scholarly journals Addressing the Needs of Persons Living With Dementia Across Care Settings (A Collaborative Symposium between the Assisted Living and Research in Quality Care Interest Groups)

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 668-668
Author(s):  
Howard Degenholtz ◽  
Candace Kemp ◽  
Doug Pace
Keyword(s):  
Interest Groups ◽  
Assisted Living ◽  
Qualitative Data ◽  
Quality Care ◽  
Well Being ◽  
Personal Care ◽  
Care Community ◽  
Person Centered Care ◽  
Centered Care ◽  
Using Data

Abstract Understanding the needs of persons living with dementia is critical to promoting quality of life and care. Co-sponsored by the Assisted Living (AL) and Research in Quality Care Interest Groups, this symposium includes four papers that present new ways to use claims data, qualitative data, benchmarking data, and intervention data to promote well-being for persons living with dementia. First, Degenholtz and Van Cleve use Pennsylvania Medicaid data from 2014-2016 to examine the provision of personal care to persons with and without dementia. They find that those living with dementia received more personal care per day across levels of physical disability and discuss implications for home and community based services policy. Next, Kemp et al. investigate meaningful engagement among assisted living residents with dementia using qualitative data collected over a one-year period in four diverse care communities. Findings show a range of engagement experiences and point to the influence of key resident, care partner, and care community influences. Third, Morgan et al. use data from a statewide probability sample of nursing home staff (n=438) to identify barriers and facilitators to person-centered care. Findings show key barriers to delivering person-centered care, including a lack of staff empowerment practices and low use of consistent assignment. Last, Zimmerman et al. present an evidence-based program, “Mouth Care Without a Battle” developed in nursing homes. Using data from over 2,000 assisted living stakeholders, they situate their findings within implementation science and the NIH Stage Model and make their findings transferable regardless of focus or setting.

scholarly journals Implementation of Person-Centered Care: A Feasibility Study Using the WE-CARE Roadmap

2021 ◽  
Vol 18 (5) ◽  
pp. 2205
Author(s):  
Roman A. Lewandowski ◽  
Jędrzej B. Lewandowski ◽  
Inger Ekman ◽  
Karl Swedberg ◽  
Jan Törnell ◽  
...  
Keyword(s):  
Pilot Study ◽  
Feasibility Study ◽  
Health Care Professionals ◽  
Quality Care ◽  
Structured Interviews ◽  
Rehabilitation Hospital ◽  
Person Centered Care ◽  
Centered Care ◽  
Multi Disciplinary Team

Background: Person-Centered Care (PCC) is a promising approach towards improved quality of care and cost containment within health systems. It has been evaluated in Sweden and England. This feasibility study examines initial PCC implementation in a rehabilitation hospital for children in Poland. Methods: The WE-CARE Roadmap of enablers was used to guide implementation of PCC for patients with moderate scoliosis. A multi-disciplinary team of professionals were trained in the PCC approach and the hospital Information Technology (IT) system was modified to enhance PCC data capture. Semi-structured interviews were conducted with the nine health care professionals involved in the pilot study and three patients/parents receiving care. Transcribed data were analyzed via content analysis. Results: 51 patients and their families were treated via a PCC approach. High proportions of new PCC data fields were completed by the professionals. The professionals were able to implement the three core PCC routines and perceived benefits using the PCC approach. Patients and their families also perceived improved quality care. The WE-CARE framework enablers facilitated PCC implementation in this setting. Conclusions: This feasibility pilot study indicates that the Gothenburg PCC approach can be successfully transferred to a rehabilitation hospital in Poland with favorable perceptions of implementation by both professionals and patients/their families.

scholarly journals From Micro to Macro: Exploring Preference-Based Person Centered Care from Multiple Perspectives

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 836-836
Author(s):  
Katherine Abbott ◽  
Kristine Williams
Keyword(s):  
Nursing Home ◽  
Assisted Living ◽  
Fixed Effects ◽  
Nursing Home Residents ◽  
Direct Care ◽  
Multiple Perspectives ◽  
Person Centered Care ◽  
Fixed Effects Panel Regression ◽  
Centered Care ◽  
The Impact

