Do interventions with staff in long-term residential facilities improve quality of care or quality of life for people with dementia? A systematic review of the evidence

2016 ◽  
Vol 28 (12) ◽  
pp. 1935-1936 ◽  
Author(s):  
Nancy A. Hodgson
Keyword(s):  
Patient Outcomes ◽  
Dementia Care ◽  
Dementia Patient ◽  
Dyadic Relationship ◽  
Quality Outcomes ◽  
Formal Caregivers ◽  
Institutional Settings ◽  
People With Dementia

The review by Bird and colleagues (2016), published in this issue of International Psychogeriatrics, is notable for jointly examining the effect of dementia care interventions on both staff and resident quality outcomes. This is an important contribution to improving dementia care because it recognizes the dynamic and dyadic relationship between residents and their caregivers in residential settings. While evidence exists on the dyadic effect of family caregiver intervention on dementia patient outcomes (Gitlin and Hodgson, 2015), less attention has been given to formal caregivers in institutional settings (Dellefield et al., 2015).

scholarly journals Supportive care for older people with dementia: socio-organisational implications

2020 ◽  
pp. 1-33
Author(s):  
Francesco Miele ◽  
Federico Neresini ◽  
Giovanni Boniolo ◽  
Omar Paccagnella
Keyword(s):  
Supportive Care ◽  
Dementia Care ◽  
Future Research ◽  
Cultural Backgrounds ◽  
Term Care ◽  
Care Givers ◽  
People With Dementia ◽  
Depth Analysis

Abstract For many years, dementia care has been dominated by the standard medical approach, in which dementia is treated mainly with drugs, such as anti-anxiety, antidepressant and anti-psychotic medications. With the aim of seeking effective treatments for patients with dementia, over the last years, several contributions have criticised the pervasive use of drugs for the management of behavioural and physiological symptoms related to dementia, proposing personalised interventions aimed at supporting patients and their relatives from diagnosis until death. With particular reference to long-term settings, in this work, we aim at understanding the organisational implications of three types of interventions (labelled supportive care interventions – SCIs) that have characterised this shift in dementia care: person-centred, palliative and multi-disciplinary care. Conducted by following the integrative review method, our review underlines how SCIs have controversial consequences on the quality of care, the care-givers’ quality of life and cultural backgrounds. After an in-depth analysis of selected papers, we offer some considerations about the implications of SCIs for long-term care organisations and future research directions.

How do staff influence the quality of long-term dementia care and the lives of residents? A systematic review of the evidence

2016 ◽  
Vol 28 (8) ◽  
pp. 1263-1281 ◽  
Author(s):  
Katrina Anderson ◽  
Mike Bird ◽  
Sarah MacPherson ◽  
Annaliese Blair
Keyword(s):  
Systematic Review ◽  
Functional Dependence ◽  
Dementia Care ◽  
Cross Sectional ◽  
Search Terms ◽  
People With Dementia ◽  
Comprehensive Search ◽  
Prospective Longitudinal

ABSTRACTBackground:Research suggests and common sense indicates that there are relationships between staff variables in residential dementia care and the quality of life (QOL) of residents, with poor care due to staff factors increasing resident suffering. Despite these indications, we do not have a coherent picture of these relationships, which variables are important, and where to intervene in order to minimize suffering for people with dementia.Methods:This systematic review examined associations between staff variables, quality of care (QOC), and QOL for residents, using published peer-reviewed literature from the last 20 years. A comprehensive search was conducted using an exhaustive list of search terms, leading to the identification of 33,204 unique papers, which was reduced to 35 on-topic papers.Results:In the main, we were able to provide collective evidence to suggest there are relationships between potentially adjustable staff variables and QOC on to QOL. When staff treat and interact empathetically and humanely in care, there is a relationship with better mood for residents, delayed functional dependence and better food intake. Where staff are more skilled and educated, there is less psychotropic medication use. Unlimited empathy about the risk of residents falling or being in pain is not enough; staff need to know about the dangers of restraint.Conclusions:Confidence in these indicative links is weakened by a lack of high-quality prospective longitudinal studies focusing on potentially adjustable staff variables, with a bias towards cross-sectional studies including only variables that are fixed or unlikely to change. (Review registration no. PROSPERO 2014:CRD42014015224).

