general equilibrium model with two sectors model: one for final goods sector and the other for elderly care services. This paper derives how the labor supply for elderly care services is determined in the theoretical model. In addition to analytical research works, this paper examines how the subsidy for elderly care service affects the labor share allocated for elderly care sector and wage inequality between the final goods sector and the elderly care sector with the numerical examples.
Findings
Related reports of the literature describe that an aging society raises the share of labor dedicated to elderly care services. However, considering a closed economy in which saving affects the capital stock, an aging society does not always raise the share of labor used for elderly care services because the wage rate of the final goods sector increases with an aging society. This effect prevents the increase of the labor supplied to elderly care services. On the other hand, the subsidy for the elderly care service raises the labor share of elderly care sector.
Research limitations/implications
The related literatures derive that an aging society raises the labor share allocated for elderly care sector. However, the paper shows that the subsidy for elderly care plays an important role in the increase in the labor share of elderly care sector.
Practical implications
This paper examines how the aging society affects the labor share of elderly care sector, wage inequality between final goods sector and elderly care sector and others with numerical examples. Thanks to the numerical examples, this paper derives the quantitative result and shows how the subsidy for elderly care service should be provided.
Originality/value
The author thinks that this paper has rich implications and originality. There exists no literature that examines how the labor share of elderly care sector and the relative wage rate of elderly care sector are determined by the aging and the subsidy for elderly care service. The author thinks that it is a very important analysis because many economically developed countries face the aging society problem.
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Jingyu Yu, Guixia Ma and Xiaoyan Jiang
The ageing of rural Chinese populations is challenging health and social policy, driving growth in rural nursing homes. Living environment plays a role in enhancing elderly…
Abstract
Purpose
The ageing of rural Chinese populations is challenging health and social policy, driving growth in rural nursing homes. Living environment plays a role in enhancing elderly quality of life (QoL), however, the impact of the built environment and care services are under-studied. The purpose of this paper is to investigate the influence of the built environment and care services on the QoL of elderly people within rural nursing homes in China.
Design/methodology/approach
A total of 242 residents of nursing home were surveyed, of which 76 percent were male and 24 percent were female. In total, 25.6 percent were aged between 60 and 69, 40.1 percent between 70 and 79, 31 percent between 80 and 89, and 3.3 percent were 90 or above. Quantitative data were analyzed through factor analysis, reliability test and multiple regression modeling.
Findings
The authors identified six built environment factors (room distance, space, barrier-free design, indoor environment, fire safety, and support facilities) and three services factors (i.e. daily care services, cleaning services, and healthcare services). QoL was measured over four dimensions: QoL, physical health, psychological health, and social relationships. Elderly QoL could be accurately predicted from room distance, space, barrier-free design, indoor environment, daily care services, and cleaning services.
Practical implications
Interventions in design of the built environment and the provision of care services are proposed, including dimensions of living space, heating, and provisions for qualified care providers.
Originality/value
This paper provides a clear picture about elderly special requirements on their built environment and healthcare services, helping architects, engineers and facilities managers understand elderly needs and improve built environment during design and operation stages.
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This article analyses community care services (CCS) in terms of availability, awareness, accessibility, and acceptance (the Four A’s approach), untangles the deep-seated factors…
Abstract
Purpose
This article analyses community care services (CCS) in terms of availability, awareness, accessibility, and acceptance (the Four A’s approach), untangles the deep-seated factors underlying the CCS and provides some short-term, medium-term, and long-term recommendations.
Design/methodology/approach
A literature review was conducted, including relevant government reports, consultation papers, Legislative Council papers and articles from academic journals from 1980 to the present.
Findings
The Four A’s approach shows that applicants to both centre-based services and home-based services endure lengthy waiting times because of the limited number of CCS. Furthermore, the awareness of day respite services is approximately 50 percent, which lags behind other CCS. Accessibility is contingent on a cross-district day respite service system and a lack of consistency between the quota and the proportion of older adults in the districts. Finally, the level of service provided by CCS is unsatisfactory due to inflexible service provision. Reviewing the brief history of long-term care services (LTC) reveals the deep-seated factors at the core of their heavy reliance on the subvention model, in contrast to the adoption of the ‘mixed economy of care’ by residential care services (RCS). An imbalance in budget allocation to RCS and CCS is also revealed.
Originality/value
Although the principle of ‘ageing in place’ was introduced in 1977, the institutionalisation rate (6.8 percent) of older adults remains unexpectedly high in Hong Kong, even surpassing its Asian counterparts, whereas the usage rate of CCS hovers around 0.8 percent. Thus, how to implement policy concerning LTC services for older adults must be re-evaluated.
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Carolien de Blok, Katrien Luijkx, Bert Meijboom and Jos Schols
The purpose of this paper is to show how modularity manifests in a service context, more specifically in the provision of care and services to independently living elderly.
Abstract
Purpose
The purpose of this paper is to show how modularity manifests in a service context, more specifically in the provision of care and services to independently living elderly.
