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Conceptual Framework for Development of Long-Term Care Policy 1. Constitutive Elements*

Published online by Cambridge University Press:  29 November 2010

François Béland  and
Delphine Arweiler
François Béland
Affiliation:
Université de Montréal.
Delphine Arweiler
Affiliation:
Université de Montréal.
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Abstract

The elements of a conceptual scheme for long-term care (LTC) were developed based on two lines of thought. The first, more practical, borrows from planning. The second, which is more theoretical, reflects sociological action theories. Planning is defined as an action that targets the development of a plan. Using values, desires, resources and constraints as a starting point, operational objectives are defined and means chosen. Planning focuses on four themes: (1) establishment of priorities, (2) setting up organizations in the form of agencies, (3) choosing objectives and (4) defining resources. These four themes are analyzed in turn, with each producing four elements defining a total of 16 themes, dilemmas, problems or issues specific to LTC. The relationships between these elements, which are by definition prescriptive, form the core of our proposal for an LTC planning model.

Résumé

Les éléments pour la conception d'un schéma conceptuel pour la planification des services de longue durée (SLD) sont élaborés en se fondant sur deux courants de pensée. L'un, plus pratique d'orientation, emprunte aux réflexions sur la démarche de planification, l'autre, théorique, est celui des théories sociologiques de l'action. La planification est définie comme une action qui vise le développement d'un plan, c'est-à-dire qu'à partir à la fois de valeurs et de désirs et de ressources et de contraintes, des objectifs opérationnels sont défïnis et des moyens sont choisis. La planification s'articule done autour de quatre thémes: (1) l'établissement d'un ordre de priorités, (2) la mise en place d'organisations sous la forme d'établissements, (3) le choix d'objectifs et (4) la détermination des ressources. Ces quatre thémes sont analysés tour à tour pour donner chacun quatre éléments qui définissent 16 thèmes, dilemmes, problèmes ou enjeux propres aux SLD. Les rapports entre ces éléments, normatifs par définition, formeront l'essentiel de notre proposition de modèle pour la planification des SLD.

Keywords

Long-Term CareConceptual FrameworkPlanningTheory of Action.Soins de longue duréeschéma conceptuelplanificationactionalisme.
Type
Articles
Information
Canadian Journal on Aging / La Revue canadienne du vieillissement , Volume 15 , Issue 4 , Hiver/Winter 1996 , pp. 649 - 681
Copyright
Copyright © Canadian Association on Gerontology 1996

