"Keep dignity intact": exploring desires for quality long-term care among midlife women

Stated preferences for long-term care: a literature review

Person-centred provision of long-term care (LTC) requires information on how individuals value respective LTC services. The literature on LTC preferences has not been comprehensively reviewed, existing summaries are contradictory. An explorative, scoping review was conducted to provide a thorough methodological description and results synthesis of studies that empirically investigated LTC preference outcomes based on respondents’ statements. A wide search strategy, with 18 key terms relating to ‘LTC’ and 31 to ‘preferences’, was developed. Database searches in PubMed, Ovid and ScienceDirect were conducted in February 2016. The 59 studies meeting the inclusion criteria were grouped and methodically described based on preference elicitation techniques and methods. Despite substantial methodological heterogeneity between studies, certain findings consistently emerged for the investigated LTC preference outcomes. The large majority of respondents preferred to receive LTC in their known physical and social environment when care needs were moderate, but residential care when care needs were extensive. Preferences were found to depend on a variety of personal, environmental, social and cultural aspects. Dependent individuals aspired to preserve their personal and social identity, self-image, independence, autonomy, control and dignity, which suggests that LTC preferences are a function of the perceived ability of a specific LTC arrangement to satisfy peoples’ basic physiological and mental/social needs. Research on LTC preferences would greatly profit from a standardisation of respective concepts and methods.

Who should take care of me? Preferences of old age individuals for characteristics of professional long-term caregivers: an observational cross-sectional study

BACKGROUND

It is most likely that the need for long-term care increases considerably in the next decades due to demographic shifts. Thus, we aimed at identifying the preferences for characteristics of professional long-term caregivers among old age individuals in Germany.

METHODS

Data were gathered from a population-based survey of the German population aged 65 and above in 2015 (n = 1006).

RESULTS

It was important for individuals in old age that long-term caregivers were 'empathetic, kind' (99.3%), 'punctual, reliable' (98.2%), have an 'orderly appearance' (96.4%), work in a 'small team' (92.5%) and have 'enough time' (91.5%). Moreover, while most of the individuals (76.5%) reported high preferences for 'German language', the preferences were lower for 'same cultural background' (54.2%) and 'same gender' (35.7%). In multiple logistic regressions, preferences for 'same gender' were positively associated with being female [OR 8.3 (5.6-12.1)], living with partner or spouse [OR 1.4 (1.0-1.9)], and being born abroad [OR 1.8 (1.1-3.1)]. Preferences for 'German language' were positively associated with being female [OR: 1.5 (1.1-2.1)]. Preferences for 'same cultural background' were positively associated with age [OR 1.0 (1.0-1.1)], living with partner or spouse [OR 1.4 (1.0-1.9)], and East Germany [OR 1.9 (1.3-2.7)]. Preferences for 'orderly appearance', 'empathetic, kind', 'punctual, reliable' and 'small nursing team' were all not significantly associated with included independent variables, whereas preferences for 'enough time' were positively associated with being female [OR 1.9 (1.1-3.5)], living with partner or spouse [OR 1.9 (1.1-3.4)], education [Apprenticeship, full-time vocational school, OR 3.1 (1.3-7.6)], not providing care for family/friends [OR 1.9 (1.1-3.3)], and involvement in the issue of need for care [OR 1.3 (1.1-1.6)].

CONCLUSIONS

Our data suggest that it is important to almost every individual aged 65 and above in Germany that professional long-term caregivers are (i) empathetic, kind, and understanding, (ii) punctual and reliable, (iii) have enough time (e.g., for conversation), (iv) and have an orderly appearance. Furthermore, several factors such as gender or region were found to be associated with preferences for characteristics of caregivers. By knowing these factors, nursing services can tailor their activities to the needs of care-recipients.

Enhancing women's health: A call for social work research

This article presents a critical synthesis of the social work empirical literature on women's health. In light of recent policy changes that directly affect women's health and social work, the authors conducted a literature review of recent publications (2010-2015) regarding social work and women's health nationally. Despite frequent accounts cited in the literature, there has been no comprehensive review of issues involving women's health and social work in the United States. The purpose of this review is to examine the current social work literature addressing women's health at the national (U.S.) level. This research presents a summary description of the status of the social work literature dealing with women's health, specifically 51 articles published between 2010 and 2015. Our search highlights the need for social work research to fill gaps and more fully address the needs of women across the lifespan.