Design/methodology/approach
Four case studies provide insight into the specification of relevant components and their subsequent assembly into a customized package of care and services.
Findings
In all cases, component specification and package construction take place in two phases: partly before and partly during care delivery. Early client involvement allows for a combination of standard components that have a lower level of customization, whereas late client involvement allows for adaptation of these components resulting in a higher level of customization. The paper proposes that modularity theory should distinguish between the creation of modular offerings in care provision versus their creation in goods production, since the findings are the exact reverse of the state‐of‐the art knowledge in manufacturing modularity.
Research limitations/implications
The empirical part of this paper is limited to providers of elderly care and services in The Netherlands and is exploratory in nature. However, the newness of care and service modularity justifies the exploratory research approach.
Practical implications
This paper offers elderly care organizations in‐depth understanding of their complex and multi‐faceted specification process. The insights help both care and service providers to make well‐considered decisions as to what level of client involvement to allow and the type of modularity to apply.
Originality/value
This paper contributes to the emerging literature on service modularity.
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H.Y. Lam, G.T.S. Ho, Daniel Y. Mo and Valerie Tang
Under the impact of Coronavirus disease 2019 (COVID-19), this paper contributes in the deployment of the Artificial Intelligence of Things (AIoT)-based system, namely AIoT-based…
Abstract
Purpose
Under the impact of Coronavirus disease 2019 (COVID-19), this paper contributes in the deployment of the Artificial Intelligence of Things (AIoT)-based system, namely AIoT-based Domestic Care Service Matching System (AIDCS), to the existing electronic health (eHealth) system so as to enhance the delivery of elderly-oriented domestic care services.
Design/methodology/approach
The proposed AIDCS integrates IoT and Artificial Intelligence (AI) technologies to (1) capture real-time health data of the elderly at home and (2) provide the knowledge support for decision making in the domestic care appointment service in the community.
Findings
A case study was conducted in a local domestic care centre which provided elderly oriented healthcare services to the elderly. By integrating IoT and AI into the service matching process of the mobile apps platform provided by the local domestic care centre, the results proved that customer satisfaction and the quality of the service delivery were improved by observing the key performance indicators of the transactions after the implementation of the AIDCS.
Originality/value
Following the outbreak of COVID-19, this is a new attempt to overcome the limited research done on the integration of IoT and AI techniques in the domestic care service. This study not only inherits the ability of the existing eHealth system to automatically capture and monitor the health status of the elderly in real-time but also improves the overall quality of domestic care services in term of responsiveness, effectiveness and efficiency.
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Valerie Tang, K.L. Choy, G.T.S. Ho, H.Y. Lam and Y.P. Tsang
The purpose of this paper is to develop an Internet of medical things (IoMT)-based geriatric care management system (I-GCMS), integrating IoMT and case-based reasoning (CBR) in…
Abstract
Purpose
The purpose of this paper is to develop an Internet of medical things (IoMT)-based geriatric care management system (I-GCMS), integrating IoMT and case-based reasoning (CBR) in order to deal with the global concerns of the increasing demand for elderly care service in nursing homes.
Design/methodology/approach
The I-GCMS is developed under the IoMT environment to collect real-time biometric data for total health monitoring. When the health of an elderly deteriorates, the CBR is used to revise and generate the customized care plan, and hence support and improve the geriatric care management (GCM) service in nursing homes.
Findings
A case study is conducted in a nursing home in Taiwan to evaluate the performance of the I-GCMS. Under the IoMT environment, the time saving in executing total health monitoring helps improve the daily operation effectiveness and efficiency. In addition, the proposed system helps leverage a proactive approach in modifying the content of a care plan in response to the change of health status of elderly.
Originality/value
Considering the needs for demanding and accurate healthcare services, this is the first time that IoMT and CBR technologies have been integrated in the field of GCM. This paper illustrates how to seamlessly connect various sensors to capture real-time biometric data to the I-GCMS platform for responsively supporting decision making in the care plan modification processes. With the aid of I-GCMS, the efficiency in executing the daily routine processes and the quality of healthcare services can be improved.
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Hong Kong implements a policy for the aging population involving the core themes of “aging in place as the core,” “institutional care as backup” and “continuum of care.”…
Abstract
Purpose
Hong Kong implements a policy for the aging population involving the core themes of “aging in place as the core,” “institutional care as backup” and “continuum of care.” Encouraging elders to live independently at home is a top priority, and elders who are not able to live at home independently are provided with various residential care services, namely Hostels for the Elderly, Homes for the Aged, Care and Attention (C&A) Homes for the Elderly and Nursing Homes (NHs). The purpose of this paper is to analyze the adoption of the publicly funded model of providing residential care services of elderly in Hong Kong.
Design/methodology/approach
The paper analyzes the current conundrum encountered by elders in residential care services and makes recommendations. A comprehensive literature review was conducted covering relevant government reports, academics' journal papers and nongovernmental organizations’ reports concerning residential care service of elderly from 1965 to present.