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References

Ackoff, R.L. (1970). A Concept of Corporate Planning. New York: Wiley.Google Scholar
Alberta Committee on Long-Term Care. (1988). A New Vision for Long-term Care, Meeting the Need. Edmonton: Committee on Long-term Care for Senior Citizens.Google Scholar
American Geriatrics Society Public Policy Committee. (1990). Financing of long-term services. Journal of the American Geriatrics Society, 38, 1051–1052.CrossRefGoogle Scholar
Canadian Medical Association. (1987). Health Care for the Elderly: Today's Challenges, Tomorrow's Options. Ottawa: CMA.Google Scholar
Baldock, J. (1993). Royaume-Uni: la politique de “soins communautaires”, le temps des incertitudes. In Lesemann, F. & Martin, C. (Eds.), Les Personnes âgées: dépendances, soins et solidarités familiales (pp. 73–93). Paris: La Documentation française.Google Scholar
Becker, G.S. (1976). The Economic Approach to Human Behavior. Chicago: University of Chicago Press.Google Scholar
Béland, F. (1987). Identifying profile of service requirements in a non-institutionalized elderly population. Journal of Chronic Disease, 40, 51–64.CrossRefGoogle Scholar
Béland, F., & Lemay, A. (1995). Quelques dilemmes, quelques valeurs pour une politique de services de longue durée. Canadian Journal on Aging, 14(2), 263–293.Google Scholar
Béland, F., & Shapiro, E. (1993). Dix provinces appellent de leurs voeux la même politique de services de longue durée. Journal of Canadian Studies, 28, 166–191.Google Scholar
Binstock, R.H., & Kahana, J. (1988). An essay on “Setting limits: Medical goals in an aging society”. The Gerontologist, 28, 424–426.Google Scholar
Binstock, R.H., & Murray, T.H. (1991). The politics of developing appropriate care for dementia. In Binstock, R.H., Post, S.G. & Whitehouse, P.J. (Eds.), Dementia and Aging: Ethics, Values and Policy Choices (pp. 153–170). Baltimore: John Hopkins University Press.Google Scholar
Blum, H.L. (1982). Planning for Health: Generics for the Eighties. New York: Human Sciences Press.Google Scholar
Boudon, R. (1979). La logique du social. Introduction à l'analyse sociologique. Paris: Hachette.Google Scholar
British Columbia Task Force on Issues of Concern to Seniors. (1989). Toward a Better Age: Strategies for Improving the Lives of Senior British Columbians. Victoria: Ministry of Health.Google Scholar
Burt, R.S. (1982). Toward a Structural Theory of Action. New York: Academic Press.Google Scholar
Caldock, K. (1993). Policy and practice: Fundamental contradictions in the conceptualization of community care for elderly people? Health & Social Care, 2, 133–141.Google Scholar
Callahan, D. (1987). Setting Limits. Medical Goals in an Aging Society. New York: Simon & Schuster.Google Scholar
Callahan, D. (1990). What Kind of Life? New York: Simon & Schuster.Google Scholar
Chappell, N.L. (1990). Aging and social care. In Binstock, R.H. & George, L.K., Handbook of Aging and the Social Sciences (pp. 438–454). San Diego: Academic Press.Google Scholar
Charles, C., & Schalm, C. (1992a). Alberta&s resident classification system for long-term care facilities. Part I. Conceptual and methodological development. Canadian Journal on Aging, 11(3), 219–232.Google Scholar
Charles, C. & Schalm, C. (1992b). Alberta's resident classification system for long-term care facilities. Part II. First-year results and policy implications. Canadian Journal on Aging, 11(3), 233–248.Google Scholar
Clark, P.G. (1989). The philosophical foundation of empowerment. Canadian Journal of Aging and Health, 1, 267–285.Google Scholar
Clark, P.G. (1993). Moral discourse and public policy in aging: Framing problems, seeking solutions, and “Public ethics”. Canadian Journal on Aging, 12(4), 485–508.CrossRefGoogle Scholar
Coleman, J.S. (1990). Foundations of Social Theory. Chicago: University of Chicago Press.Google Scholar
Deber, R.B., & Williams, P. (1995). Policy, payment and participation: Long-term care reform in Ontario. Canadian Journal on Aging, 14(2), 294–318.CrossRefGoogle Scholar
