Utilization of palliative care principles in nursing home care: Educational interventions

ABSTRACTObjective:This study is part of the overarching PVIS (Palliative Care in Nursing Homes) project aimed at building competence in palliative care for nursing home staff. Our objective was to describe nursing home staff's attitudes to competence-building programs in palliative care.Method:Three different programs were developed by specialist staff from three local palliative care teams. In all, 852 staff at 37 nursing homes in the greater Stockholm area participated. Staff from 7 nursing homes participated in 11 focus-group discussions. Variation in size between the seven nursing homes initiated purposeful selection of staff to take part in the discussions, and descriptive content analysis was used.Results:The results suggest that staff reported positive experiences as they gained new knowledge and insight into palliative care. The experiences seemed to be similar independent of the educational program design. Our results also show that staff experienced difficulties in talking about death. Enrolled nurses and care assistants felt that they carried out advanced care without the necessary theoretical and practical knowledge. Further, the results also suggest that lack of support from ward managers and insufficient collaboration and of a common language between different professions caused tension in situations involved in caring for dying people.Significance of results:Nursing home staff experienced competence-building programs in palliative care as useful. Even so, further competence is needed, as is long-term implementation strategies and development of broader communication skills among all professions working in nursing homes.

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Do Palliative Care Teams in Nursing Homes Improve the Quality of End-of-Life Care for Nursing Home Residents?

10.25302/7.2019.cer.641 ◽

2019 ◽

Author(s):

Helena Temkin-Greener Helena Temkin-Greener ◽

Dana Mukamel ◽

Susan Ladwig ◽

Thomas , Caprio ◽

Sally Norton ◽

...

Keyword(s):

Palliative Care ◽

Nursing Home ◽

Nursing Homes ◽

End Of Life ◽

End Of Life Care ◽

Nursing Home Residents ◽

Life Care ◽

Palliative Care Teams

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The concept of restraint in nursing home practice: a mixed-method study in nursing homes for people with dementia

International Psychogeriatrics ◽

10.1017/s1041610210002267 ◽

2011 ◽

Vol 23 (5) ◽

pp. 826-834 ◽

Cited By ~ 10

Author(s):

Sandra A. Zwijsen ◽

Marja F. I. A. Depla ◽

Alistair R. Niemeijer ◽

Anneke L. Francke ◽

Cees M. P. M. Hertogh

Keyword(s):

Nursing Home ◽

Nursing Homes ◽

Focus Group ◽

Nursing Home Residents ◽

Developed Countries ◽

Nursing Home Care ◽

Care Practice ◽

Focus Group Discussions ◽

Group Discussions ◽

People With Dementia

ABSTRACTIntroduction: Although in most developed countries the use of restraints is regulated and restricted by law, the concept of restraint in nursing home care remains ambiguous. This study aims to explore how care professionals and family members of nursing home residents with dementia in the Netherlands experience and define the concept of restraint.Methods: Individual interviews were held with relatives (n = 7) and key persons (n = 9) in seven nursing homes. We also conducted eight focus group discussions with nursing home staff. In addition, a structured questionnaire was administered to the nurses of participating nursing homes.Results: In the questionnaire, over 80% of the respondents indicated considering “fixation” (e.g. use of belts) as a restraint and 50 to 70% of the respondents regarded other physical interventions, such as geriatric chairs and bedrails, as restraints. The interviews and focus group discussions show that the residents' perception of the intervention, the staff's intention behind the intervention and concerns of privacy are the criteria used by the respondents in defining an intervention as a restraint.Conclusions: When trying to diminish restraint use, it is important to be aware of the “local logic” of care practice and to take into account the fact that, for staff and relatives, an intervention is only regarded as a restraint when it is bothering a resident or when an intervention is used for the sole purpose of restricting freedom and/or when interventions invade the privacy of a resident.

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Pain Intervention for People with Dementia in Nursing Homes (PID): Recognition of Pain Events in Routine Nursing Home Care

10.26226/morressier.5c76c8b9e2ea5a7237611ee5 ◽

2019 ◽

Author(s):

Andrea L Koppitz

Keyword(s):

Nursing Home ◽

Nursing Homes ◽

Home Care ◽

Nursing Home Care ◽

People With Dementia ◽

Pain Intervention

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The experiences, priorities, and perceptions of informal caregivers of people with dementia in nursing homes: A scoping review

Dementia ◽

10.1177/14713012211012606 ◽

2021 ◽

pp. 147130122110126

Author(s):

Alexandra E Harper ◽

Lauren Terhorst ◽

Marybeth Moscirella ◽

Rose L Turner ◽

Catherine V Piersol ◽

...

