Recording care time in nursing homes: development and validation of the “RUD-FOCA” (Resource Utilization in Dementia – Formal Care)

2010 ◽  
Vol 22 (8) ◽  
pp. 1291-1300 ◽  
Author(s):  
Katharina Luttenberger ◽  
Elmar Graessel
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Activities Of Daily Living ◽  
Resource Utilization ◽  
Daily Living ◽  
Direct Care ◽  
Formal Care ◽  
Retest Reliability ◽  
Dementia Patients ◽  
Home Recording

ABSTRACTBackground: Currently there is no standardized procedure for recording direct care time of dementia patients in a nursing home. Recording the direct care time, however, provides an important component of both cost estimates for time-dependent reimbursement of nursing activities and for recording the degree of dependency as an outcome measure for the efficiency of new treatment methods for dementia patients. The purpose of this study is thus to develop and validate the “RUD-FOCA” (Resource Utilization in Dementia – Formal Care), based on the RUD lite, as a standardized tool to measure the direct care time actually required in the nursing home.Methods: Based on four hypotheses, construct validity was tested within a randomized controlled trial in a sample of 148 residents in six German nursing homes. The RUD-FOCA records the care time in three areas: activities of daily living (ADL), instrumental activities of daily living (IADL) and supervision. For validation, the residents’ capabilities were examined using the Barthel Index, the Nurses’ Observation Scale on Geriatric Patients (NOSGER), the Alzheimer Disease Assessment Scale (ADAS), the Erlangen Test on Activities of Daily Living (E-ADL) and the Mini-mental State Examination (MMSE). The hypotheses assume relationships between the time required for care in the three areas and the limitations involved in these areas. The retest reliability was also determined.Results: ADL care accounts for two-thirds of total care time in the homes. The hypotheses which refer to total time, ADL and supervision are supported by differentiated correlation profiles. The IADL hypothesis is not supported owing to even, low correlations. The retest reliability was r = 0.76 for the entire care time.Conclusions: Overall time and the times for ADL care and supervision can be considered valid estimates. The validity is lowest for recording IADL times. Thus, the RUD-FOCA is suitable as an instrument to determine the direct care time in the nursing home. Recording IADL times should be improved by detailed operationalization.

Predicting Nursing Home Length of Stay and Outcome with a Resource-Based Classification System

1996 ◽  
Vol 12 (1) ◽  
pp. 72-79 ◽  
Author(s):  
Gunnar Ljunggren ◽  
Lena Brandt
Keyword(s):  
Health Care ◽  
Nursing Home ◽  
Length Of Stay ◽  
Activities Of Daily Living ◽  
Resource Utilization ◽  
Classification System ◽  
Daily Living ◽  
Prospective Payment System ◽  
Case Mix ◽  
Clinical Value

AbstractThe anticipated demographic changes with an increasing number of elderly force us to plan and use health care resources more efficiently. In this study we have used the components of a case-mix measure for nursing homes; the Resource Utilization Groups (RUG-II), to predict length of stay (LOS) and outcome in geriatric institutions. We have shown that the RUG categories and an activities of daily living (ADL) index differ significantly in both respects, but that other variables might be of more clinical value when establishing a prospective payment system, based on LOS in geriatric institutions.

Nutritional status, activities of daily living and physical activity in aged residents in 10 German nursing homes*

2007 ◽  
Vol 32 (03) ◽  
Author(s):  
J Bai ◽  
S Lesser ◽  
S Paker-Eichelkraut ◽  
S Overzier ◽  
S Strathmann ◽  
...  
Keyword(s):  
Physical Activity ◽  
Nursing Homes ◽  
Nutritional Status ◽  
Activities Of Daily Living ◽  
Daily Living

How Important Are Choice, Autonomy, and Relationships in Predicting the Quality of Life of Nursing Home Residents?