Abstract Advancing our knowledge related to honoring nursing home resident preferences is a cornerstone of person-centered care (PCC). While there are multiple approaches to providing PCC, we focus on resident preferences as assessed via the Preferences for Everyday Living Inventory (PELI). The PELI is an evidenced-based, validated instrument that can be used to enhance the delivery of PCC. In this symposium, we explore the perspectives of a variety of stakeholders including nursing home residents, staff, and the impact of preference-based care on provider level regulatory outcomes. First, we present a comparative study of preference importance among n=317 African America and White nursing home residents that found more similarities than differences between the two groups. Second, a content analysis of the responses from n=196 interviews with nursing home residents details the barriers and facilitators connected to their levels of satisfaction with their preferences being fulfilled. Third, perspectives from n=27 direct care workers explore the concept of pervasive risk avoidance to the delivery of PCC. Fourth, systems-level practices, such as shift assignments and provider schedules are identified as barriers to successfully fulfilling resident preferences from the perspectives of n=19 staff within assisted living. Our final presentation utilizes a fixed-effects panel regression analysis with n=551 Ohio nursing home providers to explore the impact of PELI use on regulatory outcomes such as substantiated complaints and deficiency scores reported in the CMS Nursing Home Compare data. Discussant Dr. Kristi Williams will integrate findings, highlighting implications for policy, practice, and future directions. Research in Quality of Care Interest Group Sponsored Symposium.

scholarly journals How Assisted Living Staff Conceive of Dementia Care

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 676-677
Author(s):  
Debra Dobbs ◽  
Sheryl Zimmerman ◽  
Stephanie Miller ◽  
Paula Carder ◽  
Anna Beeber ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Assisted Living ◽  
Medication Management ◽  
Mixed Methods Study ◽  
Organizational Characteristics ◽  
Medical Interventions ◽  
Person Centered Care ◽  
Outcomes Of Care ◽  
Centered Care ◽  
Care Practices

Abstract For those who provide care to the more than 40% of persons with dementia in assisted living (AL) communities, behavioral expressions (BEs) can be challenging. The objective of this mixed-methods study was to understand how AL staff conceive of BEs and what strategies they use to address them. Staff from 250 AL communities in seven states were asked to describe one successful and unsuccessful case of care. A conceptual model related to antecedents, behaviors, and consequences was developed and expanded to include staff strategies and outcomes of care; organizational characteristics associated with care practices were examined. Anxiety/restlessness, combativeness and resistance to care were the most prevalent BEs. Medical interventions (e.g., inpatient psychiatric assessment, medication management) were used in two-thirds of cases. Person-centered care was used more often in successful cases. Respondents in dementia-only communities identified antecedents to BEs more often than those in other communities.

scholarly journals Resident and Family Engagement in Care Conferences: Important Processes and Supporting Strategies

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 270-270
Author(s):  
Elizabeth Cox ◽  
Thuy Dan Tran ◽  
Hannah Tepsa ◽  
Tonya Roberts
Keyword(s):  
Decision Making ◽  
Family Engagement ◽  
Well Being ◽  
Self Determination ◽  
Tool Development ◽  
Engagement In Care ◽  
Person Centered Care ◽  
Centered Care ◽  
Virtual Meetings ◽  
Existing Structure

Abstract Self-determination is a core value of person-centered care. Research has shown residents and families want to be involved in decisions about care. Care conferences are one existing structure where residents and families can engage in decision-making about care goals. However, there are few tools to support effective engagement. To inform future tool development, this study sought to understand what resident and family stakeholders value about engaging in care conferences. In virtual meetings, 16 stakeholders identified 3 key areas of engagement: being informed about health/well-being, influencing care goals, and advocating for needs. They indicated current approaches do not achieve these engagement goals, which is particularly problematic during COVID when families cannot engage in person. Stakeholders offered ideas for supporting engagement such as provision of data before the conference. The study has implications for individualizing care conferences and encouraging resident and family engagement in decision-making both during and beyond COVID.

scholarly journals Delivering Person-Centered Care During a Pandemic: Stakeholder Perspectives

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 269-270
Author(s):  
Katherine Abbott ◽  
Kirsten Corazzini
Keyword(s):  
Family Involvement ◽  
Health Care Providers ◽  
Assisted Living ◽  
Direct Care ◽  
Care Providers ◽  
Improvement Project ◽  
Stakeholder Perspectives ◽  
Person Centered Care ◽  
Centered Care ◽  
The Impact

