Intimacy and sexuality of nursing home residents with dementia: a systematic review

2014 ◽  
Vol 27 (3) ◽  
pp. 367-384 ◽  
Author(s):  
Tineke S. M. Roelofs ◽  
Katrien G. Luijkx ◽  
Petri J. C. M. Embregts
Keyword(s):  
Sexual Behavior ◽  
Nursing Home ◽  
Design Research ◽  
Nursing Home Residents ◽  
Care Staff ◽  
Research Quality ◽  
Future Research ◽  
Full Spectrum ◽  
People With Dementia ◽  
Wide Range

ABSTRACTBackground:Considering people with dementia, increasing cognitive, physical, and environmental impairments can impede the capacity to express and experience intimacy and sexuality. When a move to a residential (nursing) home becomes inevitable, increasing dependency can influence this even more. The aim of the review is to provide a structured overview of all elements of intimacy across the full spectrum of intimacy and sexuality in people with dementia, living in specialist residential care.Methods:A systematic search and review were conducted. Research published between 1990 and 2013 was identified in the electronic databases: Pubmed, PsychInfo, and Medline. Inclusion and exclusion criteria were predefined. Selected studies were assessed on quality, using the Mixed Methods Appraisal Tool.Results:Twelve of the 215 initially retrieved unique research publications were selected. A varied range of studies were found; these studies differed in design, research quality, searched population, and research theme. Different themes emerged: intimate and sexual behavior, knowledge and attitudes, capacity to consent and care culture, and staff training and guidelines.Conclusions:Although results were found in a wide range of intimate and sexual behavior, knowledge, attitudes and needs of others, and descriptions of culture in residential and nursing homes, the perspective of residents was lacking in literature. Also a “protective” care paradigm was found throughout. Future research is needed to highlight resident perspective and develop training opportunities and guidelines for care staff.

scholarly journals 468 - Can a Robotic Seal Called PARO Manage Chronic Pain in People with Dementia Living in Nursing Homes?

2020 ◽  
Vol 32 (S1) ◽  
pp. 190-190
Author(s):  
Lihui Pu ◽  
Wendy Moyle ◽  
Cindy Jones ◽  
Michael Todorovic
Keyword(s):  
Chronic Pain ◽  
Nursing Home ◽  
Nursing Homes ◽  
Usual Care ◽  
Rating Scale ◽  
Nursing Home Residents ◽  
Care Staff ◽  
Term Care ◽  
Randomized Controlled ◽  
People With Dementia

AbstractObjective: To evaluate the effect of interaction with a robotic seal (PARO) for pain management in nursing home residents living with dementia.Methods: Registered with the Australian New Zealand Clinical Trials Registry (ACTRN 12618000082202), a pilot randomized controlled trial followed by semi-structured interviews were conducted between January 2018 and January 2019. Forty-three residents aged ?65 years living with dementia and chronic pain were recruited from three nursing homes in Australia. Participants were randomized to either a PARO group (individual, non-facilitated, 30-minute sessions, five days per week for six weeks) or a usual care group using a computer-generated random number. Observational pain behaviors were rated by researchers using the Pain Assessment in Advanced Dementia (PAINAD) scale and staff-rated pain levels were measured by the numeric rating scale. Medications regularly prescribed and as needed were quantified by the Medication Quantification Scale-III (MQS-III). Generalized estimating equation model and thematic analysis were used to analyze the data.Results: Participants in the PARO group had significantly lowered level of observed pain (-0.514, 95% confidence interval [CI] -0.774 to -0.254, p<0.001) and used fewer PRN medications (-1.175, 95% CI - 2.205 to -0.145, p=0.025) than those in usual care after controlling for age, gender, cognitive function and medications at baseline. There were no significant differences in staff-rated pain levels and regularly scheduled medications between the two groups. Interviews also indicated that the PARO intervention may reduce the pain experience through distraction and reminiscence of previous positive memories. Limitations of weight, voice and characteristics of PARO were identified.Conclusions and Implications: PARO shows promise in reducing pain and medications for nursing home residents living with dementia and chronic pain. This intervention might be incorporated into daily practice as an alternative to manage pain in people with dementia. Care staff need to balance the benefits and limitations of incorporating social robots into their clinical practice and residents’ individualized preferences need to be considered. Larger randomized controlled trials with longer time frames are warranted to further test the use of PARO in long-term care settings.