Experiences related to quality of life in people with dementia living in institutional settings – A meta-aggregation

2019 ◽  
Vol 83 (3) ◽  
pp. 145-161
Author(s):  
Hanne Kaae Kristensen ◽  
Hanne Peoples
Keyword(s):  
Quality Of Life ◽  
Social Relationships ◽  
Social Connectedness ◽  
Critical Appraisal ◽  
Dementia Care ◽  
Subjective Experiences ◽  
Institutional Settings ◽  
Physical Environments ◽  
People With Dementia

Introduction Within dementia care, there remains a general lack of coherence in evidence-based knowledge on issues of importance for subjective experiences of quality of life in people with dementia. The aim of the meta-aggregation was to investigate experiences related to quality of life in people with dementia living in institutional settings. Method A meta-aggregation inspired by the Joanna Briggs Institute was undertaken. A systematic search was conducted in four databases and additional studies were found in the reference lists of the included studies. Only studies in English, Danish, Swedish, and Norwegian were considered, with publication dates from 2007 to 2018. Findings Ten original qualitative studies were included. Using critical appraisal, methodological quality was assessed. We extracted five main categories: acceptance and adaptation; autonomy; personhood; social connectedness; and activities. Conclusion Significant findings for future occupational therapy in dementia care concerned the importance of coming to terms with the illness and life situation, while being able to experience feelings of autonomy, independence, and personhood. Meaningful social relationships and activities, individualized flexible routines and regulations, and adjusted physical environments with room for privacy were also prioritized in order to achieve high quality of life.

scholarly journals Patient Experiences with the Transition to Telephone Counseling during the COVID-19 Pandemic

Healthcare ◽  
2021 ◽  
Vol 9 (6) ◽  
pp. 663
Author(s):  
Augustine W. Kang ◽  
Mary Walton ◽  
Ariel Hoadley ◽  
Courtney DelaCuesta ◽  
Linda Hurley ◽  
...  
Keyword(s):  
Patient Outcomes ◽  
Interrater Reliability ◽  
Telephone Counseling ◽  
Patient Experiences ◽  
Opioid Use Disorder ◽  
Opioid Use ◽  
Therapeutic Experience ◽  
Perceived Impact

Background: To identify and document the treatment experiences among patients with opioid use disorder (OUD) in the context of the rapid move from in-person to telephone counseling due to the COVID-19 pandemic. Methods: Participants (n = 237) completed a survey with open-ended questions that included the following domains: (1) satisfaction with telephone counseling, (2) perceived convenience, (3) changes to the therapeutic relationship, (4) perceived impact on substance use recovery, and (5) general feedback. Responses were coded using thematic analysis. Codes were subsequently organized into themes and subthemes (covering 98% of responses). Interrater reliability for coding of participants’ responses ranged from 0.89 to 0.95. Results: Overall, patients reported that telephone counseling improved the therapeutic experience. Specifically, 74% of respondents were coded as providing responses consistently indicating “positive valency”. “Positive valency” responses include: (1) feeling supported, (2) greater comfort and privacy, (3) increased access to counselors, and (4) resolved transportation barriers. Conversely, “negative valency” responses include: (1) impersonal experience and (2) reduced privacy. Conclusions: Telephone counseling presents its own set of challenges that should be investigated further to improve the quality of care and long-term patient outcomes.

scholarly journals Facilitators and barriers to implement nurse-led interventions in long-term dementia care: a qualitative interview study with Swiss nursing experts and managers

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Julian Hirt ◽  
Melanie Karrer ◽  
Laura Adlbrecht ◽  
Susi Saxer ◽  
Adelheid Zeller
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Public Perception ◽  
Dementia Care ◽  
Term Care ◽  
Face To Face ◽  
People With Dementia ◽  
Qualitative Interview Study ◽  
Facilitators And Barriers

