Nursing Research and Practice / 2013 / Article / Tab 1

Research Article

Models for Designing Long-Term Care Service Plans and Care Programs for Older People

Table 1


NameInputActivityOutputRequired knowledgebase

1: assess the person's ability1-11-1: evaluate person's conditionAttribute of the person Evaluate person's conditionResults of assessment of the personAbility assessment sheet
1-21-2: determine actual abilitiesResults of assessmentDetermine actual ability of the person on the basis of the results of 1-1Actual abilities(Logic for determining actual abilities: included in ability assessment sheet)

2: assess home/facility condition2-12-1: evaluate home/facility conditionAttribute of the home/facility Evaluate environmental condition of the home/facility, where the person will live Results of assessment of the home/facilityHome/facility assessment sheet
2-22-2: reflect home/facility conditionResults of assessment of the home/facilityLimit selectable realization pattern and care option on the basis of the results of 2-1 (i) Limited selectable realization patterns
(ii) Limited selectable care options
(Table of limitation to realization pattern and care option: included in the home/facility assessment sheet)

3: assume a hypothetical way of daily living3–13–1: create a hypothetical mode of life(i) Limited selectable realization patterns
(ii) Hopes of the person/families
Set (multiple) realization patterns for the person on the basis of the results of 2-2, considering the hopes of the person/familiesRealization patterns to be achieved(List of Realization Pattern: included in the table of required ability for element action)

4: identify care needs4–14–1: identify care needs(i) Realization patterns to be achieved
(ii) Actual abilities
Identify person's care needs as gaps between required ability for (multiple) realization patterns set in 3–1 and actual abilities determined in 1-2Care needsTable of required ability for element action

5: design care program (preliminary) 5–15–1: evaluate care options(i) Care needs
(ii) Limited selectable care options
(iii) Actual abilities
Evaluate practicability of care options to meet the person's care needs identified in 4–1 and actual abilities determined in 1-2Practicable care optionsTable of required ability for care
5–25–2: design care program(i) practicable care options
(ii) hopes of the person/families
Determine care to be provided and design care program from the care options found practicable in 5–1, considering the hopes of the person/families(i) Care to be provided
(ii) Care program

6: design long-term care service plan6–16–1: evaluate care service options Care to be providedDetermine care services to implement elderly care selected in 5–2Care services to be includedTable of care service option
6–26–2: design care service plan(i) care services to be included
(ii) hopes of the person/families
(iii) social factors
Design a long-term care service plan on the basis of the results of 6–1, considering the hopes of the person/familiesLong-term care program(Design item (PIC, Timeline, etc.))