Department of Health. (1989). Caring for People: Community Care in the Next Decade and Beyond. London: HMSO, CMND 849.Google Scholar
Diamond, P.A., & Mirlees, J.A. (1976). A model of social insurance with variable retirement. Journal of Public Economics, 110, 296–336.Google Scholar
Drucker, P.F. (1975). Management: Tasks, Responsibilities, Practices. New York: Harper & Row.Google Scholar
Eros. (1982). L'Orientation du bénéficiaire dans le réseau. Montreal: DASUM, University of Montreal.Google Scholar
Eros. (1985). L'Évaluation de l'autonomie et l'évaluation médicale du bénéficiaire. Quebec: Ministère de la Santé et des Services sociaux.Google Scholar
Eros. (1987). La détermination des services requis et la mesure des ressources req-uises pour le bénéftciaire. Quebec: Ministère de la Santé et des Services sociaux.Google Scholar
Estes, C.L., & Swan, J.H. (1993). No care zone and social policy. In Ester, C.L. & Swan, J.H. et al. (Eds.), The Long-Term Care Crisis: Elders trapped in the No-Care Zone (pp. 258–271). Newbury Park: Sage.Google Scholar
Evans, R.G., & Stoddart, G.L. (1990). Producing health, consuming health care. Social Science & Medicine, 3, 1347–1363.CrossRefGoogle Scholar
Evers, A., & Oik, T. (1993). Pluralité des sources de soins: vers de nouveaux équil-ibres. In Lesemann, F. & Martin, C. (Eds.), Les personnes âgées: dépendances, soins et solidarités familiales (pp. 53–72). Paris: La Documentation française.Google Scholar
Federal/Provincial/Territorial Subcommittee on Continuing Care. (1990). Future Directions In Continuing Care. Ottawa: Health and Welfare Canada.Google Scholar
Friedman, N.J. (1967). A conceptual model for the analysis of planning behavior. Administrative Science Quarterly, 12, 225–252.Google Scholar
Ginzberg, E. (1989). How to think about health care for the elderly. In Eisdorfer, C., Kessler, D.A. & Spector, A.N. (Eds.), Caring for the Elderly. Reshaping Health Policy (pp. 451–466). Baltimore: Johns Hopkins University Press.Google Scholar
Green, A. (1992). An Introduction to Health Planning in Developing Countries. Oxford: Oxford University Press.Google Scholar
Griffiths, R. (1988). Community Care: Agenda for Action. London: HMSO.Google Scholar
Groupe d'experts sur les personnes aînées. (1991). Vers un nouvel équilibre des âges. Québec: Ministère de la Santé et des Services sociaux.Google Scholar
Havens, B. (1995). Long-term care diversity with the care continnum. Canadian Journal on Aging, 14(2), 245–262.Google Scholar
Havens, B., & Kyle, B. (1993). Formal long-term care: Case examples. In Bull, C.N. (Ed.), Aging in Rural America (pp. 173–188). Newbury Park: Sage.Google Scholar
Hilleboe, H.E., Bankuus, A., & Thomas, W.C. (1973). La planification sanitaire nationale, approches et conceptions. Geneva: Cahiers de Sante Publique, OMS.Google Scholar
Houlden, B.T. (1980). Data and effective corporate planning. Long Range Planning, 13, 106–111.Google Scholar
Hyland, J.S. (1992). Planning roadblocks and detours. Topics in Health Care Financing, 18, 16–20.Google Scholar
Ives, J.R. (1991). Articulating values and assumptions for strategic planning. Nursing Management, 22, 38–39.Google Scholar
Jamieson, A. (1993). Comparación de politicás europeas de atención a las personas ancíanas. Barcelona: SG Editores.Google Scholar
Jecker, N.S. (1987). Excluding the elderly: A reply to Callahan. Psychology and Public Policy, 7, 12–14.Google Scholar
Jecker, N.S., & Pearlman, R.A. (1989). Ethical constraints on rationing medical care by age. Journal of the American Geriatrics Society, 37, 1067–1075.CrossRefGoogle Scholar
Johnson, J.E. (1990). Developing an effective business plan. Nursing Economics, 8, 152–154.Google Scholar
Kane, R.L., & Kane, R.A. (1982). Long-term care: A field in research of values. In Kane, R.L. & Kane, R.A. (Eds.), Values and Long-Term Care (pp. 3–26). Lexington: Lexington Press.Google Scholar
