Demographic and clinical profiles of residents in long-term care facilities in South Africa: A cross-sectional survey.

BACKGROUND:  The demand for long-term care facilities (LTCFs) amongst older people in South Africa (SA) is growing and there is insufficient information on the profile and healthcare needs of this population. AIM:  This study was conducted to describe the demographic and clinical characteristics of residents in LTFCs in SA. SETTING:  Three LTCFs in eThekwini district. METHODS:  A cross-sectional design was used to collect data from a purposive sample of 102 (N = 204) residents. A structured questionnaire was used to collect demographic and clinical data. The data were entered into Microsoft Excel and analysed descriptively and inferentially using R version 3.5.1 software. RESULTS:  The majority of the residents (59.8%) were between 65 and 80 years (78.9 ± 8.1 years) and 74.5% were women. The residents were white people (91.1%), SA born (82.4%) and widowed (54.9%). English was the primary language (91.1%), with the majority being christian (52.0%). Some residents had a university education, were previously employed and are financially independent. Ninety-three percent had clinical conditions, each suffering from at least three clinical conditions. Hypertension (63.7%), high cholesterol (53.9%), arthritis (38.2%), depression (37.3%) were the most prevalent clinical conditions recorded amongst the residents. Most residents were assessed to be intermediately frail, at risk of malnutrition and had mild depression as based on the respective mean frailty-, nutrition-, and geriatric depression scores.Conc lusion: Residents in LTCFs in the eThekwini district are more likely to be white people; women, christian, widowed, intermediately frail and at risk of malnutrition.

Standards and quality of care for older persons in long term care facilities: a scoping review.

BACKGROUND: Caring for older persons has become a global necessity to ensure functional ability and healthy ageing. It is of paramount importance that standards of care are monitored, especially for older persons who live in long term care facilities (LTCF). We, therefore, scoped and summarised evidence relating to standards and the quality of care for older persons in LTCFs in gerontological literature globally. METHODS: We conducted a scoping review using Askey and O'Malley's framework, including Levac et al. recommendations. PubMed, CINAHL, Health Sources, Scopus, Cochrane Library, and Google Scholar were searched with no date limitation up to May 2020 using keywords, Boolean terms, and medical subject headings. We also consulted the World Health Organization website and the reference list of included articles for evidence sources. This review also included peer-reviewed publications and grey literature in English that focused on standards and quality of care for older residents in LTCFs. Two reviewers independently screened the title, abstract, and full-text of evidence sources screening stages and performed the data extraction. Thematic content analysis was used, and a summary of the findings are reported narratively. RESULTS: Sixteen evidence sources published from 1989 to 2017 met this study's eligibility criteria out of 73,845 citations obtained from the broader search. The majority of the studies were conducted in the USA 56% (9/16), and others were from Canada, Hong Kong, Ireland, Norway, Israel, Japan, and France. The included studies presented evidence on the effectiveness of prompted voiding intervention for urinary incontinence in LTCFs (37.5%), the efficacy of professional support to LTCF staff (18.8%), and the prevention-effectiveness of a pressure ulcer programme in LTCFs (6.3%). Others presented evidence on regulation and quality of care (12.5%); nursing documentation and quality of care (6.3%); medical, nursing, and psychosocial standards on the quality of care (6.3%); medication safety using the Beer criteria (6.3%); and the quality of morning care provision (6.3%). CONCLUSION: This study suggests most studies relating to standards and quality of care in LTCFs focus on effectiveness of interventions, few on people-centredness and safety, and are mainly conducted in European countries and the United States of America. Future studies on people-centerdness, safety, and geographical settings with limited or no evidence are recommended.

Mapping evidence on standards and quality of care for older persons in long-term care facilities: a scoping review protocol.

BACKGROUND: Ageing is a global and universal process that results in physiological, psychological and behavioural changes. Due to the changing needs of the individual and the circumstances of the family, long-term care of older persons in facilities has become essential. The standard and quality of health care for older persons in long-term care facilities is critical to maintain functional ability in keeping with international goals of healthy ageing. This study, therefore, will aim to systematically map literature and describe the evidence on standards and the quality of health care for older persons living in long-term care facilities (LTCFs). METHODS: A scoping review will be conducted using Arksey and O'Malley's framework and recommendations set out by Levac and colleagues. PubMed, CINAHL, Health Sources, PsycInfo, Web of Science, Scopus, and Google Scholar will be searched for relevant published studies/sources of evidence up to the last search date. The search will be conducted using keywords, and Boolean terms, and Medical Subject Headings/Subject Headings. EndNote X9 will be used to compile all relevant sources of evidence. This study will include studies involving participants ≥ 65 years old, living in LTCFs for older persons. English language publications, with no time limitations, and primary studies, guidelines, and quality of care specific to LTCFs for older persons will be sourced. Two reviewers will independently screen all sources of evidence at the title, abstract, and full-text screening stages as well as perform the data charting. The Preferred Reporting Items for Systematic Review and Meta-Analysis flow diagram will be used to account for all relevant sources of evidence during the screening. Thematic content analysis will be used to describe the themes aligned with this study's research question based on initial coding and categorisation and a summary of the findings reported narratively for each theme. DISCUSSION: We anticipate that this scoping review will highlight the standards of care and assessment tools available worldwide, in addition to gaps that exist in the evidence base for older persons in LTCFs. These may include an exposition of the standards and quality of care documented, monitoring and evaluation processes, instruments used for reviewing standards of care. This would contribute towards identifying the need for practical and universally acceptable tools for LTCFs for older persons.