Factors Affecting Choice of Community Residential Care Setting

Spatial accessibility and equity of residential care facilities in Beijing from 2010 to 2020

In recent years, the aging population in Beijing has rapidly increased and the demand for residential care facilities (RCFs) has also risen. As RCFs have quickly developed, the question of whether residential care resources dynamically match the changes in the demand of the elderly population is an urgent issue that must be addressed. This study analyzes the spatiotemporal variation in the supply and demand of RCFs, applies a Gaussian two-step floating catchment area method with a multi-level search radius to measure the spatial accessibility of RCFs in Beijing in 2010 and 2020, and evaluates the equity of spatial accessibility. The results show that the elderly population was decentralized from the central urban area to New Urban Development Area. However, the distribution of RCF beds shows further agglomeration towards the central urban area. The accessibility of residential care resources in the central urban area and New Urban Development Area has increased, while accessibility in Ecological Protection Area has decreased. The spatial disparities in accessibility have been reduced and the spatial equity in accessibility has been improved over the past decade. The findings provide policy recommendations for the future allocation of RCFs by considering the spatiotemporal changes in the distribution of the supply and demand of residential care resources.

Internet Resources and Searching for a Residential Care Setting: What Information Is Available for Consumers?

By making information about long-term-care facilities readily available, consumers in need of services are able to compare facilities and select one that is best for the elder. However, it is unclear how much information is available for residential care settings. In this investigation, an Internet search was performed to determine what information is available in each state. It was found that most states had a number of descriptive indicators. The way in which the information was displayed varied substantially among states, and very little quality-of-care information was available. Although the authors found a variety of useful information, they offer some suggestions to standardize the way in which the information could be presented, thus allowing a direct comparison between residential care settings to be made more easily.

Creating Compact Comparative Health Care Information

Background. The recent emphasis on providing comparative health care data to the public has resulted in a large amount of online information. To focus on the most essential attributes, insight is needed into which attributes are actually considered by consumers. Objective. To assess which attributes of Dutch hospital performance information contribute most to consumers’ hospital choice for cataract and total hip or knee replacement surgery. Design. Two discrete-choice experiments were performed: one for cataract surgery and one for total hip or knee replacement surgery. Participants viewed hypothetical hospitals based on representative values for 10 attributes (e.g., distance to the hospital, waiting time for the surgery, conduct of professionals, information provision, complication rate) and were asked to select the hospital they would choose if they needed treatment. We used multilevel logistic regression analysis to test the effects of the attributes and the interactions between attributes and respondent characteristics on consumers’ hospital choice. Results. All except one attribute (length of the first appointment with the ophthalmologist) contributed significantly to consumers’ choices. Although some differences were found between cataract and hip/knee replacement surgery, the most influential attributes for both types of surgeries were distance, waiting time, and the attributes of patient safety (complication rate of capsular rupture and the use of procedures to prevent adverse effects of thrombosis). Interaction effects were found between hospital attributes, on one hand, and age, education, and consumer choice orientation, on the other hand. Conclusions. As for cataract and total hip/knee replacement surgery, the attributes that seem most important to consumers when choosing a hospital are access (waiting time and distance) and patient safety attributes.

Improving family-staff relationships in assisted living facilities: the views of family

AIMS

This article is a report of a study of the key influences on family-staff collaboration in low level residential aged care (assisted living) facilities in Australia as seen by the family carers of residents.

BACKGROUND

Collaboration with the willing family is widely acknowledged to be important in the care of the older person. Previous work in nursing homes has shown that staff-family relationships are often ambiguous. Relatively little is known about the issue of staff-family relationships in assisted living facilities.

METHODS

Using qualitative methodology twelve family carers from five assisted living facilities were interviewed and transcripts analysed thematically. Data were collected in 2006/2007.

RESULTS

Four factors important to the establishment and maintenance of collaborative staff-family relationships were identified: comfort, communication, consultation and confidence.

CONCLUSION

Low level care facilities need to create environments that are conducive to the establishment and maintenance of constructive staff-family relationships. A number of practice considerations for care staff to foster relationship-centred care with the family in these types of facilities are presented.

Identifying characteristics of residential care facilities relevant to the placement process of seniors

OBJECTIVE

To identify which characteristics of the physical and organizational environments of residential care facilities (RCFs) need to be known to support the placement process of seniors with cognitive and physical disabilities.

DESIGN

We used a 2-round postal Delphi survey based on the RAND/UCLA Appropriateness Method with 2 groups of experts.

PARTICIPANTS

Participants are representatives of concerned stakeholder groups from various sectors (public, private, and community) and geographical regions within the province of Quebec, Canada.

RESULTS

Of the 58 persons who were interested in participating, 48 (82.8%) returned their questionnaires. The first group identified 171 items essential to consider when a cognitively impaired senior needs to move into an RCF. Of these, 88 were related to the physical environment of the RCF and 83 to its organizational environment. The second group identified 146 items to be relevant to consider when a senior with physical impairments needs to choose an RCF; 75 for the physical and 71 for the organizational environment. 85% of the items selected by both groups (cognitive versus physical group) were identical.

CONCLUSION

This study provided a list of important items that described residential care facilities in regard to their physical and organizational environments to support the placement process of seniors. It also provides the possibility to develop a self-administered tool that will supply valuable information to seniors and their relatives, to health care professionals, and to administrators and decisions-makers.

The Search and Selection of Assisted Living Facilities by Elders and Family

BACKGROUND

In this study, we examine factors associated with the search, selection, and satisfaction of residents and family members in assisted living.

METHODS

Data were collected from 375 residents of 25 assisted living facilities matched with 375 family members. We conducted face-to-face interviews with the residents to determine: (1) the principal decision maker; (2) the process of searching for a facility; (3) the factors crucial to facility selection; (4) the time frame from the relocation decision to relocation; and (5) satisfaction with selection. Similar questions were asked of family members, using a mail survey.

RESULTS

Residents described themselves as extremely influential in 39% of cases when searching for a facility, and in 27% of cases when selecting a facility. Quality, cost, and location were the most influential factors for both residents and family members in selecting a facility. Almost all residents and family would use different search and selection processes if they had to select a facility again, and almost all were dissatisfied with the sources of information available.

CONCLUSIONS

Consumers and policy makers both favor the use of assisted living settings; but, the information available to choose a setting is far from ideal, and may represent a barrier to both consumer and policy makers' agendas.