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EN
Purpose: To determine the health condition self-assessment and the possibility to improve physical functioning of patients in long-term nursing-home care. Materials and Methods: InterRAI-HC (Residential Assessment Instrument – Home Care) questionnaire was used to assess health condition and healthcare needs of a patient's in home care. A total of 100 consecutive patients who were newly admitted to long-term nursing-home care within NFZ (National Health Fund) contract in 2009-2010 took part in the study. Results: Patients most frequently assessed their health condition as poor (73.5%), only 3% ranked their health as good or fair, and self-assessment of health condition changed significantly in the range of age (p=0.017). Comparative analysis seems to indicate that the respondent more frequently assessed their health condition as good or fair in the periodic examination (6.0%) as compared to the initial examination (2.4%). Significant changes (p<0.001) were observed among the initial and the periodic examination the respondents more frequently assessed their health condition as good or fairer than as poor. In the periodic examination, more patients positively assessed the possibility of the improvement than in the initial examination (18.1% vs. 15.7%; p<0.001). Conclusions: Most patients under the long-term nursing-home care negatively ranked their own health condition. Long-term nursing-home care may have a beneficial effect on the emotional sphere of patients – more positive self-assessment tendency was observed after 90 days of care. It seems that qualifying patients with less advanced dependence in physical daily life activities to long-term nursing-home care could improve subjective assessment of health condition and increase the possibility to ameliorate physical functioning.
EN
The subject of this study is to present the problems concerning the social security of the informal carers of the dependent persons. Author discuss the solutions ad- opted in Germany and Austria, as a basis for the analysis of the polish regulations, formulating postulates of their transformation to better meet the demographi- cally conditioned social needs.
EN
Poland belongs to the group of countries in which the ageing process of the population has taken on a very violent dimension. Demographic forecasts indicate that the population of Poland in the middle of the 21st century will be one of the oldest in the group of European Union countries. The ageing of the population is a challenge, not only for the seniors themselves, but also for the whole society. Minimizing the negative effects of the ageing process requires undertaking actions in various areas of social policy in order to prepare for an increase in the number of elderly people with a simultaneous decrease in the number of people at pre-age and working age. The aim of the article is to present the impact and significance of objects and space in which seniors function on the life of older people. The ageing process of the population forces the adoption of measures aimed at adapting the private and public environment to the needs of seniors, in particular people with reduced ability to self-care and self-care. The article uses data from the GUS, NFZ, EC, MRPiPS and the results of the author’s own research.
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EN
The aim of the research was the examination of the available solutions in the field of meeting the needs of dependent elderly people in Szczecin and indicating priority actions in terms of elderly care optimization, possible to implement in Szczecin, on the basis of the diagnosis of the needs as well as resource and financial analysis. The method of desk research, including statistical and financial data concerning the social care sector, was used in the article. On the basis of the collected data it is possible to state that investing in sheltered accommodation is an alternative solution for building a nursing home. It is a less expensive replacement, which provides dependent seniors with a higher standard of care and support.
EN
This article presents the health care system in Poland, in particular the organisation, principles of functioning and financing. The financial results of the Polish system have been compared against European countries, in order to analyze the effectiveness of the system. The analysis assumes that the Polish system is not enough financed and poorly adapted to the changing socio-economic trends. Results of the analysis confirm no sufficient health care financing in Poland. Some of changes are observed and adapt to them through the development of new services. Therefore, changes are necessary in the financing of health care services and obtaining new sources and special funds.
