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Alternate housing models for older people with disabilities: their clientele, structures and resources in relation to the quality of and satisfaction with care delivery

Published online by Cambridge University Press:  06 June 2013

NICOLE DUBUC*
Affiliation:
Faculty of Medicine and Health Sciences, Université de Sherbrooke, Canada. Research Centre on Aging, University Institute of Geriatrics of Sherbrooke, Canada.
MARIE-FRANCE DUBOIS
Affiliation:
Faculty of Medicine and Health Sciences, Université de Sherbrooke, Canada. Research Centre on Aging, University Institute of Geriatrics of Sherbrooke, Canada.
LOUIS DEMERS
Affiliation:
École nationale d'administration publique, Quebec, Canada.
ANDRÉ TOURIGNY
Affiliation:
Institut national de santé publique du Québec, Centre de recherche du CHA, Canada.
MICHEL TOUSIGNANT
Affiliation:
Faculty of Medicine and Health Sciences, Université de Sherbrooke, Canada. Research Centre on Aging, University Institute of Geriatrics of Sherbrooke, Canada.
JOHANNE DESROSIERS
Affiliation:
Faculty of Medicine and Health Sciences, Université de Sherbrooke, Canada. Research Centre on Aging, University Institute of Geriatrics of Sherbrooke, Canada.
CINTHIA CORBIN
Affiliation:
Research Centre on Aging, University Institute of Geriatrics of Sherbrooke, Canada.
LISE TROTTIER
Affiliation:
Research Centre on Aging, University Institute of Geriatrics of Sherbrooke, Canada.
MICHEL RAÎCHE
Affiliation:
Research Centre on Aging, University Institute of Geriatrics of Sherbrooke, Canada.
*
Address for correspondence: Nicole Dubuc, Research Centre on Aging, University Institute of Geriatrics of Sherbrooke, 1036 Belvedere South, Sherbrooke, Quebec, Canada, J1H 4C4. E-mail: [email protected]

Abstract

This paper reports on the study of a subsidy programme that was established in Quebec for alternate housing models (AHMs), which allows private and community organisations to offer housing services within the framework of a partnership with public health-care services. The research objectives were: (a) to compare how facility characteristics and services provided by AHMs and nursing homes (NHs) differ; (b) to examine the personal characteristics of residents living in AHMs; and (c) to compare residents with similar characteristics within AHMs and NHs in terms of unmet needs, quality of care, satisfaction with care and services, and psycho-social adaptation to the residence. A cross-sectional study was undertaken with individually matched groups to assess whether AHMs meet the needs of elders in a way similar to NHs. Overall, residents in both groups had moderate to severe levels of disability and about 60 per cent had mild to severe cognitive problems. While their general features were heterogeneous, the AHMs were more comfortable and homelike than the NHs. The quality of and satisfaction with care was appropriate in both settings, although AHMs performed better. Only one-quarter of residents in both settings, however, evidenced a good level of psycho-social adaptation to their residence. This partnership approach is a good strategy to provide a useful range of housing types in communities that can respond to the needs of elders with moderate to severe disabilities.