Kane, R.L., & Kane, R.A. (1987). Long-Term Care: Principles, Programs, and Policies. New York: Springier.Google Scholar
Kane, R.L., & Kane, R.A. (1989). Vacating the premises: A reevaluation of first principles. In Eisdorfer, C., Kessler, D.A. & Spector, A.N. (Eds.), Caring for the Elderly: Reshaping Health Policy (pp. 490–506). Baltimore: Johns Hopkins University Press.Google Scholar
Kane, R.L., & Kane, R.A. (1990). Health care for older people: Organizational and policy issues. In Binstock, R.H. & George, L.K. (Eds.), Handbook of Aging and the Social Sciences (pp. 415–437). San Diego: Academic Press.Google Scholar
Kantor, B.S., & Martin, J.L. (1988). From a constellation to a continuum: Policy and management implications for long-term care. Frontiers of Health Services Management, 5(3), 35.Google Scholar
Liu, K., McBride, T.D., & Coughlin, T.A. (1990). Costs of community care for disabled elderly persons: the policy implications. Inquiry, 27, 61–72.Google Scholar
Marmor, T.D., Mashaw, J.L., & Harvey, P.L. (1990). America's Misunderstood Welfare State. New York: Basic Books.Google Scholar
Mills, C.W. (1968). The Sociological Imagination. London: Oxford University Press.Google Scholar
Ministère de la Santé et des Services sociaux. (1992a). The Policy on Health and Well-Being. Quebec: Ministère de la Santé et des Services sociaux.Google Scholar
Ministère de la Santé et des Services sociaux. (1992b). Politique de services à domicile. Quebec: Ministère de la Santé et des Services sociaux.Google Scholar
Ministerio de asuntos sociales. (1992). Piano Gerontologico. Madrid: Instituto Nacional de Servicios Sociales.Google Scholar
Moon, M. (1989). Taking the plunge. The arguments for a comprehensive long-term care system. Journal of the American Geriatrics Society, 37, 1165–1170.Google Scholar
Morreale, J.C. (1991). The Medicare catastrophic coverage act of 1998: Issues of equity in a policy reversal. Journal of Contemporary Health, Law and Policy, 7, 117–155.Google Scholar
Myles, J., & Street, D. (1995). Should the economic life course be redesigned? Old age security in a time of transition. Canadian Journal on Aging, 14(2), 335–359.Google Scholar
Myrdal, G. (1967). The Necessity and Difficulty of Planning the Future Society. Address to the National Consultation on the Future Environment of Democracy, Washington.Google Scholar
National Council of Welfare Canada. (1990). Pension Reform. Ottawa: Supply and Services Canada.Google Scholar
National Council of Welfare Canada. (1994). Poverty Profile, 1993. Ottawa: Supply and Services Canada.Google Scholar
Navarro, V. (1970). Methodology on regional planning of personal health services. Medical Care, 8, 386–394.Google Scholar
Newhouse, J.P. (1990). Predicting nursing home utilization among the high-risk elderly: Comment. In Wise, D.A. (Ed.), Issues in the Economics of Aging (pp. 200–204). Chicago: University of Chicago Press.Google Scholar
Nutt, P.C. (1984). Planning Methods for Health and Related Organizations. New York: Wiley.Google Scholar
OECD. (1992). Documentprésentépar le Canada sur les nouvelles orientations de la politique sociale. Réunion du comité de l'emploi, du travail et des affaires sociales au niveau ministériel, sur la politique sociale. Paris.Google Scholar
Ontario. (1993a). Partnerships in Long-term Care: A New Way to Plan, Manage and Deliver Services and Community Support, a Policy Framework. Toronto: Ministry of Health, Ministry of Community and Social Services, Ministry of Citizenship.Google Scholar
Ontario. (1993b). Partnerships in Long-term Care: A New Way to Plan, Manage and Deliver Services and Community Support, an Implementation Framework. Toronto: Ministry of Health, Ministry of Community and Social Services, Ministry of Citizenship.Google Scholar
Ontario. (1993c). Partnerships in Long-term Care: A New Way to Plan, Manage and Deliver Services and Community Support, Guidelines for the Establishment of Multi-service Agencies. Toronto: Ministry of Health, Ministry of Community and Social Services, Ministry of Citizenship.Google Scholar
