Characteristics of Aggressive Subjects in Australian (Melbourne) Nursing Homes

2000 ◽  
Vol 12 (2) ◽  
pp. 145-161 ◽  
Author(s):  
Ajit Shah ◽  
Edmond Chiu ◽  
David Ames ◽  
Susan Harrigan ◽  
Dean McKenzie
Keyword(s):  
Nursing Homes ◽  
Aggressive Behavior ◽  
Psychotropic Drugs ◽  
Rating Scale ◽  
Physical Restraint ◽  
Nursing Home Residents ◽  
The Elderly ◽  
Educational Programs ◽  
Homes For The Elderly ◽  
Younger Age

Background: Aggressive behavior is common in nursing homes for the elderly. It causes distress to carers and can lead to hospitalization, overmedication, and physical restraint. Method: A 6-month prospective study examining the characteristics of aggressive subjects in 11 nursing homes in Melbourne using validated, reliable instruments. Results: During the study, 121 and 143 subjects were rated aggressive on the Rating Scale for Aggressive Behavior in the Elderly and the Staff Observation Aggression Scale, respectively. Aggressive behavior was associated with younger age, men, subsequent mortality, and prescription of psychotropic drugs including neuroleptics, antidepressants, and benzodiazepines. Conclusions: Educational programs in the use of psychotropic drugs directed at staff involved in the care of nursing home residents may be of value because these drugs have modest efficacy, have significant side effects, and may simply sedate the patient rather than treat aggressive behavior.

scholarly journals Impact of educational intervention on prescribing inappropriate medication to elderly nursing homes residents

2015 ◽  
Vol 143 (3-4) ◽  
pp. 174-179 ◽  
Author(s):  
Darko Ilic ◽  
Zoran Bukumiric ◽  
Slobodan Jankovic
Keyword(s):  
Nursing Homes ◽  
Educational Intervention ◽  
Inappropriate Prescribing ◽  
Nursing Home Residents ◽  
The Elderly ◽  
Inappropriate Drugs ◽  
Start Criteria ◽  
Homes For The Elderly ◽  
Stopp Criteria ◽  
Significant Difference

Introduction. Problems with polypharmacy, adverse drug reactions and non-adherence are especially frequent among elderly nursing home residents. Objective. The aim of our study was to evaluate effectiveness of a specific form of staff education on appropriateness of prescribing in a cluster of nursing homes for the elderly. Methods. The study was designed as before-and-after trial of educational intervention on appropriateness of prescribing in nursing homes for the elderly. In total 20 nursing homes located in Belgrade, Serbia were included in the study with 104 elderly residents and 27 caring physicians. Appropriateness of prescribing was checked against Beers, START and STOPP criteria, before and 6 months after the intervention. Results. There were 349 inappropriately prescribed drugs according to Beers criteria before the intervention and 37 drugs six months after the intervention. According to STOPP criteria there were 70 drugs inappropriately prescribed before the intervention, and 20 drugs 6 months after. When both criteria are taken together, there is a significant difference between the average number of inappropriate drugs per patient before (3.4?0.5) and after (0.6?0.7) educational intervention (t=38.902; p<0.001). Finally, before the intervention 143 appropriate drugs were omitted according to START criteria, while 6 months after the intervention there were only 67 omissions. Conclusion. Simple, but well targeted educational interventions may improve polypharmacy and decrease inappropriate prescribing rate, contributing to a better care of elderly patients in nursing homes.

