Family care-giving and decisions about entry to care: a rural perspective

ABSTRACTThe aim of this qualitative study was to explore rural family carers' experiences of the nursing home placement of an older relative. The study was undertaken in a large Health and Social Care Trust in Northern Ireland using a grounded theory approach. Purposive sampling was used to initiate data collection and thereafter theoretical sampling was employed. Semi-structured interviews were conducted with 29 relatives of nursing home residents and the resultant data were recorded, transcribed and analysed using constant comparisons. The software package, QSR NVivo, was used to facilitate data management and retrieval. Older people had deep attachments to their homes and entry to care was a last resort. Rural family carers had close relationships with health- and social-care practitioners and felt supported in the decision-making process. The choice of home was a foregone conclusion for carers who had a strong sense of familiarity with the nursing homes in their area. This familiarity was influenced by the relatively rural communities in which respondents resided and by an efficient ‘grapevine’, which seemed to thrive in these small communities. This familiarity, in turn, influenced the choice of nursing home, timing of the placement and responses of family carers. The findings indicate that issues such as rurality and familiarity warrant a more detailed exploration in future research on entry to care.

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‘Making the best of things’: relatives' experiences of decisions about care-home entry

Ageing and Society ◽

10.1017/s0144686x03001259 ◽

2003 ◽

Vol 23 (4) ◽

pp. 429-450 ◽

Cited By ~ 64

Author(s):

SUE DAVIES ◽

MIKE NOLAN

Keyword(s):

Decision Making ◽

Nursing Home ◽

Social Care ◽

Care Home ◽

Close Relative ◽

Structured Interviews ◽

Care Giving ◽

Health And Social Care ◽

Working Together ◽

Constructivist Perspective

Despite the growing awareness of the significance of helping a relative to relocate to a care home as a key phase in the care-giving career, relatively few British studies have explored this experience in depth. Informed by a constructivist perspective, this study sought a better understanding of nursing home placements from the viewpoint of relatives. Data were collected in 37 semi-structured interviews involving 48 people who had assisted a close relative to move into a nursing home. Analysis revealed three perceived phases to the transition: ‘making the best of it’, ‘making the move’ and ‘making it better’. The relatives' experiences through these phases had five perceived elements, all of which were continua, from absent to very strong, reflecting the extent to which they were felt. They were: operating ‘under pressure’ or not; ‘in the know’ or ‘working in the dark’; ‘working together’ or ‘working alone’; ‘in control of events’ or not, and ‘supported’ or ‘unsupported’ both practically and emotionally. This paper reports findings about the first phase of the transition, ‘making the best of it’, and documents the experiences of decision-making about nursing home placements. It is argued that health and social care practitioners have enormous potential to influence whether or not helping a relative to move into a nursing home is perceived as a positive choice.

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‘Waiting and Wanting’: older peoples’ initial experiences of adapting to life in a care home: a grounded theory study

Ageing and Society ◽

10.1017/s0144686x20000872 ◽

2020 ◽

pp. 1-25 ◽

Cited By ~ 1

Author(s):

Marie O'Neill ◽

Assumpta Ryan ◽

Anne Tracey ◽

Liz Laird

Keyword(s):

Grounded Theory ◽

Data Analysis ◽

Social Care ◽

Care Home ◽

Theory Approach ◽

Structured Interviews ◽

Policy And Practice ◽

Senior Member ◽

Care Home Staff ◽

Health And Social Care

Abstract A grounded theory approach, consistent with the work of Strauss and Corbin, was used to undertake semi-structured interviews with 17 older people, to explore their experiences of living in a care home, during the four- to six-week period following the move. Purposive sampling was initially adopted, thereafter, theoretical sampling was employed to recruit individuals identified by care managers within older peoples’ community teams and care home managers within a large Health and Social Care Trust in the United Kingdom. Consistent with grounded theory methodology, data collection and analysis occurred simultaneously. Constant comparative analysis underpinned data analysis and data management techniques. Data analysis revealed five distinct categories that captured these experiences. These were: (a) wanting to connect – ‘I am so lost here’, (b) wanting to adapt – ‘Well mentally you have to make the best of it’, (c) waiting for assistance – ‘it's a frustration for me’, (d) ‘waiting on the end’ – I am making no plans’ and (e) wanting to re-establish links with family and home – ‘I love getting home and I like getting out to the town’. Together these five categories formed the basis of the core category, ‘Waiting and Wanting’, which encapsulates the initial adaptation experiences of the men and women in the study. Findings indicate that individuals were dependent on others to create a sense of belonging, independence and wellbeing. Moreover, risk aversive practices were perceived as a threat to individuals’ independence and autonomy. Recommendations include the need to amend policy and practice for the development of a bespoke induction programme for each resident facilitated by a senior member of the care home staff working in partnership with individuals and families, in addition to the health and social care team, to support a more positive transition for new residents, relatives and care home staff.

