Enhancing Autonomy in Long-term Care


Book Description

This volume assesses the importance of autonomy to quality of life in long-term care facilities. First addressing conceptual issues, the editors then pose such questions as: What is autonomy and what does it mean in the context of physically and/or cognitively impaired elders? What is the effect of nursing home financing and federal regulations? How does the traditional medical model, which casts residents as "patients", affect autonomy? How does the physical environment make a difference? The contributors then go on to describe six successful models of care that provide a more meaningful quality of life through promoting autonomy. Contributors include Robert and Rosalie Kane, Keren Brown Wilson, and Bart Collopy.




The Erosion of Autonomy in Long-Term Care


Book Description

In few places in American society are adults so dependent on others as in nursing homes. Minimizing this dependency and promoting autonomy has become a major focus of policy and ethics in gerontology. Yet most of these discussions are divorced from the day-to-day reality of long-term care and are implicitly based on concepts of autonomy derived from acute medical care settings. Promoting autonomy in long-term care, however, is a complex task which requires close attention to everyday routines and a fundamental rethinking of the meaning of autonomy. This timely work is based on an observational study of two different types of settings which provide long-term care for the elderly. The authors offer a detailed description of the organizational patterns that erode autonomy of the elderly. Their observations lead to a substantial rethinking of what the concept of autonomy means in these settings. The book concludes with concrete suggestions on methods to increase the autonomy of elderly individuals in long-term care institutions.




Autonomy and Long-term Care


Book Description

The realities and misconceptions of long-term care and the challenges it presents for the ethics of autonomy are analyzed in this perceptive work. While defending the concept of autonomy, the author argues that the standard view of autonomy as non-interference and independence has only a limited applicability for long-term care. He explains that autonomy should be understood as a comprehensiveness that defines the overall course of a person's life rather than as a way of responding to an isolated situation. Agich distinguishes actual and ideal autonomy and argues that actual autonomy is better revealed in the everyday experiences of long-term care than in dramatic, conflict-ridden paradigm situations such as decisions to institutionalize, to initiate aggressive treatments, or to withhold or to withdraw life-sustaining treatments. Through a phenomenological analysis of long-term care, he develops an ethical framework for it by showing how autonomy is actually manifest in certain structural features of the social world of long-term care. Throughout this timely work, the rich sociological and anthropological literature on aging and long-term care is referenced and the practical ethical questions of promoting and enhancing the exercise of autonomy are addressed.







Improving the Quality of Long-Term Care


Book Description

Among the issues confronting America is long-term care for frail, older persons and others with chronic conditions and functional limitations that limit their ability to care for themselves. Improving the Quality of Long-Term Care takes a comprehensive look at the quality of care and quality of life in long-term care, including nursing homes, home health agencies, residential care facilities, family members and a variety of others. This book describes the current state of long-term care, identifying problem areas and offering recommendations for federal and state policymakers. Who uses long-term care? How have the characteristics of this population changed over time? What paths do people follow in long term care? The committee provides the latest information on these and other key questions. This book explores strengths and limitations of available data and research literature especially for settings other than nursing homes, on methods to measure, oversee, and improve the quality of long-term care. The committee makes recommendations on setting and enforcing standards of care, strengthening the caregiving workforce, reimbursement issues, and expanding the knowledge base to guide organizational and individual caregivers in improving the quality of care.




Enhancing Autonomy in Long-term Care


Book Description

This volume assesses the importance of autonomy to quality of life in long-term care facilities. First addressing conceptual issues, the editors then pose such questions as: What is autonomy and what does it mean in the context of physically and/or cognitively impaired elders? What is the effect of nursing home financing and federal regulations? How does the traditional medical model, which casts residents as "patients", affect autonomy? How does the physical environment make a difference? The contributors then go on to describe six successful models of care that provide a more meaningful quality of life through promoting autonomy. Contributors include Robert and Rosalie Kane, Keren Brown Wilson, and Bart Collopy.




Quality of Life and Well-Being for Residents in Long-Term Care Communities


Book Description

This book explores key factors long-term care recipients have identified as impacting their quality of life and offers programmatic and policy recommendations to enhance well-being within long-term care communities. Leadership and staff who work in nursing homes and other residential care communities serve as gatekeepers to resident well-being, often without recognizing how residents’ quality of life is impacted by their decision-making. This book takes a life domain approach to build on research-based studies that document key drivers of care recipients’ quality of life, including relationships, autonomy and respect, activities and meals, environment, and care. Using a framework that enhances understanding of resident quality of life, it outlines practical, programmatic, and policy suggestions for long-term care stakeholders, such as administrators, managers, front-line staff, family members, and policy-makers, whose directives and actions impact the lived experience of long-term care residents. As such, this book serves as a roadmap for leaders and managers of long-term care communities, along with policymakers who regulate health and human services, to best structure care environments to maximize quality of life and well-being for long-term care recipients.







The Erosion of Autonomy in Long-term Care


Book Description

In few places in American society are adults so dependent on others as in nursing homes. Minimizing this dependency and promoting autonomy has become a major focus of policy and ethics in gerontology. Yet most of these discussions are divorced from the day-to-day reality of long-term care and are implicitly based on concepts of autonomy derived from acute medical care settings. Promoting autonomy in long-term care, however, is a complex task which requires close attention to everyday routines and a fundamental rethinking of the meaning of autonomy. This timely work is based on an observational study of two different types of settings which provide long-term care for the elderly. The authors offer detailed descriptions of the organizational patterns and routine practices that erode autonomy of the elderly. Their observations lead to a substantial rethinking of what the concept of autonomy means in long-term care. The book concludes with suggestions on how the autonomy of elderly individuals in long-term care institutions might be promoted.




Improving the Quality of Care in Nursing Homes


Book Description

As more people live longer, the need for quality long-term care for the elderly will increase dramatically. This volume examines the current system of nursing home regulations, and proposes an overhaul to better provide for those confined to such facilities. It determines the need for regulations, and concludes that the present regulatory system is inadequate, stating that what is needed is not more regulation, but better regulation. This long-anticipated study provides a wealth of useful background information, in-depth study, and discussion for nursing home administrators, students, and teachers in the health care field; professionals involved in caring for the elderly; and geriatric specialists.