Findings
Subsidized residential care homes for the elderly (RCHEs) clearly outperform private RCHEs in terms of space and staff provisions, but the supply of subsidized RCHEs cannot meet the demand. Hence, between 2007 and 2018, the average waiting time was 33 months for NHs and that for C&A homes was 23 months. Several viable measures to meet the demand are purchasing Enhanced Bought Place Schemes (EBPSs) from private RCHEs, subsidizing elders who opt for living in private RCHEs by providing them with Comprehensive Social Security Assistance (CSSA) and residential care service voucher (RCSV) and subsidizing elderly applicants who opt for living in RCHEs in Guangdong. However, these viable measures are problematic because of the inadequate quality of EBPSs and private RCHEs, which is attributed to the costing arrangement of public and private RCHEs that were established in the colonial period. The brief history of RCHEs also indicates a deviation from the original policy aim, namely aging in place, which was introduced in the Green Paper on Services for the Elderly in 1977.
Practical implications
The supply and quality of community and home care services should be thoroughly examined; effective community and home care services can prevent and even delay unnecessary institutionalization. Another complementary solution is to devise a long-term plan for residential care services. To address disparities in quality standards in different RCHEs, adopting the combination of punitive and compliance models such as conducting frequent inspections and implementing an accreditation system for private RCHEs is imperative.
Originality/value
Although the principle of “aging in place” originated in 1977, the institutionalization rate 6.8% of elders was unexpectedly high in Hong Kong and even surpassed the Asian counterparts. It necessities to rethink how to implement policy concerning long-term care services of elders.
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The objective is to explore how the professionalisation of care jobs is constructed in the public and private sectors and to discuss whether the instruments used by public and…
Abstract
Purpose
The objective is to explore how the professionalisation of care jobs is constructed in the public and private sectors and to discuss whether the instruments used by public and private care providers contribute to solve the ambiguities linked to this type of work and which are the consequences for caregivers.
Design/methodology/approach
This paper compares the way in which the professionalisation of home care services for elderly people is achieved in the public and private sectors in the region of Brussels. The findings are based on the analysis of interviews with professional actors working in the care sector in Brussels.
Findings
The analysis shows that there is no agreement over the best way of professionalising home care services for the elderly and that the efforts made by public and private providers are profoundly different.
Originality/value
The divergencies are not only the result of the strict institutional framework to which public care providers are bound, in opposition to the relative freedom of the private sector, but they also derive from a different understanding of care work.
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Outi Tuisku, Satu Pekkarinen, Lea Hennala and Helinä Melkas
The purpose of this paper is to investigate the publicity around the implementation of the Zora robot in elderly-care services in Lahti, Finland. The aim is to discover opinions…
Abstract
Purpose
The purpose of this paper is to investigate the publicity around the implementation of the Zora robot in elderly-care services in Lahti, Finland. The aim is to discover opinions concerning the use of robots in elderly care as well as the arguments and justifications behind those opinions. Zora is a humanoid robot intended to promote mobility and rehabilitation. The Lahti pilot was the first Zora pilot in Finland in public elderly-care services. It received much publicity, both regionally and nationally.
Design/methodology/approach
This study is based on an empirical case study on the implementation of the Zora robot in elderly-care services. The data consist of interviews with personnel who operated Zora and comments from the general public about the “Zora” robot. Two data sources were used: 107 comments were collected from online and print media, and the personnel (n=39) who worked with Zora were interviewed. The data were analysed by means of interpretative content analysis.
Findings
The results show that public opinion is mainly negative, but that the commentators apparently have little information about the robot and its tasks. The personnel had more positive views; they saw it as a recreational tool, not as a replacement for their own roles.
Originality/value
There is clearly a need for more information, for a better informed discussion on how robots can be used in elderly care and how to involve the general public in this discussion in a constructive way.
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Jean Claude Mutiganda and Janne T. Järvinen
Research was conducted to investigate whether, and how, political accountability might stabilise when agents are faced with profound changes in external structures such as…
Abstract
Purpose
Research was conducted to investigate whether, and how, political accountability might stabilise when agents are faced with profound changes in external structures such as competition laws and austerity policies.
Design/methodology/approach
We performed a field study from 2007 to 2015 in a regional hub in Finland and worked with data from document analysis, interviews and meeting observations. We have used embedded research design, where we apply methodological bracketing as well as composite sequence analysis for field research.
Findings
Accountability declined when irresistible external structures were the dominant influence on the unreflective actions of agents-in-focus. With time, however, the agents started acting critically by drawing on structures that could facilitate strategic actions to stabilise political accountability.
Research limitations/implications
The field research and interpretation of the data were limited to the organisation analysed; however, the theoretical arguments allow for analytical generalisations.
Practical implications
The research demonstrates how public officials and political decision-makers can eventually adopt a strategic approach when faced with irresistible change in external structures.
Social implications
The research demonstrates how public officials and political decision-makers can eventually adopt a strategic approach when faced with irresistible changes in external structures.
Originality/value
The study locates political accountability in the context of strong structuration theory and discusses how it is redefined by external structures.
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