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The Current Status and Problems with the Implementation of Interprofessional Education in Japan.

Journal of Research in Interprofessional Practice and Education ◽

10.22230/jripe.2015v5n1a181 ◽

2015 ◽

Vol 5 (1) ◽

Cited By ~ 4

Author(s):

Sachiko Ogawa ◽

Yoshinori Takahashi ◽

Misako Miyazaki

Keyword(s):

Community Development ◽

Interprofessional Education ◽

Social Care ◽

Current Status ◽

Future Research ◽

Clinical Settings ◽

Community Based ◽

Social Settings ◽

Health And Social Care ◽

Key Issues

Background: Although interprofessional education (IPE) has come to be considered essential in health and social care education programs, most IPE programs in Japan focus on clinical settings. However, following the 2011 Great East Japan Earthquake, IPE programs are considered essential for community development, especially in disaster-affected areas. To identify key issues for the development of IPE, we aimed to clarify the current status of IPE programs and problems in their implementation using an original questionnaire. Methods and Findings: The targets were 865 undergraduate courses that qualify students to take national registered health/social care examinations. Effective responses were received from 284 targets. Of these 284 respondents, 103 respondents had already implemented an IPE program and 181 respondents had not. Among the 103 respondents who had already implemented an IPE program, we found a tendency to collaborate with partners in clinical settings or in social settings. Furthermore, respondents who had implemented or were planning to implement an IPE program had difficulty with ‘interdisciplinary and/or extramural collaboration’ and ‘educational factors’. Conclusions: These difficulties could be considered barriers to developing effective IPE programs for community-based collaboration between health and social care professionals. Future research should investigate more specific solutions to these problems.

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The importance of a room with a view for older people with limited mobility

Quality in Ageing and Older Adults ◽

10.1108/qaoa-01-2018-0003 ◽

2018 ◽

Vol 19 (4) ◽

pp. 273-285 ◽

Cited By ~ 4

Author(s):

Charles Musselwhite

Keyword(s):

Older People ◽

Design Methodology ◽

Social Care ◽

Structured Interviews ◽

Content Type ◽

Limited Mobility ◽

Human Element ◽

Health And Social Care ◽

Vantage Points ◽

Practical Implications

Purpose The purpose of this paper is to examine how older people who are almost entirely housebound use a view from their window to make sense of the world and stay connected to the outside space that they cannot physically inhabit. Design/methodology/approach Semi-structured interviews with 42 individuals were carried out who were living at home, were relatively immobile and had an interesting view outside they liked from one or more of their windows. Findings The findings suggest that immobile older people enjoy watching a motion-full, changing, world going on outside of their own mobility and interact and create meaning and sense, relating themselves to the outside world. Practical implications Findings suggest that those working in health and social care must realise the importance of older people observing the outdoors and create situations where that is enabled and maintained through improving vantage points and potentially using technology. Originality/value This study builds and updates work by Rowles (1981) showing that preference for views from the window involves the immediate surveillance zone but also further afield. The view can be rural or urban but should include a human element from which older people can interact through storytelling. The view often contains different flows, between mundane and mystery and intrigue, and between expected and random.

