Hostname: page-component-78c5997874-mlc7c Total loading time: 0 Render date: 2024-11-20T05:24:55.008Z Has data issue: false hasContentIssue false
  • English
  • Français

Evaluating the quality of long-term care services in the city of La Plata, Argentina

Published online by Cambridge University Press:  19 August 2019

Peter Lloyd-Sherlock ,
Bridget Penhale  and
Nelida Redondo
Peter Lloyd-Sherlock*
Affiliation:
School of International Development, University of East Anglia, Norwich, UK
Bridget Penhale
Affiliation:
School of Health Sciences, University of East Anglia, Norwich, UK
Nelida Redondo
Affiliation:
SIDOM Foundation, Buenos Aires, Argentina
*
*Corresponding author. Email: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

This paper reports on an innovative survey of long-term care facilities for older people in the Argentine city of La Plata. It applies a range of qualitative methodologies, including a clandestine audit conducted by older people living in the community. The paper pays particular attention to the types and availability of services, perceived quality and the rigour of regulatory processes. It finds that there has been a rapid growth in the availability of formal services, but that there are many gaps in provision, especially for older people with complex care needs. There are strong indications that service quality is uneven and, in some cases, this amounts to the contravention of basic human rights. State regulation is hampered by institutional fragmentation and weak governance. A wider set of expert interviews and the limited available published information indicate that these findings are unlikely to be exceptional, and that similar issues affect rapidly emerging long-term care systems in many low- and middle-income countries.

Keywords

older peoplelong-term carequalityLatin America
Type
Article
Information
Ageing & Society , Volume 41 , Issue 1 , January 2021 , pp. 208 - 230
Copyright
Copyright © Cambridge University Press 2019