Violence and Aggression in the Elderly

2017 ◽  
Author(s):  
Ghulam Mustafa Surti ◽  
Laura Stanton ◽  
Robert Kohn
Keyword(s):  
Nursing Homes ◽  
Violent Behavior ◽  
Physical Restraint ◽  
Nursing Home Residents ◽  
The Elderly ◽  
Home Healthcare ◽  
Pharmacological Interventions ◽  
Term Care ◽  
Physical Injuries

In nursing homes, aggression is seen in almost 32% of residents. Often, there are medical causes associated with delirium to account for such aggressive behaviors. This chapter discusses the incidence of and issues related to resident-to-staff and resident-to-resident aggression involving patients with major neurocognitive disorders in long-term care settings. Often such aggression results in physical injuries to staff. Resident-to-staff aggression most commonly occurs during direct caregiving. Resident-to-resident assault is not uncommon and has been categorized into 13 major subtypes. Use of physical restraint and pharmacological interventions in response to agitation and aggression in nursing homes carries liability due to risk of injury. The chapter also addresses sexuality of elderly nursing home residents, federal regulations mandating the allowance of expression of sexual needs of residents, and barriers that can impede expression of sexuality by residents. The chapter concludes with a discussion of elder-to-caregiver aggression in the community, including violent behavior toward family and caregivers employed by home healthcare agencies.

scholarly journals The Difficult Balance between Ensuring the Right of Nursing Home Residents to Communication and Their Safety

2021 ◽  
Vol 18 (5) ◽  
pp. 2484
Author(s):  
Matteo Bolcato ◽  
Marco Trabucco Aurilio ◽  
Giulio Di Mizio ◽  
Andrea Piccioni ◽  
Alessandro Feola ◽  
...  
Keyword(s):  
Nursing Homes ◽  
Nursing Home Residents ◽  
The Elderly ◽  
Prevention Measures ◽  
Social And Emotional ◽  
Homes For The Elderly ◽  
The Social ◽  
The Right ◽  
Council Of Ministers ◽  
Emotional Value

The COVID-19 epidemic has had a profound impact on healthcare systems worldwide. The number of infections in nursing homes for the elderly particularly is significantly high, with a high mortality rate as a result. In order to contain infection risks for both residents and employees of such facilities, the Italian government passed emergency legislation during the initial stages of the pandemic to restrict outside visitor access. On 30 November 2020, the Italian President of the Council of Ministers issued a new decree recognizing the social and emotional value of visits to patients from family and friends. In addition, it indicated prevention measures for the purposes of containing the infection risk within nursing homes for the elderly. This article comments on these new legislative provisions from the medicolegal perspective, providing indications that can be used in clinical practice.

The Role of Nursing Homes Architectural Design in Mitigating the Risk of COVID-19 Pandemics: The Case of Slovenia

2022 ◽  
Vol 8 (1) ◽  
pp. 51-66
Author(s):  
Vesna Žegarac Leskovar ◽  
Vanja Skalicky Klemenčič
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Older People ◽  
Architectural Design ◽  
Nursing Home Residents ◽  
The Elderly ◽  
Evaluation Tool ◽  
Negative Effect ◽  
Disproportionate Number ◽  
Role Of Nursing

Currently, many older people live in institutions for various social and health reasons. In Slovenia, this proportion is almost 5% of the population aged 65 and over. In the COVID-19 pandemic, the elderly proved to be the most vulnerable social group, as they are exposed to a number of comorbidities that increase the risk of mortality. At that time, nursing homes represented one of the most critical types of housing, as seen from a disproportionate number of infections and deaths among nursing home residents worldwide, including Slovenia. During the emergency, a number of safety protocols had to be followed to prevent the spread of infection. Unfortunately, it turned out that while the safety measures protected the nursing home residents, they also had a negative effect on their mental health, mainly due to isolation and social distancing. It follows that especially in times of epidemics of infectious respiratory diseases, the quality of life in nursing homes requires special attention. In this context, it is also necessary to consider whether and how an appropriate architectural design can help mitigating the spread of infections, while at the same time enable older people to live in dignity and with a minimum of social exclusion. To this end, the present study examined 97 nursing homes in Slovenia, analysing the number of infections in nursing homes and their correlation with the degree of infection in the corresponding region in Slovenia. Additionally, 2 nursing homes were studied in more detail with the use of newly developed “Safe and Connected” evaluation tool, analysing the architectural features of each building. The advantages identified so far include living in smaller units, single rooms with balconies, the possibility of using green open spaces and the use of an adequate ventilation. Conclusions of this study are useful for further consideration of design of new nursing homes and the refurbishment of existing ones.

