The Program of All-Inclusive Care for the Elderly (PACE) enables older people to remain active members of their community who would otherwise need to reside in a nursing home. To be considered eligible for PACE, patients must be age 55 or older and certified by the state in which they reside, to have a chronic illness, disability, or be in need of physical or medical assistance. PACE developed in the Chinatown section of San Francisco CA in 1971. At the time, this community consisted of many families whose elders had immigrated from Italy, China, and the Philippines. The option of nursing home care for the elderly was culturally unacceptable for many living in this community. Based on consultant work by Marie-Louise Ansak and a federal grant, On-Lok (Cantonese for “peaceful happy abode”) was founded. The first On Lok Center provided adult day care with medical, rehabilitation, respite, and social services. Medicaid was providing the program reimbursement for day health services by 1979. On Lok was further funded by a four-year Department of Health and Human Services demonstration...
Within the U.S. Healthcare system there are different levels of healthcare; Long-Term Care also known as (LTC), Integrative Care, and Mental Health. While these services are contained within in the U.S. Healthcare system, they function on dissimilar levels.
Long term care facilities are for patients looking for 24 hour care, these are sometimes referred to as nursing homes. Providing safety and quality of life with nursing as well as endless supervision. Long term care facilities are held through profit or non profit organizations. Long-term care facilitates are generally classified by ownership: Proprietary (for profit) meaning owned by individual or corporation and run for profit. Religious, meaning owned and operated by a religious organization, lay/charitable meaning owned and operated by a voluntary, non governmental and non religious body. (non profit). And others would be municipal, regional, provincial and federal. “Ontario carries 17% For profit facilitates, 46% government owned, 18% not for profit, and 19% Religious facilities for long term care. That is a 48.4% rate of not for profit homes with a 51.6% rates of profit organizations” (Banerjee, An Overview of Long-Term Care in Canada and Selected Provinces and Territories). Through the whole of this research paper, the terms will be grouped looking through for profit facilities and not for profit facilities of Ontario. This paper also has the intention to promote the need for maximizing priorities in long term care facilities as they lack the funds needed to fully produce the mission of quality. “Take away the public relations spin and it is clear that even the for-profit association admits that cutting on food and staff costs, and charging higher fees is the practice to maximize profit taking from the homes. Conversely, municipalities are pouring funding into the operational budgets of the facilities to improve care. Non-profits fundraise to provide activities and amenities. They act ...
Culture change in long-term care is a set of guiding principles based on person-centered care tailored to each elder’s care while treating them with dignity and respect. Core values include relationship, personal choice, self-determination, and purposeful living (“Defining Culture Change”, n.d.). In person-centered care, quality of life is recognized to be as important as the quality of care. It is also recognized that every person has the right to be allowed to make their own decisions, even if those decisions may not always be safe. Finally, at the very heart of person-centered care is the relationship between the elder and their caregivers in which the way a task is done is as important, if not more, than the task itself (Jones, 2011).
A nursing home is another form of care and this involves an elderly person moving from their home to a building full of all amentities necessary for living well. The only downside to nursing homes is that they are the most exepnsive alternative and that there is a large waiting list for getting into one. In 2010, the Ontario Health Quality council reported, “wait times for a long-term care bed in Ontario have tripled since 2005” (Born, 2011). A nursing home has become a last resort because of these reasons and we need to do everything in our power to alleviate the amount of demand for these nursing homes.
Growing old is hard, and unfortunately it is also unavoidable. It is a part of life and everyone, who lives a normal lifespan, goes through it. Growing old is very hard not only on the individual growing older but also on the loved ones of that individual. Most people as they grow older start to require more and more care to be able to live a normal life from one day to the next. Over time this level of care can become too much for their loved ones to be able to provide. When something like this happens, outside help is needed. This care may come in the form of home care or having to move into a care facility. There are a lot of people that end up needing a significant amount of care to which they need to be in a facility that can give them the type of care that they require on a daily basis. Nursing homes and care centers are the last stop for many hospital patients. They can also be temporary places for people recovering from strokes or surgeries and need rehabilitation to get their lives back in place (Mcgrody). There is nothing wrong with needing to move to a nursing home but it can be a very stressful time for that individual and his or her family, because the end of life is usually not too far away. A lot of people start to have trouble eating when they get older and this can make nourishment levels decline. Weight loss usually occurs as a result of this malnourishment. Part of the reason difficulties like this may happen is because of the different aspects of mealtime in nursing homes or care facilities. There are strategies to help alleviate or to help cope with the problems that arise near the end of life due to eating. A few things to consider when thinking about the end of life are troubles with eating...
Nelda McCall (2001). Long Term Care: Definition, Demand, Cost, and Financing. Chicago: Health Administration Press, pg. 19.
