Perceptions of family and staff on the role of the environment in long-term care homes for people with dementia

2012 ◽  
Vol 24 (5) ◽  
pp. 753-765 ◽  
Author(s):  
Linda J. Garcia ◽  
Michèle Hébert ◽  
Jean Kozak ◽  
Isabelle Sénécal ◽  
Susan E. Slaughter ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Focus Groups ◽  
Long Term Care ◽  
Disruptive Behaviors ◽  
Well Being ◽  
Care Homes ◽  
Term Care ◽  
Staff Members

ABSTRACTBackground: Disruptive behaviors are frequent and often the first predictor of institutionalization. The goal of this multi-center study was to explore the perceptions of family and staff members on the potential contribution of environmental factors that influence disruptive behaviors and quality of life of residents with dementia living in long-term care homes.Methods: Data were collected using 15 nominal focus groups with 45 family and 59 staff members from eight care units. Groups discussed and created lists of factors that could either reduce disruptive behaviors and facilitate quality of life or encourage disruptive behaviors and impede the quality of life of residents. Then each participant individually selected the nine most important facilitators and obstacles. Themes were identified from the lists of data and operational categories and definitions were developed for independent coding by four researchers.Results: Participants from both family and staff nominal focus groups highlighted facility, staffing, and resident factors to consider when creating optimal environments. Human environments were perceived to be more important than physical environments and flexibility was judged to be essential. Noise was identified as one of the most important factors influencing behavior and quality of life of residents.Conclusion: Specialized physical design features can be useful for maintaining quality of life and reducing disruptive behaviors, but they are not sufficient. Although they can ease some of the anxieties and set the stage for social interactions, individuals who make up the human environment are just as important in promoting well-being among residents.

scholarly journals END-OF-LIFE CARE PREFERENCES AND WELL-BEING IN LONG-TERM CARE RESIDENTS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S669-S669
Author(s):  
Kelly Shryock ◽  
Jacinta Dickens ◽  
Anisha Thomas ◽  
Suzanne Meeks
Keyword(s):  
Quality Of Life ◽  
Positive Affect ◽  
End Of Life ◽  
End Of Life Care ◽  
Long Term Care ◽  
Well Being ◽  
Life Care ◽  
Term Care

Abstract Research on end-of-life care in nursing homes comes largely from the viewpoint of staff or family members. We examined patient perspectives on end-of-life care, preferences for care, and quality of life in long-term care settings. We hypothesized that fulfillment of the Self Determination Theory (SDT) needs of autonomy, competence, and relatedness would be related to better well-being and that the degree to which end-of-life care preferences are seen as possible in the setting would be related to SDT need fulfillment and well-being. Preliminary data, collected from older individuals at the end of life (over 55, presence of significant chronic disease, in long term care setting) (n= 72), demonstrated that autonomy, competence, and relatedness measures were moderately and significantly correlated with well-being as measured by life satisfaction, higher positive affect, lower negative affect, and overall quality of life measures The degree to which residents believed that their end-of-life care preferences could be honored in the setting was also significantly correlated with autonomy, competence, relatedness, positive affect, and psychological quality of life. These results are consistent with SDT and suggest that if long term care settings can promote autonomy, connection, and competence in making end of life decisions, possibly by discovering and fulfilling preferences for end of life care, individuals who end their lives on those settings have potential for greater satisfaction and happiness. These results suggest that SDT is a useful framework for ongoing research on how to improve the end of life experiences of older adults in long term care.

scholarly journals THE IMPACT OF A PARO INTERVENTION ON DEPRESSION AND WELL-BEING IN OLDER ADULTS WITH DEPRESSION

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S341-S341
Author(s):  
Shu-Chuan Chen ◽  
Wendy Moyle ◽  
Cindy Jones
Keyword(s):  
Quality Of Life ◽  
Older Adults ◽  
Older People ◽  
Long Term Care ◽  
Well Being ◽  
World Health ◽  
Term Care ◽  
Care Facilities