Type
Articles
Copyright
Copyright © Cambridge University Press 2013 

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References

Allen, J. 2011. Higher acuity in assisted living is here to stay. Geriatric Nursing, 32, 1, 6971.Google Scholar
Andrews, G. J. and Phillips, D. R. 2002. Changing local geographies of private residential care for older people 1983–1999: lessons for social policy in England and Wales. Social Science & Medicine, 55, 1, 6378.Google Scholar
Angelelli, J. 2006. Promising models for transforming long-term care. Gerontologist, 46, 4, 428–30.Google Scholar
Ball, M. M., Perkins, M. M., Whittington, F. J., Connell, B. R., Hollingsworth, C., King, S. V., Elrod, C. L. and Combs, B. L. 2004. Managing decline in assisted living: the key to aging in place. Journals of Gerontology: Psychological Sciences and Social Sciences, 59B, 4, S202–12.Google Scholar
Bergland, A. and Kirkevold, M. 2006. Thriving in nursing homes in Norway: contributing aspects described by residents. International Journal of Nursing Studies, 43, 6, 681–91.Google Scholar
Brandburg, G. L. 2007. Making the transition to nursing home life: a framework to help older adults adapt to the long-term care environment. Journal of Gerontological Nursing, 33, 6, 50–6.Google Scholar
Bravo, G., Charpentier, M., Dubois, M. F., DeWals, P. and Emond, A. 1998. Profile of residents in unlicensed homes for the aged in the eastern townships of Quebec. Canadian Medical Association Journal, 159, 2, 143–8.Google Scholar
Bravo, G., Dubois, M. F., Charpentier, M., De Wals, P. and Emond, A. 1999. Quality of care in unlicensed homes for the aged in the eastern townships of Quebec. Canadian Medical Association Journal, 160, 10, 1441–5.Google Scholar
Bravo, G., Girouard, D., Gosselin, S., Archambault, C. and Dubois, M. F. 1995. Further validation of the QUALCARE scale. Journal of Elder Abuse & Neglect, 7, 4, 2948.Google Scholar
Brooker, D. J., Argyle, E., Scally, A. J. and Clancy, D. 2011. The enriched opportunities programme for people with dementia: a cluster-randomised controlled trial in 10 extra care housing schemes. Aging & Mental Health, 15, 8, 1008–17.Google Scholar
Brooker, D. J. and Woolley, R. J. 2007. Enriching opportunities for people living with dementia: the development of a blueprint for a sustainable activity-based model. Aging & Mental Health, 11, 4, 371–83.Google Scholar
Camirand, J., Dugas, L., Cardin, J. F., Dubé, G., Dumitru, V. and Fournier, J. 2010. Vivre avec une incapacité au Québec. Un portrait statistique à partir de l'Enquête sur la participation et les limitations d'activités de 2001 et 2006. Institut de la statistique du Québec, Québec, Canada.Google Scholar
Castle, N. G. 2008. Service enriched housing and the Senior Living Enhancement Program. Journal of Housing for the Elderly, 22, 3, 263–78.Google Scholar
Castonguay, G. and Ferron, S. 1999. Élaboration et validation d'un instrument évaluant le degré d'adaptation de la personne âgée à sa résidence. Revue Canadienne du vieillissement, 18, 3, 363–75.Google Scholar
Chao, S. Y., Lan, Y. H., Tso, H. C., Chung, C. M., Neim, Y. M. and Clark, M. J. 2008. Predictors of psychosocial adaptation among elderly residents in long-term care settings. Journal of Nursing Research, 16, 2, 149–59.Google Scholar
Cohen, C. S., Mulroy, E., Tull, T., Bloom, C. C. and Karnas, F. 2007. Integrating services for older adults in housing settings. Journal of Gerontological Social Work, 49, 1/2, 145–64.Google Scholar
Cohen-Mansfield, J., Marx, M. S. and Rosenthal, A. S. 1989. A description of agitation in a nursing home. Journal of Gerontology, 44, 3, M7784.Google Scholar
Conseil des Aînés 2007. État de situation sur les milieux de vie substituts pour les aînés en perte d'autonomie. Gouvernement du Québec, Québec.Google Scholar
Cooney, A., Murphy, K. and O'Shea, E. 2009. Residents’ perspectives of quality of life in long-stay care. Journal of Advanced Nursing, 65, 5, 1029–38.Google Scholar
Croucher, K., Hicks, L. and Jackson, K. 2006. Housing with Care for Later Life – A Literature Review. Joseph Rowntree Foundation, University of York, York, UK. Available online from www.jrf.org.uk/sites/files/jrf/9781859354384.pdf [accessed 28 May 2013].Google Scholar
Cummings, S. M. 2002. Predictors of psychological well-being among assisted-living residents. Health & Social Work, 27, 4, 293302.Google Scholar
Cutler, L. J. 2007. Physical environments of assisted living: research needs and challenges. Gerontologist, 47, special number 3, 6882.CrossRefGoogle ScholarPubMed
Desrosiers, J., Bravo, G., Hébert, R. and Dubuc, N. 1995. Reliability of the revised functional autonomy measurement system (SMAF) for epidemiological research. Age and Ageing, 24, 5, 402–6.Google Scholar
