Efficacy of Psychosocial Treatments for Noisemaking in Severe Dementia

1997 ◽  
Vol 9 (4) ◽  
pp. 405-422 ◽  
Author(s):  
Colleen Doyle ◽  
Tania Zapparoni ◽  
Daniel O'Connor ◽  
Susannah Runci
Keyword(s):  
Management Practices ◽  
Long Term Care ◽  
Psychosocial Interventions ◽  
Care Staff ◽  
Future Research ◽  
Severe Dementia ◽  
Term Care ◽  
Standard Management ◽  
Environmental Stimulation

Noisemaking is one of the most disturbing behavior disorders associated with dementia. Standard management practices, including pharmacological interventions, are not very successful in treating the behavior. Very little research has been carried out to evaluate innovative treatments or to determine the etiology of noisemaking. In this article, we report on a series of 12 case studies in which we tested the efficacy of some psychosocial interventions in reducing the frequency of noisemaking in long-term-care residents with severe dementia. Interventions were contingent reinforcement of quiet behavior and environmental stimulation tailored to individual preferences. Of the 12 patients recruited into the study, 2 died during the course of observations, 3 were not observed to be as noisy as reported by staff, and 3 showed a clear reduction in noise during the intervention period. Four patients did not show any overall reduction in noisemaking during psychosocial interventions. Future research could differentiate between types of interventions in successful cases and attempt to control further for the consistent application of interventions by long-term-care staff.

scholarly journals Presence redefined: The reciprocal nature of engagement between elder-clowns and persons with dementia

Dementia ◽  
2016 ◽  
Vol 16 (1) ◽  
pp. 46-66 ◽  
Author(s):  
Pia Kontos ◽  
Karen-Lee Miller ◽  
Gail Joyce Mitchell ◽  
Jan Stirling-Twist
Keyword(s):  
Long Term Care ◽  
Qualitative Interviews ◽  
Dementia Care ◽  
Care Staff ◽  
Severe Dementia ◽  
Term Care ◽  
Recent Innovation ◽  
Care Relationships ◽  
Embodied Engagement

Elder-clowns are a recent innovation in arts-based approaches to person-centred dementia care. They use improvisation, humour, and empathy, as well as song, dance, and music. We examined elder-clown practice and techniques through a 12-week programme with 23 long-term care residents with moderate to severe dementia in Ontario, Canada. Analysis was based on qualitative interviews and ethnographic observations of video-recorded clown-resident interactions and practice reflections. Findings highlight the reciprocal nature of clown-resident engagement and the capacity of residents to initiate as well as respond to verbal and embodied engagement. Termed relational presence, this was achieved and experienced through affective relationality, reciprocal playfulness, and coconstructed imagination. These results highlight the often overlooked capacity of individuals living with dementia to be deliberately funny, playful, and imaginative. Relational presence offers an important perspective with which to rethink care relationships between individuals living with dementia and long-term care staff.

scholarly journals Increasing the Frequency and Timeliness of Pain Assessment and Management in Long-Term Care: Knowledge Transfer and Sustained Implementation

2016 ◽  
Vol 2016 ◽  
pp. 1-13 ◽  
Author(s):  
Thomas Hadjistavropoulos ◽  
Jaime Williams ◽  
Sharon Kaasalainen ◽  
Paulette V. Hunter ◽  
Maryse L. Savoie ◽  
...  
Keyword(s):  
Pain Assessment ◽  
Large Scale ◽  
Management Practices ◽  
Long Term Care ◽  
Future Research ◽  
Clinical Practices ◽  
Term Care ◽  
Staff Members ◽  
Before And After

Background. Although feasible protocols for pain assessment and management in long-term care (LTC) have been developed, these have not been implemented on a large-scale basis.Objective. To implement a program of regular pain assessment in two LTC facilities, using implementation science principles, and to evaluate the process and success of doing so.Methods. The implementation protocol included a pain assessment workshop and the establishment of a nurse Pain Champion. Quality indicators were tracked before and after implementation. Focus groups and interviews with staff were also conducted.Results. The implementation effort was successful in increasing and regularizing pain assessments. This was sustained during the follow-up period. Staff members reported enthusiasm about the protocol at baseline and positive results following its implementation. Despite the success in increasing assessments, we did not identify changes in the percentages of patients reported as having moderate-to-severe pain.Discussion. It is our hope that our feasibility demonstration will encourage more facilities to improve their pain assessment/management practices.Conclusions. It is feasible to implement regular and systematic pain assessment in LTC. Future research should focus on ensuring effective clinical practices in response to assessment results, and determination of longer-term sustainability.

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.