Abstract Aim: This study aimed to explore the effect of a social robot Paro intervention on depression and well-being in older adults with depression living in long-term care facilities in Taiwan. Methods: This study was adopted a single group and quasi-experimental with repeated measures design. Each participant participated in two stages: observation and Paro intervention stages. Stage 1 was an 8-week observation stage in long-term care facilities where the purpose was to observe the normal mood, behaviour and activities of older adults with depression. In stage 2, each participant was given a Paro by the researcher to keep for 24 hours for 7 days in for 8 weeks. Outcome measurements were obtained 4 times: a week before the intervention (T1), immediately the end of 8-week observation (T2), mid-point of Paro intervention (T3), and immediately the end of 8-week Paro intervention (T4). Instruments included the Geriatric Depression Scale, the UCLA Loneliness Scale version 3, and the World Health Organization Quality of Life Questionnaire-OLD. Results: There were 20 participants completed the study. The mean age of participants was 81.1years (SD = 8.2). After 8-week Paro intervention, statistically significant differences in changes were found on depression, loneliness, and quality of life from pre-intervention to post-intervention. Conclusion: This study was found that Paro intervention has beneficial effects on depression and mental well-being for older people with depression in long-term care facilities. Paro Intervention might be a suitable psychosocial intervention for older people with depression and should be considered as a useful tool in clinical practice.

Creating Bridges Between Researchers and Long-Term Care Homes to Promote Quality of Life for Residents

2010 ◽  
Vol 20 (12) ◽  
pp. 1689-1704 ◽  
Author(s):  
Sharon Kaasalainen ◽  
Jaime Williams ◽  
Thomas Hadjistavropoulos ◽  
Lilian Thorpe ◽  
Susan Whiting ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Long Term Care ◽  
Care Homes ◽  
Term Care

scholarly journals ELDER CARE COMPLEXITIES AND OUTCOMES: A MANDATE FOR INTERDISCIPLINARY GERIATRIC CLINICAL ASSESSMENT

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S502-S502
Author(s):  
Peter S Reed ◽  
Zebbedia Gibb
Keyword(s):  
Quality Of Life ◽  
Geriatric Assessment ◽  
Clinical Assessment ◽  
Elder Care ◽  
Long Term Care ◽  
Full Range ◽  
Well Being ◽  
Term Care

Abstract Interdisciplinary geriatric assessment has long been considered best practice to identify the full range of elder care needs. In 2015, the Sanford Center for Aging launched an interdisciplinary comprehensive geriatric assessment clinic. This team-based assessment includes a geriatrician, social worker and pharmacist meeting together with each client to review all aspects of their health and well-being, resulting in a comprehensive care plan to coordinate care with the client’s primary care provider. To assess this approach, a survey was conducted with 415 randomly-selected clients prior to the clinical visit, with a 6-month follow-up survey completed for 170 clients (41%), gathering data on hospitalizations, long-term care utilization and quality of life. Combining these data with clinical assessment data provides a picture of clinical complexities of elder clients and offers a mandate for comprehensive interdisciplinary care. Baseline data showed 44% hospitalized in the prior year; an average of 4 chronic conditions and 10 medications; 44% with dementia or MCI and 29% with frailty. At 6-months post-assessment, 29% reported being hospitalized, 3.5% reported moving into long-term care, and there was a slight, non-significant decrease in quality of life. These data demonstrate the profound complexities that can be identified and addressed through comprehensive assessment and care, as well as the potential to reduce hospitalizations, enable people to age-in-place and maintain quality of life. Despite the well-documented value of these approaches, Medicare and other payers have not fully embraced the opportunity to achieve these positive outcomes and remain hesitant to adequately fund comprehensive approaches to care.

scholarly journals A social robot intervention on depression, loneliness, and quality of life for Taiwanese older adults in long-term care

2020 ◽  
Vol 32 (8) ◽  
pp. 981-991 ◽  
Author(s):  
Shu-Chuan Chen ◽  
Wendy Moyle ◽  
Cindy Jones ◽  
Helen Petsky
Keyword(s):  
Quality Of Life ◽  
Older Adults ◽  
Long Term Care ◽  
Well Being ◽  
Social Robot ◽  
World Health ◽  
Term Care ◽  
Mental Well Being

