scholarly journals Exploring residential care aide experiences with oral malodour in long‐term care

Nursing Open ◽  
2020 ◽  
Vol 7 (4) ◽  
pp. 1208-1216
Author(s):  
Charanpreet Singh Dhami ◽  
Leeann R. Donnelly
2012 ◽  
Vol 25 (1) ◽  
pp. 140-147 ◽  
Author(s):  
Jenny Lee ◽  
Elsie Hui ◽  
Carolyn Kng ◽  
Tung Wai Auyeung

ABSTRACTBackground: Attitudes of residential care staff toward residents with dementia affect the quality of care. We examined the attitude of frontline residential care staff toward residents with dementia, and how the presence of specialized care units or programs may affect staff attitude.Methods: Staff working in nursing homes participated in a survey which covered demographic data, current state of dementia care in workplace, opinion regarding dementia care, and perceived importance of dementia behaviors.Results: 1,047 nurses and personal care workers participated. 78.8% respondents reported difficulties in managing dementia residents. Those who ranked positive symptoms as more important were 4.5 times more likely to report difficulties, independent of experience. Independent factors associated with positive attitudes toward further training were working in a non-profit home (OR 2.4, 95% CI 1.1, 5.0; p = 0.024) and having a dementia program or unit in the current workplace (OR 1.8, 95% CI 0.985, 3.302; p = 0.056). Only having a dementia program or unit in the current workplace was associated with a positive attitude toward commitment to stay in dementia care (OR 1.9, 95% CI 1.1, 3.2; p = 0.021), adjusted for gender, type of home, post, dementia prevalence in workplace, and work experience.Conclusion: The majority of long-term care staff felt dementia care difficult yet hold positive attitude toward further training and were committed to stay in dementia care. Having a specialized dementia care unit or program in the current workplace was associated with commitment to stay in dementia care and was marginally associated with positive attitude toward further training.


2020 ◽  
pp. 1-16
Author(s):  
Briony Jain ◽  
Viktoryia Kalesnikava ◽  
Joseph E. Ibrahim ◽  
Briana Mezuk

Abstract This commentary addresses the increasing public health problem of suicide in later life and presents the case for preventing suicide in residential long-term care settings. We do so by examining this issue from the perspective of three levels of stakeholders – societal, organisational and individual – considering the relevant context, barriers and implications of each. We begin by discussing contemporary societal perspectives of ageing; the potential impact of ageism on prevention of late-life suicide; and the roles of gender and masculinity. This is followed by a historical analysis of the origin of residential long-term care; current organisational challenges; and person-centred care as a suicide prevention strategy. Finally, we consider suicide in long-term care from the perspective of individuals, including the experience of older adults living in residential care settings; the impact of suicide on residential care health professionals and other staff; and the impact of suicide bereavement on family, friends and other residents. We conclude with recommendations for policy reform and future research. This commentary aims to confront the often unspoken bias associated with preventing suicide among older adults, particularly those living with complex medical conditions, and invoke an open dialogue about suicide prevention in this population and setting.


2014 ◽  
Vol 15 (4) ◽  
pp. 232-236 ◽  
Author(s):  
Lee Hooper ◽  
Diane K Bunn

Purpose – The purpose of this paper is to consider whether dehydration in older people should be used as a marker of lack of quality in long-term care provision. Design/methodology/approach – The piece examines the assumed relationship between dehydration and the quality of care, and then considers the factors that can lead to dehydration in older people. Findings – Even with the best care, older people, in the absence of a sense of thirst, and for fear of urinary accidents, difficulties getting to the toilet or choking, may choose to drink less than would be ideal for their health. While good care supports older people to minimise these problems, it also respects older people making their own decisions around when, what and how much to drink. It appears that dehydration may sometimes be a sign of good care, as well as arising from poor care. Social implications – Residential care homes should not be stigmatised on the basis of their residents being dehydrated, but rather helped to explore whether they are achieving an appropriate balance between care and quality of life for their residents. Originality/value – This discussion may be of use to those living in, working in, managing or assessing residential care.