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Seeing the collective: family arrangements for care at home for older people with dementia

Ageing and Society ◽

10.1017/s0144686x17001477 ◽

2018 ◽

Vol 39 (06) ◽

pp. 1200-1218 ◽

Cited By ~ 2

Author(s):

CHRISTINE CECI ◽

HOLLY SYMONDS BROWN ◽

MARY ELLEN PURKIS

Keyword(s):

Family Care ◽

High Volume ◽

Ethnographic Study ◽

Family Carers ◽

Care Giving ◽

People With Dementia ◽

Home Based ◽

Health And Social Care ◽

Care At Home ◽

At Home

ABSTRACTWith the predicted growth in the number of people with dementia living at home across the globe, the need for home-based care is expected to increase. As such, it will be primarily family carers who will provide this crucial support to family members. Designing appropriate support for family carers is thus essential to minimise risks to their health, to prevent premature institutionalisation or poor care for persons with dementia, as well as to sustain the effective functioning of health and social care systems. To date, the high volume of research related to care at home and acknowledged low impact of interventions suggests that a re-examination of the nature of care at home, and how we come to know about it, is necessary if we are to advance strategies that will contribute to better outcomes for families. This paper describes findings from an ethnographic study that was designed to support an analysis of the complexity and materiality of family care arrangements – that is, the significance of the actual physical, technological and institutional elements shaping care-giving situations. In this paper, we describe the arrangements made by one family to show the necessary collectivity of these arrangements, and the consequences of the formal care system's failure to respond to these.

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The vision of bedfast nursing home residents of their quality of life and the contribution of technological innovations in and around the bed

Journal of Enabling Technologies ◽

10.1108/jet-01-2018-0003 ◽

2018 ◽

Vol 12 (2) ◽

pp. 35-44

Author(s):

I. Martens ◽

H. Verbeek ◽

J. Aarts ◽

W.P.H. Bosems ◽

E. Felix ◽

...

Keyword(s):

Quality Of Life ◽

Nursing Home ◽

Short Form ◽

Nursing Home Residents ◽

Structured Interviews ◽

Nursing Home Population ◽

Social Contacts ◽

Content Type ◽

And Coping

Purpose Over 8 per cent of the Dutch nursing home population is bedfast, and this number is slowly increasing. The quality of life (QoL) of this population is lower than that of residents who are still mobile. Little research has been conducted on how to improve the QoL of this bedfast population, particularly through making technological adjustments to the bed and the direct surroundings. The purpose of this paper is to gain insight into the QoL of bedfast residents and how to improve this through technology. Design/methodology/approach A mixed-method multi-case study with thematic analysis was conducted in two nursing homes with seven participants based on semi-structured interviews and Short Form-12 questionnaire. Findings The major causes of the experienced low QoL were the limited opportunities for engaging in social contacts with others, and coping with the dependency on other people and having limited control. Participants suggested improvements of QoL through the application of modern communication technologies to engage in social contacts and to control the bed itself and environment around the bed. Practical implications The results may help improve the design of the bed and the direct environment in order to improve the QoL of bedfast nursing home residents. Originality/value The QoL of bedfast nursing home residents has not been studied before in relation to the bed itself and technological solutions that may help improve the QoL and level of control.

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Medicines reablement in intermediate health and social care services

Primary Health Care Research & Development ◽

10.1017/s1463423617000238 ◽

2017 ◽

Vol 18 (04) ◽

pp. 305-315

Author(s):

Kate Gerrish ◽

Sara Laker ◽

Sarah Wright ◽

Wendy Stainrod

Keyword(s):

Social Care ◽

Training Programme ◽

Care Staff ◽

Intermediate Care ◽

Structured Interviews ◽

Self Administration ◽

Frontline Staff ◽

Care Services ◽

Health And Social Care ◽

Pharmacy Technicians

Aim To evaluate a medicines reablement initiative involving health and social care, to include consideration of the training package, proportion of patients reabled successfully, and patient and staff perspectives of the service. Background Intermediate care services provide short-term intervention to support patients with chronic conditions transition from hospital to community-based services and involves maximising patients’ independence through reablement. The term ‘medicines reablement’ describes the process of rehabilitating patients to be independent with their medication. Methods Pharmacy technicians led the medicines reablement initiative. They delivered a competency-based training programme for frontline health and social care staff. They assessed and set goals with patients to facilitate independence in self-administration of their medication. The pharmacy technicians provided on-going support to staff helping patients to reable. They reassessed patients after six weeks to determine if medicines reablement had been successful or whether further input was needed. Data were collected by means of a questionnaire and semi-structured interviews with pharmacy technicians, frontline staff, managers, and patients. Findings Twenty per cent of patients discharged from hospital to intermediate care were assessed to be suitable for medicines reablement. Of these patients, 44% were successfully reabled and a further 25% benefited from the input of a pharmacy technician. Patients and staff were positive about medicines reablement, emphasising the importance of patients attaining independence for self-administration of medication. Although following training, health and social care staff felt confident in facilitating medicines reablement they valued on-going access to pharmacy technicians for timely support, help with problem solving, and advice throughout the reablement process. Conclusion Medicines reablement can lead to patients becoming independent with taking medication and contribute to staff satisfaction. Pharmacy technicians can play an important part in delivering medicines reablement training to frontline staff and overseeing the reablement process. Further research examining medicines reablement is needed to develop a stronger evidence base.

