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Open Access
Article
Publication date: 3 April 2024

Niamh Griffin, Leah O’Sullivan and Ruth Usher

Ireland’s ageing population has resulted in an increasing number of older adults living with frailty. Despite growing attention towards older adults’ and health professionals’…

Abstract

Purpose

Ireland’s ageing population has resulted in an increasing number of older adults living with frailty. Despite growing attention towards older adults’ and health professionals’ perspectives of frailty, occupational therapy research is limited. This study aims to explore occupational therapists’ perceptions of frailty and how their perceptions impact their approach to the assessment and management of frailty.

Design/methodology/approach

Using qualitative descriptive design, 19 occupational therapists working with older adults participated in online focus groups. Data were analysed using thematic analysis.

Findings

Perceptions of occupational therapists were constructed into three main themes: conceptualising frailty; management of frailty; and advancing frailty practice. Findings indicate that occupational therapists perceived frailty as a multidimensional concept but highlight a reluctance to use frailty terminology with patients. Findings also suggest that although occupational therapists are involved in provision of care for older adults living with frailty, the profession’s scope is not optimised in the assessment and management of frailty.

Originality/value

Findings provide insight into occupational therapists’ perceptions of frailty. Development of a shared understanding of frailty between clinicians and patients and enhancement of undergraduate frailty education are recommended to progress occupational therapy’s role in frailty management.

Details

Irish Journal of Occupational Therapy, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 2398-8819

Keywords

Open Access
Article
Publication date: 7 December 2020

Punkanit Harirugsakul, Issarapong Kaewkamnerdpong, Sudaduang Krisdapong, Piyada Prasertsom, Kornkamol Niyomsilp and Warangkana Vejvithee

The number of older adults in Thailand is currently increasing. To create the appropriate oral health service for this age group requires an understanding of the factors that are…

1159

Abstract

Purpose

The number of older adults in Thailand is currently increasing. To create the appropriate oral health service for this age group requires an understanding of the factors that are associated with their dental service utilization. This study aimed to determine the associations between social backgrounds, oral behaviors and dental service utilization among Thai older adults.

Design/methodology/approach

This was a cross-sectional study on a representative sample of older adults in the 8th Thai National Oral Health Survey (TNOHS). Data of 4,130 Thai older adults were collected through interviews. The association between social backgrounds, oral behaviors and dental service utilization were investigated using chi-square and logistic regression models.

Findings

Of the older adults aged 60–74 years old, 38.4% had used dental services in the last 12 months. Smokers used dental services the least (32.1%). Location, income, education and social welfare were significantly associated with dental service utilization. Among the oral behaviors evaluated, smoking was significantly associated with low dental service utilization.

Originality/value

Thai older adults with a poor social background including location, income, education, entitlement to the Universal Coverage Scheme (UCS) and smoking made less use of dental services.

Details

Journal of Health Research, vol. 35 no. 6
Type: Research Article
ISSN: 0857-4421

Keywords

Open Access
Article
Publication date: 27 May 2022

Paul Wankah, Mylaine Breton, Carolyn Steele Gray and James Shaw

The purpose of this paper was to develop deeper insights into the practices enacted by entrepreneurial healthcare managers to enhance the implementation of a partnership logic in…

1058

Abstract

Purpose

The purpose of this paper was to develop deeper insights into the practices enacted by entrepreneurial healthcare managers to enhance the implementation of a partnership logic in integrated care models for older adults.

Design/methodology/approach

A multiple case study design in two urban centres in two jurisdictions in Canada, Ontario and Quebec. Data collection included 65 semi-structured interviews with policymakers, managers and providers and analysis of key policy documents. The institutional entrepreneur theory provided the theoretical lens and informed a reflexive iterative data analysis.

