Developments in Long-Term Care for Older People between Residential and Community-Based Services

In long-term care facilities, there are many residents aged 65+ who do not have the ability to seek shelter by themselves in the case of an emergency. Therefore, it is extremely important that nursing home staff be equipped with correct disaster prevention concepts, emergency survival responses, and hazard mitigation measures. The purpose of this study was to discuss the intervention effectiveness of different fire prevention and emergency response trainings at nursing homes, and the relationship and predictivity of awareness to self-efficacy. We used a quasi-experimental research method and recruited staff from two nursing homes through purposive sampling, using a two-team pre- and post-test design to collect results from 41 individuals in the experiment group and 40 individuals in the control group. The research tool was the “Nursing Home Fire Prevention and Emergency Response Awareness and Self-Efficacy Scale”, which was used to compare the effectiveness of advanced and general fire safety training. After receiving improved advanced fire safety training, the total score and the result of the experiment group in fire prevention and emergency response awareness and self-efficacy were both better than those of the control group who had received only general fire safety training (p < 0.001); fire prevention and emergency response awareness had a significant and positive correlation with self-efficacy (r = 0.601, p < 0.001), and awareness was a significant predictor variable of self-efficacy (β = 0.601, p < 0.001). This study finds that the key to improving learning effectiveness includes adding a fire science concept chapter when creating fire safety training material in order to strengthen basic awareness; fire safety training should comprehensively introduce all related duties and responsibilities for staff fire defense formation, thereby enabling mutual responsive support for the needs of the site. Moreover, becoming familiarized with the knowledge requires the appropriate frequency of training and enhancement of the staff’s awareness of fire prevention and emergency response, which is the most important key to learning effectiveness. Full article

Italian Long-Term Care is considered largely inadequate, and the recent COVID-19 pandemic has dramatically exposed its limitations. Public Home Care Services in particular were revealed as under-financed and unable to cover the potential demand for care from the older population. But does the type of municipality and its geographic location play a role in creating or mitigating unmet demand? This is the first study addressing this research question in Italy. Our hypothesis is that older people’s care preferences and care possibilities may vary between small, medium and metropolitan areas, as will the organisation, funding and availability of services, and the combination will influence (unmet) demand for public home care services. In this paper, using nationally representative survey data collected by the Italian National Statistical Institute in 2003 and 2016, we investigate changes and differences in the use of public and private home care services among people aged 75 or older in Italy by size of the municipality. Our results reveal inequalities in service use between Northern and Southern areas of the country and in particular between metropolitan areas, medium and small municipalities. Such differences reinforce post-pandemic calls for new investment and changes in the design of the Italian Long-Term Care system. Full article

In light of the increased demand for long-term care services in China, there is an ongoing discussion on what factors contribute to older adults’ intended use of long-term care services. This study empirically recruited 239 community-dwelling older adults aged ≥60 years in China and explored factors influencing their intended use of four types of long-term care (basic life care, basic medical care, rehabilitation care, and psychological care) based on the Andersen behavioral model (i.e., predisposing characteristics, enabling resources, and need factors). The results showed that older adults were most likely to use psychological care. Age (as the predisposing characteristic) was the significant predictor of the intended use of four types of care. Regarding the intended use of basic life care, the enabling resources of marital status, household composition, income, as well as need factors of preference for the care setting, were influential. Moreover, income and need factors of self-rated physical health status were only two variables associated with the intended use of basic medical care. Concerning the intended use of rehabilitation care, household composition, income, self-rated physical health status, and preference for the care setting were significant predictors. The intended use of psychological care was influenced by enabling resources of marital status, household composition, and need factors of self-rated physical health status, preference for the care setting, and preference for the caregiver. These results can promote the sensitivity of policymakers and caregivers to the community-dwelling older adults’ intended use of long-term care and contribute to the delivery of appropriate care services by public policy. Full article

When frail older people age alone in place, with increasing functional limitations, they require support in performing daily living activities. In this respect, it is important to assess their preferences in terms of future housing solutions, and their opinions/orientations on the care responsibilities of both family and public services. The present study aimed to explore these aspects in Italy. Qualitative interviews were carried out in 2019 within the “Inclusive ageing in place” (IN-AGE) research project, involving 120 frail older people who lived at home in three Italian regions (Lombardy, Marche, and Calabria). A content analysis was conducted, and some quantifications of interviewees’ statements were provided. The results revealed that the majority of seniors prefer ageing at home, at least with a personal care assistant (PCA), whereas moving to a nursing home is typically deemed as a last option. Moreover, they considered the family to be primarily responsible for taking care of them, even with the support of public services. In addition, some territorial differences emerged. Strengthening an integrated model of long-term care (LTC) for older people, where both formal and informal supports allow frail older people to age at home, seems thus a good overall policy solution to pursue, with interventions based also on the needs and preferences of both seniors and their respective families. Full article