scholarly journals Professional caregivers' experiences with the Liverpool Care Pathway in dementia: An ethnographic study in a Dutch nursing home

2017 ◽  
Vol 16 (4) ◽  
pp. 479-486 ◽  
Author(s):  
Natashe Lemos Dekker ◽  
Marjolein Gysels ◽  
Jenny T. van der Steen
Keyword(s):  
Nursing Home ◽  
Data Collection ◽  
The Netherlands ◽  
Care Pathway ◽  
Elderly Care ◽  
Ethnographic Study ◽  
Nursing Home Care ◽  
Communication Tool ◽  
Care Needs ◽  
People With Dementia

ABSTRACTObjective:There are few studies on how professional caregivers apply the Liverpool Care Pathway (LCP) in nursing home care for people with dementia. Further, despite critiques in the United Kingdom, the LCP continues to be used in the Netherlands, while, to the best of our knowledge, no studies have been conducted since its implementation. The purpose of the present study was to analyze professional caregivers' experiences with the LCP in this context.Method:This article draws on an ethnographic study. Data collection was based on 4 months of ethnographic fieldwork in 2015 in 11 psychogeriatric units of a nursing home in a rural area of the Netherlands. Data collection included participant observation and 25 semistructured audiotaped interviews with specialist elderly care physicians, nursing staff, and a nurse practitioner.Results:We found that professional caregivers appreciate the LCP as a communication tool and as a reminder of care goals. However, the document was deemed too complicated and to cause duplication of work. It was also reported that the LCP did not cover the complexity of care needs that emerge in practice. Actual care needs were prioritized over the LCP, which calls its contribution into question.Significance of Results:Overall, the LCP does not match the context of dementia care in the nursing home. While it could be argued that the LCP does not intend to replace good care, its benefits as a reminder and a communication tool need continued consideration in relation to the amount of work it requires as a bureaucratic obligation.

scholarly journals 423 - Characteristics of specialized units for people with dementia and very severe challenging behavior in the Netherlands: a mixed method study

2021 ◽  
Vol 33 (S1) ◽  
pp. 45-45
Author(s):  
Gerrie Van Voorden ◽  
Mijke Lips ◽  
Sytse Zuidema ◽  
Richard Christiaan Oude Voshaar ◽  
Martin Smalbrugge ◽  
...  
Keyword(s):  
Nursing Home ◽  
The Netherlands ◽  
Nursing Staff ◽  
Challenging Behavior ◽  
Elderly Care ◽  
Patient Characteristics ◽  
Nursing Home Care ◽  
Treatment Characteristics ◽  
People With Dementia

Introduction:Little is known about the raising number of specialized units for patients with dementia and very severe challenging behavior in the Netherlands. This study describes organizational and treatment characteristics of a sample of these units.Methods:The organizational and treatment characteristics were studied with digital questionnaires completed by the unit managers, interviews with the main physician(s) and observation of the physical environment. The questionnaire consisted of questions about general patient characteristics, unit characteristics and staff characteristics. Furthermore, an interview was held with the main/treating physician often together with another physician or psychologist. The interview guide consisted of questions about admission criteria, the role of staff involved and the treatment process.Results:Thirteen units participated. Five units were part of a mental health (MH) institution, seven units were part of a nursing home (NH) organization and one unit was a cooperation of MH and NH. Unit sizes ranged from 10 to 28 places. Ten of thirteen units started in 2010 or later. The age of patients admitted was estimated at 75 years. The percentage of involuntary admitted patients was 53% at MH-units and 18% at NH-units. Unit managers mentioned that due to a difference in reimbursement between MH and NH units had difficulty providing the specialized care. Another problem managers faced was recruiting nursing staff. Units strived for expertise in general staffing from both MH and NH. The education level of the nursing staff was comparable between MH and NH. At every unit a physician with background in elderly care medicine or geriatrics and a psychiatrist was involved. Interviewees stressed the role of the nursing staff in the treatment. They were key in providing the care and treatment that, since the main goal of interventions is treatment of and coping with challenging behavior.Conclusion:The main finding of this study is that units caring for patients with dementia and challenging behavior, despite barriers in regulations and staffing shortage, search for combining expertise from nursing home care and psychiatry in their treatment.

scholarly journals The ideals of group living homes for people with dementia: do they practice what they preach?

2011 ◽  
Vol 23 (9) ◽  
pp. 1526-1527 ◽  
Author(s):  
Selma te Boekhorst ◽  
Marja F.I.A. Depla ◽  
Anne Margriet Pot ◽  
Jacomine de Lange ◽  
Jan A. Eefsting
Keyword(s):  
Twentieth Century ◽  
Nursing Home ◽  
Nursing Homes ◽  
The Netherlands ◽  
Home Care ◽  
Older People ◽  
Hospital Care ◽  
Group Living ◽  
Nursing Home Care ◽  
People With Dementia

In the Netherlands, as well as in other countries, nursing home care has been traditionally modeled on hospital care. However, in the last decades of the twentieth century, realization grew that, unlike hospitals, nursing homes needed to serve as literal homes to people. As a consequence, the concept of group living homes for older people with dementia has taken root.