scholarly journals Load on the Low Back of Care Workers in Nursing Homes for the Elderly

2005 ◽  
Vol 47 (4) ◽  
pp. 131-138 ◽  
Author(s):  
Shinji Kumagai ◽  
Hidetsugu Tainaka ◽  
Keiko Miyajima ◽  
Naoko Miyano ◽  
Junko Kosaka ◽  
...  
Keyword(s):  
Nursing Homes ◽  
The Elderly ◽  
Low Back ◽  
Homes For The Elderly ◽  
Care Workers

scholarly journals REVEALING FEATURES OF THE ARCHITECTURAL TYPOLOGY OF NURSING HOMES

2020 ◽  
pp. 33-39
Author(s):  
I. Zhdanova ◽  
A. Kuznecova ◽  
P. Mihaylina
Keyword(s):  
Social Interaction ◽  
Nursing Homes ◽  
Functional Organization ◽  
The Elderly ◽  
Comfort Level ◽  
Functional Improvement ◽  
Foreign Experience ◽  
Homes For The Elderly ◽  
Care Health

The article focuses on the study of modern approaches in the typology of nursing homes. Global data on the increase in the share of older people in the total population are presented. In addition, Rosstat data confirm the relevance of studying this topic. Examples of foreign experience in designing and building homes for the elderly show the developed functional composition of the premises, along with the function of accommodation and care - health care, leisure, trade, sports, food and multifunctional spaces to ensure social interaction of different groups of the population. The research reveals a method of "functional improvement" aimed at developing optimal functional interactions between public and residential spaces. A concept project for a "dynamic" scheme has been developed, showing the inclusion of residential blocks in a multifunctional complex. The chosen functional organization allows the creation of private spaces for residents of retirement age and walking areas for visitors to the complex. It is determined that in Russia it is necessary to implement modern approaches adapted to Russian conditions, based on foreign experience. This will enhance the consumer quality of the facility and the comfort level of the elderly, which will undoubtedly provide social interaction through the introduction of educational and leisure functions, as well as improve the ecological and aesthetic qualities of the environment.

scholarly journals Vaccine effectiveness for influenza in the elderly in welfare nursing homes during an influenza A (H3N2) epidemic

2000 ◽  
Vol 125 (2) ◽  
pp. 393-397 ◽  
Author(s):  
Y. DEGUCHI ◽  
Y. TAKASUGI ◽  
K. NISHIMURA
Keyword(s):  
Nursing Homes ◽  
Influenza Vaccine ◽  
Influenza A ◽  
Hospital Admissions ◽  
Influenza Virus Infection ◽  
Severe Infection ◽  
The Elderly ◽  
Trivalent Influenza Vaccine ◽  
Homes For The Elderly ◽  
Vaccine Effect

Influenza vaccine effect on the occurrence and severity of influenza virus infection in a population residing in nursing homes for the elderly was studied as a cohort study during an influenza A (H3N2) epidemic in Japan. Of 22462 individuals living in 301 welfare nursing homes, 10739 voluntarily received inactivated, sub-unit trivalent influenza vaccine in a programme supported by the Osaka Prefectural Government. There were statistically significantly fewer cases of influenza, hospital admissions due to severe infection, and deaths due to influenza in the vaccinated cohort compared to the unvaccinated controls. No serious adverse reactions to vaccination were recorded. Thus influenza vaccination is effective for preventing influenza disease in persons aged 65 years and over, and should be an integral part of the care of this population residing in nursing homes.

scholarly journals The opportunities of biodynamic lighting in homes for the elderly