EN
As a result of two trends: the increase in average life expectancy and the decline in the birthrate, population aging in many developed countries has been progressing rapidly. As the baby boomer generation (cohorts born between 1946 and 1964) ages, considerable attention has to be given to the increased demand for aff ordable and effi cient long-term care (LTC). Th e term LTC encompasses a broad range of primarily low-tech services provided by paid professionals and unpaid family members to individuals with chronic health conditions or disabilities who need help with daily activities of living (e.g. bathing, meal preparation, cleaning). Th is article aims to provide a brief overview of the long-term care systems in diff erent developed countries. Considering that current demographic trends, the aging population, and the number of people aff ected by chronic health conditions is increasing at an alarming rate, it is not surprising that there is a growing interest in developing interventions and creating policies that could lower the cost of providing long-term care and at the same time ensuring that all individuals have an access to health care. Some countries dedicated to introduce asocial long-term care insurance as a way of ensuring aff ordable access to long-term care. In this paper we review long-term care systems in developed countries such as Japan, Australia, the Netherlands, the United States, Sweden, Poland, and Germany. Although achieving superior outcomes such as longer life expectancy and decreased mortality rates at a relatively low cost is diffi cult, we suggested a few solutions on how to improve long-term care.
EN
The ageing of Polish population poses a challenge to the society resulting in the necessity to meet the needs of the increasing number of the elderly. Despite the progress of civilization (i.a. in medical technology), not every elderly person will be in good health and maintain their ability to care for themselves until their last days. In the event of some kinds of risks, i.a. social or health, some seniors will be able to count on their families’ support, whereas the number of seniors who are dependable on social welfare institutions will continue to increase, according to the latest demographic and economic forecasts. The aim of this article is to present the challenges the social welfare system has to face as a result of the ageing population. In particular, the coverage, forms and kinds of benefits the elderly receive from the social welfare, and what main limits and barriers they have to overcome to receive them. The presented data suggests that the government will experience difficulties with meeting the demands for care services, especially long-term ones, due to the lack of resources, including human and financial ones. In addition, the policy agenda does not show any form of pressure on this area of public policy. 
PL
Starzenie się populacji Polski stawia przed społeczeństwem wyzwania związane z koniecznością zabezpieczenia zróżnicowanych potrzeb rosnącej grupy osób starszych. Pomimo postępu cywilizacyjnego (m.in. w zakresie technologii medycznych) nie każda osoba starsza będzie się cieszyła dobrym zdrowiem i zachowa zdolność do samoopieki do ostatnich dni życia. Część seniorów będzie mogła w przypadku wystąpienia różnego typu ryzyka, m.in. socjalnego lub zdrowotnego, liczyć na wsparcie ze strony rodziny. Natomiast według prognoz demograficznych i ekonomicznych zwiększać się będzie liczba seniorów, których zabezpieczenie potrzeb będzie uzależnione od wsparcia ze strony sektora pomocy społecznej. Celem artykułu jest przedstawienie, przed jakimi wyzwaniami staje sektor pomocy społecznej w związku z procesem starzenia się populacji. W szczególności, jakie są zakres, formy i rodzaje świadczeń z pomocy społecznej dla osób starszych oraz jakie są główne ograniczenia i bariery w ich realizacji. Zaprezentowane dane wskazują, że rządzącym w Polsce trudno będzie w najbliższym czasie sprostać zapotrzebowaniu na usługi opiekuńcze, szczególnie w wymiarze długoterminowym z uwagi na niedostatek zasobów, w tym ludzkich, finansowych itp. Dodatkowo w agendzie politycznej nie widać nacisku na tę sferę polityki publicznej.
EN
The progressive process of ageing of contemporary societies and the increase in life expectancy related to the process result in a steady rise in the number of people suffering from Alzheimer’s. The disease is becoming a serious problem for a growing number of families who need to provide constant, long-term care for Alzheimer’s patients. The article presents the results of a research conducted among the participants of support groups for Alzheimer’s families. The purpose of the research was to grasp the way in which the presence of an Alzheimer’s patient in a family influences interactions, family relations and functioning of the family. The conclusions presented in the article are related to such problems as a sense of moral duty to provide the patient with care, changes in the structure of a family caused by Alzheimer’s disease, relations between the patient and their main caregiver, problems of acting as a caregiver, the influence of Alzheimer’s disease on family relations and bonds.
