Choosing to live in a nursing home: a culturally and linguistically diverse perspective

2015 ◽  
Vol 21 (2) ◽  
pp. 239
Author(s):  
Cecilia A. Yeboah
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Older People ◽  
Cultural History ◽  
Nursing Home Residents ◽  
Linguistically Diverse ◽  
Culturally And Linguistically Diverse ◽  
Individual Interviews ◽  
Cultural Origins ◽  
Diverse Perspective

As part of the findings of a study on culturally and linguistically diverse older people relocating to a nursing home, this paper contributes to our understanding of how older people draw on their cultural history to explain their decisions to relocate. Family reciprocity was identified by most participants as central to their decisions, regardless of their specific cultural origins. Using the grounded theory methodology, data were collected through progressive, semi-structured, repeated, in-person, individual interviews with 20 residents of four nursing homes in the northern suburbs of Melbourne, Australia. Culturally and linguistically diverse (CALD) older people, regardless of specific cultural origin, make relocation decisions based on the importance and meaning of reciprocity within families. Understanding their decisions as reflecting a culturally valued reciprocity offered a sense of cultural continuity to the relocation and was comforting to the older adults involved in the study. This study also suggests that culturally and linguistically diverse older people are much more active participants in the decision to relocate to a nursing home than is commonly recognised. The four nursing homes in the northern suburbs of Melbourne and the 20 participants studied constitute only a small proportion of all culturally and linguistically diverse older nursing home residents in Australia. Therefore, the findings may not be pertinent to other culturally and linguistically diverse elderly. Nonetheless, this study makes an important contribution to future discussions regarding cultural diversity in the nursing home relocation of culturally and linguistically diverse older Australians. The study findings provide some insight into the conditions and contexts that impact nursing home relocation.

The Role of Nursing Homes Architectural Design in Mitigating the Risk of COVID-19 Pandemics: The Case of Slovenia

2022 ◽  
Vol 8 (1) ◽  
pp. 51-66
Author(s):  
Vesna Žegarac Leskovar ◽  
Vanja Skalicky Klemenčič
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Older People ◽  
Architectural Design ◽  
Nursing Home Residents ◽  
The Elderly ◽  
Evaluation Tool ◽  
Negative Effect ◽  
Disproportionate Number ◽  
Role Of Nursing

Currently, many older people live in institutions for various social and health reasons. In Slovenia, this proportion is almost 5% of the population aged 65 and over. In the COVID-19 pandemic, the elderly proved to be the most vulnerable social group, as they are exposed to a number of comorbidities that increase the risk of mortality. At that time, nursing homes represented one of the most critical types of housing, as seen from a disproportionate number of infections and deaths among nursing home residents worldwide, including Slovenia. During the emergency, a number of safety protocols had to be followed to prevent the spread of infection. Unfortunately, it turned out that while the safety measures protected the nursing home residents, they also had a negative effect on their mental health, mainly due to isolation and social distancing. It follows that especially in times of epidemics of infectious respiratory diseases, the quality of life in nursing homes requires special attention. In this context, it is also necessary to consider whether and how an appropriate architectural design can help mitigating the spread of infections, while at the same time enable older people to live in dignity and with a minimum of social exclusion. To this end, the present study examined 97 nursing homes in Slovenia, analysing the number of infections in nursing homes and their correlation with the degree of infection in the corresponding region in Slovenia. Additionally, 2 nursing homes were studied in more detail with the use of newly developed “Safe and Connected” evaluation tool, analysing the architectural features of each building. The advantages identified so far include living in smaller units, single rooms with balconies, the possibility of using green open spaces and the use of an adequate ventilation. Conclusions of this study are useful for further consideration of design of new nursing homes and the refurbishment of existing ones.

scholarly journals Effect on secondary care of providing enhanced support to residential and nursing home residents: a subgroup analysis of a retrospective matched cohort study

2019 ◽  
Vol 28 (7) ◽  
pp. 534-546 ◽  
Author(s):  
Therese Lloyd ◽  
Stefano Conti ◽  
Filipe Santos ◽  
Adam Steventon
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Older People ◽  
Residential Care ◽  
Rate Ratio ◽  
Care Home ◽  
Nursing Home Residents ◽  
Care Homes ◽  
Emergency Admissions ◽  
Hospital Use