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The Virtuous Circle: A Grounded Theory Exploration of the Good Lives Model

Sexual Abuse ◽

10.1177/1079063218780730 ◽

2018 ◽

Vol 31 (8) ◽

pp. 908-929

Author(s):

Miriam Ryan ◽

Mathew McCauley ◽

Davina Walsh

Keyword(s):

Grounded Theory ◽

Constructivist Grounded Theory ◽

Future Research ◽

Theory Approach ◽

Structured Interviews ◽

Community Based ◽

Good Lives Model ◽

Sexual Offenses ◽

Grounded Theory Approach ◽

Good Lives

Sexual offenses evoke strong emotional responses and frequently elicit demands from society that offenders be indefinitely incarcerated or treated until they are deemed safe, which may impact the provision of therapeutic treatment for offenders. However, in recent years, there has been a proposal to move toward a positive, strengths-based treatment approach, namely the Good Lives Model (GLM). The present study used semi-structured interviews and a constructivist grounded theory approach to examine the experience of 13 men who were voluntarily engaging in or had completed a GLM community-based treatment program. A conceptual model emerged which outlines the process the men underwent, the factors they identified as crucial for change, and the perceived gains. The model extends previous work by exploring the process from the clients’ perspective. Implications for future research, prevention, and treatment are discussed.

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Association between environmental stimulation and apathy in nursing home residents with dementia

International Psychogeriatrics ◽

10.1017/s1041610219000589 ◽

2019 ◽

Vol 31 (08) ◽

pp. 1109-1120 ◽

Cited By ~ 2

Author(s):

Ying-Ling Jao ◽

Wen Liu ◽

Kristine Williams ◽

Habib Chaudhury ◽

Jyotsana Parajuli

Keyword(s):

Nursing Home ◽

Linear Models ◽

Rating Scale ◽

Nursing Home Residents ◽

Repeated Measure ◽

Future Research ◽

Video Observations ◽

Environmental Stimulation ◽

Multilevel Linear Models ◽

Environmental Feedback

ABSTRACTObjectives:Prior research and theories established the link between care environments and apathy. Yet, empirical evidence on how environmental stimulation impacts apathy is lacking. This study examined the association between environmental stimulation and apathy in nursing home residents with dementia.Design:This repeated-measure study analyzed 104 video observations of staff caregiver–resident interactions.Setting:12 nursing homes.Participants:63 unique staff caregiver–resident dyads that involved 42 caregivers and 44 residents with moderate to severe dementia.Measurements:Second-by-second behavioral coding using Noldus Observer software was conducted to assess apathy and environmental stimulation, using the Person-Environment Apathy Rating scale. The environment subscale includes six items: stimulation clarity, stimulation strength, stimulation specificity, interaction involvement, physical accessibility, and environmental feedback. The apathy subscale includes six items: facial expression, eye contact, physical engagement, purposeful activity, verbal tone, and verbal expression. Multilevel linear models were used for analysis.Results:Results showed that apathy was not associated with the overall quality of environmental stimulation but was significantly associated with stimulation specificity (coefficient = −2.23,p= 0.049). However, the association was not significant after controlling for resident characteristics (p= 0.082). In addition, higher levels of environmental feedback were associated with lower apathy levels (coefficient = −2.14,p= 0.001). The association remained significant after controlling for resident characteristics (coefficient = −1.65,p= 0.014).Conclusion:Findings reveal that when environmental stimulation is individually tailored and prompts engagement, residents are less apathetic. This study highlights the effect of environmental stimulation on apathy. Future research should explore interventions that modify environmental stimulation to reduce apathy and improve dementia care.

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