Findings

While each case faced unique challenges, there were similarities and differences in how managers enhanced a partnership’s institutional logic. In both cases, entrepreneurial healthcare managers created new roles, negotiated mutually beneficial agreements and co-located staff to foster inter-organisational partnerships between public, private and community organisations in the continuum of care for older adults. In addition, managers in Ontario secured additional funding, while managers in Quebec organised biannual meetings and joint training to enhance inter-organisational partnerships.

Originality/value

This study has two main implications. First, efforts to enhance inter-organisational partnerships should strategically include institutional entrepreneurs. Second, successful institutional changes may be supported by investing in integrated implementation strategies that target roles of staff, co-location and inter-organisational agreements.

Details

Journal of Health Organization and Management, vol. 36 no. 6
Type: Research Article
ISSN: 1477-7266

Keywords

Open Access
Article
Publication date: 1 January 1970

Kwanrutai Sampoon, Nuengruethai Posri and Boonsri Kittichotpanich

The purpose of this paper is to test the effectiveness of social dance exercise and social support program to improve quality of life (QOL) for older adults in Thailand.

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Abstract

Purpose

The purpose of this paper is to test the effectiveness of social dance exercise and social support program to improve quality of life (QOL) for older adults in Thailand.

Design/methodology/approach

A quasi-experimental pre-test and post-test research design was used. The participants were 102 older adults selected by systematic sampling technique. Participants were assigned using the matched-pair technique by age, physical fitness test by the Time up and Go test into intervention and control groups of 51 subjects each. Intervention was conducted for 12 weeks, three times weekly, to improve physical, psychosocial and spiritual domains leading to enhanced QOL as measured by the World Health Organization Quality of Life (WHOQOL–BREF–THAI) assessment parameter. Data on QOL were collected before and after a 12-week training period.

Findings

Most adults were between 70 and 79 years old (67 percent). After program completion, before and after mean QOL scores for the intervention group at 60.15 and 95.82, respectively, were statistically significant with p-value<0.05. Post-program QOL shown by the intervention group was significantly higher than the control group (p<0.05).

Originality/value

Application of social dance exercise and social support program is an alternative to traditional methods to improve QOL and maintain functional capacity for older adults.

Details

Journal of Health Research, vol. 33 no. 3
Type: Research Article
ISSN: 2586-940X

Keywords

Open Access
Article
Publication date: 14 March 2023

Gabriela Uribe, Ferdinand Mukumbang, Corey Moore, Tabitha Jones, Susan Woolfenden, Katarina Ostojic, Paul Haber, John Eastwood, James Gillespie and Carmen Huckel Schneider

Integrated health and social care initiatives are increasing and health and social care systems are aiming to improve health and social outcomes in disadvantaged groups. There is…

1414

Abstract

Purpose

Integrated health and social care initiatives are increasing and health and social care systems are aiming to improve health and social outcomes in disadvantaged groups. There is a global dialogue surrounding improving services by shifting to an integrated health and social care approach. There is consensus of what is “health care”; however, the “social care” definition remains less explored. The authors describe the state of “social care” within the current integrated care literature and identify the depth of integration in current health and social care initiatives.

Design/methodology/approach

A narrative literature review, searching Medline, PsychINFO, CINAHL, PubMed, Scopus and Cochrane databases and grey literature (from 2016 to 2021), employing a search strategy, was conducted.

Findings

In total. 276 studies were eligible for full-text review, and 33 studies were included and categorised in types: “social care as community outreach dialogues”, “social care as addressing an ageing population”, “social care as targeting multimorbidity and corresponding social risks factors” and “social care as initiatives addressing the fragmentation of services”. Most initiatives were implemented in the United Kingdom. In total, 21 studies reported expanding integrated governance and partnerships; 27 studies reported having health and social care staff with clear integrated governance; 17 had dedicated funding and 11 used data-sharing and the integration of systems’ records.

Originality/value

The authors' demonstrate that social care approaches are expanding beyond the elderly, and these models have been used to respond to multimorbidity [including coronavirus disease 2019 (COVID-19)], targeting priority groups and individuals with complex presentations.