BackgroundThirteen residential care homes and 10 nursing homes specialising in older people in Rushcliffe, England, participated in an improvement programme. The enhanced support provided included regular visits from named general practitioners and additional training for care home staff. We assessed and compared the effect on hospital use for residents in residential and nursing homes, respectively.MethodsUsing linked care home and administrative hospital data, we examined people aged 65 years or over who moved to a participating care home between 2014 and 2016 (n=568). We selected matched control residents who had similar characteristics to the residents receiving enhanced support and moved to similar care homes not participating in the enhanced support (n=568). Differences in hospital use were assessed for residents of each type of care home using multivariable regression.ResultsResidents of participating residential care homes showed lower rates of potentially avoidable emergency admissions (rate ratio 0.50, 95% CI 0.30 to 0.82), emergency admissions (rate ratio 0.60, 95% CI 0.42 to 0.86) and Accident & Emergency attendances (0.57, 95% CI 0.40 to 0.81) than matched controls. Hospital bed days, outpatient attendances and the proportion of deaths that occurred out of hospital were not statistically different. For nursing home residents, there were no significant differences for any outcome.ConclusionsThe enhanced support was associated with lower emergency hospital use for older people living in residential care homes but not for people living in nursing homes. This might be because there was more potential to reduce emergency care for people in residential care homes. In nursing homes, improvement programmes may need to be more tailored to residents’ needs or the context of providing care in that setting.

Statin Intake and All-Cause Mortality among Older Nursing Home Residents

Gerontology ◽  
2021 ◽  
pp. 1-5
Author(s):  
Anton De Spiegeleer ◽  
Jordi Van Migerode ◽  
Antoon Bronselaer ◽  
Evelien Wynendaele ◽  
Milan Peelman ◽  
...  
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Older People ◽  
Absolute Risk ◽  
Nursing Home Residents ◽  
Absolute Risk Reduction ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
All Cause Mortality ◽  
The Impact

<b><i>Background:</i></b> Statins are progressively accepted as being associated with reduced mortality. However, few real-world statin studies have been conducted on statin use in older people and especially the most frail, that is, the nursing home residents. <b><i>Objective:</i></b> The aim of this study was to evaluate the impact of statin intake in nursing home residents on all-cause mortality. <b><i>Method:</i></b> This is a cross-sectional study of 1,094 older people residing in 6 nursing homes in Flanders (Belgium) between March 1, 2020 and May 30, 2020. We considered all residents who were taking statins for at least 5 days as statin users. All-cause mortality during the 3 months of data collection was the primary outcome. Propensity score overlap-weighted logistic regression models were applied with age, sex, functional status, diabetes, and cardiac failure/ischemia as potential confounders. <b><i>Results:</i></b> 185 out of 1,094 residents were on statin therapy (17%). The statin intake was associated with decreased all-cause mortality: 4% absolute risk reduction; adjusted odds ratio 0.50; CI 0.31–0.81, <i>p</i> = 0.005. <b><i>Conclusions:</i></b> The statin intake was associated with decreased all-cause mortality in older people residing in nursing homes. More in-depth studies investigating the potential geroprotector effect of statins in this population are needed.

scholarly journals The Psychological Consequences of the COVID-19 on Residents and Staff in Nursing Homes

2020 ◽  
Vol 6 (4) ◽  
pp. 254-259
Author(s):  
Shenjiang Mo ◽  
Junqi Shi
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Older People ◽  
Nursing Home Residents ◽  
Future Research ◽  
Psychological Consequences ◽  
Ethical Challenges ◽  
Role Conflicts ◽  
External Stakeholders

Abstract In this commentary, we overview the existing research on psychological consequences caused by COVID-19 for both residents and staff in the nursing homes. We identify loneliness and emotional anxiety as main psychological consequences for nursing home residents, whereas uncertainty, hopelessness, work overload, and role conflicts are the most salient psychological challenges for the staff in the nursing homes during the pandemic. We then summarize the existing strategies and interventions responsive to the above challenges. We suggest that this overview may help nursing home managers understand what are the key psychological challenges and how to deal with them during a crisis period. Finally, we also encourage future research to pay more attention to exploring interventions specifically designed for vulnerable older people, understanding the role of the nursing home leader team in managing emotional and ethical challenges in organizations, and developing community-wide collaboration with multiple external stakeholders.

scholarly journals Profil Kerapuhan dan Masalah terkait Obat pada Kelompok Lanjut Usia di Panti Jompo Kota Surabaya

2019 ◽  
Vol 9 (4) ◽  
pp. 225
Author(s):  
Verlita Evelyn Susanto ◽  
Adji Prayitno Setiadi ◽  
Bobby Presley ◽  
Steven Victoria Halim ◽  
Eko Setiawan
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Older People ◽  
Nursing Home Residents ◽  
Cross Sectional Study ◽  
Inappropriate Drug ◽  
Limited Information ◽  
Drug Related Problems ◽  
Cross Sectional ◽  
Drugs Interaction