Abstract Person-centered care (PCC) is an approach to care that both nursing homes (NH) and assisted living (AL) communities strive to provide. PCC is a philosophy that recognizes knowing the person and honoring individual preferences. However, when COVID-19 emerged, the NH and AL environments were ground zero for infection spread and disproportionate numbers of deaths among residents. As a result, many practices changed dramatically in efforts to reduce the transmission of COVID-19 in these communities. The purpose of this symposium is to discuss several projects that can speak to the impact of the pandemic on stakeholder efforts to provide PCC. First, Dr. Roberts presents feedback from residents and family members on the challenges COVID-19 created for family involvement in care conferences. In the second study, Dr. Behrens examines focus group data from direct-care nurses on their perceptions of delivering PCC related to risk of harm to staff and residents. The third study presents the voices of activities professionals who were implementing a PCC quality improvement project to communicate resident preferences, which illustrates both the importance of PCC during the pandemic, but also the challenges implementing during the pandemic. Fourth, the Kansas PEAK 2.0 program used provider feedback to direct and inform program responses through components such as consistent staffing. Finally, Dr. Zimmerman presents qualitative data from over 100 AL administrators, medical, and mental health care providers on their experiences pivoting during COVID-19. Our discussant will explore the implications of these studies in terms of the future of PCC in residential settings.

scholarly journals PERSON-CENTERED CARE: DEFINITIONS AND PERCEPTIONS OF VARIOUS STAKEHOLDERS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S359-S359
Author(s):  
Nancy Kusmaul ◽  
Gretchen Tucker
Keyword(s):  
Nursing Homes ◽  
Well Being ◽  
Direct Care ◽  
Care Staff ◽  
Administrative Staff ◽  
Direct Care Staff ◽  
Potential Conflict ◽  
Person Centered Care ◽  
Centered Care

Abstract Implementation of culture change in nursing homes shifts the care model from a traditional, more medically focused approach to person-directed care. Person-directed care promotes resident autonomy and decision making and the empowerment of direct care staff. In this paper, we examine how different stakeholders in nursing homes (residents, family members, direct care staff, administrative staff) conceptualize and experience a selection of person-centered care concepts (consistent assignment, meal choice, waking/bedtime practices, and bathing). We describe the commonalities and differences in the ways different groups of stakeholders operationalize these core person centered care practices and describe areas of potential conflict of views. Lastly, we consider how the well-being and quality of life for residents is affected by the use of these practices.

scholarly journals 415 - Evaluation of an e-learning aiming to improve person-centered attitude in healthcare professionals working with people with dementia

2020 ◽  
Vol 32 (S1) ◽  
pp. 131-131
Author(s):  
Claudia van der Velden ◽  
Marleen Prins ◽  
Henriëtte van der Roest
Keyword(s):  
Pilot Study ◽  
Healthcare Professionals ◽  
Well Being ◽  
User Friendliness ◽  
Sense Of Competence ◽  
Positive Effects ◽  
Person Centered Care ◽  
People With Dementia ◽  
Centered Care ◽  
E Learning

Introduction Healthcare professionals working with people with dementia (PwD) have increasingly been moving away from task-oriented models of healthcare towards a more person-centered care (PCC) model. Several studies have showed positive results of PCC on the quality of life of PwD. Also, it shows positive effects on self -esteem and work satisfaction of healthcare professionals. An effective way to educate professionals in PCC and improve their knowledge and person-centered attitude is by using online learning tools.We developed an e-learning in co-creation with end users focusing on well-being and (changing) behavior of PwD. The interactive e-learning supports healthcare professionals in developing a person-centered attitude, by using practical videos and exercises.Methods In the current pilot study, the e-learning is evaluated. To date, 33 healthcare professionals working in Dutch care homes from different care organizations participated in the study and completed the e-learning. In addition, they filled in online questionnaires before and after completing the e-learning. The questionnaires include the Approach to Dementia Questionnaire, Dementia Knowledge, Person Centered Care, Sense of Competence in Dementia Care Questionnaire. Post-measurement also included questions about satisfaction with the e-learning and user-friendliness.Results The final participants are currently completing their post-measurement questionnaires and final results are expected in September 2019. Preliminary data-analysis shows promising results. Positive effects on knowledge about dementia, person-centered attitude and sense of competence are expected. Also, user-friendliness, especially the flexibility of the e-learning (being able to follow the e-learning at home or at work and being able to stop and continue at any time) and the practice-oriented videos are positively evaluated.Conclusion Preliminary results of this pilot study suggest that the e-learning might contribute to developing a more person-centered attitude in healthcare professionals and indicate that participants have positive experiences with the e-learning module.