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

2019 ◽  
Vol 31 (08) ◽  
pp. 1109-1120 ◽  
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.

Increasing enjoyable activities to treat depression in nursing home residents with dementia: A pilot study

Dementia ◽  
2016 ◽  
Vol 16 (2) ◽  
pp. 204-218 ◽  
Author(s):  
Catherine Travers
Keyword(s):  
Nursing Home ◽  
Pilot Study ◽  
Nursing Home Residents ◽  
Significant Treatment ◽  
Qualitative Feedback ◽  
Intervention Measures ◽  
People With Dementia ◽  
Moderate Dementia ◽  
University Of Louisville ◽  
The University

This pilot study aimed to assess the feasibility and acceptability of a behavioral activities intervention (BE-ACTIV) in Australian nursing homes. BE-ACTIV was developed by researchers at the University of Louisville, USA, to improve mood and quality of life (QOL) in nursing home residents with mild to moderate dementia. An eight-week trial was conducted and 10 residents with mild to moderate dementia received the BE-ACTIV intervention while eight residents received a Walking and Talking intervention. Measures of depression (GDS-12R) and QOL (QOL-AD-NH) were administered prior to and following the interventions. Qualitative feedback indicated residents benefited from BE-ACTIV, evident by improved mood, although no statistically significant treatment effect was found. Moreover, the intervention was found to be feasible and acceptable to Australian nursing home staff and our findings highlight the importance of individualizing activities for people with dementia, of which 1:1 staff attention was a key component.

An Observational Study of Agitation in Agitated Nursing Home Residents

1989 ◽  
Vol 1 (2) ◽  
pp. 153-165 ◽  
Author(s):  
Jiska Cohen-Mansfield ◽  
Perla Werner ◽  
Marcia S. Marx
Keyword(s):  
Nursing Home ◽  
Observational Study ◽  
Nursing Home Residents ◽  
Future Research ◽  
Cognitively Impaired ◽  
High Frequencies ◽  
Direct Observations ◽  
Very High Frequencies ◽  
Very High

Direct observations of 24 highly agitated, cognitively impaired nursing home residents were performed during each hour of the 24-hour day for 2–3 months. Results showed that agitated behaviors (in particular, strange noises, requests for attention, repetitious mannerisms, picking at things, strange movements, and pacing) were manifested at very high frequencies. The data also showed that daytime agitation was positively related to nighttime agitation. Patterns of agitation were specific to each resident, an important finding for future research and intervention.

scholarly journals Association of care workers’ job satisfaction and global happiness with change of functional performance of severely disabled elderly residents in nursing homes: a cohort and questionnaire study in Japan

BMJ Open ◽  
2020 ◽  
Vol 10 (10) ◽  
pp. e033937
Author(s):  
Shino Ikeda-Sonoda ◽  
Nao Ichihara ◽  
Jiro Okochi ◽  
Arata Takahashi ◽  
Hiroaki Miyata
Keyword(s):  
Job Satisfaction ◽  
Nursing Home ◽  
Nursing Homes ◽  
Functional Performance ◽  
Nursing Home Residents ◽  
Care Staff ◽  
Lower Probability ◽  
Disabled Elderly ◽  
The Impact