Author(s):  
Marcus J. Hollander ◽  
Neena L. Chappell

ABSTRACTThis paper reports on the results of analyses using administrative data from British Columbia for 10 years from fiscal 1987/1988 to 1996/1997, inclusive, to examine the comparative costs to government of long-term home care and residential care services. The analyses used administrative data for hospital care, physician care, drugs, and home care and residential long-term care. Direct comparisons for cost and utilization data were possible, as the same care-level classification system is used in BC for home care and residential care clients. Given significant changes in the type and/or level of care of clients over time, a full-time equivalent client strategy was used to maximize the accuracy of comparisons. The findings suggest that, in general, home care can be a lower-cost alternative to residential care for clients with similar care needs. The difference in costs between home care and residential care services narrows considerably for those who change their type and/or level of care, and home care was found to be more costly than long-term institutional care for home care clients who died. The findings from this study indicate that with the appropriate substitution for residential care services, in a planned and targeted manner, home care services can be a lower-cost alternative to residential long-term care in integrated systems of care delivery that include both sets of services.


2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 90-90
Author(s):  
Meghan Jenkins Morales ◽  
Stephanie Robert

Abstract At some point in our lives, approximately 70% of us will need support to help with daily care. Without adequate assistance we may experience unmet care need consequences (UCNC) – such as skipping meals, going without clean clothes, or taking the wrong medication. This study examines the likelihood of experiencing UCNC related to gaps in assistance with activities of daily living (ADL) and instrumental activities of daily living (IADL) across long-term care arrangements: informal community care, paid community care, residential care, and nursing homes. We examine a sample of older adults receiving assistance in a care arrangement (N=2,499) from the nationally representative 2015 National Health and Aging Trends Study. Cross-sectional and longitudinal regression models, adjusting for differences in demographic and health/functioning characteristics, examine if type of care arrangement in 2015 is associated with UCNC in 2015 and change in UCNC by 2017. Holding all else constant, there were no significant differences in UCNC related to ADLs in 2015 across care arrangements. However, those receiving paid community care were more likely to experience UCNC related to IADLs (going without clean clothes, groceries, or a hot meal and making medication errors) compared to those receiving only informal care (OR=1.64, p<.05) or residential care (OR=2.19, p<.01). By 2017, paid care was also significantly associated with continued UCNC, but older adults in informal care arrangements were most likely to experience a new UCNC. Results suggest improving/expanding assistance with IADLs among community-dwelling older adults, and promoting equitable access to residential care, to reduce UCNC.


2021 ◽  
Vol 29 (4) ◽  
pp. 2389-2400
Author(s):  
Syazreen Niza Shair ◽  
Thomas Sachi Purcal

This research compares the quality of life of Malaysian elderlies living in public formal long-term care institutions, including residential care and nursing home care. It provides evidence of the cost-effectiveness of both programs. The sample of Malaysian elderlies aged 60 years and above was collected from the World Health Survey, including five dimensions of health status: mobility, self-care, usual activities, pain and discomfort, and anxiety and depression. Each of the dimensions has three levels, including 1 (“no problems”), 2 (“some problems”) and 3 (“major problem”). The quality-adjusted life-years (QALYs) of elderlies living in both institutions are estimated using a generic health-related measurement method, EQ-5D. In addition, cost-utility analysis is adopted to compare the effectiveness of programs in allocating resources. The QALY of those living in nursing home care is reasonably lower than those in residential care due to their worse chronic health conditions. The majority are categorised as severely disabled. The cost-effectiveness evaluation of each public long-term care model suggests that the residential care program is cost-effective, with the cost per QALY being MYR22 945. At the same time, a nursing home for disabled people is not effective as the cost per QALY is MYR57 822, falls outside the willingness to pay (WTP) range between (MYR 19,929–MYR 28,470).


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