scholarly journals ‘We go for a homely feel … not the clinical dementia side’: care home managers’ experiences of supporting residents with dementia to orientate and navigate care environments

2020 ◽  
pp. 1-27
Author(s):  
Michelle Heward ◽  
Amanda Adams ◽  
Ben Hicks ◽  
Jan Wiener
Keyword(s):  
Social Inclusion ◽  
Care Home ◽  
Design Principles ◽  
Theory And Practice ◽  
Home Environments ◽  
Business Context ◽  
Telephone Interviews ◽  
Important Challenge ◽  
Past Experiences ◽  
Neuropsychological Theory

Abstract Living with dementia can adversely affect people's spatial (orientation and navigation) and reality (time, date and place) orientation, which can detrimentally impact on their sense of social inclusion and wellbeing. This is an important challenge to address within United Kingdom (UK) care homes where around 70 per cent of the residents are living with dementia or severe memory problems. Care home managers have some autonomy in decision-making that impacts on the daily functioning of residents and are key in enacting the orientation and navigation agenda within a care home environment. Yet a paucity of literature explores their understanding and experiences of this issue. Contributing to this knowledge gap, our exploratory study examined managers’ current practice of supporting residents with dementia to minimise disorientation and their knowledge of dementia-friendly design principles, guidelines and audit tools. Semi-structured telephone interviews with 12 UK care home managers were conducted. Questions started generally targeting residents’ orientation and navigation abilities, followed by specific questions to draw out strategies used to support residents. Thematic analysis identified three higher-order themes: aligning strategies with needs, intuitive learning and managing within the wider business context. The findings demonstrated that managers perceive dementia to impact on a person's spatial and reality orientation. Consequently, the strategies they chose to adopt were tailored towards alleviating both challenges. However, although managers were aware of some design principles, they frequently relied on intuitive learning and past experiences to inform their choice of interventions, reporting a lack of knowledge and/or time to seek out orientation-specific training and guidance, resulting in a low uptake of guidelines and audit tools in practice. This gap between theory and practice highlights a need for accessible guidelines that integrate strategies with neuropsychological theory, and appropriate training to improve orientation and navigation in care home environments. Managers, staff, business owners, architects and designers all play a key role in implementing orientation guidelines into practice and ensuring dementia-friendly care home environments for residents.

scholarly journals The role of the internet in testimony: the case of the ‘Forgotten Australians’

2014 ◽  
Vol 36 (8) ◽  
pp. 1151-1167 ◽  
Author(s):  
Barbara Adkins ◽  
Donna Hancox
Keyword(s):  
Web 2.0 ◽  
Social Inclusion ◽  
Church And State ◽  
The Internet ◽  
Case Examples ◽  
Abuse And Neglect ◽  
The Uk ◽  
Past Experiences ◽  
National Museum Of Australia

This article examines the case of the Forgotten Australians as an opportunity to examine the role of the internet in the presentation of testimony. ‘Forgotten Australians’ are a group who suffered abuse and neglect after being removed from their parents – either in Australia or in the UK – and placed in Church- and State-run institutions in Australia between 1930 and 1970. The campaign by this profoundly marginalized group coincided with the decade in which the opportunities of Web 2.0 were seen to be diffusing throughout different social groups, and were considered a tool for social inclusion. We outline a conceptual framework that positions the role of the internet as an environment in which the difficult relationships between painful past experiences and contemporary injunctions to remember them, are negotiated. We then apply this framework to the analysis of case examples of posts and interaction on websites with web 2.0 functionality: YouTube and the National Museum of Australia. The analysis points to commonalities and differences in the agency of the internet in these two contexts, arguing that in both cases the websites provided support for the development of a testimony-like narrative and the claiming, sharing and acknowledgement of loss.

scholarly journals Enhancing Service-Oriented Behaviors in an Asian Business Context: Lessons From a Pakistani Bank

2018 ◽  
Vol 2 (1) ◽  
pp. 73
Author(s):  
Rea Prouska
Keyword(s):  
Distributive Justice ◽  
Structural Equation ◽  
Customer Orientation ◽  
Organizational Outcomes ◽  
Theory And Practice ◽  
Service Organizations ◽  
Orientation Data ◽  
Business Context ◽  
Member Exchange ◽  
Service Oriented

This article examines how service organizations can enhance employees’ customer orientation, often exhibited through the display of service-oriented citizenship behaviors. The study, in this respect, quantitatively analyses the relationships between organizational distributive justice, leader-member exchange (LMX), and team-member exchange (TMX) on customer orientation. Data were gathered through a survey of 658 middle managers working in a Pakistani bank and were analyzed via full structural equation modelling. The findings reveal that organizational distributive justice, LMX, and TMX are key predictors of customer orientation. Specifically, the analysis suggests that the relationships between organizational distributive justice and LMX with customer orientation are mediated partially and fully, respectively, by TMX. Simultaneously, TMX partially mediates the relationship between organizational tenure and customer orientation. Our study contributes to both theory and practice of service organization functioning by signifying the importance of the organization’s fair distribution of rewards as well as it’s leader’s and co-worker’s behaviors in affecting organizationally desired employee behaviors and thereby, arguably, enabling positive organizational outcomes. Service organizations can, based on our findings, create a culture of service excellence by placing emphasis on specific elements at the organizational, leadership, and team level.

