Open Access

Background: We see a growing number of older adults receiving long-term care in industrialized countries. The Healthcare Utilization Model by Andersen suggests that individual need characteristics influence utilization. The purpose of this study is to analyze correlations between need characteristics and service utilization in home care arrangements. Methods: 1,152 respondents answered the questionnaire regarding their integration of services in their current and future care arrangements. Care recipients with high long-term care needs answered the questionnaire on their own, the family caregiver assisted the care recipient in answering the questions, or the family caregiver responded to the questionnaire on behalf of the care recipient. They were asked to rank specific needs according to their situation. We used descriptive statistics and regression analysis. Results: Respondents are widely informed about services. Nursing services and counseling are the most used services. Short-term care and guidance and training have a high potential for future use. Day care, self-help groups, and mobile services were the most frequently rejected services in our survey. Women use more services than men and with rising age utilization increases. Long waiting times and bad health of the primary caregiver increases the chance of integrating services into the home care arrangements. Conclusion: The primary family caregiver has a high impact on service utilization. This indicates that the whole family should be approached when offering services. Professionals should react upon the specific needs of care dependents and their families.

Report on visits in hospices located in Osnabrück/Germany and the Saint Cristopher’s Hospice in London/United Kingdom; and present a discussion about the care mode. Methods: Experience report based on a post-doctoral research period in Germany between November 2013 and October 2014, funded by the CAPES Foundation (Coordination for the Improvement of Higher Education Personnel). Results: The structure, operation mode of the institutions and the main labor force were discussed, especially the nursing staff and volunteers’ participation, the main care activities and challenges. These issues were very similar at the hospices, highlighting the hospice responsible for spreading this moviment worldwide. Conclusion: The hospice may be the place of death, but it provides a pleasant environment that preserves the person’s individuality and autonomy. It relies on the participation of volunteers, dissemination of its idea and training programs, which ensure the strengthening of this movement.

Objective: to understand the meaning of the Adult Intensive Care Unit environment of care, experienced by professionals working in this unit, managers, patients, families and professional support services, as well as build a theoretical model about the Adult Intensive Care Unit environment of care. Method: Grounded Theory, both for the collection and for data analysis. Based on theoretical sampling, we carried out 39 in-depth interviews semi-structured from three different Adult Intensive Care Units. Results: built up the so-called substantive theory “Sustaining life in the complex environment of care in the Intensive Care Unit”. It was bounded by eight categories: “caring and continuously monitoring the patient” and “using appropriate and differentiated technology” (causal conditions); “Providing a suitable environment” and “having relatives with concern” (context); “Mediating facilities and difficulties” (intervenienting conditions); “Organizing the environment and managing the dynamics of the unit” (strategy) and “finding it difficult to accept and deal with death” (consequences). Conclusion: confirmed the thesis that “the care environment in the Intensive Care Unit is a living environment, dynamic and complex that sustains the life of her hospitalized patients”.