Dubuc, N., Dubois, M. F., Raîche, M., Gueye, N. R. and Hébert, R. 2011. Meeting the home-care needs of disabled older persons living in the community: does integrated services delivery make a difference? BMC Geriatrics, 11, 67, e113.Google Scholar
Dubuc, N., Hebert, R., Desrosiers, J., Buteau, M. and Trottier, L. 2006. Disability-based classification system for older people in integrated long-term care services: the Iso-SMAF profiles. Archives of Gerontology and Geriatrics, 42, 2, 191206.Google Scholar
Edelman, P., Guihan, M., Bryant, F. B. and Munroe, D. J. 2006. Measuring resident and family member determinants of satisfaction with assisted living. Gerontologist, 46, 5, 599608.Google Scholar
Folstein, M. F., Folstein, S. E. and McHugh, P. R. 1975. ‘Mini-mental state’. A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 3, 189–98.CrossRefGoogle Scholar
Frank, J. 2001. How long can I stay? The dilemma of aging in place in assisted living. Journal of Housing for the Elderly, 15, 1/2, 530.Google Scholar
Gagnon, M., Hebert, R., Dube, M. and Dubois, M. F. 2006. Development and validation of the Health Care Satisfaction Questionnaire (HCSQ) in elders. Journal of Nursing Measurement, 14, 3, 190204.Google Scholar
Gaugler, J. E., Kane, R. L., Kane, R. A. and Newcomer, R. 2005. Early community-based service utilization and its effects on institutionalization in dementia caregiving. Gerontologist, 45, 2, 177–85.Google Scholar
Gibson, M. C., Carter, M. W., Helmes, E. and Edberg, A. K. 2010. Principles of good care for long-term care facilities. International Psychogeriatrics, 22, 7, 1072–83.Google Scholar
Glendinning, C. and Newbronner, E. 2008. The effectiveness of home care reablement – developing the evidence base. Journal of Integrated Care, 16, 4, 32–9.Google Scholar
Hawes, C. and Phillips, C. D. 2007. Defining quality in assisted living: comparing apples, oranges, and broccoli. Gerontologist, 47, special number 3, 4050.Google Scholar
Hébert, R., Bravo, G. and Girouard, D. 1992. Validation de l'adaptation française du modified mini-mental state (3MS). La Revue de Gériatrie, 17, 8, 443–50.Google Scholar
Hébert, R., Dubuc, N., Buteau, M., Desrosiers, J., Bravo, G., Trottier, L., St-Hilaire, C. and Roy, C. 2001 a. Resources and costs associated with disabilities of elderly people living at home and institutions. Canadian Journal on Aging, 20, 1, 121.Google Scholar
Hébert, R., Guilbeault, J., Desrosiers, J. and Dubuc, N. 2001 b. The functional autonomy measurement system (SMAF): a clinical-based instrument for measuring disabilities and handicaps in older people. Geriatrics Today: Journal of Canadian Geriatrics Society, 4, September, 141–7.Google Scholar
Howe, A. L., Jones, A. E. and Tilse, C. 2013. What's in a name? Similarities and differences in international terms and meanings for older peoples’ housing with services. Ageing & Society, 33, 4, 547–78.Google Scholar
Hyer, K., Thomas, K. S., Branch, L. G., Harman, J. S., Johnson, C. E. and Weech-Maldonado, R. 2011. The influence of nurse staffing levels on quality of care in nursing homes. Gerontologist, 51, 5, 610–6.Google Scholar
Kane, R. A., Chan, J. and Kane, R. L. 2007. Assisted living literature through May 2004: taking stock. Gerontologist, 47, special number 3, 125–40.Google Scholar
Kim, H., Kovner, C., Harrington, C., Greene, W. and Mezey, M. 2009. A panel data analysis of the relationships of nursing home staffing levels and standards to regulatory deficiencies. Journals of Gerontology: Psychological Sciences and Social Sciences, 64B, 2, 269–78.Google Scholar
LaPlante, M. P., Kaye, H. S., Kang, T. and Harrington, C. 2004. Unmet need for personal assistance services: estimating the shortfall in hours of help and adverse consequences. Journals of Gerontology: Psychological Sciences and Social Sciences, 59B, 2, S98108.Google Scholar
Lestage, C., Dubuc, N. and Bravo, G. 2008. Identifying characteristics of residential care facilities relevant to the placement process of seniors. Journal of the Americal Medical Directors Association, 9, 2, 95101.Google Scholar
Lévesque, G. 2007. L'hébergement et les soins de longue durée en établissement au Québec: évolution et tendances de la clientèle, des normes d'hébergement et du financement- Comparaisons nationales et internationales. Ordre des infirmières et infirmiers auxiliaires du Québec, Québec, Canada.Google Scholar
Lewin, G. and Vandermeulen, S. 2010. A non-randomised controlled trial of the Home Independence Program (HIP): an Australian restorative programme for older home-care clients. Health & Social Care in the Community, 18, 1, 91–9.Google ScholarPubMed
Ministère de la Santé et des Services sociaux du Québec 2004. Pour un nouveau partenariat au service des personnes en perte d'autonomie. Projets novateurs, Document explicatif 2004–2005. Direction des personnes âgées en perte d'autonomie. Document de travail, Ministère de la Santé et des Services sociaux du Québec, Québec, Canada.Google Scholar
