Choosing the place of care for an elderly patient with a long-term illness
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Extract
- The OECD defines that the long-term care of a person should be organized at his/her home or in another facility, and it may be temporary or permanent in nature.
- An elderly person with a long-term illness may receive the care related to his/her primary disease either at home or in an institution. National or regional legislation may steer the selection of the primary place of living and care.
- The various care facilities have commonly, e.g. in Finland, been graded according
to the care workload in such a manner that persons who need the least amount of care
are assigned to care facilities with the smallest number of staff and those with highest
care requirements are placed in care facilities with highest staff numbers.
- The driving force behind this type of grading has been cost-efficiency and the ability to address various needs, but the downside of this approach has been the need to transfer elderly persons around during their last years of life. The personnel structure of different types of care facilities in Finland, however, has become increasingly similar over the years with regard to the skill level and number of staff, although the number of personnel available for those living at home is lower than for persons living in other types of living and care facilities.
- Moving away from home is a major decision, which at worst affects the elderly person's autonomy and changes the content of the rest of his/her life.
- Dementia syndrome is the most significant illness that leads to a change of treatment place.
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Linked evidence summaries
- Hospital at home services appear to provide similar outcomes to inpatient hospital care and decrease the likelihood of being admitted to institutional care. Hospital at home services may increase patient satisfaction.B↑↑
- Medical day hospital care for the elderly appears to be more effective than no intervention but appears to have no clear advantage over other forms of comprehensive elderly medical services.B
- Comprehensive geriatric assessment (CGA) appears to increase the patient apos;s likelihood of being in their own home at up to 12 months.B
Search terms
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