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Transitions of People with Dementia ...

Cepoiu-Martin, Monica.

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Transitions of People with Dementia in the Continuing Care System.

紀錄類型:	書目-電子資源 : Monograph/item
正題名/作者:	Transitions of People with Dementia in the Continuing Care System./
作者:	Cepoiu-Martin, Monica.
出版者:	Ann Arbor : ProQuest Dissertations & Theses, : 2017,
面頁冊數:	181 p.
附註:	Source: Dissertation Abstracts International, Volume: 78-11(E), Section: B.
Contained By:	Dissertation Abstracts International78-11B(E).
標題:	Public health. -
電子資源:	http://pqdd.sinica.edu.tw/twdaoapp/servlet/advanced?query=10630387
ISBN:	9780355007893

Transitions of People with Dementia in the Continuing Care System.
Cepoiu-Martin, Monica.

Transitions of People with Dementia in the Continuing Care System. - Ann Arbor : ProQuest Dissertations & Theses, 2017 - 181 p.

Source: Dissertation Abstracts International, Volume: 78-11(E), Section: B.

Thesis (Ph.D.)--University of Calgary (Canada), 2017.

Aging of the population raises a number of challenges to health care and continuing care systems around the world. One of them is ensuring that seniors with disabilities receive the best care at home and in the continuing care system, in order to avoid unnecessary transitions. Dementia is one of the major sources of disability in seniors and the literature exploring the transitions of people with dementia in the continuing care system is growing. Nevertheless, there are still important gaps in the literature pertaining to specific factors that govern these transitions, especially those related to informal caregivers. Moreover, the complexity of the continuing care system makes it difficult to meaningfully incorporate research data on transitions into policies meant to improve the outcomes of people with dementia. The work reported in this dissertation focuses on addressing these gaps and applying system thinking to policy making in continuing care. The systematic review and meta-analysis provided pooled estimates of known and less well-known risk factors for long-term care (LTC) placement in people with dementia. Also, our review highlighted the scarcity of data on resident and caregiver related factors that may delay the LTC placement in people with dementia living in supporting living (SL) settings. This gap in the literature was addressed in the second study, which found that low strength of social relationships, among other factors, significantly increases the risk of LTC placement (HR=1.57, 95% CI: 1.02 -- 2.43). Also, the number of activities performed by the informal caregivers modified the effect of residents' level of ADL impairment on the risk of LTC placement. Specifically, among residents with severe ADL impairment, those with caregivers that performed 5 to 7 activities had a significantly lower risk of LTC placement, compared to those with caregivers that performed 4 or fewer activities (p=0.017). These research findings, along with data extracted from various reports and information obtained from continuing care stakeholders, were used to build a system dynamics (SD) model that describes the Alberta Continuing Care System (ACCS). This computer simulation model was used to explore policy options in the ACCS, illustrating the applicability of system thinking to developing and testing policies in continuing care. In the particular case of modifying benchmarks for staff/resident ratios in the continuing care system, increasing the availability of trained staff in SL might help decrease costs in the system by reducing the rapid transitions of people with dementia from SL to LTC, and consequently, reducing the pressure for adding LTC beds in the system.

ISBN: 9780355007893Subjects--Topical Terms:

534748
Public health.

Transitions of People with Dementia in the Continuing Care System.
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