Prevalence, Characteristics, and Unmet Needs of Unbefriended Residents in Alberta Long-Term Care Homes
Notice bibliographique
Résumé
Background: Older adults who lack decision-making capacity and a willing or able surrogate to act as their representative are defined as unbefriended. These unbefriended older adults often require a public guardian and reside in long-term care (LTC) homes. Unbefriended LTC residents are at risk of poor quality of care, yet very little is known about this vulnerable resident population. Purpose: The purpose of this dissertation was to assess the prevalence, characteristics, and potentially unmet needs of unbefriended residents in Alberta LTC homes. Methods: This dissertation consisted of four linked studies: (1) a scoping review of the peer-reviewed and grey literature on unbefriended older adults; (2) a qualitative interview study of LTC staff and public guardians to identity the characteristics and unmet needs of unbefriended LTC residents; (3) a prevalence survey to assess the prevalence of unbefriended residents in all 172 Alberta LTC homes; and (4) a retrospective cohort study of health administrative data to further assess the prevalence, characteristics and health outcomes of unbefriended residents from a LTC home sample from Alberta. Findings and Conclusions: Our findings demonstrated that there is little research on unbefriended older adults and no other Canadian studies or reports. Neither the United States (US) nor Canada systematically collect information on unbefriended older adults’ characteristics or quality of care. Unbefriended LTC residents are socially isolated. Compared to LTC residents with family, they had lower social engagement, worse symptoms of depression, and more aggressive behaviours. Across two of our studies (interviews and administrative data), our findings indicated that unbefriended residents had significant mental health issues including diagnoses of depression, schizophrenia, and bipolar disorder. Unbefriended residents have limited financial resources and have significant issues accessing personal care items and services. Our findings suggest that unbefriended individuals experience poor quality of care, particularly at the end of life. Public guardians visit unbefriended residents infrequently and are often unavailable when contacted by LTC staff. The public guardians’ scope of work does not reflect the needs of unbefriended LTC residents, leaving the LTC staff responsible for providing the additional care and support. Unbefriended residents accounted for over 4% of all LTC residents in Alberta. Facilities with the highest proportion of unbefriended residents had more than 135 beds and were public-not-for profit. Unbefriended residents experienced more symptoms of depression, more frequent and severe pain, and exhibited more aggressive behaviours than residents with family. The findings from this dissertation indicated the unbefriended LTC residents have complex care needs and are vulnerable to poor quality of care.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,002 | 0,005 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,002 | 0,003 |
| Études des sciences et des technologies | 0,002 | 0,001 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,001 | 0,001 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».