EN
This paper is devoted to the analysis of the relationships between the level of development of long-term care (LTC) support for the elderly in selected European countries and public expenditure on long-term care, the health condition of the population and the scale of labor market flexibility in connection with a need to provide home care for dependents by working family members (informal carers). For this purpose, one performed a multidimensional analysis of the relationship and showed spatial similarities, creating their own rankings.
XX
Presented article analyzes the Commission staff working document on long-term care. The role if this document is to show that the social investment should not just be spending on young people but also for the elderly. The article presents demographics, describes conditions that have infl uence on independent and self-governing live and also gives examples of long-term care in various countries of European Union.
PL
Artykuł koncentruje się na najnowszych pracach Komisji Europejskiej w zakresie opieki długoterminowej.
EN
The problems of the long term caring date from the beginnings of the 21st century. One of them is to provide a 24-hour caring under appropriate conditions to all the people in need. The article presents the rules of the functioning of welfare houses in Poland, paying special attention to their financing. The author analyses an average cost of maintenance as well as the cost paid by communities in relation to subsidizing the stays in stationary 24-hour facilities.
XX
Problemy opieki długoterminowej są problemami początków XXI wieku. Jednym z nich jest zapewnienie całodobowej opieki w odpowiednich warunkach wszystkim potrzebującym niesamodzielnym. W artykule przedstawiono zasady funkcjonowania domów pomocy społecznej w Polsce, w szczególności pod kątem ich finansowania. Przeanalizowano średni koszt utrzymania mieszkańców w domach pomocy społecznej województwa łódzkiego oraz koszty, jakie ponoszą gminy w związku z dofinansowaniem pobytów w placówkach stacjonarnych w całej Polsce. Przybliżono problemy związane z finansowaniem placówek całodobowego pobytu.
PL
Konsekwencją procesu starzenia się ludności jest wzrost liczby osób niesamodzielnych, co powoduje eskalację wydatków ponoszonych na opiekę długoterminową. W tej sytuacji konieczne jest poszukiwanie nowych źródeł finansowania tej opieki. Jednym z potencjal-nych rozwiązań jest wykorzystanie prywatnego ubezpieczenia opiekuńczego. Ten produkt uchodzi jednak za niszowy, a jego popularność jest z reguły niewielka. Aby zwiększyć zakres korzystania z prywatnej ochrony ubezpieczeniowej, niezbędna jest odpowiednia polityka państwa. Celem artykułu jest przedstawienie potencjalnych działań, jakie instytucje publiczne mogą podejmować w ramach tzw. polityki ubezpieczeniowej. Te działania zostały pogrupowane w trzy obszary: (1) regulacje, (2) popyt i (3) podaż. Skupiono się z jednej strony na problemach rynku ubezpieczenia opiekuńczego, z drugiej zaś na możliwych sposobach przeciwdziałania tym problemom.
EN
The consequences of population ageing are an increase in the number of dependents and increase expenditures on long-term care. One of the major challenges for public autho- rity is to find new sources of financing long-term care services. One potential solution is to introduce long-term care insurance. Unfortunately this product is widely regarded as a niche, and the scope of its use is relatively small. To change this situation an appropriate public policy is necessary. The aim of the article is to present the potential actions that public bodies may take in the framework of the so-called insurance policy. These activi- ties are grouped in regard to three areas: (1) regulatory, (2) demand and (3) supply. The article presents the problems of the long-term care insurance market, and possible ways to counteract them.
EN
The Czech Republic is the notable exception in Central and Eastern Europe, being the only country in the region to implement comprehensive Long-Term Care reform. The aim of this article is to critically evaluate the outcome of this reform concerning developments of community care services. Also, the article describes the system of dependency level and argues that such system is not a panacea for problems with implementation of Long-Term Care reform. The empirical analysis is mainly based on Czech sources.
