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Aging, Chronic Disease, and the Impact of Long Term Care

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Keywords
Published Papers

A special issue of Healthcare (ISSN 2227-9032).

Deadline for manuscript submissions: closed (15 May 2019) | Viewed by 42115

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Special Issue Editor

Dr. Carol Fox

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Guest Editor

Department of Pharmacotherapeutics and Clinical Research, College of Pharmacy, University of South Florida, 12901 Bruce B. Downs Blvd., Tampa, FL 33612, USA
Interests: geriatrics; transitions of care; medication safety; Alzheimer’s disease; Parkinson’s disease; herbals and alternative medicine; heart failure; osteoarthritis; pain management
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear colleagues,

As the world’s population continues to age, the proportion of that population that requires long-term care will also grow. The management of chronic disease states has positively evolved, allowing our older adults to live longer with multiple comorbidities. Clinicians rely on evidence-based guidelines to drive patient care. However, these guidelines are often based on evidence from clinical trials that exclude older adults, especially those with multiple chronic disease states and those requiring long term care. It is difficult at times to decide on the best course of treatment with little to no guidance.

This Special Issue will focus on the treatment of chronic diseases in older adults requiring long-term care. Original research and review articles on best practices for disease-state management in this setting, how decision making may be impacted by the care setting or frailty of the population, and how we can improve the management of chronic diseases in this setting to decrease healthcare costs will be included in this issue.

Dr. Carol Fox
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Healthcare is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2700 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

long-term care
diabetes
heart disease
HIV/AIDS
Alzheimer’s disease or dementia
Parkinson’s disease
COPD/asthma
pain
gastroesophageal reflux disease
gastrointestinal disorders
psychiatric disorders
kidney disease
liver disease

Published Papers (5 papers)

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Research

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9 pages, 193 KiB

Open AccessArticle

Long-Term Care Admissions Following Hospitalization: The Role of Social Vulnerability

by Judith Godin, Olga Theou, Karen Black, Shelly A. McNeil and Melissa K. Andrew

Healthcare 2019, 7(3), 91; https://doi.org/10.3390/healthcare7030091 - 15 Jul 2019

Cited by 16 | Viewed by 4041

Abstract

We sought to understand the association between social vulnerability and the odds of long-term care (LTC) placement within 30 days of discharge following admission to an acute care facility and whether this association varied based on age, sex, or pre-admission frailty. Patients admitted to hospital with acute respiratory illness were enrolled in the Canadian Immunization Research Network’s Serious Outcomes Surveillance Network during the 2011/2012 influenza season. Participants (N = 475) were 65 years or older (mean = 78.6, SD = 7.9) and over half were women (58.9%). Incident LTC placement was rare (N = 15); therefore, we used penalized likelihood logistic regression analysis. Social vulnerability and frailty indices were built using a deficit accumulation approach. Social vulnerability interacted with frailty and age, but not sex. At age 70, higher social vulnerability was associated with lower odds of LTC placement at high levels of frailty (frailty index (FI) = 0.35; odds ratio (OR) = 0.32, 95% confidence interval (CI) = 0.09–0.94), but not at lower levels of frailty. At age 90, higher social vulnerability was associated with greater odds of LTC placement at lower levels of frailty (FI = 0.05; OR = 14.64, 95%CI = 1.55, 127.21 and FI = 0.15; OR = 7.26, 95%CI = 1.06, 41.84), but not at higher levels of frailty. Various sensitivity analyses yielded similar results. Although younger, frailer participants may need LTC, they may not have anyone advocating for them. In older, healthier patients, social vulnerability was associated with increased odds of LTC placement, but there was no difference among those who were frailer, suggesting that at a certain age and frailty level, LTC placement is difficult to avoid even within supportive social situations. Full article

(This article belongs to the Special Issue Aging, Chronic Disease, and the Impact of Long Term Care)

18 pages, 273 KiB

Open AccessArticle

Understanding Male Caregivers’ Emotional, Financial, and Physical Burden in the United States

by Monika Lopez–Anuarbe and Priya Kohli

Healthcare 2019, 7(2), 72; https://doi.org/10.3390/healthcare7020072 - 22 May 2019

Cited by 28 | Viewed by 6243

Abstract

Men caregivers face caregiving burden, have weak support networks and are less likely to seek out programs which increase their caregiving capabilities and help them cope with this burden. Using the 2011 and 2015 National Study of Caregiving (NSOC) database and hierarchical regressions, we studied the emotional, financial, and physical burden of male caregivers as spouses, sons, and other caregivers by assessing the impact of caregiver characteristics, tasks and resources for each subgroup. We highlighted the importance of using a nationally representative database for men caregivers only and emphasized that these caregivers are not a monolithic group. We found that all caregivers experienced these three burden types, particularly elevated emotional stress, with sons reporting the highest emotional and financial strain levels. Assisting with personal care was the most stressful task and caregivers vastly under-utilized support and training. Our results suggest that burden suppressants included having family and friends help with caregiving, having time to decompress, and feeling appreciated by the care recipient. These findings offer insight for devising future policies that intentionally include relationship and burden type to encourage improved and more caregiving from men while supporting their well-being. Full article