Frailty and drug related problems (DRPs) are common among elderly who lives in the nursing home. There is currently limited information available regarding the profile of frailty and DRPs among elderly living in the nursing homes in Indonesia. This project aims to describe the profile of frailty and DRPs among nursing home residents in Surabaya. This cross-sectional study was conducted in three nursing homes in Surabaya. Integrated Systematic Care for older People (ISCOPE) questionnaire was used to identify the frailty profile among participants. Beers Criteria, screening tool of older person’s prescriptions (STOPP), geriatric dosage handbook and drug interactions analysis and management were used as tools to identify and analyse drug related problems in this study. Several DRPs were identified in this study including inappropriate drug choices, drugs interaction, and inappropriate dose of drugs. In total, 68 elderly were recruited in this study and 41.18% of them were classified as frail older people. There was no drugs interaction with “clinical significance” being identified, however, inappropriate dose of drugs and potentially inappropriate drug choices were found in 58.82% and 19.12% of nursing home residents, respectively. Findings regarding the profile of frailty and DRPs among elderly may indicate the needs to implement an appropriate intervention strategic in order to optimize the use of medications among nursing homes-dwelling elderly people.

scholarly journals Effect of COVID-19-related Interruption of Visiting Dental Services on Pneumonia in Nursing Home Residents

2021 ◽  
Author(s):  
Kayoko Ito ◽  
Yuto Ochiai ◽  
Hirokazu Ashiga ◽  
Hirokazu Hayashi ◽  
Tomoko Iizumi ◽  
...  
Keyword(s):  
Nursing Home ◽  
Oral Health ◽  
Nursing Homes ◽  
Older People ◽  
Questionnaire Survey ◽  
Nursing Home Residents ◽  
Mortality Rates ◽  
Postal Questionnaire ◽  
Dental Services ◽  
Significant Difference

Abstract Background :The occurrence of pneumonia is strongly associated with oral health in older people. The study aim was to clarify the effect of the suspension of visiting dental services on the occurrence of pneumoniaduring thecoronavirus disease 2019 (COVID-19) pandemic.Methods :A self-administered postal questionnaire survey was conducted in 215 nursing homes in Japan. The questionnaire assessed the provision of visiting dental services and the interruption of theseservices following COVID-19emergency restrictions. Pneumonia, hospitalization, and mortality rates were examinedfor January–June 2019 and January–June 2020. Results :Of facilities receiving visiting dental services, 37.7%had interruptions tothoseservices. Overall, pneumonia, hospitalization, and mortality rates were lower in 2020 compared with 2019.In those facilities with nointerruptions, rates were significantly lower in 2020 compared with 2019,whereasthere was no significant difference between 2019 and 2020 in facilities with interruptions.Conclusion :Continuous dental services in nursing homes during the COVID-19 pandemic led to lower rates of pneumonia, hospitalization, and mortality.

scholarly journals A tablet-based intervention for activating nursing home residents with dementia: results from a cluster-randomized controlled trial

2021 ◽  
pp. 1-13
Author(s):  
Julie L. O’Sullivan ◽  
Sonia Lech ◽  
Paul Gellert ◽  
Ulrike Grittner ◽  
Jan-Niklas Voigt-Antons ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Randomized Controlled Trial ◽  
Nursing Home ◽  
Nursing Homes ◽  
Psychotropic Medication ◽  
Controlled Trial ◽  
Nursing Home Residents ◽  
Randomized Controlled ◽  
Cluster Randomized

Abstract Objectives: To investigate global and momentary effects of a tablet-based non-pharmacological intervention for nursing home residents living with dementia. Design: Cluster-randomized controlled trial. Setting: Ten nursing homes in Germany were randomly allocated to the tablet-based intervention (TBI, 5 units) or conventional activity sessions (CAS, 5 units). Participants: N = 162 residents with dementia. Intervention: Participants received regular TBI (n = 80) with stimulating activities developed to engage people with dementia or CAS (n = 82) for 8 weeks. Measurements: Apathy Evaluation Scale (AES-I, primary outcome), Quality of Life in Alzheimer’s Disease scale, QUALIDEM scale, Neuropsychiatric Inventory, Geriatric Depression Scale, and psychotropic medication (secondary outcomes). Momentary quality of life was assessed before and after each activity session. Participants and staff were blinded until the collection of baseline data was completed. Data were analyzed with linear mixed-effects models. Results: Levels of apathy decreased slightly in both groups (mean decrease in AES-I of .61 points, 95% CI −3.54, 2.33 for TBI and .36 points, 95% CI −3.27, 2.55 for CAS). Group difference in change of apathy was not statistically significant (β = .25; 95% CI 3.89, 4.38, p = .91). This corresponds to a standardized effect size (Cohen’s d) of .02. A reduction of psychotropic medication was found for TBI compared to CAS. Further analyses revealed a post-intervention improvement in QUALIDEM scores across both groups and short-term improvements of momentary quality of life in the CAS group. Conclusions: Our findings suggest that interventions involving tailored activities have a beneficial impact on global and momentary quality of life in nursing home residents with dementia. Although we found no clear advantage of TBI compared to CAS, tablet computers can support delivery of non-pharmacological interventions in nursing homes and facilitate regular assessments of fluctuating momentary states.