Abstract Background To support the implementation of nurse-led interventions in long-term dementia care, in-depth knowledge of specific supporting factors and barriers is required. Conditions and structures of caring for people with dementia differ widely, depending on the country and the care context. Our study aimed to describe the experiences and opinions of nursing experts and managers with regard to facilitators and barriers to the implementation of nurse-led interventions in long-term dementia care. Methods We conducted a qualitative descriptive study using individual interviews based on qualitative vignettes as a useful stimulus to generate narrations allowing to study peoples’ perceptions and beliefs. The study took place in nursing homes in the German-speaking part of Switzerland and in the Principality of Liechtenstein using purposive sampling. We intended to conduct the interviews face-to-face in a quiet room according to the participant’s choice. However, due to the lockdown of nursing homes during the COVID-19 pandemic in spring 2020, we performed interviews face-to-face and by video. We analysed data thematically following Braun and Clarke to achieve a detailed, nuanced description. To verify our interpretation and to ensure congruence with participants’ perspectives, we conducted member checks. The Standards for Reporting Qualitative Research (SRQR) served to structure our manuscript. Results Six dyads of nursing home managers and nursing experts from six nursing homes took part in our study (n = 12). Our thematic analysis yielded seven themes reflecting facilitators and barriers to implementing nurse-led interventions in long-term dementia care: «A common attitude and cohesion within the organization», «Commitment on several levels», «A needs-oriented implementation», «The effect and the public perception of the intervention», «A structured and guided implementation process», «Supporting knowledge and competencies», as well as «Resources for implementing the intervention». Conclusions To support the implementation of nurse-led interventions in long-term dementia care, active commitment-building seems essential. It is necessary that the value of the intervention is perceptible.Commitment-building is the precondition to reach the persons involved, such as nursing home managers, nursing staff, residents and relatives. Furthermore, nurses should precisely inform about the intervention. It is necessary that the value of the intervention is perceptible. In addition, nurses should adjust the interventions to the situational needs of people with dementia, thus. Therefore, it is important to support dementia-specific competencies in long-term care. Findings indicate that the barrier is determined by the intervention and its implementation – and not by the behaviour of the person with dementia.

scholarly journals The Effect of Long Term Care Resources on Burdens for Caregiving People Living with Dementia in Taiwan

2021 ◽  
Author(s):  
Yang-Hao Ou ◽  
Ming-Che Chang ◽  
Wen-Fu Wang ◽  
Kai-Ming Jhang
Keyword(s):  
Caregiver Burden ◽  
Long Term Care ◽  
Dementia Care ◽  
Care Team ◽  
Control Group ◽  
Term Care ◽  
People With Dementia ◽  
Home Based ◽  
Caregiver Group

Abstract Background: There is an increasing awareness of caregiver's burden, especially in those caring for people with dementia. The caregiver burden has been studied extensively in Western countries; however, the interpretation of the results and replication of the intervention may deem unfit in the Chinese culture. Therefore, this study identifies the change in caregiver burden by interventional methods under current Taiwan's long-term care Act 2.0.Method: A total of 2,598 newly diagnosed dementia outpatients was evaluated by the Changhua Christian Hospital dementia care team. Eighty patients utilize one of the three care resources, including community-based services (n = 33), home-based services (n = 19), or taking care by foreign caregivers (n = 28). Participants in the control group were selected by matching their global CDR score, gender, age, and caregivers' age with a 1:4 ratio. All caregivers completed the Zarit Burden Interview (ZBI) questionnaires before and six months after utilizing the care resources. Results: The home-based and the foreign caregiver groups have the highest baseline ZBI scores with 37.63±16.14 and 36.57±17.14, respectively. The second ZBI score was assessed about six months after the baseline showing that the home-based group remained the highest caregiver burden (ZBI = 31.74±12.23) and the foreign caregiver group showed the lowest burden (ZBI = 25.68±12.09). The mean difference in the ZBI score confirmed that the foreign caregiver group had the most improvement, averaging a decrease of 17.99±31.08 points (adjust observation time). A linear regression model showed that home-based care and foreign caregiver contributes the most reduction in caregiver burden (-11.83 and -19,07 ZBI scores, respectively).Conclusion: Caring for people with dementia includes caring for their caregivers. Dementia care team should provide proper social resources, which are crucial in the alleviation of caregiver burden.

