Objective: This research explores the critical need for individualized care planning to ensure maximum cost savings by providing a balance between individuals’ care needs and care wishes. The primary objective of this research is to identify common goals of care (GoC) expressed by long-term care residents (using the interRAI LTCF) and clients receiving community supportive services (using the interRAI CHA) or community mental health services (using the interRAI CMH). Methods: Three interRAI datasets were used to perform data analyses. The responses to the open-ended GoC item were quantified and grouped into common goal categories, which were then examined against the interRAI outcome measures and Clinical Assessment Protocols (CAPs). Demographic and clinical characterisitics were compared across the sample populations using the chi-square test. Logistic regression models were created to reveal variables that are predictive of not having a GoC recorded within each care setting. Results: Twenty-five GoC categories were created. Although the GoC responses were very diverse, many persons had no goal recorded. Nearly 70% of long-term care (LTC) residents and community support service (CSS) clients were unable to state a GoC. Different populations in different service settings had distinct GoC but had some commonalities as well such as goals that focused on general physical or mental health issues. GoC varied with the CAPs- the triggering of a CAP did not necessarily mean a corresponding GoC was noted. Each care sector had different predictor variables that were strongly associated with not having a GoC. Conclusions: There is not a “one size fits all” solution to care planning. The same goals and outcome measures are not appropriate or realistic for all persons. It is critical to incorporate self-reported goals into the development of effective and individualized care plans to ultimately improve one’s quality of life, satisfaction with care, and success in achieving desired outcomes of care.

Objective: This research explores the critical need for individualized care planning to ensure maximum cost savings by providing a balance between individuals’ care needs and care wishes. The primary objective of this research is to identify common goals of care (GoC) expressed by long-term care residents (using the interRAI LTCF) and clients receiving community supportive services (using the interRAI CHA) or community mental health services (using the interRAI CMH). Methods: Three interRAI datasets were used to perform data analyses. The responses to the open-ended GoC item were quantified and grouped into common goal categories, which were then examined against the interRAI outcome measures and Clinical Assessment Protocols (CAPs). Demographic and clinical characterisitics were compared across the sample populations using the chi-square test. Logistic regression models were created to reveal variables that are predictive of not having a GoC recorded within each care setting. Results: Twenty-five GoC categories were created. Although the GoC responses were very diverse, many persons had no goal recorded. Nearly 70% of long-term care (LTC) residents and community support service (CSS) clients were unable to state a GoC. Different populations in different service settings had distinct GoC but had some commonalities as well such as goals that focused on general physical or mental health issues. GoC varied with the CAPs- the triggering of a CAP did not necessarily mean a corresponding GoC was noted. Each care sector had different predictor variables that were strongly associated with not having a GoC. Conclusions: There is not a “one size fits all” solution to care planning. The same goals and outcome measures are not appropriate or realistic for all persons. It is critical to incorporate self-reported goals into the development of effective and individualized care plans to ultimately improve one’s quality of life, satisfaction with care, and success in achieving desired outcomes of care.

<p>This thesis deals with a very important issue in South African society, i.e. the provision of financial and non-cash support to older persons. Older persons in South Africa can be described as a sizeable but vulnerable group requiring specific protection. Section 27 of the South African Constitution of 1996 obliges the state to take reasonable legislative and other measures within available resources to progressively realise the right of access to social security. Hence, the steps taken by the state to promote older persons&rsquo / right of access to social security and to protect their right to dignity need to be evaluated. The legislative framework for the provision of financial and non-cash support to older persons currently is fragmented into various statutes dealing with retirement income, state grants to older persons and care and support services for older persons. Therefore, the current legislation lacks an integrated approach to the provision of support and care to older persons, as well as a central principle on which to base future legislation concerning older persons. One such principle that could potentially be adopted is intergenerational solidarity, which can be described as the solidarity between the active working-age population, as one generation, from which benefits flow to older persons as the other. This thesis evaluates whether intergenerational solidarity should form the basis of South African legislation on the provision of retirement income and the provision of care and support to older persons, and if so, whether it in fact does. If the answer to the latter is in the negative, the thesis further examines whether the current process to reform the retirement income system and related legislation in South Africa would be a suitable platform to introduce the concept of intergenerational solidarity to legislation concerning older persons.</p>

<p>This thesis deals with a very important issue in South African society, i.e. the provision of financial and non-cash support to older persons. Older persons in South Africa can be described as a sizeable but vulnerable group requiring specific protection. Section 27 of the South African Constitution of 1996 obliges the state to take reasonable legislative and other measures within available resources to progressively realise the right of access to social security. Hence, the steps taken by the state to promote older persons&rsquo / right of access to social security and to protect their right to dignity need to be evaluated. The legislative framework for the provision of financial and non-cash support to older persons currently is fragmented into various statutes dealing with retirement income, state grants to older persons and care and support services for older persons. Therefore, the current legislation lacks an integrated approach to the provision of support and care to older persons, as well as a central principle on which to base future legislation concerning older persons. One such principle that could potentially be adopted is intergenerational solidarity, which can be described as the solidarity between the active working-age population, as one generation, from which benefits flow to older persons as the other. This thesis evaluates whether intergenerational solidarity should form the basis of South African legislation on the provision of retirement income and the provision of care and support to older persons, and if so, whether it in fact does. If the answer to the latter is in the negative, the thesis further examines whether the current process to reform the retirement income system and related legislation in South Africa would be a suitable platform to introduce the concept of intergenerational solidarity to legislation concerning older persons.</p>

Doctor Legum - LLD / This thesis deals with a very important issue in South African society, i.e. the provision of financial and non-cash support to older persons. Older persons in South Africa can be described as a sizeable but vulnerable group requiring specific protection. Section 27 of the South African Constitution of 1996 obliges the state to take reasonable legislative and other measures within available resources to progressively realise the right of access to social security. Hence, the steps taken by the state to promote older persons&rsquo; right of access to social security and to protect their right to dignity need to be evaluated. The legislative framework for the provision of financial and non-cash support to older persons currently is fragmented into various statutes dealing with retirement income, state grants to older persons and care and support services for older persons. Therefore, the current legislation lacks an integrated approach to the provision of support and care to older persons, as well as a central principle on which to base future legislation concerning older persons. One such principle that could potentially be adopted is intergenerational solidarity, which can be described as the solidarity between the active working-age population, as one generation, from which benefits flow to older persons as the other. This thesis evaluates whether intergenerational solidarity should form the basis of South African legislation on the provision of retirement income and the provision of care and support to older persons, and if so, whether it in fact does. If the answer to the latter is in the negative, the thesis further examines whether the current process to reform the retirement income system and related legislation in South Africa would be a suitable platform to introduce the concept of intergenerational solidarity to legislation concerning older persons. / South Africa