2018 ◽  
Vol 4 (1) ◽  
pp. 123-126
Author(s):  
Herbert Plischke ◽  
Matthäus Linek ◽  
Johannes Zauner
Keyword(s):  
Nursing Homes ◽  
Nursing Staff ◽  
The Elderly ◽  
Design Guidelines ◽  
Visual Effects ◽  
Homes For The Elderly ◽  
Improve Health Status ◽  
Lighting Systems ◽  
Photometric Measurements ◽  
Dynamic Lighting

AbstractLight is an important factor for regulation of circadian, endocrine and metabolic processes in the human body. Through this light has a positive effect on cognition, on the stabilization of circadian rhythms and for general wellbeing. These effects are described as non-visual effects of light. Many dynamic lighting systems are already in use in workplaces and living spaces, aiming to address visual and also non-visual effects. In Europe and US the term “Human Centric Lighting” or abbreviated "HCL” was introduced, as a scientifically agreed concept on how to plan non-visual effects of artificial light in synergy with natural light. Older people, especially with neurological and psychological diseases can especially benefit from this lighting concept. However, in order to achieve the desired non-visual effects, certain conditions should be fulfilled. In Germany the DIN SPEC 67600 is a guideline for the design of biologically effective illumination, with examples for senior- and nursing homes. A goal of this evaluation was to check whether the recommendations of the specification DIN SPEC 67600 in three nursing homes were met and another goal was if effectiveness of the lighting on residents and nursing staff can be determined. Photometric measurements were taken and subjective perceived non-visual effects of light were surveyed using a questionnaire. Results: Although none of the three facilities met all the criteria of the DIN SPEC 67600 guidelines, non-visual lighting effects on residents and nursing staff could be detected. The results also indicate that careful attention should be paid on maintenance of HCL systems. The correct use of HCL solutions in homes for the elderly has opportunities to improve health status if the system is properly designed and maintained. Therefore next to the existing (non-visual) metrics and HCL design guidelines, guidelines for maintaining and regular inspections should be established.

Use of physical restraint in nursing homes in Spain and relation with resident characteristics: a retrospective multi-centre cohort study with a self-organised maps approach

2019 ◽  
Vol 40 (11) ◽  
pp. 2410-2428
Author(s):  
José-María Blasco ◽  
Celedonia Igual-Camacho ◽  
Francisco-José Pérez-Moltó ◽  
Pablo García-Molina ◽  
Juan Gómez-Salgado ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Nursing Homes ◽  
Visual Analysis ◽  
Physical Restraint ◽  
Nursing Home Residents ◽  
Developed Countries ◽  
Physical Restraints ◽  
Rating Systems ◽  
Relevant Role

AbstractThis is a retrospective cohort study based on data from five nursing homes which aims to appraise how physical and cognitive characteristics of nursing home residents were associated with the use of restraints, and to provide information on their prevalence in Spain. The goal was to assess, in a visual way, the possible interactions between the nursing homes residents’ characteristics and their association with the use of restraints. Motivation, risk factors, characteristics of the residents analysed by validated rating systems that assess mobility, level of dependence, cognitive condition and nutritional status, and their association with the use of restraints, were described by means of linear and non-linear multivariate approaches in the form of self-organised maps. Findings showed that the prevalence of restraints was high when compared to other developed countries. The visual analysis reinforced the knowledge that a greater impairment was associated with the use of restraints and vice versa. However, the residents’ characteristics were not always associated with the use of restraints. Subjective factors seem to play a relevant role in decision-making, so it is important to assess risk factors continuously and determine the actual need for the use of restraints from an individual perspective by basing the criteria on specific objectives, and on consistent, reproducible and reliable methods. Initiatives to minimise these subjective factors should be promoted. Likewise, a clear definition of physical restraints should be offered at each centre. In addition, effective legislation that clearly states the need, alternatives and motivation for the use of restraints is needed.

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