Challenges in Long-Term Care (2)
Introduction and Background
Research in the long-term care domain is critical in the maintenance and improvement of healthcare quality and delivery to people in need of long-term care. However, conducting long-term care research faces a number of challenges. Such research challenges impact the long-term care delivery system, including staffing, funding, and regulation. In the research article “Pragmatic Trials in Long‐Term Care: Research Challenges and Potential Solutions in Relation to Key Areas of Care,” the authors focus on the challenges of carrying out pragmatic trials and research in LTC with a focus on dementia patients in LTC facilities. The authors focus on the challenges of behavior change and implementing new approaches to care. The paper concentrates on the need for pragmatic trials in long‐term care, specifically identifying the challenges of carrying out pragmatic trials and the possible solutions to such challenges. The recommendations provided in this article can be of interest to stakeholders in LTC, including LTC facilities, policymakers, LTC nurses, researchers, and related healthcare organizations.
The article argues that despite developing new care practices, such practices are hard to implement in real-world long-term care. The reason for implementation challenges to such trials is that they are evaluated in controlled conditions that do not represent the real world. This means such intervention trials cannot be actualized in reality. The authors argue that pragmatic trials offer solutions to the implementation challenges as they examine the efficacy of interventions using real LTC settings. Real-world trials help develop interventions for long-term care that can easily and effectively be adopted and implemented.
Identified Challenges in Pragmatic Trials in Long-Term Care Continuum
LTC facilities and people in need of long-term care present a complex adaptive system (Anderson et al., 2003). Within such complex adaptive systems, there exist interactions and relationships among individuals. The nature of long-term care provided needs to always adapt to the needs of these individuals despite their unpredictability. Due to this, research challenges exist in conducting pragmatic trials in LTC.
Identified challenges include;
Heterogeneity of needs among participants in long-term care,
Identification of primary outcomes in a heterogeneous population,
Participant adherence to interventions,
Flexibility in delivery,
Ensuring sufficient control over a trial intervention to determine effectiveness,
The variability of LTC facilities and organizations,
The assent and consent dilemma for dementia patients,
Heterogeneity of staff training,
Lack of localized results (Resnick et al., 2022).
Impact of the Challenges on the Long-Term Care System (Staffing, Funding, and Regulation)
The heterogeneity of needs among LTC facility residents and the growing acuity level of residents in LTC facilities may create an artificial shortage of nursing and other staff, as each will require specialized care to meet their individual needs. The heterogeneity of organizations and nursing training processes may affect the number of qualified licensed nurses available for long-term care. The overall challenges impact funding and pose a dilemma on the responsibility of funding LTC between individuals and the government. Further, the challenges of asserting and consenting aged residents, especially those with dementia, and the lack of localized results may affect the regulation of certain interventions at a national level.
Recommended Solutions to the Challenges
The authors’ recommendations to overcome challenges in pragmatic trials research in LTC include:
Active participation of stakeholders,
Use of technology such as in keeping health records, wearables, LTC-targeted health applications,
Targeted staff training,
Use of feedback from organizational and LTC partners,
Consideration of health care and cost/benefit of the new care approaches,
Removal of existing ineffective care interventions.
References
Anderson, R. A., Issel, L. M., & McDaniel Jr, R. R. (2003). Nursing homes as complex adaptive systems: the relationship between management practice and resident outcomes. Nursing research, 52(1), 12.
Resnick, B., Zimmerman, S., Gaugler, J., Ouslander, J., Abrahamson, K., Brandt, N., & Verbeek, H. (2022). Pragmatic trials in long-term care: research challenges and potential solutions in relation to key areas of care. Journal of the American Medical Directors Association, 23(3), 330-338.
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Question 
Please research the university library to find a research article relating to the current challenges in the long-term care continuum and their impact on the current long-term care industry. Research the South University Online Library and the Internet to learn more about the topic. After you have completed your review, create a Microsoft Word document addressing the main challenges discussed in the paper. Be sure to incorporate the following:
Challenges in Long-Term Care (2)
Introduction and background of the research paper
Stakeholders interested in the study
Challenges in the long-term care continuum
Impact of the challenges on the long-term care system (specifically on staffing, funding, and regulation)
Recommendations to address the challenges
To support your work, use your course and textbook readings and also use the South University Online Library. As in all assignments, cite your sources in your work and provide references for the citations in APA format.
Submission Details:
Your assignment should be addressed in a 2- to 3-page document.
Submit your document to the Submissions Area by the due date assigned.