[Care preferences and spatial mobility : Factors influencing care-related willingness to move of elderly people in partnerships in a rural area]

Wer kann sich vorstellen, von Angehörigen gepflegt zu werden?

Hintergrund

Die Zahl pflegebedürftiger Personen wird in den kommenden Jahren, bedingt durch den demografischen Wandel, weiterhin zunehmen. Um eine hochwertige bedarfs- und bedürfnisorientierte pflegerische Versorgung zu gewährleisten, nimmt die Berücksichtigung der Pflegepräferenzen eine besondere Bedeutung ein.

Ziel der Arbeit

Dieser Beitrag soll zum einen die Pflegepräferenzen 65- bis 75-Jähriger darstellen und zum anderen Prädiktoren der Präferenz für eine Pflege durch Angehörige identifizieren.

Methoden

Es wurde eine repräsentative Bevölkerungsbefragung der 65- bis 75-Jährigen in der Region Bodensee-Oberschwaben durchgeführt (n = 625). Die Daten werden deskriptiv dargestellt und hinsichtlich der Präferenz für informelle Pflege bi- und multivariat (χ2-Tests; logistische Regression) ausgewertet.

Ergebnisse

Die Mehrheit der Befragten präferiert eine Pflege im häuslichen Umfeld; zumeist mit professioneller Unterstützung. Zudem stehen die Befragten „alternativen“ Wohnformen (z. B. Mehrgenerationenwohnen oder Wohngemeinschaften für ältere Menschen) positiv gegenüber.

Bedeutende Prädiktoren für die Präferenz informeller Pflege sind das männliche Geschlecht, das Vorhandensein weiterer im Haushalt lebender Personen, eine eigene Pflegebereitschaft und ein fehlender Berufsabschluss.

Diskussion

Die Präferenz für eine pflegerische Versorgung im häuslichen Umfeld bringt Herausforderungen für informell und formell Pflegende sowie für die Pflegebedürftigen selbst mit sich, die zu einem Spannungsfeld zwischen den Erwartungen und Möglichkeiten führen können. Zur Sicherstellung einer zukunftsfähigen und nutzer*innenorientierten pflegerischen Versorgung bedarf es daher einer qualitativen sowie quantitativen Weiterentwicklung der ambulanten Versorgung.

Factors influencing the mutual-support willingness and needs among the rural elderly in Hunan Province, China: a cross-sectional study

Background

This study aimed to assess the influence factors of the mutual-support willingness and identify the mutual-support needs of elderly living in rural areas of Hunan Province, China.

Methods

Using the Chi-square test and logistic regression to analyze factors influencing Participants’ mutual-support willingness and needs.

Results

Factors influencing the mutual-support willingness and needs included individual characteristics, family environment, and so on. And the rural elderly’s demand for mutual-support is at a relatively high level. The total score for social support for the aged was 36.944 ± 6.487, at a moderate level.

Conclusions

It is necessary to objectively evaluate the factors related to mutual-support willingness and needs and take steps to enhance social support and meet elderly the needs of mutual-support, which is of great significance for improving the happiness of the elderly in their later years and alleviating the crisis of population aging in China.

Determination of gaps in the spatial accessibility of nursing services for persons over the age of 65 with lowered self-sufficiency: Evidence from the Czech Republic

The subject of this research is one of the main preconditions for the provision of high-quality social care services for people over the age of 65 with lowered self-sufficiency. It involves the spatial accessibility of formally established nursing services examined in 76 districts of the Czech Republic. The aim of this article is to identify and evaluate the gaps in spatial accessibility of the selected residential and outpatient-clinic services at the level of districts in individual regions of the Czech Republic in 2018. A three-phase analysis was performed, including an ArcGIS network analysis, multi-criteria evaluation according to the TOPSIS method, and a correlation analysis encompassing the confidence interval gained via the Bootstrap method. Seven indicators were selected-recipients of the allowance for the care, capacity of residential and outpatient-clinic services, and four indicators of accessibility via individual and public transport within the set time intervals. The results show good availability of residential care (no gap) within 30 min. by individual and public transport in most districts (94%). However, day services centers do not have a space gap in only 28% of districts by individual transport, and 8% of districts by public transport. In the case of day care centers, 54% of districts by individual transport, and 29% of districts by public transport do not have a space gap. The results also show that the level of spatial availability of care (gaps) in the district is not related to the number of people aged 65+ with reduced self-sufficiency in the district. On the contrary, the correlation analysis shows that with the growing number of people aged 65+ with reduced self-sufficiency in the district, the capacity of residential and outpatient services increases and the gaps in spatial accessibility do not decrease.

[The attitude of patients in geriatric rehabilitation towards nursing homes]

Hintergrund

Mit Erreichen des höheren Lebensalters nehmen unterstützende Wohnformen eine immer wichtigere Rolle ein. Eingeschränkte Selbstständigkeit kann dazu führen, dass ein Umzug in ein Pflegeheim unabdingbar ist. Die Einstellung zu Pflegeheimen ist von großer Bedeutung sowohl für die Vorbereitung auf diesen Fall als auch für die psychische Reaktion auf sein Eintreten, wurde allerdings bisher kaum näher beforscht.

