Engaging residents of long-term care homes (LTCHs) in their home’s environment, programs, and operations is required in some jurisdictions and could improve resident quality of life and other outcomes. This scoping review summarized existing research on resident engagement in LTCH organizational design and governance, including associated enablers, barriers, approaches, and outcomes. The database search yielded 5,580 records (after deduplication), and 62 articles covering 59 studies were included. These studies predominantly described Residents’ Councils (n = 38; 64%) and enablers or barriers pertaining to resident and home perspectives, as well as implementation and sustainability infrastructure. Few studies described approaches to considerations of resident diversity (n = 8; 14%) or the presence of dementia and/or cognitive impairment (n = 12; 20%). Ten studies reported quantitative data evaluating resident engagement, and only four with resident-reported outcomes. Robust, evidence-informed frameworks that are co-designed with residents, staff, and others in the LTCH sector are needed to engage residents in their LTCHs.

Background: There are national policy drivers for mental health services to demonstrate that they are effectively meeting the psychological needs of people with long-term health conditions/medically unexplained symptoms (LTC/MUS). Aims: To evaluate the implementation of a stepped-care service delivery model within an Improving Access to Psychological Therapies (IAPT) service for patients with depression or anxiety in the context of their LTC/MUS. Method: A stepped-care model was designed and implemented. Clinical and organizational impacts were evaluated via analyses of LTC/MUS patient profiles, throughputs and outcomes. Results: The IAPT service treated N = 844 LTC and N = 172 MUS patients, with the majority (81.81%) receiving a low intensity intervention. Dropout across the service steps was low. There were few differences between LTC and MUS outcome rates regardless of step of service, but outcomes were suppressed when compared to generic IAPT patients. Conclusions: The potential contribution of IAPT stepped-care service delivery models in meeting the psychological needs of LTC/MUS patients is debated.

In this paper we model the life-history of LTC-patients using a Markovian multi-state model in order to calculate premiums for a given LTC-plan. Instead of estimating the transition intensities in this model we use the approach suggested by Andersen et al. (2003) for a direct estimation of the transition probabilities. Based on the Aalen-Johansen estimator, an almost unbiased estimator for the transition matrix of a Markovian multi-state model, we calculate so-called pseudo-values, known from Jackknife methods. Further, we assume that the relationship between these pseudo-values and the covariates of our data are given by a GLM with the logit as link-function. Since the GLMs do not allow for correlation between successive observations we use instead the “Generalized Estimating Equations” (GEEs) to estimate the parameters of our regression model. The approach is illustrated using a representative sample from a German LTC portfolio.