(This article belongs to the Special Issue Aging, Chronic Disease, and the Impact of Long Term Care)

11 pages, 677 KiB

Open AccessArticle

Alarming and/or Alerting Device Effectiveness in Reducing Falls in Long-Term Care (LTC) Facilities? A Systematic Review

by Michael Mileski, Matthew Brooks, Joseph Baar Topinka, Guy Hamilton, Cleatus Land, Traci Mitchell, Brandy Mosley and Rebecca McClay

Healthcare 2019, 7(1), 51; https://doi.org/10.3390/healthcare7010051 - 25 Mar 2019

Cited by 7 | Viewed by 20000

Abstract

Perceptions against the use of alarming devices persist in long-term care environments as they are seen as annoying, costly, and a waste of time to the staff involved. Ascertaining whether these perceptions are true or false via the literature was a focus of this study. Proper information to educate staff and to work past these perceptions can be a positive effector for resident safety. Many facilitators for the use of alarming devices were found, as well as many barriers to their use as well. New technology is changing the perceptions regarding these types of devices as time passes. Education is a key component for staff, residents, and families. There are “traditional” issues with the use of alarms such as alarm fatigue by caregivers, high costs of implementation, and issues with proper implementation of alarms. Alarms are perceived as intrusive and the noise from them can be a potential cause of falls. However, alarming devices can be a key intervention in the safety of those residents who are prone to falls. This requires proper implementation and education for all parties involved, and proper oversight surrounding use of the devices. Full article

(This article belongs to the Special Issue Aging, Chronic Disease, and the Impact of Long Term Care)

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Review

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13 pages, 435 KiB

Open AccessReview

End-of-Life Care Challenges from Staff Viewpoints in Emergency Departments: Systematic Review

by Ali J. Alqahtani and Geoffrey Mitchell

Healthcare 2019, 7(3), 83; https://doi.org/10.3390/healthcare7030083 - 29 Jun 2019

Cited by 19 | Viewed by 5837

Abstract

The hospital emergency department (ED) is the place where people most commonly seek urgent care. The initial diagnosis of an end-of-life (EOL) condition may occur in the ED. In this review we described the challenges; from the staff members’ perspectives, to safe, appropriate, and high quality end-of-life care (EOLC) for people who are diagnosed with non-malignant diseases who present to ED settings internationally. We conducted a systematic review of peer-reviewed literature. PubMed, Scopus, CINAHL, Medline, and Web of Science were searched from 2007 to 2017. In this review the challenges in providing quality EOLC from staff viewpoints, for EOL people who are diagnosed with non-malignant progressive diseases in ED settings, were classified into eight themes: (1) EOLC education and training, (2) ED design, (3) Lack of family support, (4) Work Load, (5) ED staff communication and decision making, (6) EOLC quality in ED, (7) resource availability (time, space, appropriate interdisciplinary personnel) and (8) integrating palliative care (PC) in ED. The formulation of EOLC using this review result may help to improve the quality of life for dying people by providing ED staff with clear guidelines that can guide them in their daily practice Full article

(This article belongs to the Special Issue Aging, Chronic Disease, and the Impact of Long Term Care)

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12 pages, 893 KiB

Open AccessReview

Review of Programs for Persons Facing Death with Dementia

by Ladislav Volicer

Healthcare 2019, 7(2), 62; https://doi.org/10.3390/healthcare7020062 - 15 Apr 2019

Cited by 10 | Viewed by 5316

Abstract

Background: Persons with advanced dementia cannot initiate activities because of the executive dysfunction. The lack of activities was identified as one of the most important factors contributing to behavioral problems of these persons. The unmet needs were boredom/sensory deprivation, loneliness/need for social interaction, and need for meaningful activities. There is a need for activities designed specifically for residents with advanced dementia. Objective: A description of patient’s needs and of programs that intend to maintain quality of life for people with dementia and facing death. Data sources: A literature review of programs used for persons with advanced dementia and residing in long-term facilities, using the PubMed data base and collateral sources. Results: Since palliative care is appropriate for persons with advanced dementia, attention has to be paid to three following important aspects of care: Medical issues, behavioral symptoms, and meaningful activities. Medical interventions should be limited to those which have more benefits than burdens, behavioral symptoms should be distinguished according to the context in which they occur, and treated by non-pharmacological interventions that involve meaningful activities. This review describes four programs that may promote the quality of life in persons with advanced dementia and facing death. They are designed for persons with advanced dementia, taking into account their functional impairments. Most of these programs involve short infrequent sessions. In contrast, Namaste Care is a daily extended program of enhanced nursing care that can provide quality of life until the last breath. Conclusions: It is possible to maintain quality life for people with advanced dementia if a special program of activities is available. Full article

(This article belongs to the Special Issue Aging, Chronic Disease, and the Impact of Long Term Care)

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