Results for 'nursing homes'
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SIMARD Joyce, VOLICER Ladislav
Editorial. In all countries affected by COVID-19, the message that is being sent by government officials and medical experts is “stay at home” and “isolate in place.” The isolation is especially difficult for people living in nursing homes and assisted living communities. This article provides some easy to implement ideas, with little or no cost or hiring additional staff, and can decrease the loneliness of residents in nursing homes or assisted living communities The article concludes that preventing loneliness in institutionalized persons is at least as important as helping them with personal hygiene. This is especially important during the COVID-19 pandemic when residents must be protected from contact with other individuals to reduce the risk of infection. Implementation of some of the strategies listed in this article requires education of staff members and supply of required items; however, this effort can significantly improve the quality of life of residents affected by pandemic restrictions.
GULKA Heidi J, et al
Objectives: To determine the efficacy of fall intervention programs in nursing homes (NHs) and the generalizability of these interventions to people living with cognitive impairment and dementia. Design: Systematic review and meta-analysis. Setting and Participants: NH residents (n = 30,057) living in NHs defined as residential facilities that provide 24-hours-a-day surveillance, personal care, and some clinical care for persons who are typically aged ≥65 years with multiple complex chronic health conditions. Methods: Meta-analysis of falls prevention interventions on number of falls, fallers, and recurrent fallers. Results: Thirty-six studies met inclusion criteria for the systematic review. Overall, fall prevention interventions reduced the number of falls [risk ratio (RR) = 0.73, 95% confidence interval (CI) = 0.60-0.88], fallers (RR = 0.80, 95% CI = 0.72-0.89), and recurrent fallers (RR = 0.70, 95% CI = 0.60-0.81). Subanalyses revealed that single interventions have a significant effect on reducing fallers (RR = 0.78, 95% CI = 0.69-0.89) and recurrent fallers (RR = 0.60, 95% CI = 0.52-0.70), whereas multiple interventions reduce fallers (RR = 0.69, 95% CI = 0.39-0.97) and multifactorial interventions reduce number of falls (RR = 0.65, 95% CI = 0.45-0.94). Conclusions and Implications: Exercise as a single intervention reduced the number of fallers and recurrent fallers by 36% and 41%, respectively, in people living in NHs. Other effective interventions included staff education and multiple and multifactorial interventions. However, more research on exercise including people with cognitive impairment and dementia is needed to improve the generalizability of these interventions to the typical NH resident.
QUAN Nicolas G., et al
Objectives: This study aimed to review loneliness interventions for older adults living in long-term care (LTC) facilities over the past 10 years, to categorise interventions by type, and to compare effectiveness of loneliness interventions in these settings. Methods: Systematic review followed PRISMA guidelines. Articles matching search criteria were collected from PubMed, PsycINFO, and Web of Science from 2009 to 2019. The inclusion criteria were as follows: 1) English language, 2) intervention studies with a quantitative measure that compares pre-trial to post-trial changes, 3) loneliness as a primary or secondary outcome 4) subjects age >65, and 5) subjects living in a LTC facility, such as a nursing home, assisted-living, or hospice. Results: A total of 15 intervention studies qualified for systematic review. Most of these interventions were psychological therapies and leisure/skill development interventions. Approximately, 87% of studies reported significant decreases in loneliness following intervention. Laughter therapy, horticultural therapy, and reminiscence therapy were associated with the greatest decreases in loneliness. Discussion: Results suggest that, although less common than interventions in the community, there are several effective interventions to reduce loneliness among older adults living in LTC facilities. Lack of standardised measures and high-quality studies limits comparisons between intervention types and generalizability to different populations.
van LOON Jolande, et al
Autonomy is important in every stage of life. However, little is known about how autonomy is enhanced for older adults living in residential care facilities (RCFs). This leads to the research question: which facilitators and barriers to autonomy of older adults with physical impairments due to ageing and chronic health conditions living in RCFs are known? The results will be organised according to the framework of person-centred practice, because this is related to autonomy enhancement. To answer the research question, a systematic literature search and review was performed in the electronic databases CINAHL, PsycINFO, PubMed, Social Services Abstracts and Sociological Abstracts. Inclusion and exclusion criteria were derived from the research question. Selected articles were analysed and assessed on quality using the Mixed Methods Appraisal Tool. Facilitators and barriers for autonomy were found and arranged in four themes: characteristics of residents, prerequisites of professional care-givers, care processes between resident and care-giver, and environment of care. The established facilitators and barriers are relational and dynamic. For a better understanding of the facilitators and barriers to autonomy for older adults with physical impairments living in RCFs, a description is based on the 35 included articles. Autonomy is a capacity to influence the environment and make decisions irrespective of having executional autonomy, to live the kind of life someone desires to live in the face of diminishing social, physical and/or cognitive resources and dependency, and it develops in relationships. The results provide an actual overview and lead to a better understanding of barriers and facilitators for the autonomy of older adults with physical impairments in RCFs. For both residents and care-givers, results offer possibilities to sustain and reinforce autonomy. Scientifically, the study creates new knowledge on factors that influence autonomy, which can be used to enhance autonomy.
