Comparing the cross-national impact of the COVID-19 pandemic on care received by community-dwelling older adults in 2020 and 2021: restoring formal home care versus polarizing informal care?

The COVID-19 pandemic has changed the supply of formal and informal home care to older adults in many countries across the world. This study aims to compare the initial picture of how the supply of formal and informal home care to older adults in European countries and Israel changed during the first pandemic year (from mid-2020 to mid-2021) and to examine the changes that these countries made in the provision of adequate care to older adults. Using data from the two COVID-19 waves of SHARE, we show that the provision of formal home care services improved in the investigated period, as in 2021 the share of those who reported difficulties in receiving formal home care dropped significantly compared to the previous year.

Association between COVID-19 vaccination and critical outcomes among older adults with dementia: a comparative cohort study.

Background: As COVID-19 vaccines became available, understanding their potential benefits in vulnerable populations has gained significance. This study explored the advantages of COVID-19 vaccination in individuals with cognitive disorders by analyzing health-related variables and outcomes.

Methods: A prospective cohort study analyzed electronic medical records of 25,733 older adults with cognitive disorders and 65,544 older adults without cognitive disorders from March 2020 to February 2022.

Out-of-pocket expenditure on community healthcare services at end-of-life among decedents from cardiovascular disease in six European countries and Israel.

Objectives: Most people who develop chronic diseases, including cardiovascular disease (CVD), live in their homes in the community in their last year of life. Since cost-sharing is common in most countries, including those with universal health insurance, these people incur out of pocket expenditure (OOPE). The study aims to identify the prevalence and measure the size of OOPE among CVD decedents at end-of-life (EOL) explore differences among countries in OOPE, and examine whether the decedents' characteristics or their countries' health policy affects OOPE more.

Advance Care Planning and Attainment of Cancer Patients' End-of-Life Preferences: Relatives' Perspective.

Purpose: The purpose of this study is to determine which element of advance care planning (ACP) - an advance directives (AD) document or an end-of-life discussion between patient and family (DwF), if any-improves the likelihood of cancer patients' attaining their preferences regarding treatments in the last month of life and dying in the place they prefer.

Methods: First-degree relatives of deceased cancer patients, interviewed by telephone, were asked if the treatments the patients received in their last month of life and their place of death corresponded to the patients' preferences. Nominal logistic regression analyses were conducted in search of significant association between having an AD document and/or conducting a DwF and patients' treatment and place of death in accordance with their preferences.

Perceived deterioration in health status among older adults in Europe and Israel following the first wave of the COVID-19 pandemic.

The COVID-19 pandemic has created challenges in providing medical care for people with health conditions other than COVID-19. The study aims to assess the prevalence of older adults' reportage of decline in health relative to pre-pandemic and to identify its determinants. The study is based on the Survey of Health, Ageing and Retirement in Europe (SHARE) data collected during the pandemic.

The Contribution of Frailty to Participation of Older Adults.

Background: Participation, which is involvement in life situations, is an important indicator of human health and well-being of older adults. Frailty is known to be related to difficulties in activities of daily living (ADL) but the association with participation restriction has not been sufficiently researched. Therefore, we aimed to (1) to assess the correlations between frailty, ADL, and participation; and (2) to identify the contribution of frailty to explaining the participation restriction of older adults.

Understanding out-of-pocket spending and financial hardship among patients who succumb to cancer and their caregivers.

Background: In most countries, including those with national health insurance or comprehensive public insurance, some expenses for cancer treatment are borne by the ill and their families.

Objectives: This study aims to identify the areas of out-of-pocket (OOP) spending in the last half-year of the lives of cancer patients and examine the extent of that spending; to examine the probability of OOP spending according to patients' characteristics; and to examine the financial burden on patients' families.

Methods: 491 first-degree relatives of cancer patients (average age: 70) who died 3-6 months before the study were interviewed by telephone.

Out-of-Pocket Spending for Cancer Medication, Financial Burden, and Cost Communication with Oncologists in the Last Six Months of Life in Israel.

Honest communication between oncologists and patients is important in alleviating the financial burden of cancer care. This study explored patient-relative-oncologist communication regarding the affordability of out-of-pocket (OOP) medication and the extent to which this communication addresses itself to the families' financial burden. A cross-sectional survey was conducted among primary caregivers of deceased cancer patients.

Out-of-pocket spending of deceased cancer patients in five European countries and Israel.

Objective: Cancer imposes a substantial economic burden on society, health and social care systems, patients and their families. This study aims to examine the out-of-pocket spending of cancer patients in their last year of life, in six countries with health insurance system hat have a defined benefits package.

Methods: Data from SHARE and SHARE End-of-Life surveys among people aged +50 were analysed.

Is Pain Assessment of Community-Dwelling Persons With Advanced Dementia by Family and Paid Care Workers Feasible?

Context: The experience of pain is aggravated among older persons with advanced dementia (OPAD). It is often undetected and therefore untreated because of their limited capacity to identify and report their symptoms. Therefore, it is crucial to improve the pain identification skills of those who know and live with them.

Depressive symptoms and use of health services among older adults in Israel.

Objectives: Depressive symptoms are often undetected, particularly among older adults. The purpose of this study is to provide information on the prevalence, characteristics, and patterns of depressive symptoms among older adults residing in the community in Israel, and their health-care utilization.

Methods: A cross-sectional survey was conducted among a random sample of 2502 members of one HMO in Israel, aged 65+.

Musculoskeletal Pain Medication Use in Middle Age and Older Adults in 15 European Countries and Israel.

Background: The experience of musculoskeletal pain is widespread among adults and entails high costs to both individuals and society. Few studies look at disparities in pain management.

