20/6/2018

OPAL 2018 Blog

#1

A global ageing population

     The world’s population is ageing - older people are increasing in number and make up a growing share of the population in almost every country, with implications for nearly all sectors of society, including the demand for goods and services such as housing, transportation, and social and health care, as well as family structures and inter-generational ties (UN, 2017). The number of older people is expected to double by 2050, when it is projected to reach nearly 2.1 billion. Two thirds of the world’s older people live in the developing regions, where their numbers are growing faster than in the developed regions.  In 2050, it is expected that nearly 8 in 10 of the world’s older people will be living in the developing regions (UN, 2017). There is a need for policies to address the needs and interests of older people, including those related to health and social care, which include access to quality long-term care.

Long term care in the UK

     The UK has seen a rise in the number of older people needing long term care, with over 400,000 older people living in 19,000 care homes across the UK. The number of care home residents living with severe frailty has risen and many now live longer with multiple conditions, including long-term physical and mental health problems. Care homes are usually independently owned, with health services provided by a wide range of health care professionals from the National Health Service (NHS).

    There are more than twice as many people living in care homes in England and Wales than are staying in hospital, however until now there has been much less health care research in care homes (NIHR, 2017). Recent years have seen an increase in the amount of research carried out with care homes to improve both the care and experiences of older people living in care homes, although further work is needed.

Long term care in Brazil

     In Brazil, long term care for chronic older patients remains an unknown problem. According to Leme (2014), Nursing Homes exist mainly in large cities, but only a few of them work in association with SUS. Asylum institutions exist in the whole country, usually supported by religious institutions, but in insufficient numbers. Frequently, patients remain with their own family, with some kind of support from civil and/or religious communities. A nationwide census study conducted by Camarano (2010) using mailed interviews with institutions managers registered 3.549 institutions, most of these (65%) were philanthropic in nature. On average, the institutions were small, housing about 30 residents, and weree working at full capacity, using 91.6% of the existing 109,447 beds. On average, each institution spendt US$ 450/month per resident, with a very wide range (US$ 58 to U$ 5,750).

Shared challenges of conducting research in long term care

Accessibility of long term care institutions when undertaking research

Research in the care home setting must have demonstrable benefit for residents

    Care homes are not clinical environments like hospitals, they are the usually permanent homes of the residents who live their. As such, researchers must be aware of the burden of any research project and be sensitive that their presence can be intrusive. Research in this setting must be able to demonstrate the potential to benefit to the residents that balances out the burden. Practical ways to ensure this is achieved including establishing relationships with care home managers, staff and when permissions are in place, residents and relatives and ensuring all research staff have been trained to be respectful of each care homes routines and practices.

Engagement with wider team of health care professionals

Lack of published research