2021 ◽  
pp. 073346482098397
Author(s):  
Marita McCabe ◽  
Jessica Byers ◽  
Lucy Busija ◽  
David Mellor ◽  
Michelle Bennett ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Nursing Home ◽  
Nursing Homes ◽  
Social Relationships ◽  
Daily Living ◽  
Nursing Home Residents ◽  
Predictor Variables ◽  
Social Connections ◽  
Hierarchical Regression

Older people face major challenges when they move into nursing homes, particularly in relation to independence and their ability to influence their activities of daily living (ADLs). This study evaluated the contribution of resident choice, as well as the staff–resident relationship, to promoting resident quality of life (QoL). A total of 604 residents from 33 nursing homes in Australia completed measures of QoL, perceived levels of choice in various ADLs, and the staff–resident relationship. A hierarchical regression demonstrated that the predictor variables accounted for 25% of the variance in QoL. Two of the four predictor variables (resident choice over socializing and the staff–resident relationship) significantly contributed to resident QoL. These findings reinforce the important contribution of autonomy and social relationships to resident QoL. Nursing home staff have a key role to play in supporting resident autonomy as a means of building residents’ chosen social connections, and thereby promoting QoL.

scholarly journals Automated Classification of Normal Control and Early-Stage Dementia Based on Activities of Daily Living (ADL) Data Acquired from Smart Home Environment

2021 ◽  
Vol 18 (24) ◽  
pp. 13235
Author(s):  
Lee-Nam Kwon ◽  
Dong-Hun Yang ◽  
Myung-Gwon Hwang ◽  
Soo-Jin Lim ◽  
Young-Kuk Kim ◽  
...  
Keyword(s):  
Activities Of Daily Living ◽  
Normal Control ◽  
Daily Living ◽  
Smart Home ◽  
Early Stage ◽  
Machine Learning Techniques ◽  
Evaluation Tool ◽  
Dementia Patients ◽  
Diagnosis Of Dementia

With the global trend toward an aging population, the increasing number of dementia patients and elderly living alone has emerged as a serious social issue in South Korea. The assessment of activities of daily living (ADL) is essential for diagnosing dementia. However, since the assessment is based on the ADL questionnaire, it relies on subjective judgment and lacks objectivity. Seven healthy seniors and six with early-stage dementia participated in the study to obtain ADL data. The derived ADL features were generated by smart home sensors. Statistical methods and machine learning techniques were employed to develop a model for auto-classifying the normal controls and early-stage dementia patients. The proposed approach verified the developed model as an objective ADL evaluation tool for the diagnosis of dementia. A random forest algorithm was used to compare a personalized model and a non-personalized model. The comparison result verified that the accuracy (91.20%) of the personalized model was higher than that (84.54%) of the non-personalized model. This indicates that the cognitive ability-based personalization showed encouraging performance in the classification of normal control and early-stage dementia and it is expected that the findings of this study will serve as important basic data for the objective diagnosis of dementia.

Reliability and Validity of Turkish Myasthenia Gravis-Activities of Daily Living Scale

2020 ◽  
pp. 153944922096107
Author(s):  
Ecem Karanfil ◽  
Yeliz Salcı ◽  
Ayla Fil-Balkan ◽  
Can Ebru Bekircan-Kurt ◽  
Sevim Erdem Özdamar ◽  
...  
Keyword(s):  
Construct Validity ◽  
Myasthenia Gravis ◽  
Activities Of Daily Living ◽  
Daily Living ◽  
Intraclass Correlation ◽  
Reliability And Validity ◽  
Life Questionnaire ◽  
Good Test ◽  
Retest Reliability ◽  
Test Retest Reliability

Linguistic, reliable, and valid secondary efficacy measures are important in clinical settings and studies. The aim of the study is to report test–retest reliability and construct validity of Turkish version of Myasthenia Gravis-Activities of Daily Living Scale (MG-ADL-T) in Myasthenia Gravis (MG) patients. Fifty-two ocular and generalized individuals with MG, applying to rehabilitation center, were included in the study. MG-ADL-T, MG quality-of-life questionnaire (MG-QoL), MG composite (MGC), quantitative MG score (QMGS), and pulmonary function test were administered. Reliability was assessed with intraclass correlation coefficient (ICC) and Cronbach’s alpha. Spearman correlation test and receiver operating characteristic (ROC) analysis were performed for construct validity. MG-ADL-T had fair internal consistency (Cronbach’s α = .67), excellent test–retest reliability (ICC = 0.96) and moderate construct validity (MG-QoL, r = 0.59; QMGS, r = .58; MGC, r = .68). MG-ADL, a unique scale that evaluates activities of daily living (ADL), has good test–retest reliability and construct validity in Turkish MG patients.