BOERSMA Petra, et al
Background and Objectives: There is a lack of research on implementation of person-centered care in nursing home care. The purpose of this study was to assess the implementation of the Veder contact method (VCM), a new person-centered method using theatrical, poetic and musical communication for application in 24-hr care. Research Design and Methods: Caregivers (n = 136) and residents (n = 141) participated in a 1-year quasi-experimental study. Foundation Theater Veder implemented VCM on six experimental wards and rated implementation quality. Six control wards delivered care-as-usual. Before and after implementation, caregiver behavior was assessed during observations using the Veder-observation list and Quality of Caregivers’ Behavior-list. Caregiver attitude was rated with the Approaches to Dementia Questionnaire. Quality of life, behavior, and mood of the residents were measured with QUALIDEM, INTERACT and FACE. Residents’ care plans were examined for person-centered background information. Results: Significant improvements in caregivers’ communicative behavior (i.e., the ability to apply VCM, establishing positive interactions) and some aspects of residents’ behavior and quality of life (i.e., positive affect, social relations) were found on the experimental wards with a high implementation score, as compared to the experimental wards with a low implementation score, and the control wards. No significant differences were found between the groups in caregivers’ attitudes, residents’ care plans, or mood. Discussion and Implications: The positive changes in caregivers’ behavior and residents’ well-being on the high implementation score wards confirm the partly successful VCM implementation. Distinguishing between wards with a high and low implementation score provided insight into factors which are crucial for successful implementation.
CANTARELLA A., et al
Objectives: Among the psychosocial interventions intended to reduce the behavioural and psychological symptoms of dementia (BPSD), doll therapy (DT) is increasingly used in clinical practice. Few studies on DT have been based on empirical data obtained with an adequate procedure; however, none have assessed its efficacy using an active control group, and the scales used to assess changes in BPSD are usually unreliable. The aim of the present study was to measure the impact of DT on people with severe dementia with a reliable, commonly used scale for assessing their BPSD, and the related distress in formal caregivers. Effects of DT on the former's everyday abilities (i.e., eating behaviour) were also examined. Method: Twenty‐nine nursing home residents aged from 76 to 96 years old, with severe dementia (Alzheimer's or vascular dementia), took part in the experiment. They were randomly assigned to an experimental group that used dolls or an active control group that used hand warmers with sensory characteristics equivalent to the dolls. Benefits of DT on BPSD and related formal caregiver distress were examined with the Neuropsychiatric Inventory. The effects of DT on eating behaviour were examined with the Eating Behavior Scale. Results: Only the DT group showed a reduction in BPSD scores and related caregiver distress. DT did not benefit eating behaviour, however. Conclusions: This study suggests that DT is a promising approach for reducing BPSD in people with dementia, supporting evidence emerging from previous anecdotal studies.
Somerset Care and Yeovil District Hospital
Cookson’s Court nursing home was opened by Somerset Care in September 2015 with one floor of the new facility reserved solely for the use of the company’s new intermediate care/reablement service, delivered in collaboration with Yeovil District Hospital. “There are no words to express my gratitude, thank you with all my heart. I’ve been born again.” (Service user feedback). In part a response to poor delayed discharge performance in the Somerset area, the collaboration aims to: improve patient flow at Yeovil District Hospital and reduce lengths of stay; provide a reablement focused environment; and improve clinical outcomes and reduce costs.
This report sets out key steps that commissioners can take in collaboration with service providers to enable people who are approaching the end of life to avoid being admitted to hospital when this is possible and appropriate, as well as enabling those who are admitted to make a transition to a community setting quickly. The report argues that as well as reducing the costs to the NHS, enabling people to stay out of hospital at the end of life can make a significant difference to the experiences of dying people and their families. The report makes a number of recommendations for commissioners, service providers and health and social care staff, including: commissioning the increased provision of 24/7 care in community settings, through care homes and hospices, and community health and social care services that can provide care in people’s homes; commissioning anticipatory prescribing of medicines for people approaching the end of life; using available funding, through System Resilience Groups, the Better Care Fund, and Integrated Personal Commissioning, to improve co-ordination between hospitals and community settings, including hospices, for people approaching the end of life; and health and social care staff identifying carers of people who are approaching the end of life and referring them for local authority assessments.
Sets out Care England’s vision for the next five years on how the organisation and the sector plan to deal with a number of issues facing the health and social care system. The report focuses on critical areas of the current social care landscape, including: integrated and person-centred care; falling fees and local authorities’ budgetary constraints; recruitment of nurses; recruitment, pay and training of the care workforce; raising awareness of the value of the sector; the Care Quality Commission and the need for further improvement of the regulation process; learning disabilities; and dementia. The report warns of the risk of a collapse in the system if providers and commissioners do not work together and more nurses are not recruited into the independent sector.
DOUGHTY Kevin, MULVIHILL Patrick
Purpose: The purpose of this paper is to consider the importance of digital healthcare through telecare and portable assistive devices in supporting the reengineering of healthcare to deal with the needs of an older and more vulnerable population wishing to remain in their own homes.
Design/methodology/approach: It supports the importance of the assessment process to identify hazards associated with independent living, and the possible consequences of accidents. By measuring and prioritising the risks, appropriate management strategies may be introduced to provide a safer home environment.
Findings: A process for assessing and managing these risks has been developed. This can be applied to a wide range of different cases and yields solutions that can support independence.
Research limitations/implications: The developed digital reablement process can be used to provide vulnerable people with a robust form of risk management.
Practical implications: If telecare services follow the process described in this paper then they will improve the outcomes for their users.
Originality/value: The process described in this paper is the first attempt to produce a robust assessment process for introducing telecare services in a reablement context.
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