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Future Directions for Community-Based Long-Term Care Health Services Research

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Table 2. Priority Long-Term Care Quality Concerns

Quality Concerns Process and structure Outcome

Caregiving

Caregiver training

Caregiver health: Burden, Stress, Physical decline.

Economic impact: Impact on employment

Quality of care

Clinical care: Skin care, Periodic turning, Range of motion exercises, Medications, Toilet training, Use of restraints.

Care planning: Adequacy of care plan.

Staffing: Turnover, Staff ratios and composition, Training, Compensation.

Responsiveness: Elapsed time to receive services.

Mental health: Cognition, Mood.

Disability: ADLs and IADLs, Unmet functional needs, Mobility, Strength—balance—and endurance, Social integration, Ability to engage in productive activity, Social development (children).

Infections: Tooth and gum decay and loss, Pneumonia, Septicemia, Urinary tract infections.

Geriatric syndromes: Pressure ulcers, Incontinence, Contractures, Sleep disturbances, Bruises.

Satisfaction

Discomfort: Pain.

Preventable outcomes: Falls, Transportation accidents, Unnecessarily restrictive environment, Inappropriate hospitalizations—emergency department use.

Nutrition: Weight loss, Dehydration.

Quality of life

Home environment: Noisiness in common areas, Furnishings, Safety features.

Organized activities

Personal/internal: Autonomy, Dignity, Privacy.

Personal/social: Social interaction, Locus of control.

External/societal: Safety, Abuse and neglect, Financial harm.

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