scholarly journals Impact of Roommates on MDRO Spread in Nursing Homes

2020 ◽  
Vol 41 (S1) ◽  
pp. s66-s67
Author(s):  
Gabrielle M. Gussin ◽  
Ken Kleinman ◽  
Raveena D. Singh ◽  
Raheeb Saavedra ◽  
Lauren Heim ◽  
...  
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Secondary Analysis ◽  
Nursing Home Residents ◽  
Multidrug Resistant ◽  
Healthcare Intervention ◽  
Odds Ratios ◽  
Care Needs ◽  
Environmental Cleaning ◽  
The Impact

Background: Addressing the high burden of multidrug-resistant organisms (MDROs) in nursing homes is a public health priority. High interfacility transmission may be attributed to inadequate infection prevention practices, shared living spaces, and frequent care needs. We assessed the contribution of roommates to the likelihood of MDRO carriage in nursing homes. Methods: We performed a secondary analysis of the SHIELD OC (Shared Healthcare Intervention to Eliminate Life-threatening Dissemination of MDROs in Orange County, CA) Project, a CDC-funded regional decolonization intervention to reduce MDROs among 38 regional facilities (18 nursing homes, 3 long-term acute-care hospitals, and 17 hospitals). Decolonization in participating nursing homes involved routine chlorhexidine bathing plus nasal iodophor (Monday through Friday, twice daily every other week) from April 2017 through July 2019. MDRO point-prevalence assessments involving all residents at 16 nursing homes conducted at the end of the intervention period were used to determine whether having a roommate was associated with MDRO carriage. Nares, bilateral axilla/groin, and perirectal swabs were processed for methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant enterococcus (VRE), extended-spectrum β-lactamase (ESBL)–producing Enterobacteriaceae, and carbapenem-resistant Enterobacteriaceae (CRE). Generalized linear mixed models assessed the impact of maximum room occupancy on MDRO prevalence when clustering by room and hallway, and adjusting for the following factors: nursing home facility, age, gender, length-of-stay at time of swabbing, bedbound status, known MDRO history, and presence of urinary or gastrointestinal devices. CRE models were not run due to low counts. Results: During the intervention phase, 1,451 residents were sampled across 16 nursing homes. Overall MDRO prevalence was 49%. In multivariable models, we detected a significant increasing association of maximum room occupants and MDRO carriage for MRSA but not other MDROs. For MRSA, the adjusted odds ratios for quadruple-, triple-, and double-occupancy rooms were 3.5, 3.6, and 2.8, respectively, compared to residents in single rooms (P = .013). For VRE, these adjusted odds ratios were 0.3, 0.3, and 0.4, respectively, compared to residents in single rooms (P = NS). For ESBL, the adjusted odds ratios were 0.9, 1.1, and 1.5, respectively, compared to residents in single rooms (P = nonsignificant). Conclusions: Nursing home residents in shared rooms were more likely to harbor MRSA, suggesting MRSA transmission between roommates. Although decolonization was previously shown to reduce MDRO prevalence by 22% in SHIELD nursing homes, this strategy did not appear to prevent all MRSA transmission between roommates. Additional efforts involving high adherence hand hygiene, environmental cleaning, and judicious use of contact precautions are likely needed to reduce transmission between roommates in nursing homes.Funding: NoneDisclosures: Gabrielle M. Gussin, Stryker (Sage Products): Conducting studies in which contributed antiseptic product is provided to participating hospitals and nursing homes. Clorox: Conducting studies in which contributed antiseptic product is provided to participating hospitals and nursing homes. Medline: Conducting studies in which contributed antiseptic product is provided to participating hospitals and nursing homes. Xttrium: Conducting studies in which contributed antiseptic product is provided to participating hospitals and nursing homes.

scholarly journals Antibiotic Susceptibility of Common Organisms Isolated from Urine Cultures of Nursing Home Residents