ObjectivesThere is growing concern regarding quality of work life (QWL) among care staff in nursing homes. However, little is known about the impact of QWL on nursing home residents’ functional performance. Recent literature suggests that job satisfaction and happiness of healthcare workers reflect their perceived QWL and impact the quality of their care. This study examined the association between job satisfaction and global happiness with change in functional performance of severely disabled elderly residents in nursing homes.DesignA retrospective cohort study of nursing home residents combined with a questionnaire survey of their care staff.SettingEighteen nursing homes in Japan.ParticipantsData were collected from 1000 residents with a required care level of 3–5 and from 412 care staff in nursing homes between October 2017 and March 2018.Outcomes and explanatory variablesFunctional performance was structurally assessed with ICF (International Classification of Functioning, Disability and Health) staging, composed of 52 items concerning activities of daily life, cognitive function and social participation, at baseline and 6 months later. Deterioration and improvement of functional performance were dichotomously defined as such change in any of the items. QWL of care staff was evaluated with a questionnaire including questions about job satisfaction and global happiness.ResultsFunctional performance deteriorated and improved in 23.0% and 12.7% of residents, respectively. Global happiness of care staff was associated with lower probability of residents’ deterioration (adjusted OR, 0.61; CI 0.44 to 0.84). There was no significant correlation between job satisfaction or happiness of care staff and improvement of residents’ functional performance.ConclusionThese results suggest that QWL of care staff is associated with changes in functional performance of elderly people with severe disabilities in nursing homes.

An exploration of hydration care for nursing home residents living with dementia

2021 ◽  
Vol 23 (12) ◽  
pp. 1-8
Author(s):  
Carolynn Greene ◽  
Jennie Wilson ◽  
Alison Tingle ◽  
Heather Loveday
Keyword(s):  
Nursing Home ◽  
Fluid Intake ◽  
Care Home ◽  
Nursing Home Residents ◽  
Care Staff ◽  
Key Factors ◽  
Missed Opportunities ◽  
Individual Support ◽  
Limited Support ◽  
Individual Choices

Background/aims Older adults residing in nursing homes are vulnerable to dehydration. Residents living with dementia can experience additional challenges, making it difficult to independently consume sufficient fluids. The aim of this study was to describe the experience of hydration care for nursing home residents living with dementia. Methods Observations of hydration care were conducted between 06:00 and 22:45 on one care home unit. Twenty-two residents with dementia were eligible for observation. Conversations with staff and relatives provided further insights. The data were analysed using thematic analysis. Findings Hydration care provision was highly routinised with little flexibility. Residents received limited support to express individual choices, and staff missed opportunities to provide drinks. More fluid was consumed when care staff developed strategies to encourage fluid intake. Conclusions Key factors to optimise hydration care include providing individual support to encourage fluid intake and expression of choice, flexible care routines, and focus on communication and teamworking.

Communicating With Nursing Home Residents About End of Life

2021 ◽  
pp. 104990912110648
Author(s):  
Janet Sopcheck ◽  
Ruth M. Tappen
Keyword(s):  
Nursing Home ◽  
End Of Life ◽  
End Of Life Care ◽  
Family Members ◽  
Secondary Analysis ◽  
Nursing Home Residents ◽  
Future Research ◽  
Life Care ◽  
Older Individuals ◽  
Past Experiences

Approximately 33% of the 1.2 million older individuals residing in nursing homes have the capacity to discuss their preferences for end-of-life care, and 35% will die within their first year in the nursing home. These conversations necessary to promote care consistent with the resident’s preferences are often limited and most often occur when the resident is actively dying. The purpose of this secondary analysis was to understand the resident’s perspectives on end-of-life communication in the nursing home and suggest approaches to facilitate this communication. We interviewed 46 participants (16 residents, 10 family members, and 20 staff) in a Southeast Florida nursing home from January to May 2019. The data were analyzed using descriptive and pattern coding and matrices to decipher preliminary categories and thematic interpretation within and across each participant group. Two themes emerged from this secondary analysis that residents assume others know their end-of-life preferences, and past experiences may predict future end-of-life choices. Residents and family members were willing to discuss end-of-life care. Study findings also suggested that past experiences with the end-of-life and critical illness of another could impact residents’ and family members’ end-of-life care decisions, and that nurses’ recognition of subtle signs of a resident’s decline may trigger provider-initiated end-of-life conversations. Future research should focus on strategies to promote earlier end-of-life discussions to support independent decision-making about end-of-life care in this relatively dependent population of older adults.