Ministère de la Santé et des Services sociaux du Québec 2005. Plan d'action 2005–2010 – Un défi de solidarité: les services aux aînés en perte d'autonomie. Gouvernement du Québec, Québec, Canada.Google Scholar
Ministère de la Santé et des Services sociaux du Québec 2010. Info-hébergement. Bulletin d'information présentant des statistiques de base, Ministère de la Santé et des Services sociaux du Québec, Québec, Canada, February.Google Scholar
Mitty, E. 2010. An assisted living community environment that optimizes function: housing enabler assessment. Geriatric Nursing, 31, 6, 448–51.Google Scholar
Morgan, L. A., Eckert, J. K., Gruber-Baldini, A. L. and Zimmerman, S. 2004. Policy and research issues for small assisted living facilities. Journal of Aging & Social Policy, 16, 4, 116.Google Scholar
Newcomer, R., Kang, T., Laplante, M. and Kaye, S. 2005. Living quarters and unmet need for personal care assistance among adults with disabilities. Journals of Gerontology: Psychological Sciences and Social Sciences, 60B, 4, S205–13.CrossRefGoogle Scholar
Phillips, L. R., Morrison, E. F. and Chae, Y. M. 1990 a. The QUALCARE Scale: developing an instrument to measure quality of home care. International Journal of Nursing Studies, 27, 1, 6175.Google Scholar
Phillips, L. R., Morrison, E. F. and Chae, Y. M. 1990 b. The QUALCARE Scale: testing of a measurement instrument for clinical practice. International Journal of Nursing Studies, 27, 1, 7791.Google Scholar
Pinsonnault, E., Desrosiers, J., Dubuc, N., Kalfat, H., Colvez, A. and Delli-Colli, N. 2003. Functional autonomy measurement system: development of a social subscale. Archives of Gerontology and Geriatrics, 37, 3, 223–33.Google Scholar
Pynoos, J., Liebig, P., Alley, D. and Nishita, C. M. 2005. Homes of choice: towards more effective linkages between housing and services. Journal of Housing for the Elderly, 18, 3/4, 549.Google Scholar
Rabig, J., Thomas, W., Kane, R. A., Cutler, L. J. and McAlilly, S. 2006. Radical redesign of nursing homes: applying the green house concept in Tupelo, Mississippi. Gerontologist, 46, 4, 533–9.Google Scholar
Resnick, B., Galik, E., Gruber-Baldini, A. L. and Zimmerman, S. 2009 a. Implementing a restorative care philosophy of care in assisted living: pilot testing of Res-Care-AL. Journal of the American Academy of Nurse Practitioners, 21, 2, 123–33.Google Scholar
Resnick, B., Gruber-Baldini, A. L., Galik, E., Pretzer-Aboff, I., Russ, K., Hebel, J. R. and Zimmerman, S. 2009 b. Changing the philosophy of care in long-term care: testing of the restorative care intervention. Gerontologist, 49, 2, 175–84.Google Scholar
Sands, L. P., Wang, Y., McCabe, G. P., Jennings, K., Eng, C. and Covinsky, K. E. 2006. Rates of acute care admissions for frail older people living with met versus unmet activity of daily living needs. Journal of the American Geriatrics Society, 54, 2, 339–44.Google Scholar
Schulz, E. 2010. The long-term care system in Denmark. Discussion paper 1038. Deutsches Institut für Wirtschaftsforschung (German Institute for Economic Research), Berlin. Available online at www.diw.de/documents/publikationen/73/diw_01.c.359021.de/dp1038.pdf.Google Scholar
Spillman, B. C., Liu, K. and McGilliard, C. 2002. Trends in Residential Long Term Care: Use of Nursing Homes and Assisted Living and Characteristics of Facilities and Residents. ASPE, US Department of Health and Human Services, Office of the Assistant Secretary for Planning and Evaluation, Office of Disability, Aging and Long-term Care Policy and the Urban Institute, Washington DC.Google Scholar
Spilsbury, K., Hewitt, C., Stirk, L. and Bowman, C. 2011. The relationship between nurse staffing and quality of care in nursing homes: a systematic review. International Journal of Nursing Studies, 48, 6, 732–50.Google Scholar
Stone, R. I. and Reinhard, S. C. 2007. The place of assisted living in long-term care and related service systems. Gerontologist, 47, special number 3, 2332.Google Scholar
Street, D., Burge, S., Quadagno, J. and Barrett, A. 2007. The salience of social relationships for resident well-being in assisted living. Journals of Gerontology: Psychological Sciences and Social Sciences, 62B, 2, S129–34.Google Scholar
Stuart, M. and Weinrich, M. 2001. Home- and community-based long-term care: lessons from Denmark. Gerontologist, 41, 4, 474–80.Google Scholar
Trahan, L. and Caris, P. 2002. The systems of care and services for frail older persons in Canada and Quebec. Aging – Clinical and Experimental Research, 14, 4, 226–32.Google Scholar
Wiles, J. 2005. Conceptualizing place in the care of older people: the contributions of geographical gerontology. Journal of Clinical Nursing, 14, 8B, 100–8.Google Scholar