Involuntary care – capturing the experience of people with dementia in nursing homes. A concept mapping study

Abstract Background The purpose of this study was (1) to develop a virtual reality (VR) intervention program based on the psychological needs of patients residing in nursing facilities in South Korea to alleviate their behavioral and psychological symptoms and (2) to confirm the possibility of utilizing VR in patients with dementia. Methods In the first phase, patients with dementia residing in nursing homes and experiencing behavioral and psychological symptoms were recruited. Surveys and questionnaires were used to identify activities that alleviated the behavioral and psychological symptoms of dementia (BPSD) among the patients. These activities were classified into five types of psychological needs. In the second phase, a fully immersive, interactive, easy-to-use VR platform was developed that reflected these psychological needs. Patients with dementia experienced the VR content. The researchers assessed the level of the participants’ immersion, preference, and interaction with the VR using a 5-point Likert scale. Results In the feasibility test, 10 nursing home residents were recruited. The mean immersion score was 4.93 ± 0.16 points, the mean preference score was 4.35 ± 0.41 points, and the mean interaction score was 3.84 ± 0.43 points using a 5-point Likert scale. Higher mean scores indicated a more positive outcome. Six of the 10 participants required assistance while using the VR. The mean VR experience duration was 10.00 ± 3.46 min. Conclusions The VR-based intervention program that was developed to reduce BPSD was feasible for the participants and provided them with a high degree of satisfaction and immersion. Furthermore, this study also confirmed the convenience and safety of the program. These findings support the potential use of VR-based BPSD intervention programs to treat patients with dementia.

Download Full-text

Parental expectations for children with intellectual disability or autism in Ghana and Zambia: A concept mapping study

Research in Developmental Disabilities ◽

10.1016/j.ridd.2021.103989 ◽

2021 ◽

Vol 114 ◽

pp. 103989

Author(s):

Princess-Melissa Washington-Nortey ◽

Zewelanji Serpell

Keyword(s):

Intellectual Disability ◽

Concept Mapping ◽

Parental Expectations ◽

Mapping Study ◽

Children With Intellectual Disability

Download Full-text

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.

Download Full-text

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

BMC Geriatrics ◽

10.1186/s12877-021-02120-1 ◽

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.

Download Full-text

Mealtime Care for People With Dementia: What Do Nursing Home Staff Think?

Innovation in Aging ◽

10.1093/geroni/igaa057.591 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 182-183

Author(s):

James Faraday ◽

Clare Abley ◽

Catherine Exley ◽

Joanne Patterson

Keyword(s):

Nursing Homes ◽

Ethnographic Study ◽

Direct Care ◽

Care Staff ◽

Direct Care Staff ◽

Structured Interviews ◽

Staff Members ◽

People With Dementia ◽

Comparison Approach ◽

The Right

Abstract More and more people with dementia are living in nursing homes (NH). Often, they depend on NH staff for help with eating and drinking. It is important that staff have the skills and support they need to provide good care at mealtimes. This qualitative study explores mealtime care for people with dementia, from the perspective of NH staff. Semi-structured interviews with NH staff (n=16) were carried out in two nursing homes. The homes were chosen to have diverse characteristics: one home had a large number of beds and was part of a small local organization; the other had a small number of beds and was part of a large national organization. Various staff members were interviewed, including direct care staff, senior carers, nurses, managers, and kitchen staff. Interviews were audio-recorded and transcribed verbatim. A constant comparison approach was taken, so that data from early interviews were explored in more depth subsequently. From the analysis, five themes emerged as important in mealtime care for people with dementia living in nursing homes: Setting the right tone; Working well as a team; Knowing the residents; Promoting autonomy and independence; Gently persevering. This work forms part of a larger ethnographic study on the topic, which includes data from residents with dementia, and family carers. Results will inform the development of a staff training intervention to optimize mealtime care for this population.

Download Full-text

A national eHealth vision developed by University Medical Centres: A concept mapping study

International Journal of Medical Informatics ◽

10.1016/j.ijmedinf.2019.104032 ◽

2020 ◽

Vol 133 ◽

pp. 104032

Author(s):

Anneloek Rauwerdink ◽

Marise J. Kasteleyn ◽

Joke A. Haafkens ◽

Niels H. Chavannes ◽

Marlies P. Schijven

Keyword(s):

Concept Mapping ◽

Mapping Study

Download Full-text

The meaning of slow nursing in dementia care

Dementia ◽

10.1177/1471301215625112 ◽

2015 ◽

Vol 16 (7) ◽

pp. 930-947 ◽

Cited By ~ 8

Author(s):

Daniela Lillekroken ◽

Solveig Hauge ◽

Åshild Slettebø

Keyword(s):

Nursing Homes ◽

Focus Group ◽

Best Practices ◽

Sense Of Coherence ◽

Participant Observation ◽

Research Literature ◽

Focus Group Interviews ◽

People With Dementia ◽

Group Interviews ◽

The Moment

Research literature in the dementia field lacks examples of ‘best-practices’ demonstrating concretely how it is possible to support the sense of coherence in people with dementia. The purpose of this study was to elucidate the nurses’ views concerning a caring approach that may support the sense of coherence in people with dementia. The data were collected through participant observation and focus group interviews during a four-month period in 2011. Sixteen registered nurses recruited from two Norwegian nursing homes participated in this study. The data were interpreted using a phenomenological-hermeneutical method. Three themes were identified: ‘being in the moment’, ‘doing one thing at a time’, and ‘creating joy and contentment’. An overall interpretation of these themes is described by the metaphor ‘slow nursing’, a caring approach that may lead to supporting the sense of coherence in people with dementia.

Download Full-text

How to Achieve the Desired Outcomes of a Complex Intervention in Nursing Homes: A Theory of Change

Innovation in Aging ◽

10.1093/geroni/igaa057.1234 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 383-383

Author(s):

Martin Dichter ◽

Jonas Hylla ◽

Almuth Berg ◽

Daniela Eggers ◽

Ralph Möhler ◽

...

Keyword(s):

Nursing Homes ◽

Psychosocial Intervention ◽

Sleep Disturbances ◽

Intervention Development ◽

Psychosocial Interventions ◽

Causal Chain ◽

Theory Of Change ◽

Expert Survey ◽

People With Dementia ◽

Individual Knowledge

Abstract Background Recent systematic reviews suggest the effectiveness of complex psychosocial interventions to reduce sleep disturbances in people with dementia (PwD) living in nursing homes. However, it is unclear how and under which circumstances these interventions work and which components and processes are crucial determinants for effectiveness. Objectives To develop a Theory of Change (ToC) that describes a causal chain for the reduction of sleep disturbances. Design and Methods The ToC approach is a participatory method in intervention development to generate knowledge about how, why, and under which circumstances interventions are effective. We conducted two expert workshops, a subsequent expert survey (n=12), a systematic literature review, and expert interviews (day and night nurses). Results Necessary preconditions for the reduction of sleep disturbances were identified on staff, management and cultural levels of nursing homes. Intermediate goals like “individual knowledge on PwD is available”, “a specific institutional concept to promote sleep is implemented”, “person-centred care is implemented” and “sleep preferences of PwD are fulfilled” were defined. The intermediate goals, interventions, promoting and inhibiting factors as well as rationales were sorted into a causal chain. All intermediate goals were rated as relevant or highly relevant based on the expert survey. Conclusions The ToC model displays how a complex psychosocial intervention is likely to be effective in reducing sleep disturbances and meeting sleep preferences of PwD in nursing homes. The model is the basis for the development and evaluation of a planned complex psychosocial intervention to prevent and reduce sleep disturbances in PwD.

Download Full-text