scholarly journals Measuring social integration among residents in a dementia special care unit versus traditional nursing home: A pilot study

Dementia ◽  
2016 ◽  
Vol 16 (3) ◽  
pp. 388-403 ◽  
Author(s):  
Katherine M Abbott ◽  
Justine S Sefcik ◽  
Kimberly Van Haitsma
Keyword(s):  
Nursing Home ◽  
Social Integration ◽  
Objective Assessment ◽  
Nursing Home Residents ◽  
Special Care ◽  
Special Care Unit ◽  
Physical And Mental Health ◽  
People With Dementia ◽  
Public Areas ◽  
Staff Interactions

The physical and mental health of older adults with dementia is affected by levels of social integration. The development of dementia special care units (D-SCU) arose, in part, to facilitate more meaningful social interactions among residents implying greater social integration of D-SCU residents as compared to residents in a traditional nursing home (TNH). But, it is unknown whether D-SCU residents are receiving equal or greater benefits from living on a segregated unit intended to enhance their social environment and integration through both design and staff involvement. The purpose of this study was to pilot test a comprehensive objective assessment to measure social integration among nursing home residents with dementia and to compare levels of integration of residents living on a D-SCU to those living in a TNH. A total of 29 residents participated (15 D-SCU and 14 TNH) and data were gathered from medical charts, visitor logs, and through direct observations. Over 1700 interactions were recorded during 143 h of observation. Specifically, the location, context, type, quantity, and quality of residents’ interactions were recorded. Overall, the majority of resident interactions were verbal and initiated by staff. Interactions were social in context, and occurred in public areas, such as the common room with a large screen TV. Average interactions lasted less than 1 min and did not change the resident’s affect. Residents spent between 10% and 17% of their time interacting with other people on average. D-SCU staff were significantly more likely to initiate interactions with residents than TNH staff. D-SCU residents also experienced more interactions in the afternoons and expressed more pleasure and anxiety than residents in the TNH. This study helps to lay the groundwork necessary to comprehensively and objectively measure social integration among people with dementia in order to evaluate care environments.

scholarly journals Nursing home quality of life in the Lebanon

2017 ◽  
Vol 18 (2) ◽  
pp. 145-156
Author(s):  
Marina Gharibian Adra ◽  
John Hopton ◽  
John Keady
Keyword(s):  
Quality Of Life ◽  
Nursing Home ◽  
Nursing Homes ◽  
Family Caregivers ◽  
Comparative Method ◽  
Nursing Home Residents ◽  
Care Staff ◽  
Care Practice ◽  
Content Type

Purpose The purpose of this paper is to explore perceptions, perspectives and meaning of quality of life for a sample of older residents, care staff and family caregivers in two nursing homes in Lebanon. Design/methodology/approach A classic grounded theory study was conducted between 2010 and 2011 in two nursing homes in Beirut. The semi-structured interviews were undertaken with a theoretical sample of 20 residents, 8 family caregivers and 11 staff. The constant comparative method was used to analyze the data. Findings Three distinct but interrelated properties of quality of life emerged from this process: “maintaining self,” “maintaining identity” and “maintaining continuity”. The dynamics that exist within and between each of these properties provide an indicator about shared and distinct meanings and the implications for care practice. Research limitations/implications The study was conducted in one city in Lebanon; accordingly, the transferability of findings may be challenging. Practical implications Implications for nursing and nursing policy – improving Lebanese national standards and regulations applicable to nursing home residents may help to enhance residents’ care needs and quality of life. Social implications There was limited guidance aimed at helping older residents to voice and increase their choice and control. Originality/value This paper provides new insights into the process of outlining the properties attached to the phenomenon of quality of life in nursing homes in Lebanon. It will be of interest to those in nursing home care as well as to policy makers.

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