scholarly journals Improving Dementia Care Among Family Physicians: From Stigma to Evidence-Informed Knowledge

2020 ◽  
Vol 23 (4) ◽  
pp. 340-343
Author(s):  
Juanita-Dawne R. Bacsu ◽  
Farrah J. Mateen ◽  
Shanthi Johnson ◽  
Marc D. Viger ◽  
Paul Hackett
Keyword(s):  
Older Adults ◽  
Family Physicians ◽  
Primary Source ◽  
Dementia Care ◽  
Public Health Issue ◽  
Research Education ◽  
People With Dementia ◽  
The Government ◽  
Government Of Canada

Dementia is a national public health issue and a growing concern across Canada. Recently, the Government of Canada released a national dementia strategy focused on the need to prevent dementia, advance therapies, find a cure, and improve the quality of life for people with dementia. Family physicians are a primary source of care in discussing concerns of cognitive health and dementia, especially in rural and remote communities in Canada. However, research indicates that family physicians often lack knowledge and feel ill-equipped in providing care to older adults with dementia. Inadequate knowledge and education of dementia contributes to the stigmatization (stereotypes, labeling, discriminatory practices) of people with dementia and creates barriers to diagnosis and treatment. Moreover, studies show that there is dementia-related stigma among family physicians. We believe that there is a critical gap and urgent need for better dementia education and training among family physicians to improve dementia care, treatment and timely diagnosis. Thus, it is time to rethink our approach to dementia care in Canada, and to recognize that better care of older adults requires more evidence-informed research, education and interprofessional collaboration in order to reduce stigma and improve the quality of care for people with dementia.

Management of dementia

2020 ◽  
pp. 557-570
Author(s):  
Sarah Cullum ◽  
Tesema Taye
Keyword(s):  
Quality Of Life ◽  
Social Care ◽  
Ethical Issues ◽  
Family Members ◽  
Dementia Care ◽  
Psychosocial Aspects ◽  
People With Dementia

The cornerstone of dementia care is social care, and much of this is delivered by the families and carers of people with dementia. The management of dementia should therefore focus on supporting and developing the care provided by family members and carers in the community, because their education and enablement will help to optimize the quality of life for all people living with dementia. This chapter concentrates on the assessment and management of people with dementia in the early and later stages of the disorder. At both stages we consider engagement, autonomy, respect, protection, and ethical issues, as well as describing the clinical and psychosocial aspects of treatment. The emphasis is on the broader principles of management, which apply to people with dementia of any aetiology, their families, carers, and communities, and take into account the different settings in which they may present.

A methodological approach to accessing informal dementia care

2019 ◽  
Vol 23 (4) ◽  
pp. 228-240
Author(s):  
James Rupert Fletcher
Keyword(s):  
Design Methodology ◽  
Methodological Approach ◽  
Dementia Care ◽  
Lessons Learned ◽  
Content Type ◽  
Complex Sampling ◽  
Institutional Settings ◽  
People With Dementia ◽  
Dementia Research ◽  
Methodological Approaches

Purpose A growing body of research seeks to include people with dementia as both participants and co-designers. It is also increasingly recognized that dementia research must pay greater attention to informal care, provided by family and friends in non-institutional settings, because this is the situation of most people affected by dementia. Accessing these kinds of naturalistic care sites through meaningfully inclusive studies can be challenging for researchers in many fields. The paper aims to discuss this issue. Design/methodology/approach This paper describes a methodology designed to facilitate meaningful inclusion and access to hard-to-reach dementia care networks. It describes the implementation of this methodology in the field, the problems that emerged and the lessons learned. Findings A two-step sampling approach was used. People with dementia were sampled through organizations unrelated to dementia. Care networks were sampled through ecomapping with people with dementia. The strategy successfully accessed the desired population, but it was labour-intensive and biased the sample in several respects. Originality/value It is hoped that this outline will encourage further reflection and discussion regarding methodological approaches to complex sampling and recruitment issues in dementia research.

Sign in / Sign up

Export Citation Format

Share Document