Certain cultures that live at or below the poverty line prefer this type of assistance for their elderly family members because it allows them to have someone meet them at their home. This convenience is a big factor and provides the elderly with a way to fulfill their communal culture by living out their time at home among family, while still receiving any necessary assistance for health checks or IADL’s. This improves their quality of life by meeting their needs in a different way. These alternative methods to older adult care are more popular among minorities and cultural groups (Bookman & Kimbrel, 2011). Bookman and Kimbrel acknowledge the gap between financial status as well as culture and race, they stated, “...because elders are widely diverse by race and socioeconomic status, their families attach differing cultural meanings to care and have widely different resources with which to accomplish their care goals” (2011). Thus, creating the large gap seen in nursing home facilities. Specifically, cultures like the Chinese who maintain traditions like filial piety, in which the adult children must care for their elderly parent (Li & Buechel, 2007). This type of culture defines the line between those who view nursing homes as ideal and those who prefer a separate
Zinn, . L., 2005. So Simple, It's Genius. Nursing Homes: Long Term Care Management. Feb2005, Vol. 54 Issue 2, p30-31, viewed 3 February 2014,
The Senior Alliance Initiative is a non-profit organization designed to help improve the quality of life for senior citizens and integrate seniors into the community. The program will originate in Manitoba’s rural communities where there is often a shortage of close resources such as food, toiletries, and health services. As of 2011, 20.3% of Manitobans over the age of 65+ live in rural communities which means approximately one in five senior-aged Manitobans are not able to receive the help they need without aid from family/friends, home care, or a senior care home. (Univeristy of Manitoba, 2016) Often these resources are not available or are unreasonable due to:
In California ethnic minorities make up a large part of our population. In the book Culture and Nursing Care: A Pocket Guide, there are characteristics of these groups and generalizations are made about how they care for their elderly. (Lipson, 1996) The following table highlights some of these groups that are represented in the Bay Area.
Matthews, J. L. Beat the Nursing Home Trap: A Consumer's Guide to Assisted Living and
Upon growing older there are many decisions to be made. Among one of the most difficult and perhaps most important decisions is where the elder person will live and how long-term care needs will be met when he/she is no longer capable of doing so independently due to the incapacity that accompanies many with old age. Nursing homes seem to be the popular choice for people no matter the race, gender, or socioeconomic status with 1.5 million Americans being admitted to them yearly.[3] Because nursing homes are in such a high demand and are not cheap, $77.9 billion was spent for nursing home care in the United States in 2010 alone, they are under criticism of many professions including the legal profession, which is in the process of establishing elder law as a defense to issues with in the elder community. Nursing homes have a duty to provide many things to the elderly including medical, social, pharmaceutical, and dietary services so that the individual may maintain the highest well-being possible.[4] Stated another way 'a nursing facility must care for its residents in such a manner and in such an environment as will promote maintenance or enhancement of the q...
The long-term care system consists of an integrated continuum of many institutional and non-institutional providers who deliver extended care when needed. Long-term care providers deliver a variety of care to individuals with chronic, mobility and/or cognitive impairments/limitations. These providers include: nursing facilities, sub acute care, assisted living, residential care, elderly housing options and community based adult services (Pratt, 2010). A great majority of these providers are already taking care of the many baby boomers that are present today and will be present in the future. “Baby boomers” are individuals who were born between the years 1946-1964. Since 2011, every day 10,000 baby boomers turn 65 years old (Pratt, 2010). This
There are changes in the demographic as the population grows older, the number of older adult’s increases and thus, there is an increase of proportion of patients that are older adults for nurses to take care of (Wells, Y., Foreman, P., Gething, L., & Petralia, W., 2004). The nurses are there to assist and support the older adults in achieving wellness within their situation through empowering the clients (Touhy, et al (2012). Caring for older adults is important as there is an increase in population with deteriorating health. When caring for a client it is important to incorporate Jean Watson’s caring theories and Carative Factors to help influence and support the care. She encourages nurses to co-participate within the caring process by establishing unity and trust between the nurse and client. First, this paper will explain a situation in where I cared for an older adult and it will then introduce Jean Watson’s lower order needs, specifically the need for activity and how it relates to the older adult I cared for. Lastly, this paper will explain the nursing interventions I implemented to meet the lower order need, with a discussion of Carative Factor #4 relating to the client.
America is becoming more and more diverse, and Mansfield, Ohio is no exception. Although, only 1.8% of Mansfield’s population is Asian, the Asian American population is growing faster than any other cultural group. It is predicted by 2030, the Asian population will reach 20 million with the Chinese community growing the most. ( ) Personally, I have always admired the loyalty and respect the Chinese populace has toward their aged. This admiration has driven me to learn more, not only to prepare to work together, but to also assure I can lead others to provide culturally sensitive care to this growing community. As a nurse, I have always acknowledged individualism, but attaining “cultural competence is an aspect of nursing that will move the profession to its next developmental phase”. ( DeNisco,Susan and Barker Anne Chap 22, p 486 Advanced Practical Nursing)