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Health Care Preferences Among Nursing Home Residents: Perceived Barriers and Situational Dependencies to Person-Centered Care
While people with dementia and their carers have reported several benefits of remaining physically active, it is often difficult to do so.
Declining confidence in their abilities, inappropriately designed residential aged care facilities or risk averse cultures are some of the many barriers people with dementia face.
The paper urges health and aged care providers and governments to act to ensure people with dementia are able to remain physically active as regular exercise and physical activity can help improve things like coordination, balance, functional ability, cognition and create a better sense of wellbeing.
Recommendations in the discussion paper include the Federal Government funding a series of pilot exercise programs in residential aged care and community aged care; mandate private health insurance rebates for gym memberships and exercise physiologist sessions for people with dementia and their carers; and that the Federal and State Governments encourage the delivery of exercise programs for people with dementia by offering funding incentives to aged care providers.
There are also recommendations for aged care providers to put in place exercise programs to improve the social and emotional wellbeing of people with dementia and that they ensure their environments enable mobility and freedom of movement.
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A Case Exemplar for National Policy Leadership: Expanding Program of All-Inclusive Care for the Elderly (PACE)
In November 2015, President Obama signed the Program of All-Inclusive Care for the Elderly (PACE) Innovation Act, which expands a proven model of care to serve high-cost and high-need populations. Specifically, the law provides the Centers for Medicare & Medicaid Services with the authority to waive Medicaid requirements that could not be waived without additional statutory authority. Those requirements include the age of the beneficiary to be served and nursing home eligibility as a condition for PACE enrollment. The law also allows providers and other entities who are not current PACE providers the opportunity to become PACE providers and serve a predominately dually eligible population that has high needs and high cost through a coordinated, integrated model. The current article describes the impact of nursing on the legislation and policy that has shaped the evolution of the PACE program for more than 40 years. [Journal of Gerontological Nursing, 42(3), 9–14.]