Details

Journal of Integrated Care, vol. 31 no. 5
Type: Research Article
ISSN: 1476-9018

Keywords

Open Access
Article
Publication date: 20 July 2021

Martin Powell

This article explores to what extent the long debate in England over the funding of long-term care (LTC) has involved learning from abroad.

Abstract

Purpose

This article explores to what extent the long debate in England over the funding of long-term care (LTC) has involved learning from abroad.

Design/methodology/approach

It draws on Mossberger and Wolman’s (2003) framework which proposes criteria for assessing policy transfer as a form of prospective policy evaluation: awareness; assessment and application. The documents examined are the sources cited by the reports that examined funding LTC in England since 1999. The study uses interpretive content analysis in a deductive approach (applying the framework) that focuses on both manifest and latent content.

Findings

It finds that both the reports and the cited studies tend to focus on a fairly narrow range of nations, with most attention on Germany, Japan and Scotland. Most studies broadly do not provide much in the way of a clear rationale, and the level of details provided varies. There is relatively little focus on problems. Aims, objectives and goals are little mentioned in some studies, but they tend to be fairly abstract or “high level.” Similarly, there is limited detail on settings. Finally, only a few studies provide a clear recommendation.

Originality/value

It focuses on the neglected topic of the evidence behind reports which are intended to provide recommendations for policy change. The Mossberger and Wolman’s (2003) framework has been used in a small-scale but appears to be well-suited for this purpose.

Details

Fulbright Review of Economics and Policy, vol. 1 no. 1
Type: Research Article
ISSN: 2635-0173

Keywords

Open Access
Article
Publication date: 14 October 2022

Gigi Lam

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…

4502

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.

Details

Public Administration and Policy, vol. 25 no. 3
Type: Research Article
ISSN: 1727-2645

Keywords

Open Access
Article
Publication date: 4 December 2023

Mariona Espaulella-Ferrer, Felix Jorge Morel-Corona, Mireia Zarco-Martinez, Alba Marty-Perez, Raquel Sola-Palacios, Maria Eugenia Campollo-Duquela, Maricelis Cruz-Grullon, Emma Puigoriol-Juvanteny, Marta Otero-Viñas and Joan Espaulella-Panicot

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…

Abstract

Purpose

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.

Design/methodology/approach

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.

Findings

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.

Originality/value

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.

Open Access
Article
Publication date: 13 February 2023

Rose Onyeali, Benjamin A. Howell, D. Keith McInnes, Amanda Emerson and Monica E. Williams

Older adults who are or have been incarcerated constitute a growing population in the USA. The complex health needs of this group are often inadequately addressed during…

1281

Abstract

Purpose

Older adults who are or have been incarcerated constitute a growing population in the USA. The complex health needs of this group are often inadequately addressed during incarceration and equally so when transitioning back to the community. The purpose of this paper is to discuss the literature on challenges older adults (age 50 and over) face in maintaining health and accessing social services to support health after an incarceration and to outline recommendations to address the most urgent of these needs.

Design/methodology/approach

This study conducted a narrative literature review to identify the complex health conditions and health services needs of incarcerated older adults in the USA and outline three primary barriers they face in accessing health care and social services during reentry.

Findings

Challenges to healthy reentry of older adults include continuity of health care; housing availability; and access to health insurance, disability and other support. The authors recommend policy changes to improve uniformity of care, development of support networks and increased funding to ensure that older adults reentering communities have access to resources necessary to safeguard their health and safety.

Originality/value

This review presents a broad perspective of the current literature on barriers to healthy reentry for older adults in the USA and offers valuable system, program and policy recommendations to address those barriers.

Details

International Journal of Prisoner Health, vol. 19 no. 1
Type: Research Article
ISSN: 1744-9200

Keywords

Open Access
Book part
Publication date: 5 February 2019

Johanna L. H. Birkland

Abstract

Details

Gerontechnology
Type: Book
ISBN: 978-1-78743-292-5

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