PL
Republika Czeska jest pierwszym państwem w Europie Środkowo-Wschodniej, które wprowadziło kompleksową zmianę w zakresie usług społecznych, mających wspierać osoby niesamodzielne. Celem artykułu jest krytyczna analiza zmian i efektów czeskiej reformy, głównie z punktu widzenia jej niezrealizowanych zamierzeń, jakim był rozwój sektora usług opieki środowiskowej. W artykule stwierdzono, że opracowanie spójnego systemu oceny niesamodzielności to warunek konieczny, ale niewystarczający realizacji założonych wcześniej celów w zakresie polityki społecznej względem niesamodzielności. Artykuł opiera się przede wszystkim na podsumowaniu badań czeskich autorów oraz analizie danych pochodzących z czeskiej statystyki publicznej.
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Puls Uczelni
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2012
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issue 3
10-12
PL
Starzenie się społeczeństw i coraz liczniejsze potrzeby zdrowotne populacji w wieku podeszłym były powodem rozwoju form stacjonarnej opieki długoterminowej. W pracy przedstawiono amerykański system zintegrowanych form opieki (doraźnej w nagłych przypadkach i stałej w zaburzeniach przewlekłych) wraz ze wskazaniem struktur w ramach których funkcjonują osoby w wieku podeszłym w USA.
EN
The continued aging of societies with more and more health needs has made necessary the development of more stationary long-term care in the advanced age. An American system of integrated forms of the care was presented at work (temporary in emergencies and the constant in lengthy disorders), together with emphasis in which people are functional at this advanced age in the USA.
EN
An article focuses on the policy of long-term care adressed to dissabled children and their informal carers. In fifi rst part author considers whether long-term care analysis should be used not only in case of the frail elderly people, but also disabled children and then considers why lots of scientififi c works and policy papers neglect the needs of children in the long-term context. In the second part author presents main institutions of public support for heaviliy disabled children and their parents. In that analysis the emphasis is put on the benefifi ts given to the families that care for the children themselves. Next, there are presented some projects of changes in long-term care. Those proposals show that children and edults demanding long-term care are often treated seperately in the reforms currently prepared. At the end, there is a conclusion and recomendations.
PL
Artykuł poświęcony jest polityce w zakresie opieki długoterminowej wobec niepełnosprawnych dzieci i ich opiekunów. W pierwszej części autor pokazuje, że analiza opieki długoterminowej nie powinna być skoncentrowana wyłącznie na niedołężnych osobach starszych, ale także na niepełnosprawnych dzieciach. W drugiej części prezentuje główne instytucje i instrumenty publicznego wsparcia wobec głęboko niepełnosprawnych dzieci i ich rodziców. Szczególną uwagę położono na świadczenia kierowane do rodzin, które same opiekują się dziećmi. W artykule dokonano analizy projektu ustawy o pomocy osobom niesamodzielnym pod kątem tego, jak może poprawić sytuację dzieci niepełnosprawnych i ich opiekunów. Okazuje się, że w projekcie tym nie uwzględnia się niepełnosprawnych dzieci, co w opinii autora budzi wiele zastrzeżeń. Opracowanie kończy zbiór wniosków i rekomendacji.
EN
BackgroundHand hygiene (HH) is the simplest and the most fundamental means of hospital-acquired infection (HAI) prevention in both hospitals and long-term care facilities (LTCFs) which differ as to their structure, organization and epidemiology. The objective of this study was to evaluate the knowledge of, and attitudes towards, compliance with the HH guidelines by medical staff of LTCFs and hospitals, in the context of infection control organization.Material and MethodsThe study was carried out among medical staff of LTCFs and hospitals using an anonymous questionnaire designed by the authors. The questionnaire was composed of 22 questions.ResultsAmong 237 healthcare workers from LTCFs and hospitals (51.5% vs. 48.5%), the vast majority were women (97.5% vs. 94.8%), who were nurses (86.9% vs. 91.3%) with 21–30 years of experience (28.5% vs. 44.3%). The respondents, both working in hospitals and in LTCFs, declared that there was some surveillance of HAIs in their workplace – 78.8% vs. 87.8%, respectively, p = 0.082. However, the respondents from LTCFs significantly more often than those working in hospitals declared the lack of HAI registration (12.3% vs. 0.9%, p = 0.002), as well as the lack of surveillance of multidrug-resistant microorganisms (16.4% vs. 4.3%, p = 0.010). Although the knowledge of WHO HH guidelines was declared by over 90% of the respondents, only about 70% of them (with no significant difference between both types of facilities) properly indicated the 5 moments of HH.ConclusionsThe results of the study indicate that the organizational conditions and practice of HH in LTCFs and hospitals present some differences. Therefore, there is a need for observational studies concerning HH in the context of the structure and organization of infection control, as they are necessary for the development and implementation of effective programs to improve the situation in this field.