ABSTRACTObjectives:To investigate the effect of a social robot intervention on depression, loneliness, and quality of life of older adults in long-term care (LTC) and to explore participants’ experiences and perceptions after the intervention.Design:A mixed-methods approach consisting of a single group, before and after quasi-experimental design, and individual interview.Participants:Twenty older adults with depression from four LTC facilities in Taiwan were recruited.Intervention:Each participant participated in 8 weeks of observation and 8 weeks of intervention. In the observation stage, participants received usual care or activities without any research intervention. In the intervention stage, each participant was given a Paro (Personal Assistive RobOt) to keep for 24 hours, 7 days a week.Measurements:The Geriatric Depression Scale, the UCLA Loneliness Scale Version 3, and the World Health Organization Quality of Life Questionnaire for older adults were administered at four time points. Individual qualitative interviews with thematic analysis followed.Results:A repeated multivariate analysis of variance and Friedmanʼs test showed no significant changes during the observation stage between T1 and T2 for depression and quality of life (p >.5). For the intervention stage, statistically significant changes in decreasing depression and loneliness and improving quality of life over time were identified. Three themes emerged from the interviews: (i) humanizing Paro through referring to personal experiences and engagement; (ii) increased social interaction with other people; and (iii) companionship resulting in improved mental well-being.Conclusions:There were significant improvements in mental well-being in using Paro. Further research may help us to understand the advantages of using a Paro intervention as depression therapy.

scholarly journals Social integration and loneliness among long-term care home residents: protocol for a scoping review

BMJ Open ◽  
2019 ◽  
Vol 9 (12) ◽  
pp. e033240 ◽  
Author(s):  
Jennifer Bethell ◽  
Jessica Babineau ◽  
Andrea Iaboni ◽  
Robin Green ◽  
Rachelle Cuaresma-Canlas ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Social Integration ◽  
Scoping Review ◽  
Long Term Care ◽  
Care Home ◽  
Well Being ◽  
Physical And Mental Health ◽  
Term Care

IntroductionSocial well-being is associated with better physical and mental health. It is also important for quality of life, including from the perspectives of those living in long-term care (LTC) homes. However, given the characteristics of the LTC home environment and the people who live there, the nature and influence of social integration and loneliness, and strategies to address them, may differ in this population compared with those living in the community. The objective of this scoping review is to provide an overview of the nature and extent of research on social integration and loneliness among LTC home residents, including a summary of how these concepts have been operationalised and any evidence from specific groups.Methods and analysisThis study protocol describes the methods of a scoping review of peer-reviewed literature related to social integration and loneliness among LTC home residents. A literature search was developed by an Information Specialist and will be conducted in MEDLINE(R) ALL (in Ovid, including Epub Ahead of Print, In-Process & Other Non-Indexed Citations, Ovid MEDLINE(R) Daily) and then translated into CINAHL (EBSCO), PsycINFO (Ovid), Scopus, Sociological Abstracts (Proquest), Embase and Embase Classic (Ovid), Emcare Nursing (Ovid) and AgeLine (EBSCO). Two reviewers will independently screen titles and abstracts of articles identified in the search. Two reviewers will then independently review full text articles for inclusion. Data extraction will also be carried out in duplicate. We will engage LTC home community members, including residents, family and staff, to refine the review questions, assist in interpreting the results and participate in knowledge translation.Ethics and disseminationEthics approval is not required. We will present findings at conferences and publish in a peer-reviewed journal. Ultimately, we hope to inform future observational and interventional research aimed at improving the health and quality of life of LTC home residents.

scholarly journals Advancing Long-Term Care Science Through Using Common Data Elements: Candidate Measures for Care Outcomes of Personhood, Well-Being, and Quality of Life

2019 ◽  
Vol 5 ◽  
pp. 233372141984267 ◽  
Author(s):  
David Edvardsson ◽  
Rebecca Baxter ◽  
Laura Corneliusson ◽  
Ruth A. Anderson ◽  
Anna Beeber ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Organizational Context ◽  
Long Term Care ◽  
Well Being ◽  
Term Care ◽  
Common Data Elements ◽  
Care Outcomes ◽  
Data Elements