scholarly journals Adopt a Care Home: An intergenerational initiative bringing children into care homes

Dementia ◽  
2017 ◽  
Vol 18 (5) ◽  
pp. 1679-1694 ◽  
Author(s):  
Laura Di Bona ◽  
Sheila Kennedy ◽  
Gail Mountain
Keyword(s):  
Mixed Methods ◽  
Focus Groups ◽  
Social Inclusion ◽  
Care Home ◽  
Care Homes ◽  
Care Home Staff ◽  
Impact Data ◽  
School Care

Dementia friendly communities, in which people living with dementia actively participate and those around them are educated about dementia, may improve the wellbeing of those living with dementia and reduce the associated stigma. The Adopt a Care Home scheme aims to contribute towards this by teaching schoolchildren about dementia and linking them with people living with dementia in a local care home. Forty-one children, 10 people living with dementia and 8 school/care home staff participated in a mixed methods (questionnaires, observations, interviews and focus groups) evaluation to assess the scheme’s feasibility and impact. Data were analysed statistically and thematically. The scheme was successfully implemented, increased children’s dementia awareness and appeared enjoyable for most participants. Findings, therefore, demonstrate the scheme’s potential to contribute towards dementia friendly communities by increasing children’s knowledge and understanding of dementia and engaging people living with dementia in an enjoyable activity, increasing their social inclusion.

scholarly journals An evaluation of group reminiscence arts sessions for people with dementia living in care homes

Dementia ◽  
2018 ◽  
Vol 19 (3) ◽  
pp. 805-821 ◽  
Author(s):  
Frank Keating ◽  
Laura Cole ◽  
Robert Grant
Keyword(s):  
Quality Of Life ◽  
Social Inclusion ◽  
Care Home ◽  
Well Being ◽  
Care Homes ◽  
Primary Data ◽  
Evaluation Team ◽  
People With Dementia ◽  
Group Reminiscence

Dementia has been identified as one of the major challenges in the 21st Century. The detrimental effects of dementia can jeopardise personhood, thus person-centred interventions including reminiscence and arts practice have been recommended as tools to promote social inclusion and improve the quality of life. This study aimed to evaluate the effectiveness of group reminiscence arts sessions for people living with dementia in care homes (residential and nursing homes) using a comparative and time series design to collect data on quality of life. The intervention was conducted in six care homes in London over a period of 24 weeks and compared with six care homes not receiving the intervention (control). Dementia Care Mapping was used as the primary data collection instrument to measure positive behaviours and rate quality of life before, during and after group reminiscence arts sessions. The evaluation team observed the sessions at three-weekly intervals. Statistical modelling found that positive behaviours and quality of life of care home residents participating in group reminiscence arts sessions increased over the 24-week period. Well-being increased sharply during each session and plateaued at 50 minutes with a sustained positive effect after the sessions. On a longer timescale, well-being and quality of life increased slowly and steadily from one session to the next. The findings were statistically significant ( p < 0.001). The study concludes that group reminiscence arts sessions can have a positive and sustained impact on the quality of life of people with dementia. However, the evidence on the sustainability of the effect over time remains unknown. More research is needed to assess in much greater depth the association between quality of life and group reminiscence arts sessions.

scholarly journals Optimising Medication Use along Dementia Progression: Recommendations from a Qualitative Study

Healthcare ◽  
2021 ◽  
Vol 9 (8) ◽  
pp. 982
Author(s):  
Dalal Alsaeed ◽  
Mine Orlu ◽  
Felicity Smith
Keyword(s):  
Family Caregivers ◽  
Caregiver Burden ◽  
Information Needs ◽  
Care Home ◽  
Medication Use ◽  
Medicines Management ◽  
Home Setting ◽  
Face To Face ◽  
Care Home Staff ◽  
Telephone Interviews

Medicines management is known to be an integral part of the role of family caregivers; it also contributes to the burden and stress of caregivers’ experience. As dementia progresses, new challenges arise as a consequence, which negatively affects the ability of people living with dementia (PLWD) regarding practical decision making and may lead to a change of setting. The aim of this study is to identify and explore changes in medicines management and associated caregiver burden as dementia progresses. To examine medicines management and related issues across severities, a qualitative approach utilising face-to-face and telephone interviews with PLWD and their family caregivers in both the community and care-home setting in London was used. Follow-up interviews with family caregivers were also conducted to gain additional insight into change over time. Eleven family caregivers, ten PLWD, and eight care-home staff were interviewed in 2016. Findings identified how key changes along dementia progression affect medication use. These include changes to caregiver burden, respecting the PLWD’s autonomy and decline in capacity, scheduling and administration, choice of formulation, interactions with and between providers, and information needs. The findings assist in informing recommendations to optimise medication use and alleviate caregiver burden.