Willingness of long‐term care staff to receive a COVID ‐19 vaccine: A single state survey

2020 ◽  
Author(s):  
Kathleen T. Unroe ◽  
Russell Evans ◽  
Lindsay Weaver ◽  
Dan Rusyniak ◽  
Justin Blackburn
Keyword(s):  
Long Term Care ◽  
Care Staff ◽  
Term Care ◽  
Single State ◽  
To Receive

scholarly journals A Cross-Sectional Study on the Impacts of Perceived Job Value, Job Maintenance, and Social Support on Burnout among Long-Term Care Staff in Hawaii

2021 ◽  
Vol 18 (2) ◽  
pp. 476
Author(s):  
Bum Jung Kim ◽  
Sun-young Lee
Keyword(s):  
Social Support ◽  
Long Term Care ◽  
Cross Sectional Study ◽  
Care Staff ◽  
Hierarchical Regression ◽  
Sectional Study ◽  
Cross Sectional ◽  
Term Care ◽  
The Impact

Extensive research has demonstrated the factors that influence burnout among social service employees, yet few studies have explored burnout among long-term care staff in Hawaii. This study aimed to examine the impact of job value, job maintenance, and social support on burnout of staff in long-term care settings in Hawaii, USA. This cross-sectional study included 170 long-term care staff, aged 20 to 75 years, in Hawaii. Hierarchical regression was employed to explore the relationships between the key independent variables and burnout. The results indicate that staff with a higher level of perceived job value, those who expressed a willingness to continue working in the same job, and those with strong social support from supervisors or peers are less likely to experience burnout. Interventions aimed at decreasing the level of burnout among long-term care staff in Hawaii may be more effective through culturally tailored programs aimed to increase the levels of job value, job maintenance, and social support.

scholarly journals Online Opioid Stewardship Training for Long-Term Care Staff

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 533-533
Author(s):  
Linda Edelman ◽  
Troy Andersen ◽  
Cherie Brunker ◽  
Nicholas Cox ◽  
Jorie Butler ◽  
...  
Keyword(s):  
Staff Training ◽  
Long Term Care ◽  
Treatment Strategies ◽  
Care Staff ◽  
Video Content ◽  
Opioid Use ◽  
Term Care ◽  
Increased Risk ◽  
Pain Management Strategy

Abstract Opioids are often the first-line chronic pain management strategy for long-term care (LTC) residents who are also at increased risk for opioid-related adverse events. Therefore, there is a need to train LTC providers and staff about appropriate opioid use and alternative treatment strategies. Our interdisciplinary team worked with LTC partners to identify staff educational needs around opioid stewardship. Based on this need’s assessment, we developed eight modules about opioid use and risks for older adults, including those with dementia, recommendations for de-prescribing including other pharmacological and non-pharmacological alternatives, SBIRT, and motivational interviewing to determine “what matters”. Each 20-minute module contains didactic and video content that is appropriate for group staff training or individuals and provides rural LTC facilities access to needed training in their home communities. Within the first month of launching online, the program received over 1100 hits and LTC partners are incorporating modules into clinical staff training schedules.

scholarly journals Understanding contributors to quality of care in long-term care and changes under COVID-19

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 960-960
Author(s):  
Sara Luck ◽  
Katie Aubrecht
Keyword(s):  
Quality Of Care ◽  
Long Term Care ◽  
The United States ◽  
Control Measures ◽  
Qualitative Description ◽  
Care Staff ◽  
Term Care ◽  
The Impact

Abstract Nursing home facilities are responsible for providing care for some of the most vulnerable groups in society, including the elderly and those with chronic medical conditions. In times of crisis, such as COVID-19 or other pandemics, the delivery of ‘regular’ care can be significantly impacted. In relation to COVID-19, there is an insufficient supply of personal protective equipment (PPE) to care for residents, as PPE not only protects care staff but also residents. Nursing homes across the United States and Canada have also taken protective measures to maximize the safety of residents by banning visitors, stopping all group activities, and increasing infection control measures. This presentation shares a research protocol and early findings from a study investigating the impact of COVID-19 on quality of care in residential long-term care (LTC) in the Canadian province of New Brunswick. This study used a qualitative description design to explore what contributes to quality of care for residents living in long-term care, and how this could change in times of crisis from the perspective of long-term care staff. Interviews were conducted with a broad range of staff at one LTC home. A semi-structured interview guide and approach to thematic analysis was framed by a social ecological perspective, making it possible to include the individual and proximal social influences as well as community, organizations, and policy influencers. Insights gained will improve the understanding of quality of care, as well as potential barriers and facilitators to care during times of crisis.

scholarly journals Implementation of Assistive Technologies and Robotics in Long-Term Care Facilities: A Three-Stage Assessment Based on Acceptance, Ethics, and Emotions