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

Dementia ◽  
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.

scholarly journals Living at the farm, innovative nursing home care for people with dementia – study protocol of an observational longitudinal study

2015 ◽  
Vol 15 (1) ◽  
Author(s):  
B. de Boer ◽  
J.P.H. Hamers ◽  
H.C. Beerens ◽  
S.M.G. Zwakhalen ◽  
F.E.S. Tan ◽  
...  
Keyword(s):  
Nursing Home ◽  
Longitudinal Study ◽  
Home Care ◽  
Study Protocol ◽  
Nursing Home Care ◽  
People With Dementia

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

Healthcare ◽  
2018 ◽  
Vol 6 (4) ◽  
pp. 137 ◽  
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.

scholarly journals Interventions to support people with dementia and their informal caregivers during the transition from home care to nursing home care – a protocol for a systematic review / Interventionen zur Unterstützung von Menschen mit Demenz und ihren Angehörigen während des Übergangs von der häuslichen Pflege ins Pflegeheim – ein Studienprotokoll für eine systematische Übersichtsarbeit

2016 ◽  
Vol 3 (2) ◽  
pp. 122-135
Author(s):  
Christian Müller ◽  
Janine Puls ◽  
Sindy Lautenschläger ◽  
Astrid Stephan ◽  
Gabriele Meyer
Keyword(s):  
Systematic Review ◽  
Nursing Home ◽  
Home Care ◽  
Data Extraction ◽  
Informal Caregivers ◽  
The Body ◽  
Nursing Home Care ◽  
Bibliographic Databases ◽  
People With Dementia ◽  
Mrc Framework

Abstract Background The transition from home care to nursing home care is a significant event in the life of a person with dementia and also for informal caregiver, who deal with many crises and changes. Aim To describe a protocol for a systematic review based on the `‘PRISMA-P 2015 statement`. We will carry out this review firstly to identify interventions that support people with dementia and their informal caregivers in the transition from home care to nursing home care, secondly to synthesise the available evidence for the efficacy of identified interventions, and thirdly to examine whether the identified interventions have been systematically developed, evaluated and implemented according to the MRC framework. Design This systematic review will be conducted according to the recommendations specified in the Cochrane Handbook for Intervention Reviews; reporting will follow the PRISMA statement. Methods The search strategy covers six electronic bibliographic databases, Google Scholar and ALOIS. In addition, backward citation tracking will be applied. The protocol includes decisions made on the research questions, inclusion/exclusion criteria, search methods, study selection, data extraction, assessment of risk of bias, data synthesis and plans for dissemination and funding. Discussion This systematic review will summarise the body of evidence of interventions supporting people with dementia and their informal caregivers during the transition from home care to nursing home care. Protocol Registration This review protocol has been registered on the Prospective Register of Systematic Reviews (PROSPERO 2015: CRD42015019839).

scholarly journals For-Profit Nursing Homes in the Netherlands: What Factors Explain Their Rise?

2020 ◽  
Vol 50 (4) ◽  
pp. 431-443 ◽  
Author(s):  
Aline Bos ◽  
Florien Margareth Kruse ◽  
Patrick Paulus Theodoor Jeurissen
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
The Netherlands ◽  
Nonprofit Organizations ◽  
Private Equity ◽  
Nonprofit Sector ◽  
Nursing Home Care ◽  
Specialist Care ◽  
Labor Costs ◽  
For Profit

This exploratory, mixed-methods study analyzes characteristics of the emerging for-profit nursing home industry in the Netherlands and identifies the interrelated set of factors (context, trends, and sector conditions) that contribute to its growth. Until recently, the Dutch nursing home sector relied almost exclusively on nonprofit providers. Even though profit distribution in nursing home care is still banned, the for-profit nursing home sector is expanding. The study uses economic theory on nonprofit organizations and mixed-form markets to understand this expansion. We find that changes in the regulatory framework have unlocked the potential of the for-profit nursing home sector, enabling for-profit nursing homes to circumvent the for-profit ban. The expansion of the for-profit sector was mainly driven by the low responsiveness of the nonprofit sector to increased and changed demands. For-profit providers took advantage of this void. Moreover, they exploited “cream-skimming” potential in the market and used the wider care system to reduce their labor costs by relying on external specialist care. Another main driver was the access to financial capital from private investors (e.g., private equity firms).

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