Keyword(s):

Nursing Home ◽

Nursing Homes ◽

Home Care ◽

Scoping Review ◽

Informal Caregivers ◽

Nursing Home Care ◽

Person Centered Care ◽

People With Dementia ◽

Centered Care

Background Person-centered care has been shown to increase desired outcomes for people with dementia, yet informal caregivers’ dissatisfaction with care is often reported. For those living in a nursing home, informal caregivers are uniquely situated to provide key insights into the individual’s care. However, little is known of the informal caregivers’ perspective, which hinders efforts to improve their satisfaction with person-centered nursing home care. Thus, we examined the comprehensive experiences, priorities, and perceptions of informal caregivers of nursing home residents with dementia. Methods In collaboration with stakeholders, a scoping review of Medline (Ovid), EMBASE.com , CINAHL (EBSCO), the Cochrane Library (Wiley), and PsycINFO (Ovid) databases from January 2000 to July 2020 was conducted. Data were extracted reflecting the experiences, priorities, and preferences of caregivers of people with dementia residing in nursing homes. Results We identified 114 articles that revealed nine themes: (1) communication, (2) transition to nursing home, (3) quality of care, (4) quality of life, (5) informal caregiver role, (6) knowledge of dementia, (7) end-of-life preferences, (8) medication use to manage neuropsychiatric behaviors, and (9) finances. Conclusion Informal caregivers described aspects of care that led to both positive and negative experiences with and perceptions of nursing home care. The shortcomings in communication were discussed most frequently, indicating a high priority area. While researchers define the identified themes individually, informal caregivers perceive them to be interwoven as they relate to person-centered care delivery. Although we did not assess the quality of included articles, by identifying themes relevant to caregivers’ perspectives of nursing home care, our findings may help to inform efforts to optimize caregivers’ satisfaction with nursing home care for residents with dementia.

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Moss Releases Report on Positive Aspects of Nursing Home Care: Suggests Able-Bodied Seniors Work in Nursing Homes

Journal of Gerontological Nursing ◽

10.3928/0098-9134-19760101-10 ◽

1976 ◽

Vol 2 (1) ◽

pp. 33-33

Author(s):

Anonymous

Keyword(s):

Nursing Home ◽

Nursing Homes ◽

Home Care ◽

Nursing Home Care

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The Physical Environment of Nursing Homes for People with Dementia: Traditional Nursing Homes, Small-Scale Living Facilities, and Green Care Farms

Healthcare ◽

10.3390/healthcare6040137 ◽

2018 ◽

Vol 6 (4) ◽

pp. 137 ◽

Cited By ~ 11

Author(s):

Bram de Boer ◽

Hanneke Beerens ◽

Melanie Katterbach ◽

Martina Viduka ◽

Bernadette Willemse ◽

...

Keyword(s):

Nursing Home ◽

Nursing Homes ◽

Physical Environment ◽

Well Being ◽

Nursing Home Care ◽

Small Scale ◽

People With Dementia ◽

Different Types ◽

Centered Care ◽

Green Care Farms

It is well recognized that the physical environment is important for the well-being of people with dementia. This influences developments within the nursing home care sector where there is an increasing interest in supporting person-centered care by using the physical environment. Innovations in nursing home design often focus on small-scale and homelike care environments. This study investigated: (1) the physical environment of different types of nursing homes, comparing traditional nursing homes with small-scale living facilities and green care farms; and (2) how the physical environment was being used in practice in terms of the location, engagement and social interaction of residents. Two observational studies were carried out. Results indicate that the physical environment of small-scale living facilities for people with dementia has the potential to be beneficial for resident’s daily life. However, having a potentially beneficial physical environment did not automatically lead to an optimal use of this environment, as some areas of a nursing home (e.g., outdoor areas) were not utilized. This study emphasizes the importance of nursing staff that provides residents with meaningful activities and stimulates residents to be active and use the physical environment to its full extent.

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Families, Alzheimer's Disease, and Nursing Homes

Journal of Applied Gerontology ◽

10.1177/073346488800700305 ◽

1988 ◽

Vol 7 (3) ◽

pp. 331-349 ◽

Cited By ~ 29

Author(s):

Nathan L. Linsk ◽

Baila Miller ◽

Roberta Pflaum ◽

Anna Ortigara-Vicik

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Nursing Home ◽

Nursing Homes ◽

Care Center ◽

Family Members ◽

Nursing Home Care ◽

Demonstration Program ◽

Home Setting

The Alzheimer's Disease Family Care Center program was established within an intermediate care teaching nursing home as a demonstration program to investigate ways to involve families in care of their relatives. In total, 45 family members participated in a program including an orientation session; a preliminary family involvement interview; contracts with family members, in which they chose specific tasks to engage in during visits; a five-session course on Alzheimer's disease and how families may be partners in care within the facility; and an ongoing family support group. Evaluation data sources include a baseline and 9-month follow-up questionnaire completed by families, preliminary and follow-up family interviews conducted by project codirectors, records of family visits, and family choices on contracts. Findings from the 23 family members who contracted for tasks during their visits and from the follow-up questionnaire completed by 25 family members showed that most sought social and emotional interactions with relatives, some maintained direct personal care activities, and only a few identified interest in extensive involvement with staff and facility. At follow-up, family members involved in the program reported they continued to feel close to their relatives. Many felt that their relatives were generally stable or improved with regard to cognitive function, but over a third noted difficulties in communicating. Participating family members reported that the program of staff supports helped them to feel more integral to the unit. They expressed a need for more education and support for their involvement in the nursing home setting. Project findings confirm previous studies recommending that programming at nursing homes needs to include specific institutional and staff supports to maintain and enhance family contributions to the long-term nursing home care of their relatives.

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