Palliative care in Japanese long-term care facilities

Iida, Kieko; Ryan, Assumpta; Payne, Sheila; Hasson, Felicity; McIlfatrick, Sonja

doi:10.12968/ijpn.2022.28.1.28

Cited by 3 publications

(8 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…1,2 Our findings suggest that nursing home closures reduce local health care jobs.The employment decline is persistent and largest in rural areas. Protecting resident access to nursing home care is important, and policy makers and rural community stakeholders should consider interventions to mitigate the adverse effects of nursing home closure on the local health care workforce.…”

mentioning

confidence: 70%

“…1 More than 1.7 million individuals worked in nursing homes in 2019. 2 Nursing assistants, registered nurses, licensed practical nurses, personal care aides, and housekeeping staff are the most common occupations, accounting for over 60% of the nursing home workforce. 2 In areas with small labor markets, nursing homes employ a larger share of the health care workforce.…”

Section: Introductionmentioning

confidence: 99%

“…2 Nursing assistants, registered nurses, licensed practical nurses, personal care aides, and housekeeping staff are the most common occupations, accounting for over 60% of the nursing home workforce. 2 In areas with small labor markets, nursing homes employ a larger share of the health care workforce. 3 Between 2001 and 2015, nursing homes accounted for 34.5% of health care employment in rural counties (with less than 10,000 population) and 25% in micropolitan counties (a core urban area of 10,000-<50,000 population).…”

Section: Introductionmentioning

confidence: 99%

“…In addition, nursing home closures also affect the local/state economy in lost tax revenue and economic activity generated by nursing homes with local businesses. 2 Between 2008 and 2018, 1255 Medicaid and/or dually certified nursing homes closed in the US. 4 More than 300 nursing homes closed during the COVID-19 pandemic between 2020 and 2021 and another 400 nursing homes are at risk of closure due to financial distress and workforce crises.…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

The effect of nursing home closure on local employment in the United States

Sharma

Wehby

2023

Health Services Research

View full text Add to dashboard Cite

Objective To estimate the effect of nursing home closure on local employment, overall, and by rurality. Data Sources and Study Setting We obtained 2008–2018 county‐level data from the Quarterly Workforce Indicators, Medicare Provider of Services, Area Health Resource, and Urban Influence Codes files. From 2008 to 2018, 878 counties experienced at least one nursing home closure, and 2055 counties did not experience a closure. Study Design Using a difference‐in‐difference study design, we compare the changes of total employment, health sector employment and non‐health sector employment over time between counties with and without a nursing home closure. We utilize the variation in the year and quarter of nursing home closures to estimate subsequent employment changes as well as employment trends before closure. We also account for contemporaneous events including nursing home entries and hospital entries and closures, and evaluate heterogeneity by rurality. Data Extraction We include data on nursing home closure from the Medicare Provider of Service file. Quarterly county‐level employee counts were obtained from the Quarterly Workforce Indicators provided by the Census Bureau. County‐level demographic data were obtained from the Area Health Resource Files. We use Urban Influence Codes from the Economic Research Service, Department of Agriculture, to classify metropolitan, micropolitan, and rural (noncore) counties. Principal Findings Health sector employment decreased by about 3.2%–4.1% (p < 0.01) in counties with a nursing home closure. The reduction was largest in rural counties (approximately 7.2%–9.4%, p < 0.01). The reduction in health sector employment persisted over time, particularly in rural counties. Overall, there was no discernable effect on non‐health sector employment. Conclusions Nursing home closure is associated with a persistent decline in health sector employment, particularly in rural counties, suggesting a reduction in the health care workforce and in the ability to sustain health care services supply, particularly in rural areas.

show abstract

mentioning

confidence: 70%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

The effect of nursing home closure on local employment in the United States

Sharma

Wehby

2023

Health Services Research

View full text Add to dashboard Cite

show abstract

“…Focus group and semi-structured interview schedules were developed and used to guide the data collection process. The schedules were informed by the integrative review (Iida et al ., 2021) and expert elicitation of Japanese palliative and end-of-life and long-term care experts conducted by the authors (Iida et al ., 2022). They included participants' current palliative/end-of-life care practices, challenges, opportunities experienced and views on palliative/end-of-life care in their facility.…”

Section: Methodsmentioning

confidence: 99%

An exploration of the views of staff on cultural aspects of end-of-life care in Japanese long-term care facilities: a qualitative study

et al. 2022

Self Cite

View full text Add to dashboard Cite

Long-term care facilities are increasingly important places for palliative and end-of-life care provision in Japan. While the importance of culture has been noted for palliative and end-of-life care, an exploration of its influence on care provision in long-term care settings has received little direct attention in Japan. Exploring staff views and beliefs in palliative and end-of-life care in these settings can potentially enhance our understanding of culturally oriented care and facilitate the development of tailored and more effective support practices. This study aimed to explore the cultural views and beliefs regarding palliative and end-of-life care among the staff in Japanese long-term care facilities. A qualitative exploratory study was conducted using focus groups with facility staff (N = 71) and semi-structured interviews with facility managers (N = 10) in the Kanto region of Japan. Thematic analysis was conducted according to Braun and Clarke's approach. The findings are presented in five key themes: ‘Changes in society's and family's end-of-life perspectives’, ‘Values and beliefs regarding death and dying’, ‘Anxiety and regret’, ‘Tensions in doing the right thing’ and ‘Ways of alleviating pressure’. The findings indicate that the provision of palliative and end-of-life care is underpinned by cultural nuances that influence care providers' approach and delivery. Recognising and understanding the cultural beliefs of staff around death, dying and end-of-life care are important in meeting the needs of residents. Palliative care education for staff in these settings should include cultural considerations that reflect changing societal views on death and dying.

show abstract

Provision of Palliative Care for Patients with Advanced Dementia across Various Long-Term Care Settings in Japan: A Questionnaire-Based Survey

Hirakawa,

Komatsu,

Saito

et al. 2024

Preprint

View full text Add to dashboard Cite

Long-term care (LTC) settings are increasingly used for palliative care in Japan. This study aimed to assess the proportion of LTC settings that provide palliative care services for older clients with advanced dementia in Japan and the trends across the types of settings. A nationwide questionnaire survey was conducted between November 2022 and January 2023, targeting 1,000 geriatric hospitals (GHs), 1,000 geriatric health services facilities (GHSFs), and 1,000 home nursing care stations (HNCSs). The palliative care practices for older patients with advanced dementia and their families in the agencies were assessed. Less than half of the GHs supported family participation or the spiritual needs of their older clients with dementia, while many had access to pain and symptom assessments and analgesic prescriptions by physicians. Less than half the GHSFs used pain assessment tools, assessed and supported family caregivers' pain and distress, and supported family participation in palliative care. More than 80% of the HNCSs practiced most of the listed palliative care. Current palliative care practices for older adults with dementia vary among GHs, GHSFs, and HNCSs. This emphasizes the need for targeted approaches to improve the provision of palliative care for patients with dementia across LTC settings in Japan.

show abstract

Palliative care in Japanese long-term care facilities

Cited by 3 publications

References 18 publications

The effect of nursing home closure on local employment in the United States

The effect of nursing home closure on local employment in the United States

An exploration of the views of staff on cultural aspects of end-of-life care in Japanese long-term care facilities: a qualitative study

Provision of Palliative Care for Patients with Advanced Dementia across Various Long-Term Care Settings in Japan: A Questionnaire-Based Survey

Contact Info

Product

Resources

About