To support the development of internationally comparable common data elements (CDEs) that can be used to measure essential aspects of long-term care (LTC) across low-, middle-, and high-income countries, a group of researchers in medicine, nursing, behavioral, and social sciences from 21 different countries have joined forces and launched the Worldwide Elements to Harmonize Research in LTC Living Environments (WE-THRIVE) initiative. This initiative aims to develop a common data infrastructure for international use across the domains of organizational context, workforce and staffing, person-centered care, and care outcomes, as these are critical to LTC quality, experiences, and outcomes. This article reports measurement recommendations for the care outcomes domain, focusing on previously prioritized care outcomes concepts of well-being, quality of life (QoL), and personhood for residents in LTC. Through literature review and expert ranking, we recommend nine measures of well-being, QoL, and personhood, as a basis for developing CDEs for long-term care outcomes across countries. Data in LTC have often included deficit-oriented measures; while important, reductions do not necessarily mean that residents are concurrently experiencing well-being. Enhancing measurement efforts with the inclusion of these positive LTC outcomes across countries would facilitate international LTC research and align with global shifts toward healthy aging and person-centered LTC models.

scholarly journals Confirmatory analysis of a health state classification system for people living with dementia: a qualitative approach

2019 ◽  
Vol 24 (4) ◽  
pp. 256-265 ◽  
Author(s):  
Alyssa Welch ◽  
Nguyen Kim-Huong ◽  
John Quinn ◽  
Caroline Gregory ◽  
Wendy Moyle ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Alzheimer’S Disease ◽  
Focus Groups ◽  
Content Validity ◽  
Long Term Care ◽  
Community Members ◽  
Term Care ◽  
People With Dementia

Objectives This paper aims to confirm the content validity of the domains identified during the development of the Alzheimer’s disease – five dimensions (AD-5D) algorithm for the quality of life – Alzheimer’s disease (QOL-AD) and to identify the rationale for stated quality of life preferences. Methods Focus groups were conducted to elicit the priorities for quality of life in dementia from three perspectives: the person with dementia; family caregivers; and the community. Participants were recruited through industry research partners (long-term care providers) based on knowledge of their experience with dementia. Three focus groups were conducted – one each in Brisbane, Sydney and Adelaide, Australia – between November 2016 and February 2017. Each focus group included participants providing a different perspective on dementia – people with dementia ( n = 3), caregivers ( n = 9) and general community members or relatives of residents of a long-term care facility ( n = 10), although some groups contained one participant with a different perspective. The focus groups were used to validate the AD-5D domains and examine quality of life preferences across the three perspectives. Thematic analysis was used to identify the priorities underlying preference selection. Results All activities affecting the quality of life for people with dementia could be mapped to one of the five AD-5D domains: memory, mood, physical health, living situation and ability to do things for fun. The domains considered most important for quality of life differed between people with dementia, their caregivers and members of the community, with memory the least important domain for all three groups. The rationale for priorities also varied between groups. Conclusions This study confirmed the content validity of the selection of the AD-5D domains and identified multiple differences in the reasons behind stated priorities for quality of life for people with dementia, their caregivers and community members.

Communication Disordered: Program Implementation in Long-Term Care

2016 ◽  
Vol 1 (15) ◽  
pp. 64-67
Author(s):  
George Barnes ◽  
Joseph Salemi
Keyword(s):  
Program Implementation ◽  
Long Term Care ◽  
Family Satisfaction ◽  
Regulatory Compliance ◽  
Care Staff ◽  
Term Care ◽  
Staff Members ◽  
Change Policy

The organizational structure of long-term care (LTC) facilities often removes the rehab department from the interdisciplinary work culture, inhibiting the speech-language pathologist's (SLP's) communication with the facility administration and limiting the SLP's influence when implementing clinical programs. The SLP then is unable to change policy or monitor the actions of the care staff. When the SLP asks staff members to follow protocols not yet accepted by facility policy, staff may be unable to respond due to confusing or conflicting protocol. The SLP needs to involve members of the facility administration in the policy-making process in order to create successful clinical programs. The SLP must overcome communication barriers by understanding the needs of the administration to explain how staff compliance with clinical goals improves quality of care, regulatory compliance, and patient-family satisfaction, and has the potential to enhance revenue for the facility. By taking this approach, the SLP has a greater opportunity to increase safety, independence, and quality of life for patients who otherwise may not receive access to the appropriate services.

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