Ziel der Arbeit (Fragestellung)

Das Ziel dieser Untersuchung ist herauszufinden, wie Pflegeheime von älteren Menschen je nach ihrem subjektiven Kontrollerleben, ihrem Informationsstand und ihren Erfahrungen bewertet werden.

Material und Methoden

Zu Einstellungen gegenüber Pflegeheimen wurden insgesamt 150 geriatrische Rehabilitationspatienten mit einer ersten Fragebogenversion (n = 64) oder einer revidierten Fassung (n = 86) befragt.

Ergebnisse

Mittels Polaritätsprofil konnte eine eher positive Einstellung zu Pflegeheimen beobachtet werden, jedoch wurden bei freiem Antwortformat überwiegend negative Assoziationen geäußert. Der Großteil der Probanden hat eine ängstliche Haltung zu einem Umzug in ein Pflegeheim. Stärkeres Kontrollerleben, ein besserer Informationsstand und positive Erfahrungen mit Pflegeheimen stehen mit einer positiven Haltung zum Umzug in ein Pflegeheim im Zusammenhang.

Diskussion

Mit Blick auf geäußerte Ängste, einen verbreitet geringen Informationsstand und die starke Abwehrhaltung einiger Befragter gilt es, die Betroffenen proaktiv zu informieren und stärker in die Entscheidungen für eine Wohnoption einzubinden. Neueste Entwicklungen zu aussagekräftigerer Qualitätsdarstellung der Pflegeheime können dabei unterstützen.

Claims data-based analysis of the influence of individual and regional characteristics on the utilisation of long-term care by people with dementia in Baden-Wurttemberg, Germany

Background

Challenges of future dementia care include increasing shortage of qualified healthcare providers and decreasing potential of informal care by relatives. In order to meet those challenges, changes in dementia care are needed. These changes should be based on data of both care utilisation and care supply. The aim of this study was to provide insight into individual and regional characteristics that influence the utilisation of long-term care by people with dementia.

Methods

The study was a retrospective cross-sectional analysis of claims-based data and other available data referring to one index year. All data were aggregated for small geographic districts. The study population comprised people with a dementia diagnosis, 65 years and older in Baden-Wuerttemberg and insured by the largest health insurer. Utilisation of nursing home care, informal care, and respite care was analysed using binary coded logistic multilevel analyses.

Results

Seventy nine thousand three hundred forty-nine people with dementia were included in the analyses. Nursing home care was used by 20.4%, informal care by 30.6%, and respite care by 3.5% of people with dementia. Individual characteristics that influence care utilisation included age, sex and the level of care dependency. The utilisation of informal care (OR = 1.713) and respite care (OR = 2.036) was higher in rural districts than in city districts. Respite care supply had an effect on the utilisation of respite care (OR = 1.173).

Conclusions

The study found differences between districts in the utilisation of long-term care for dementia. These differences were largely explained by the composition of the population within the districts. An exception was the utilisation of respite care, which was higher in districts which have higher supply. Individual characteristics that influenced care utilisation are age, sex, level of care dependency and, with regard to informal care, comorbidity. Further research should be conducted on a small-area level, include further individual characteristics as well as other care and living forms.

Do Individuals in Old Age Prepare for the Risk of Long-Term Care? Results of A Population-Based Survey in Germany

The aim of the present study was to identify specific actions and financial precautions undertaken by individuals in preparation for their long-term care needs, as well as to determine the correlates of these actions. A population-based survey of the German population aged 65 years and above (n = 1006) was used. Individuals were asked whether they have undertaken financial preparations for their long-term care needs (no; yes). With respect to specific actions, individuals were asked whether they (no; yes): (i) Had obtained information (e.g., from doctor, internet, care support center, care facility), (ii) had modified their home (e.g., installed a stair lift), and (iii) had moved (e.g., old-age housing, care in relatives’ homes). In total, 30.4% had undertaken financial preparations for their long-term care needs. With respect to the specific actions undertaken, 6.5% had obtained information, 4.8% modified their home, and 7.3% had moved. The outcome measure, ‘had modified home’, was positively associated with lower age, West Germany, and lower self-rated health. The outcome measure, ‘had moved’, was positively associated with being female, and higher education. The outcome measure, ‘financial preparations for long-term care needs‘, was positively associated with lower age, West Germany, higher education, being born in Germany, and private health insurance. It is alarming that only around one in three individuals aged 65 and older had undertaken financial preparations for long-term care needs, and that far fewer individuals had undertaken other actions to prepare for their long-term care needs. The provision of timely information regarding the risk of long-term care, as well as its associated costs, may assist in sustaining the satisfaction of long-term care recipients. It may also help to reduce the risk of long-term care for individuals in old age.