Aims: To examine factors associated with the presence of musculoskeletal pain and the use of pain medication use among individuals aged 50+.

Multidisciplinary staff perspectives on the integration of spiritual care in a new setting: Israel.

Objective: Integrating spiritual care into multidisciplinary care teams has seen both successful thoughtful collaboration and challenges, including feelings of competition and poor cross-disciplinary understanding. In Israel, where the profession is new, we aimed to examine how spiritual care is perceived by other healthcare professionals learning to integrate spiritual caregivers into their teams.

Method: Semi-structured qualitative interviews of 19 professionals (seven physicians, six nurses, three social workers, two psychologists, and one medical secretary) working with spiritual caregivers in three Israeli hospitals, primarily in oncology/hematology.

Home hospice for older people with advanced dementia: a pilot project.

Background: Dementia is a terminal illness making the palliative and hospice approach to care appropriate for older people with advanced dementia.

Objective: To examine clinical and health services outcomes of a quality improvement pilot project to provide home hospice care for older people with advanced dementia.

Study Design: Twenty older people with advanced dementia being treated in the Maccabi Healthcare Services homecare program, received home hospice care as an extension of their usual care for 6-7 months (or until they died) from a multidisciplinary team who were available 24/7.

Sociodemographic inequality in joint-pain medication use among community-dwelling older adults in Israel.

Joint pain is a common experience among adults aged 65 and over. Although pain management is multifaceted, medication is essential in it. The paper examines the use of medication among older adults with joint pain in Israel and asks whether socioeconomic factors are associated with this usage.

Dementia care in Israel: top down and bottom up processes.

Dementia is one of the main causes of disability among older adults and is viewed as one of the most distressing and devastating of conditions. Dementia has a profound impact on those who suffer from the disease and on their family caregivers. In this article, we describe the added benefit of implementing top-down and bottom-up strategies in the process of influencing and developing healthcare services.

Implementation of a structured communication tool improves family satisfaction and expectations in the intensive care unit.

Background: Intensive care unit (ICU) physicians should provide relatives of critically ill patients with appropriate and clear information, regarding prognosis, treatment options and expectations.

Objectives: To assess whether a structured communication tool improves satisfaction with care and engenders realistic expectations among relatives of critically ill patients.

Study Design: A controlled, pre-post intervention design was implemented in the General and Medical ICUs in the Hadassah-Hebrew University Medical Center, Jerusalem, Israel.

[FROM PASTORAL CARE TO SPIRITUAL CARE - TRANSFORMING THE CONCEPTION OF THE ROLE OF THE SPIRITUAL CARE PROVIDER].

Spirituality is a difficult concept to define, one that is often understood differently by different cultures and religious communities. Illness constitutes a dramatic change in the ongoing flow and norms of a person's life, raising questions of the value or meaning of life, questions of self-worth, and questions of forgiveness, to ourselves and others. The profession of spiritual care comes to provide support in these areas.

Implementation of Advance Care Planning in Israel: A Convergence of Top-Down and Bottom-Up Processes.

Although public health has traditionally been concerned with primary, secondary, and tertiary prevention, more attention needs to be focused on patient-centered care at the end of life. Improved access to quality end-of-life care can be achieved by advance care planning (ACP). In this article, we present an example of the processes of change regarding ACP and preparing advance directives (ADs) that have begun to take place in Israel in recent years.

[DO WE HAVE MEDICAL MEASURES THAT ATTEST TO THE EFFECT OF SPIRITUAL CARE IN TIME OF ILLNESS?].

Everyone has spiritual resources that generally serve them well, and in times of struggle, part of people's suffering is spiritual. Tending to patients' "whole pain" must include their spiritual pain. Studies from Israel and worldwide found that approximately one-third of advanced cancer patients suffer spiritual distress.

Frailty Transitions in Community Dwelling Older People.

Background: Frailty is a dynamic process with transitions over time.

Objectives: To examine frailty transitions and their relationship to utilization of health services.

Methods: Frailty status using the Vulnerable Elders Survey (VES-13) was determined for 608 community-dwelling older people interviewed in a 2008 national survey and for 281 re-interviewed in 2014.

The contribution of comprehensive geriatric assessment to primary care physicians.

Background: To provide quality care to the growing number of older patients, primary care physicians (PCPs) will require support from geriatric specialists. Multidisciplinary comprehensive geriatric assessment (CGA) has been found to improve outcomes in older people. This study explored the contribution of CGA to the management of older patients by their PCPs; PCP attitudes to CGA; and PCP satisfaction with CGA.

Quality of end-of-life care for cancer patients: does home hospice care matter?

Objectives: Since metastasized cancer patients receive many treatments and services, it is important to ascertain whether home hospice (HH) care makes a meaningful contribution to end-of-life quality for terminal patients. This study examines whether people who had died from metastasized cancer-both recipients of HH care and nonrecipients-were cared for according to palliative indicators and whether HH care made a difference.

Study Design: Three to 6 months after the deaths of 193 metastatic cancer patients, members of their families were interviewed face-to-face.

[Spiritual care in hospitals and other healthcare settings in Israel--a profession in the making].

Faced with a serious, incurable illness, disability, and other symptoms, both physical and mental, some patients find themselves wondering about the meaning of their Lives. They need the help of a professional who can perceive their mental turmoil and identify their spiritual needs, and who knows how to help them find meaning in their uncertain state. Spiritual care providers are professionals whose role it is to provide patients with support in their hour of need, to help them preserve their identity in life-threatening situations, and to help them re-endow their world with meaning, employing a special language and set of tools that enable patients to get in touch with their spiritual resources and internal powers of healing.