scholarly journals ORGANIZATIONAL CHARACTERISTICS OF HIGHLY PERSON-CENTERED UNITS IN SWEDISH NURSING HOME

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S700-S701
Author(s):  
Anders B Sköldunger ◽  
Annica Backman
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Organizational Context ◽  
Organizational Characteristics ◽  
Direct Care ◽  
Cross Sectional ◽  
Care Services ◽  
Individualized Care ◽  
Private And Public ◽  
Institutional Model

Abstract The movement from an institutional model of care towards a person-centred care as the gold standard of practice is now guiding the provision of care services in nursing homes around the world. The organizational context of care has been described as a determining factor for the extent to which staff can offer person-centred care. However, few studies have empirically investigated which factors that defines nursing home units as being person-centred. Providing information about organizational characteristics would therefor provide insight into an organizational context with capacity to enhance a person-centred care. Thus, the aim was to explore factors of nursing homes with high vs. low person-centred care with focus on organizational variables. The study was based on a cross-sectional national survey, and data on 4831 residents, 3605 staff, and facility variables were collected in 2014. Descriptive statistics and regression modelling were used to analyze the data. The preliminary results showed that characteristics of highly person-centred units were; dementia specific units and units with fewer number of beds. No significant differences were seen between private and public nursing homes in terms of degree of person-centred care. Person-centred units was characterized by managers supporting staff to provide individualized care based on the resident’s needs, as well as staff receiving supervision of a reg. nurse in the direct care. These findings can be seen as facilitators ’ for person-centred care, suggesting several contextual and organizational elements of significance for enhancing person-centred practice.

Predictors of the Level of Care assigned to New Nursing Home Residents

1985 ◽  
Vol 4 (1) ◽  
pp. 38-46 ◽  
Author(s):  
Peter R. Grant
Keyword(s):  
Nursing Home ◽  
Activities Of Daily Living ◽  
Behavioral Problems ◽  
Daily Living ◽  
Stressful Life Event ◽  
Nursing Home Residents ◽  
Level Of Care ◽  
Admission Data ◽  
Major Predictor ◽  
High Level

ABSTRACTAdmission data from 159 residents of four Saskatchewan nursing homes were analysed in order to identify predictors of level of care. Multiple regression analyses showed that a high level of care was assigned to those who were unable to perform various activities of daily living, those who had behavioral problems, and those who had recently experienced a stressful life event; with these variables and a nursing home variable explaining 47.2% of the variance. Appropriately, the most important predictor is activities of daily living. The other major predictor is behavioral problems which, the results suggest, are caused by either an organic psychotic disorder or a high level of stress. It is recommended that, following admission, new residents with behavioral problems caused by stress should be the recipients of programs designed to help them cope with this stress and mitigate their behavioral problems. Then, they should be reassessed and, where appropriate, reassigned to a lower level of care.

The Reliability and Validity of the Safety Assessment of Function and the Environment for Rehabilitation (SAFER Tool)

1998 ◽  
Vol 61 (3) ◽  
pp. 127-132 ◽  
Author(s):  
Lori Letts ◽  
Sheri Scott ◽  
Jill Burtney ◽  
Linda Marshall ◽  
Martha McKean
Keyword(s):  
Cognitive Impairment ◽  
Activities Of Daily Living ◽  
Daily Living ◽  
Safety Assessment ◽  
Reliability And Validity ◽  
Predictive Ability ◽  
Retest Reliability ◽  
Functional Activities ◽  
Limited Variation ◽  
Test Retest Reliability

The Safety Assessment of Function and the Environment for Rehabilitation (SAFER Too)) was developed to assess people's abilities to manage functional activities safety within their homes. The results of a study to evaluate the instruments inter-rater and test-retest reliability and construct validity are reported. Reliability was evaluated using kappa for each dichotomous item. For inter-rater reliability, 59 of 66 items had acceptable reliability. For test-retest reliability, 63 of 70 items had acceptable kappa scores. For items where kappa could not be calculated because of limited variation between raters, percentage agreement was over 80%. For validity, higher SAFER Tool scores (that is, more safety problems) were hypothesised to be associated with less independence in activities of daily living (ADL) and instrumental activities of daily living (IADL) and more cognitive impairment. The correlation between SAFER Tool scores and cognitive impairment supported this hypothesis. The results of the correlations with ADL and IADL scores were less clear. This could be attributed to caregivers' assistance with activities which might have reduced risk, and generally limited variation in ADL scores. The reliability results from this study are positive. Further research to assure the SAFER Tools validity and predictive ability are needed.

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