eMagazine January 2023

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OUR PEOPLE, OUR MISSION Global Health eMagazine January 2023 Perspective Highlights Reflections Innovation and Technology Section Editor: Nursing Division Catherine G Winkler, PhD, MPH, APRN-BC Director of the Nuvance Health Global Health Program Nursing Division An Aging Population Across the World and Senior Care: Part 2 Written by Catherine G Winkler, PhD, MPH, APRN-BC Director of the Nuvance Health Global Health Program Nursing Division Nursing Division Women’s Health Education Global Local Art to Remind Us of Who We Can Be Article of the Month Video of the Month Our Beautiful Planet Welcome Congratulations Among the Letters Global Health Family Calendar Photo News Photo Gallery Resources As populations age, countries will need to continue to assess and weave elders into the fabric of society at much higher numbers to meet the needs of older persons as well as to utilize their skills and knowledge to ensure that there are efficient, cost-effective approaches to achieving societal balance across all age groups. Some countries have begun innovative programs or modified existing ones to promote infrastructure changes that support public services for elderly persons while concurrently adding benefits to society. Japan, which is the world’s oldest county, instituted caring relationship tickets or currency to encourage volunteer services for elders by younger folks that then can be later used to support their own older family members. Further, education on dementia has been provided with some communities instituting wellness checks, QR codes in elders’ clothing to help identify a senior who might have wandered, and cafes who cater to elders with forgetfulness or dementia. Other countries such as Germany have shared apartments where eight roommates who all have dementia can live, learn, and share responsibilities within a home with 24-hour nursing care. Additionally, in China where nursing homes are uncommon, the government continues to support the notion that 90% of the elderly population receives support and care from family with 6% at the community level with elder centers and 4% at nursing homes. This is a challenge with fewer young people who can serve as caregivers due to the one-child rule that has since been lifted along with many young people moving from rural homes to the urban setting to work, leaving seniors alone. China has started a University of the Aged to provide education and a sense of connection for those who attend and a Silver College with cultural activities. Here in North America, nursing homes (extended care facilities) and short-term rehabilitation facilities have been common for several years. Currently, 1.5 million Americans reside in nursing homes (Stats., 2022) with projections citing that more than 70% of people in the U.S. will require long-term care (Stats, 2022). However, others believe that the need for nursing homes will decrease in the future due to alternatives in elder care management such as assisted living, while others believe that with an increase incidence in dementia and many skilled facilities closing during the pandemic (estimated 300) with another 400 pending per Becker’s Review (2022) it is difficult to predict. 18
OUR PEOPLE, OUR MISSION Global Health eMagazine January 2023 Perspective Highlights Reflections Innovation and Technology Nursing Division Women’s Health Education Global Local Art to Remind Us of Who We Can Be Whether the need for skilled long-term care remains or not, what is agreed upon is that it is expensive and requires most patients to rely on Medicaid (funding by the state and federal government) to cover the cost over time. With this being the case there are many actions that can be standardized to improve costs, increase efficiencies, and provide safe, quality care. Recommendations to bridge care from the hospital to the post-acute care phase are many and we can go into detail in the next publication about the necessary changes to better transition patients. Generally, patients should be discharged on Friday before 3 PM or if necessary between 12 noon and 3 PM on Sundays if they are not discharged from the hospital during the week. This change will ensure that medications from off-site pharmacies are available, that physicians and nurse practitioners are available within 24 hours to admit the patient, and that that the transfer occurs when nursing is better-staffed (on days). A report from provider to provider predischarge would be advantageous and an integrated or linked medical record will provide enhanced and timely communication. Additionally, patient-centered care, improved transportation for medical follow-up, accessible equipment at facility and home, tighter relationships with homecare and hospice services, and perhaps a consortium between the principles in senior care to include hospitals, ECFs, hospices, pharmacies, senior centers, and community groups would also be incorporated. Before the next Global Health eMagazine edition, please send your ideas or recommendations regarding improvements in senior care around the world so that we can share them next month. Thank you. Article of the Month Video of the Month Our Beautiful Planet Welcome Congratulations Among the Letters Global Health Family Calendar Photo News Photo Gallery Resources Birds of a Feather, Salem, Massachusettes, (Amanda Wallace) 19
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