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Camarano, A, Kanos, S, Leitão e Mello, J and Fernandes Carvalho, D (2010) As instituições de longa permanência para idosos: abrigo ou retiro? In Camarano, A (ed.), Cuidados de longa duração para a população idosa: um novo risco a ser assumido? Rio de Janeiro: IPEA. pp. 13–38.Google Scholar
Carbone-Moane, C and Giacchetti-Vega, M (2016) Malnutrición en adultos mayores institucionalizados en un asilo de Lima, Perú. Revista Peruana de Medicina Experimental y Salud Pública 33, 175–176.CrossRefGoogle Scholar
Cárdenas, W, Pereira, A and Machado, C (2017) Trajetória das relações público-privadas no sistema de saúde da Colômbia de 1991 a 2015. Cadernos de Saúde Pública 33, supplement 2, e00114016.CrossRefGoogle Scholar
Castle, N and Ferguson, J (2010) What is nursing home quality and how is it measured? The Gerontologist 50, 426–442.CrossRefGoogle Scholar
Cheung Wong, Y and Leung, J (2012) Long-term care in China: issues and prospects. Journal of Gerontological Social Work 55, 570–586.CrossRefGoogle Scholar
Comisión Económica para América Latina y el Caribe (CEPAL) (2009) Envejecimiento y sistemas de cuidados: ¿oportunidad o crisis? Santiago de Chile: CEPAL. Available at http://repositorio.cepal.org/bitstream/handle/11362/3859/1/S2009000_es.pdfGoogle Scholar
Day, P and Klein, R (1987) The regulation of nursing homes: a comparative perspective. The Milbank Quarterly 65, 303–347.CrossRefGoogle ScholarPubMed
Department of Health/Social Services Inspectorate (1989) Homes Are for Living In. London: HMSO.Google Scholar
European Partnership for the Wellbeing and Dignity of Older People (2014) European Quality Framework for Long-term Care Services. Principles and Guidelines for the Wellbeing and Dignity of Older People in Need of Care and Assistance. Available at http://wedo.tttp.eu/system/files/24171_WeDo_brochure_A4_48p_EN_WEB.pdf.Google Scholar
Findlay, A (2015) Low health literacy and older adults: meanings, problems, and recommendations for social work. Social Work in Health Care 54, 65–81.CrossRefGoogle Scholar
Gascón, S and Redondo, N (2014) Calidad de los servicios de largo plazo para personas adultas mayores con dependencia. Santiago de Chile: CEPAL. Available at http://www.cepal.org/es/publicaciones/36948-calidad-de-los-servicios-de-largo-plazo-para-personas-adultas-mayores-con.Google Scholar
Giacomin, K and Camargos Couto, E (2010) A fiscalização das ILPIS: o papel dos conselhos, do ministério público e da vigilancia sanitaria. In Camarano, A (ed.), Cuidados de longa duração para a população idosa: um novo risco a ser assumido? Rio de Janeiro: IPEA. pp. 213–248.Google Scholar
Goffman, E (1968) Asylums. Harmondsworth, UK: Penguin Books.Google Scholar
Gutiérrez-Robledo, L, Reyes-Ortega, G, Rocabado-Quevedo, F and López-Franchin, J (1996) Evaluacíon de instituciones de cuidados prolongados para ancianos en el Distrito Federal. Una visión crítica. Salud Pública de México 38, 487–500.Google Scholar
Hao, Q, Wu, S, Ying, L, Luo, L, Dong, D and Dong, B (2012) Current dilemmas of nursing homes in Chengdu: a cross-sectional survey. Journal of the American Medical Directors’ Association 13, 406.e9–12.Google ScholarPubMed
Hirdes, J, Fries, B, Morris, J, Ikegami, N, Zimmerman, D, Dalby, D, Aliaga, P, Hammer, S and Jones, R (2004) Home care quality indicators (HCQIs) based on the MDS-HC. The Gerontologist 44, 665–679.CrossRefGoogle ScholarPubMed
Huenchuan, S and Rodríguez Velázquez, P (2015) Necesidades de cuidado de las personas mayores en la Ciudad de México: diagnóstico y lineamientos de política. Santiago de Chile: CEPAL. Available at http://www.cepal.org/es/publicaciones/38879-necesidades-de-cuidado-de-las-personas-mayores-en-la-ciudad-de-mexico.Google Scholar
Inter-American Development Bank (2015) Age-friendly Cities: How Urban Planning Can Keep Older People Active. Available at http://blogs.iadb.org/ciudadessostenibles/2015/11/23/age-friendly-cities-2/.Google Scholar
Koren, M (2010) Person-centered care for nursing home residents: the culture-change movement. Health Affairs 29, 312–317.CrossRefGoogle ScholarPubMed
Lloyd-Sherlock, P (2016) Barriers to linking research and policy: the case of long-term care in low and middle-income countries. Population Horizons 12, 62–67.CrossRefGoogle Scholar
Lloyd-Sherlock, P (2018) Long term care for older people in South Africa: the enduring legacies of apartheid and HIV/AIDS. Journal of Social Policy 48, 147–167.CrossRefGoogle Scholar
Lloyd-Sherlock, P, Mayston, R, Acosta, A, Gallardo, S, Guerra, M, Sosa, AL, de Oca, VM and Prince, M (2017 a) Allocating family responsibilities for dependent older people in Mexico and Peru. Journal of Development Studies 54, 682–701.CrossRefGoogle Scholar
Lloyd-Sherlock, P, Penhale, B and Redondo, N (2019) The admission of older people into residential care homes in Argentina: coercion and human rights abuse. The Gerontologist. 59, 610–618CrossRefGoogle ScholarPubMed
Lloyd-Sherlock, P, Sasat, S, Morales, F and Pot, A-M (2017 b) Long-term-care policy in Thailand and Costa Rica and the role of volunteers: key success factors for development and implementation. Bulletin of the World Health Organization 95, 774–778.CrossRefGoogle Scholar
Mor, V (2014) A framework for understanding regulation of long-term care quality. In Mor, V, Leone, T and Maresso, A (eds), Regulating Long-term Care Quality: An International Comparison. Cambridge: Cambridge University Press. pp. 3–28.CrossRefGoogle Scholar
Owen T and National Care Home Research and Development Forum (eds) (2006) My Home Life: Quality of Life in Care Homes. London: Help the Aged, National Care Forum and National Care Home Research and Development Forum.Google Scholar
Pager, D (2007) The use of field experiments for studies of employment discrimination: contributions, critiques and directions for the future. Annals of the American Academy of Political and Social Sciences 609, 104–133.CrossRefGoogle Scholar
Phillips, C, Hawes, C and Fries, B (1993) Reducing the use of physical restraints in nursing homes: will it increase costs? American Journal of Public Health 83, 342–348.CrossRefGoogle ScholarPubMed
Redondo, N and Lloyd-Sherlock, P (2010) Institutional care for older people in developing countries: repressing rights or promoting autonomy? The case of Buenos Aires, Argentina. Journal of Population Ageing 2, 41–56.Google Scholar
Rhodes, K and Miller, F (2012) Simulated patient studies: an ethical analysis. The Millbank Quarterly 90, 706–724.CrossRefGoogle ScholarPubMed
Roqué, M, Fassio, A, Arias, C and Croas, P (2016) Residencias de larga estadía para adultos mayores en Argentina. Relevamiento y evaluación. Buenos Aires: Ministerio de Desarrollo Social. Available at http://www.algec.org/biblioteca/RESIDENCIAS_LARGA-ESTADIA.pdf.Google Scholar
Rosenthal, E, Jehn, E and Galván, S (2010) Abandoned & Disappeared: Mexico's Segregation and Abuse of Children and Adults with Disabilities. New York: Disability Rights International and Comisión Méxicana de Defensa y Promoción de los Derechos Humanos. Available at http://www.disabilityrightsintl.org/wordpress/wp-content/uploads/Mex-Report-English-Nov30-finalpdf.pdf.Google Scholar
Shippee, T, Henning-Smith, C, Kane, R and Lewis, T (2015) Resident- and facility-level predictors of quality of life in long-term care. The Gerontologist 55, 643–655.CrossRefGoogle ScholarPubMed
Smith, J and Firth, J (2011) Qualitative data analysis: the framework approach. Nurse Researcher 18, 52–62.Google ScholarPubMed
Souza, S and Santos, S (2007) Factores de riesgo para el desarrollo de úlceras por presión en ancianos atendidos en asilo [Risk factors for pressure ulcer development in institutionalised elderly]. Revista Latinoamericana de Enfermagem 15, 958–964.CrossRefGoogle Scholar
Weinstein, R (1994) Goffman's Asylums and the total institution model of mental hospitals. Psychiatry 57, 348–367.CrossRefGoogle ScholarPubMed
Wilberforce, M, Glendinning, C, Challis, D, Fernandez, J-L, Jacobs, S, Jones, K, Knapp, M, Manthorpe, J, Moran, N, Netten, A and Stevens, M (2011) Implementing consumer choice in long-term care: the impact of individual budgets on social care providers in England. Social Policy and Administration 45, 593–612.Google Scholar
World Health Organization (WHO) (2015) World Report on Ageing and Health. Geneva: WHO.Google Scholar
Zurbriggen, C (2014) Governance: a Latin America perspective. Policy and Society 33, 345–360.CrossRefGoogle Scholar