How Is Quality of Life Assessed in People With Dementia? A Systematic Literature Review and a Primer for Speech-Language Pathologists

2020 ◽  
Vol 29 (3) ◽  
pp. 1702-1715
Author(s):  
Sabine Heuer ◽  
Rebecca Willer
Keyword(s):  
Quality Of Life ◽  
Literature Review ◽  
Systematic Literature Review ◽  
Well Being ◽  
Self Report ◽  
Speech Language Pathologists ◽  
Person Centered Care ◽  
People With Dementia ◽  
Centered Care

Purpose The purpose of this study was to determine how quality of life (QoL) is measured in people with dementia involved in interventions designed to improve well-being and to explore how those measures align with principles of person-centered care. Method A systematic literature review was conducted utilizing PsychInfo, CINAHL, and PubMed and combinations of the search terms: “dementia,” “outcome measure,” “creative engagement,” “creative intervention,” “TimeSlips,” “art,” “quality of life,” and “well-being.” The search was limited to studies published in peer-reviewed journals that reported outcomes for people with dementia in response to a creative intervention. Results Across the 24 reviewed studies, 30 different outcome measures were reported including eight self-reported, nine observational, and 13 proxy-reported measures. Self-report of QoL was elicited 16 times, observational measures were reported 17 times, and proxy-reported measures were used 28 times. All measures were used with participants across the dementia severity spectrum. Conclusion Current clinical practice of QoL evaluation does not align well with person-centered care principles of self-determination based on the low proportion of self-report. The previously reported limitations of proxy-report have been in part confirmed with this study. Implications of the findings for speech-language pathologists are discussed.

scholarly journals A Preference-Based Model of Care: An Integrative Theoretical Model of the Role of Preferences in Person-Centered Care

2019 ◽  
Vol 60 (3) ◽  
pp. 376-384 ◽  
Author(s):  
Kimberly Van Haitsma ◽  
Katherine M Abbott ◽  
Annabelle Arbogast ◽  
Lauren R Bangerter ◽  
Allison R Heid ◽  
...  
Keyword(s):  
Older Adults ◽  
Theoretical Model ◽  
Positive Emotions ◽  
Positive Impact ◽  
Well Being ◽  
Cognitive Capacity ◽  
Model Of Care ◽  
Person Centered Care ◽  
Centered Care ◽  
Services And Supports

Abstract Knowledge of individuals’ everyday preferences is a cornerstone of person-centered care (PCC). Initial evidence demonstrates the positive impact of honoring preferences in care for older adults receiving long-term services and supports (LTSS). Yet, the mechanisms through which preference-based care affects individual well-being remain poorly understood. This article proposes a theoretical model of PCC entitled the Preference-Based Model of Care that integrates the Theory of Human Motivation, Self-determination Theory, the Competence-Press Model of person and environment fit, the Living Systems Framework, and the Broaden-and-Build theory of positive emotions to deepen our understanding of the processes through which preference-based care affects well-being among older adults receiving LTSS. The Preference-Based Model of Care illustrates how goal-directed behaviors facilitate need fulfillment through the expression of individual preferences and how these behaviors mediate the relationship between person–environment fit and affect balance within a particular social, cultural, and political context. The Preference-Based Model of Care can advance research on PCC in LTSS and can inform LTSS clinical practice guidelines for older adults, regardless of functional or cognitive capacity.

Determinants of Resident Autonomy in Assisted Living Facilities: A Review of the Literature

2007 ◽  
Vol 8 (4) ◽  
pp. 187-193 ◽  
Author(s):  
Elzbieta Sikorska-Simmons ◽  
James D. Wright
Keyword(s):  
Assisted Living ◽  
Environmental Conditions ◽  
Systems Approach ◽  
Quality Care ◽  
Organizational Factors ◽  
Well Being ◽  
Organizational Structures ◽  
Assisted Living Facilities ◽  
Supportive Services ◽  
Natural Systems

Assisted living (AL) stresses the importance of resident autonomy in the provision of good quality care. Resident autonomy has been linked to better resident well-being, less reliance on supportive services, and greater participation in social activities. Little is known, however, about factors that foster resident autonomy in AL. This article reviews what is currently known about organizational determinants of resident autonomy in AL. The open-natural systems approach to organizational effectiveness, which views organizations in relation to their environment, provides a broad conceptual framework for this analysis. Factors that influence resident autonomy in AL are classified into two categories: (a) external environmental conditions (e.g., ownership status, chain membership, regulatory environment) and (b) internal organizational structures and processes (e.g., facility size, residents’ functional ability, resident social resources, and staff work environment). Environmental conditions represent the most antecedent set of factors that influence resident autonomy, indirectly through their effects on internal organizational structures and processes. Internal organizational factors influence resident autonomy through their impact on policies that enable resident choice and control in the facility. More research is needed to better understand the complex mechanism(s) through which organizational factors influence resident autonomy.

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