Parsons, T. (1937). The Structure of Social Action. New York: Free Press.Google Scholar
Parsons, T. (1960). A sociological approach to the theory of organizations. In Parsons, T. (Ed.), Structure and Process in Modern Societies (pp. 16–58). New York: Free Press.Google Scholar
Parsons, T. (1963a). On the concept of influence. Public Opinion Quarterly, 27, 37–62.Google Scholar
Parsons, T. (1963b). On the concept of political power. Proceedings of the American Philosophical Society, 107, 232–262.Google Scholar
Parsons, T. (1968). On the concept of value-commitment. Sociological Inquiry, 38, 135–160.Google Scholar
Parsons, T. (1977). Social structure and the symbolic media of interchange. In Parsons, T. (Ed.), Social Systems and the Evolution of Action Theory (pp. 204–228). New York: Free Press.Google Scholar
Parsons, T., & Platt, G. (1973). Technical appendix: Some general theoretical paradigms. In Parsons, T. & Platt, G. (Eds.), The American University (pp. 423–447). Cambridge: Harvard University Press.Google Scholar
Parsons, T., & Smelser, N.J. (1956). Economy and Society. London: Routledge & Kegan Paul.Google Scholar
Pineault, R., & Daveluy, C. (1986). La planification de la santé. Montreal: Agence d'Arc.Google Scholar
Reinke, W.A. (1988). The integration of planning with action. Introduction. In Reinke, W.A. (Ed.), Health Planning for Effective Management (pp. 3–4). New York: Oxford University Press.Google Scholar
Rice, T. (1987). An assessment of health care coverage for the elderly. Millbank Memorial Fund Quarterly, 65, 488–520.Google Scholar
Rice, T., Thomas, K., & Weissert, W. (1991). The effect of owning private long-term care insurance policies on out-of-pocket costs. Health Services Research, 25, 907–933.Google Scholar
Rivlin, M.A., & Wiener, J.M. (1988). Caring for the Disabled Elderly: Who Will Pay? Washington: The Brookings Institutions.Google Scholar
Rosen, H.S. (1985). Public Finance. Homewood: Irwin.Google Scholar
RRSSSMC. (1995). Vers un nouvel équilibre. Montreal: Regie Régionale de la Santé et des Services Sociaux de Montreal-Centre.Google Scholar
Schaefer, M. (1975). L'Administration desprogrammes de salubrité de l'environne-ment: approche systémique. Geneva: World Health Organization.Google Scholar
Schopflin, P. (1991). Dépendance et solidarités: mieux aider les personnes âgées. Paris: La Documentation française.Google Scholar
Shapiro, E. (1993). Long-Term Care and Population Aging. Winnipeg: Centre for Health Policy and Evaluation.Google Scholar
Singer, P. (1988). Review essay: Setting limits. Boethics, 2, 151–169.Google Scholar
Somers, A.R. (1982). Long-term care for the elderly and disabled: A new health priority. The New England Journal of Medicine, 307, 221–226.Google Scholar
Thomas, A.M. (1993). Strategic planning, a practical approach. Nursing Management, 2(4), 34–35.Google Scholar
Vayda, E., & Deber, R.B. (1992). The Canadian health care system: A development overview. In Naylor, C.D. (Ed.), Canadian Health Care and the State (pp. 141–192). Montreal & Kingston: McGill Queen's University Press.Google Scholar
Walker, A. (1995). The future of long-term care In Canada — A British perspective. Canadian Journal on Aging, 14(2), 437–446.Google Scholar
Walker, A., & Warren, L. (1994). The case of frail older people in Britain: Current policies, and future prospects. In Olsen, K.K. (Ed.), The Graying of the World (pp. 129–162). New York: Hayworth Press.Google Scholar
Weber, M. (1971). Économie et Société. Paris: Plon.Google Scholar
Wiener, J.M., Hawley, R.J., & Hixon Illstar, I. (1992). Financing long-term care: How much public? How much private?. Journal of Health Politics, Policy and Law, 17, 425–434.Google Scholar
Wittenberg, R. (1989). Prototype insurance policy for long-term care. London: Department of Health.Google Scholar
Wrong, D. (1961). The oversocialized conception of man In modern sociology. American Sociological Review, 26, 183–193.Google Scholar