2020 ◽  
Vol 41 (S1) ◽  
pp. s118-s120
Author(s):  
Austin R. Penna ◽  
Taniece R. Eure Eure ◽  
Nimalie D. Stone ◽  
Grant Barney ◽  
Devra Barter ◽  
...  
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Antibiotic Susceptibility ◽  
Clinical Decision Making ◽  
Service Providers ◽  
Urine Culture ◽  
Nursing Home Residents ◽  
Antibiotic Prescribing ◽  
E Coli ◽  
Susceptibility Data

Background: With the emergence of antibiotic resistant threats and the need for appropriate antibiotic use, laboratory microbiology information is important to guide clinical decision making in nursing homes, where access to such data can be limited. Susceptibility data are necessary to inform antibiotic selection and to monitor changes in resistance patterns over time. To contribute to existing data that describe antibiotic resistance among nursing home residents, we summarized antibiotic susceptibility data from organisms commonly isolated from urine cultures collected as part of the CDC multistate, Emerging Infections Program (EIP) nursing home prevalence survey. Methods: In 2017, urine culture and antibiotic susceptibility data for selected organisms were retrospectively collected from nursing home residents’ medical records by trained EIP staff. Urine culture results reported as negative (no growth) or contaminated were excluded. Susceptibility results were recorded as susceptible, non-susceptible (resistant or intermediate), or not tested. The pooled mean percentage tested and percentage non-susceptible were calculated for selected antibiotic agents and classes using available data. Susceptibility data were analyzed for organisms with ≥20 isolates. The definition for multidrug-resistance (MDR) was based on the CDC and European Centre for Disease Prevention and Control’s interim standard definitions. Data were analyzed using SAS v 9.4 software. Results: Among 161 participating nursing homes and 15,276 residents, 300 residents (2.0%) had documentation of a urine culture at the time of the survey, and 229 (76.3%) were positive. Escherichia coli, Proteus mirabilis, Klebsiella spp, and Enterococcus spp represented 73.0% of all urine isolates (N = 278). There were 215 (77.3%) isolates with reported susceptibility data (Fig. 1). Of these, data were analyzed for 187 (87.0%) (Fig. 2). All isolates tested for carbapenems were susceptible. Fluoroquinolone non-susceptibility was most prevalent among E. coli (42.9%) and P. mirabilis (55.9%). Among Klebsiella spp, the highest percentages of non-susceptibility were observed for extended-spectrum cephalosporins and folate pathway inhibitors (25.0% each). Glycopeptide non-susceptibility was 10.0% for Enterococcus spp. The percentage of isolates classified as MDR ranged from 10.1% for E. coli to 14.7% for P. mirabilis. Conclusions: Substantial levels of non-susceptibility were observed for nursing home residents’ urine isolates, with 10% to 56% reported as non-susceptible to the antibiotics assessed. Non-susceptibility was highest for fluoroquinolones, an antibiotic class commonly used in nursing homes, and ≥ 10% of selected isolates were MDR. Our findings reinforce the importance of nursing homes using susceptibility data from laboratory service providers to guide antibiotic prescribing and to monitor levels of resistance.Disclosures: NoneFunding: None

scholarly journals Improving Quality of Life in Nursing Homes: The Structured Resident Interview Approach

2014 ◽  
Vol 2014 ◽  
pp. 1-8 ◽  
Author(s):  
Howard B. Degenholtz ◽  
Abby L. Resnick ◽  
Natalie Bulger ◽  
Lichun Chia
Keyword(s):  
Quality Of Life ◽  
Nursing Home ◽  
Nursing Homes ◽  
Planning Process ◽  
Intervention Group ◽  
Nursing Home Residents ◽  
Care Plan ◽  
Control Group ◽  
Improvement Programs

The quality of life (QOL) of the approximately 1.5 million nursing facility (NF) residents in the US is undoubtedly lower than desired by residents, families, providers, and policy makers. Although there have been important advances in defining and measuring QOL for this population, there is a need for interventions that are tied to standardized measurement and quality improvement programs. This paper describes the development and testing of a structured, tailored assessment and care planning process for improving the QOL of nursing home residents. The Quality of Life Structured Resident Interview and Care Plan (QOL.SRI/CP) builds on a decade of research on measuring QOL and is designed to be easily implemented in any US nursing home. The approach was developed through extensive and iterative pilot testing and then tested in a randomized controlled trial in three nursing homes. Residents were randomly assigned to receive the assessment alone or both the assessment and an individualized QOL care plan task. The results show that residents assigned to the intervention group experienced improved QOL at 90- and 180-day follow-up, while QOL of residents in the control group was unchanged.

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