scholarly journals Some key points on the evaluation of public policies as related to the case of social policies

Ánfora ◽  
2017 ◽  
Vol 13 (21) ◽  
pp. 54-76
Author(s):  
Joan Subirats I
Keyword(s):  
Social Inclusion ◽  
Public Policies ◽  
A Priori ◽  
Theory And Practice ◽  
Social Policies ◽  
Public Action ◽  
Key Points ◽  
The Subject ◽  
Best Offer ◽  
Evaluation Of Public Policies

This paper pretends to go deeply into the reasons that would explainjustify this dissarrengment between theory and practice, and propose some ways of advancement. Today, the policies of social inclusion almost always have strong elements of innovation, of creative adaptation to heterogeneous situations, not standarized a priori, and precisely for this reason, the elements of the proccess are very significative. It should not be strange to us, -lt is advised- that the evaluations that have this elements of proccess in mind, can be notably more powerful and useful than those that are centered exclusively in the subject "results".In these 14 points for debate, a discusion is presented about the role and results of public action, that it is not situated today only in how to make things, but it demands instruments that let also answer the questions of what public instruments must deal with, and who can best offer these effective and efficient results to these social demands channeled through these representative powers.

Reminiscence and Life Review

2017 ◽  
Author(s):  
Nancy P. Kropf ◽  
Sherry M. Cummings
Keyword(s):  
Meaning Making ◽  
Life Review ◽  
Theory And Practice ◽  
Trauma Survivors ◽  
Cognitively Impaired ◽  
Older Individuals ◽  
Older Woman ◽  
Major Function ◽  
Past Experiences

Chapter 11, “Reminiscence and Life Review: Theory and Practice,” examines the history and theory of reminiscence and life review, outlining their major tenets and principles. A major function of these two approaches is to foster a sense of meaning within the lives of older adults. Various types of reminiscence and life review are highlighted with the connection to meaning-making activities of older individuals. The therapeutic function of life review, which enables individuals to reconcile past experiences that have left pain or feelings of incompleteness, is discussed, and differing types of life review are described. The primary functions of reminiscence are also examined, as are the practice applications of both approaches. Additionally, particular populations for which these approaches have been successfully implemented are highlighted, including trauma survivors and the cognitively impaired. A case study of life review with an older woman experiencing depression following the loss of a son is provided.

scholarly journals Setting Priorities to Inform Assessment of Care Homes’ Readiness to Participate in Healthcare Innovation: A Systematic Mapping Review and Consensus Process

2020 ◽  
Vol 17 (3) ◽  
pp. 987 ◽  
Author(s):  
Frances Bunn ◽  
Claire Goodman ◽  
Kirsten Corazzini ◽  
Rachel Sharpe ◽  
Melanie Handley ◽  
...  
Keyword(s):  
Organizational Context ◽  
Care Home ◽  
Theory And Practice ◽  
Care Homes ◽  
Successful Implementation ◽  
Systematic Mapping ◽  
Organisational Context ◽  
Care Home Staff ◽  
Mapping Review ◽  
Systematic Mapping Review

Organisational context is known to impact on the successful implementation of healthcare initiatives in care homes. We undertook a systematic mapping review to examine whether researchers have considered organisational context when planning, conducting, and reporting the implementation of healthcare innovations in care homes. Review data were mapped against the Alberta Context Tool, which was designed to assess organizational context in care homes. The review included 56 papers. No studies involved a systematic assessment of organisational context prior to implementation, but many provided post hoc explanations of how organisational context affected the success or otherwise of the innovation. Factors identified to explain a lack of success included poor senior staff engagement, non-alignment with care home culture, limited staff capacity to engage, and low levels of participation from health professionals such as general practitioners (GPs). Thirty-five stakeholders participated in workshops to discuss findings and develop questions for assessing care home readiness to participate in innovations. Ten questions were developed to initiate conversations between innovators and care home staff to support research and implementation. This framework can help researchers initiate discussions about health-related innovation. This will begin to address the gap between implementation theory and practice.

scholarly journals DEVELOPING INCLUSIVE CARE HOME ENVIRONMENTS FOR OLDER LGBT PEOPLE: A PILOT SCHEME IN ENGLAND

2017 ◽  
Vol 1 (suppl_1) ◽  
pp. 626-626
Author(s):  
P. Willis ◽  
T. Hafford-Letchfield ◽  
K. Almack ◽  
P. Simpson
Keyword(s):  
Care Home ◽  
Home Environments ◽  
Pilot Scheme ◽  
Lgbt People
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