EN
The article aims to establish the essence of the right to care benefits from the point of view of the development of benefits related to the need for long-term care, and taking into account the category of social risk. The essence of the article boils down to the statement that the care benefit is accociated with the risk of inability to perform work due to the need to provide care to a dependent person. Formally we have protection against the risk that affects a family member of a dependent, and not herself.
PL
Artykuł zmierza do ustalenia istoty prawa do świadczenia pielęgnacyjnego z punktu widzenia rozwoju świadczeń związanych z potrzebą długoterminowej pomocy, opieki i pielęgnacji oraz z uwzględnieniem kategorii ryzyka socjalnego. Zasadnicza teza artykułu sprowadza się do stwierdzenia, że świadczenie pielęgnacyjne związane jest z ryzykiem niemożności świadczenia pracy z powodu konieczności sprawowania opieki i pielęgnacji względem osoby zależnej. Formalnie zatem mamy do czynienia z ochroną na wypadek ryzyka, które dotyka członka rodziny osoby zależnej, a nie jej samej (ryzyka niesamodzielności).
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PL
W artykule autor opisuje rozwiązania w dziedzinie opieki długoterminowej w państwach Unii Europejskiej. Dokonuje analizy różnych definicji opieki długoterminowej w poszczególnych krajach. Omawia rozwiązania organizacyjne, finansowanie oraz zakres przedmiotowy i podmiotowy poszczególnych świadczeń.
EN
In this article author describes long term-care in european countries. Article begins by examination of different definitions of LTC in EU members. Then author analyzes organization, funding, scope and various categories of benefits.
EN
In 1995, social long-term care insurance was introduced in Germany. Since that time it has been changed many times in response to changing social and demographic conditions. Part of the system that has undergone fundamental modification was the eligibility criteria. The aim of the article is to present the idea of that reform, its determinants and consequences. In addition, the assessment of the reform was done in terms of social (compliance with social expectations), organizational (achieving the objectives) and financial (budget stability) effectiveness.
PL
W 1995 r. w Niemczech wprowadzono społeczne ubezpieczenie pielęgnacyjne. Od tego czasu było ono wielokrotnie reformowane w reakcji na zmianę warunków otoczenia społecznego, demograficznego i gospodarczego. Jednym z elementów, który został poddany zasadniczej modyfikacji, był system orzecznictwa o niesamodzielności (zmiany przeprowadzone w latach 2013–2017). Celem niniejszego artykułu jest przedstawienie idei tej reformy, jej przesłanek i konsekwencji. Ponadto dokonana została ocena reformy pod względem społecznym (zgodność z oczekiwaniami społecznymi), organizacyjnym (skuteczność realizacji celów) i finansowym (utrzymanie stabilności budżetowej).
EN
Public long-term care insurance currently operates in five countries: Germany, Japan, Netherlands, Luxembourg and South Korea. The model of fi nancing long-term care services is relatively uniform in those countries, but some technical solutions of the system are different, in some aspects even essentially. The aim of the article is to present the institutional construction of the long-term care, with particular emphasis on similarities and differences that occur in those five countries.
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