An Evaluation of Texture-Modified Diets Compliant with the International Dysphagia Diet Standardization Initiative in Aged-Care Facilities Using the Consolidated Framework for Implementation Research

Dysphagia ◽  
2022 ◽  
Author(s):  
Xiaojing Sharon Wu ◽  
Anna Miles ◽  
Andrea Braakhuis
Keyword(s):  
Implementation Research ◽  
Aged Care ◽  
Care Facilities ◽  
Aged Care Facilities

scholarly journals An Evaluation of Texture Modified Diets Compliant with the International Dysphagia Diet Standardisation Initiative in Aged-Care Facilities Using the Consolidated Framework for Implementation Research

2021 ◽  
Author(s):  
Xiaojing Sharon Wu ◽  
Anna Miles ◽  
Andrea Braakhuis
Keyword(s):  
Quality Of Care ◽  
Implementation Research ◽  
Aged Care ◽  
Successful Implementation ◽  
Site Specific ◽  
Barriers And Enablers ◽  
Care Facilities ◽  
Aged Care Facilities ◽  
Specific Implementation

Abstract Background: Texture modified diets (TMDs) are commonly prescribed for older adults with swallowing difficulties to improve swallowing safety. The International Dysphagia Diet Standardization Initiative (IDDSI) provides a framework for terminology, definitions and testing of TMDs. This observational mixed-method study used the Consolidated Framework for Implementation Research (CFIR) to establish the barriers and enablers to IDDSI adoption in aged-care facilities (ACFs).Methods: Five New Zealand ACFs who had adopted IDDSI >12 months previously were recruited. Evaluation tools were developed based on CFIR constructs, integrating data from i) mealtime observations; ii) manager interviews and iii) staff (nursing, carers and kitchen) self-administrated surveys. Results: All facility and kitchen managers were IDDSI-aware and had access to online resources. Three sites had changed to commercially compliant products post-IDDSI adoption, which had cost implications. Awareness of IDDSI amongst staff ranged from 5-79% and <50% of staff surveyed felt sufficiently trained. Awareness was greater in large sites and where IDDSI was mandated by head office. Managers had not mandated auditing and they felt this had led to reduced perceived importance. Managers felt staff required more training and staff wanted more training, believing it would improve food safety and quality of care. Lack of a dedicated project leader and no speech pathologist onsite were perceived barriers. Collaboration between healthcare assistants, kitchen staff and allied health assisted implementation. Conclusion: ACF staff were aware of IDDSI but staff awareness was low. Using the CFIR, site-specific and generic barriers and enablers were identified to improve future implementation effectiveness. Managers and staff want access to regular training. Multidisciplinary collaboration and improving communication are essential. ACFs should consider TMD auditing regularly. Successful implementation of IDDSI allows improvement of quality of care and patient safety but requires a systematic, site-specific implementation plan.

Resident and family engagement in medication management in aged care facilities: a systematic review

2021 ◽  
Author(s):  
Elizabeth Manias ◽  
Tracey Bucknall ◽  
Alison Hutchinson ◽  
Briony Dow ◽  
Narelle Borrott
Keyword(s):  
Systematic Review ◽  
Medication Management ◽  
Family Engagement ◽  
Aged Care ◽  
Care Facilities ◽  
Aged Care Facilities

scholarly journals Inadequate completion of advance care directives by individuals with dementia: national audit of health and aged care facilities

2021 ◽  
pp. bmjspcare-2020-002767
Author(s):  
Jamie Bryant ◽  
Marcus Sellars ◽  
Craig Sinclair ◽  
Karen Detering ◽  
Kimberly Buck ◽  
...  
Keyword(s):  
Healthcare Providers ◽  
Aged Care ◽  
Care Plan ◽  
Residential Aged Care ◽  
Multinomial Regression ◽  
People With Dementia ◽  
Care Facilities ◽  
Aged Care Facilities ◽  
Advance Care Directives ◽  
Advance Care

Objectives(i) Describe the prevalence and type of advance care directives (ACDs) and other advance care planning (ACP) documentation completed by persons with dementia, healthcare providers and others on behalf of a person with dementia; (ii) identify the personal and ACP programme characteristics associated with having ACP documentation in the health record; (iii) identify the personal and ACP programme characteristics associated with having a self-completed ACD.MethodsA multicentre audit was undertaken in Australian hospitals, general practices and residential aged care facilities. Auditors extracted demographic and ACP data from the records of eligible patients. ACP programme characteristics were provided by a site representative. Logistic and multinomial regression were used respectively to examine the factors associated with completion of any ACP documentation, and self-completion of an ACD by persons with dementia.ResultsA total of 1388 people with dementia (33.2%) from 96 sites were included. Overall, 60.8% (n=844) had ACP documentation; 31.6% (n=438) had a self-completed ACD and 29.3% (n=406) had an ACP document completed by a health professional or someone else on their behalf. Older participants were more likely to have ACP documented. Multivariate analyses indicated the odds of having self-completed ACP documents, compared with no advance care plan or ACP completed by someone else, were significantly influenced by age, country of birth, setting and whether the site had ACP training, policies or guidelines.DiscussionWhile 60% of people with dementia had some form of ACP documentation, only half of the cases in which ACP was documented included an ACD completed by the person themselves.

Dementia in Aboriginal people in Residential Aged Care Facilities in Alice Springs: A Descriptive Study

2019 ◽  
Vol 20 (2) ◽  
pp. 171-179
Author(s):  
Bruce Hocking ◽  
Michael Lowe ◽  
Tricia Nagel ◽  
Caroline Phillips ◽  
Melissa Lindeman ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Cognitive Assessment ◽  
Aboriginal People ◽  
Aged Care ◽  
Residential Aged Care ◽  
Aboriginal Populations ◽  
Care Facilities ◽  
Aged Care Facilities ◽  
Residential Aged Care Facilities ◽  
Clinical File

AbstractBackground:A high prevalence of dementia among Aboriginal and Torres Strait Islanders has been reported but knowledge of underlying causes and associations remains limited.Objective:To identify the prevalence of factors that may be associated with the categories of Major neurocognitive disorders (Major NCDs) in Aboriginal people living in residential aged care facilities in Alice Springs in the Northern Territory (NT).Design and Setting:This descriptive cross-sectional study analysed clinical file and cognitive assessment data of participants who were identified as having cognitive impairment between January and June 2016.Method:Screening for the presence of cognitive impairment using the Kimberley Indigenous Cognitive Assessment (KICA) was undertaken and 58 of 84 Aboriginal people were admitted to the study. Using a clinical file audit, diagnoses of Major NCDs consistent with the DSM-5 classification were made and the prevalence of factors possibly associated with these diagnoses described.Results:Fifty of the 58 participants were diagnosed with a Major NCD. The most frequent diagnoses were Major NCD due to vascular disease (30%), Major NCD due to Alzheimer’s Disease (26%) and Major NCD due to brain injury (20%). Hypertension, Type 2 Diabetes Mellitus and alcohol misuse were commonly reported together with hypothyroidism, hypoglycaemia and vitamin D deficiency.Conclusion(s):This study identified possible associations with Major NCDs in this population as well as a different spread of Major NCD diagnoses to previous studies in Aboriginal populations. There is a need for further research to understand the causes of dementia in Australian Aboriginal people and to use this information to appropriately tailor treatment and prevention programmes.

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