2021 ◽  
Vol 12 ◽  
Author(s):  
Annette Franke ◽  
Elmar Nass ◽  
Anna-Kathleen Piereth ◽  
Annabel Zettl ◽  
Christian Heidl
Keyword(s):  
Transformational Leadership ◽  
Long Term Care ◽  
Implementation Process ◽  
Well Being ◽  
Emotion Management ◽  
Assistive Technologies ◽  
Care Staff ◽  
Term Care ◽  
Care Facilities

Assistive technologies including assistive robots (AT/AR) appear to be a promising response to the increasing prevalence of older adults in need of care. An increasing number of long-term care facilities (LTCFs) try to implement AT/AR in order to create a stimulating environment for aging well and to reduce workload for professional care staff. The implementation of new technologies in an organization may lead to noticeable cultural changes in terms of social interactions and care practices associated with positive or negative emotions for the employees. This applies especially for LTCFs with high rates of vulnerable residents affected by increasing care needs and specific ethics in nursing and cultural rules within the setting. Thus, systematic consideration in leadership management of emotions and ethical aspects is essential for stakeholders involved in the implementation process. In this article, we explicitly focus on the emotions of the employees and leaders within LTCFs. We relate to direct consequences for the organizational well-being and culture, which is of course (indirectly) affecting patients and residents. While aspects of technology acceptance such as safety and usefulness are frequently discussed in academic literature, the topic of emotion-management and ethical questions during the organizational implementation process in LTCFs received little attention. Emotional culture entails affective values, ethical norms and perceptions of employees and further investigation is needed to address the importance of transformational leadership during implementation process. For this purpose, we developed a three-staged assessment tool for implementation of AT/AR in long-term care institutions. Acceptance (A), ethical acceptability (A) and emotional consequences (E) are considered as comprehensive assessment, in which emotional consequences comprise management aspects of transformational leadership (T), emotion-management (E) and organizational culture (O). Based on AAE and TEO, this paper presents an integrated framework illustrated with a illustrative example and aims to combine established approaches with ethical insights in order to unfold potentials of AT/AR in LTCSs.

scholarly journals Characteristics Associated with Quality of Life in Long-Term Care Residents with Dementia: A Cross-Sectional Study

2016 ◽  
Vol 42 (3-4) ◽  
pp. 186-197 ◽  
Author(s):  
Maartje S. Klapwijk ◽  
Monique A.A. Caljouw ◽  
Marjoleine J.C. Pieper ◽  
Jenny T. van der Steen ◽  
Wilco P. Achterberg
Keyword(s):  
Quality Of Life ◽  
Social Relations ◽  
Long Term Care ◽  
Neuropsychiatric Symptoms ◽  
Pulmonary Diseases ◽  
Severe Dementia ◽  
Cross Sectional ◽  
Term Care

Background: To determine which characteristics are associated with quality of life (QOL) in residents with moderate to very severe dementia in long-term care facilities (LTCFs). Material and Methods: This was a cross-sectional analysis of a cluster randomized controlled study in 12 Dutch LTCFs that enrolled 288 residents, with moderate to severe dementia assessed with the Reisberg Global Deterioration Scale (Reisberg GDS) and QOL with the QUALIDEM. Characteristics that were hypothesized to be associated with the six domains of QOL (applicable to very severe dementia) included demographic variables, activities of daily living (Katz ADL), cognitive performance (Cognitive Performance Scale; CPS), pain (Pain Assessment Checklist for Seniors with Limited Ability to Communicate; PACSLAC-D), neuropsychiatric symptoms (Neuropsychiatric Inventory-Nursing Home Version; NPI-NH) and comorbidities. Results: Multivariate logistic regression modelling showed associations with age in the domain Social isolation [odds ratio, OR, 0.95 (95% confidence interval, CI, 0.91-0.99)], ADL level in the domain Positive affect [OR 0.89 (95% CI 0.83-0.95)] and the domain Social relations [OR 0.87 (95% CI 0.81-0.93)], severity of dementia in the domain Social relations [OR 0.28 (95% CI 0.12-0.62)] and in the domain Social isolation [OR 2.10 (95% CI 1.17-3.78)], psychiatric disorders in the domain Positive affect [OR 0.39 (95% CI 0.17-0.87)] and pulmonary diseases in the domain Negative affect [OR 0.14 (95% CI 0.03-0.61)] of the QUALIDEM. Neuropsychiatric symptoms were independently associated with all six domains of the QUALIDEM [OR 0.93 (95% CI 0.90-0.96) to OR 0.97 (95% CI 0.95-0.99)]. Pain was associated with the domains Care relationship [OR 0.92 (95% CI 0.84-1.00)] and Negative affect [OR 0.92 (95% CI 0.85-1.00)]. Conclusion: QOL in dementia is independently associated with age, ADL, dementia severity, pain, psychiatric disorders, pulmonary diseases and neuropsychiatric symptoms. It is possible to detect persons with dementia at risk for a lower QOL. This information is important for developing personalized interventions to improve QOL in persons with dementia in LTCFs.

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