scholarly journals The Road to Improved Assisted Living Quality: State Efforts and New Metrics

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 726-726
Author(s):  
Tetyana Shippee ◽  
Lindsay Schwartz
Keyword(s):  
Assisted Living ◽  
Well Being ◽  
Family Satisfaction ◽  
Policy Implications ◽  
Term Care ◽  
Senior Housing ◽  
The Road ◽  
Housing Option ◽  
Centered Care

Abstract Assisted living (AL), a senior housing option that combines housing, support services, and health care, is recognized as one of the fastest-growing components of the long term care industry. AL is also a relatively expensive service, whether it’s paid for privately or publicly. Also, an increasing proportion of AL residents have diagnoses of Alzheimer’s and related dementias. However, little is known about AL quality, in part due to lack of measures. Quality of AL matters to residents, their families, and policy makers because AL is not only about the experience of receiving specific services, but about a place that many will call home. Concerns have been surfacing regarding the quality of AL, including poor staffing, inadequate teamwork, and poor management, which can negatively impact resident well-being and result in abuse and neglect in some cases. This symposium will feature four presentations that will review efforts from two states that have been actively developing measures to address AL quality: Oregon and Minnesota. We focus on new legislation in both states to address AL quality, the new metrics being adopted, and preliminary results. Individual presentations will describe 1) Oregon’s new quality measures for AL ;2) Oregon’s use of Resident VIEW project, including measures of person-centered care from the perspectives of residents; 3) Minnesota’s development of AL report card, and 4) development and results from MN pilot surveys of resident quality of life and family satisfaction in all licensed ALs in the state. Policy implications for other states and researchers will be discussed.

scholarly journals Assessing Quality for People Living With Dementia in Residential Long-Term Care: Trends and Challenges

2019 ◽  
Vol 5 ◽  
pp. 233372141986119
Author(s):  
Eleanor S. McConnell ◽  
Julienne Meyer
Keyword(s):  
Performance Indicators ◽  
Long Term Care ◽  
Well Being ◽  
Subjective Assessment ◽  
Term Care ◽  
Centered Care ◽  
Care Health ◽  
Residential Long Term Care

The global prevalence of dementia is growing rapidly, driving an increased use of residential long-term care (LTC) services. Performance indicators for residential LTC should support targeting of limited resources to promote person-centered care, health, and well-being for both patients and caregivers (formal and informal), yet many performance indicators remain focused on structure, process, or outcome measures that are only assumed to support personally relevant outcomes for those with dementia, without direct evidence of meaningfulness for these individuals. In this article, two complementary approaches to assessing quality in residential LTC serve as a lens for examining a series of tensions related to assessment in this setting. These include measurement-focused approaches using generic psychometrically valid instruments, often used to monitor quality of services, and meaning-focused approaches using individual subjective assessment of personally relevant outcomes, often used to monitor care planning. Examples from the European and U.S. literature suggest an opportunity to strengthen an emphasis on personally meaning-focused outcomes in quality assessment.

scholarly journals Staff Barriers to Fulfilling Assisted Living Resident Daily Care and Activity Preferences

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 837-837
Author(s):  
Tonya Roberts ◽  
Jillian Parks ◽  
Ella Greenhalgh ◽  
Josephine Hansen ◽  
Olivia Wheelis ◽  
...  
Keyword(s):  
Assisted Living ◽  
Structured Interviews ◽  
Implementation Barriers ◽  
Term Care ◽  
Delivery Of Care ◽  
Daily Care ◽  
Centered Care ◽  
Activity Preferences ◽  
Staff Meet

Abstract Person-centered care (PCC), or delivery of care consistent with preferences, has been associated with improved care and quality of life for residents in long-term care (LTC). However, research has shown PCC has not been universally adopted. While general implementation barriers have been identified, little research has focused on barriers to meeting specific types of resident daily care and activity preferences. The purpose of this study was to describe LTC staff barriers to fulfilling specific types of resident preferences. A descriptive, qualitative study with 19 assisted living staff from nursing, dietary, and activities was conducted. Semi-structured interviews focused on identifying work system barriers to meeting specific types of resident preferences were analyzed using thematic analysis. Findings suggest shift assignments, staffing challenges, and facility schedules influence staff ability to meet certain types of preferences. The results suggest innovative design of shift schedules and assignments may help staff meet certain types of preferences. Part of a symposium sponsored by the Research in Quality of Care Interest Group.

Communication Disordered: Program Implementation in Long-Term Care

2016 ◽  
Vol 1 (15) ◽  
pp. 64-67
Author(s):  
George Barnes ◽  
Joseph Salemi
Keyword(s):  
Program Implementation ◽  
Long Term Care ◽  
Family Satisfaction ◽  
Regulatory Compliance ◽  
Care Staff ◽  
Term Care ◽  
Staff Members ◽  
Change Policy

The organizational structure of long-term care (LTC) facilities often removes the rehab department from the interdisciplinary work culture, inhibiting the speech-language pathologist's (SLP's) communication with the facility administration and limiting the SLP's influence when implementing clinical programs. The SLP then is unable to change policy or monitor the actions of the care staff. When the SLP asks staff members to follow protocols not yet accepted by facility policy, staff may be unable to respond due to confusing or conflicting protocol. The SLP needs to involve members of the facility administration in the policy-making process in order to create successful clinical programs. The SLP must overcome communication barriers by understanding the needs of the administration to explain how staff compliance with clinical goals improves quality of care, regulatory compliance, and patient-family satisfaction, and has the potential to enhance revenue for the facility. By taking this approach, the SLP has a greater opportunity to increase safety, independence, and quality of life for patients who otherwise may not receive access to the appropriate services.

scholarly journals Challenges Related to Informal Care Partners’ Involvement in End-of-Life-Care in Assisted Living

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 16-17
Author(s):  
Molly Perkins ◽  
Ann Vandenberg ◽  
Candace Kemp ◽  
Mary Ball ◽  
Joanna Jungerman ◽  
...  
Keyword(s):  
End Of Life ◽  
Informal Care ◽  
Caregiver Burden ◽  
Assisted Living ◽  
End Of Life Care ◽  
Life Care ◽  
Term Care ◽  
Care Partners ◽  
Relational Factors

Abstract Limited empirical evidence suggests that caregiver burden is greater for informal care partners (family and friends) in assisted living (AL) compared with other long-term care settings, particularly within context of end of life. Using qualitative data from a larger 5-year, 7-site study of end-of-life care in AL funded by the National Institute on Aging (R01AG047408), we investigate informal care partners’ involvement in end-of-life care and identify challenges related to informal caregiving that might contribute to care burden. Grounded theory analysis of ethnographic data and in-depth interviews (average interview length = 97 minutes) with 59 racially and ethnically diverse informal care partners (mean age = 60) shows that informal care partner involvement in end-of-life care varies across participants and over time and is shaped by multiple intersecting social and structural determinants. At individual levels, these include many personal, situational, and relational factors. Personal factors include but are not limited to care partners’ own physical and mental health and material resources (e.g., ability to pay for supplementary care). Situational and relational factors include care partners’ awareness (or lack thereof) of residents’ impending death and the quality of the caregiving relationship. AL and wider community-level factors include understaffing, staff turnover, inadequate hospice support, and lack of access to these services. We find that informal care partners navigate these caregiving challenges through a basic social process we conceptualize as “negotiating risks.” Strategies for easing caregiver burden and improving informal care partner and resident quality of life at end of life are implicated.

scholarly journals FEDERAL POLICY SUPPORTS AND GAPS IN ADDRESSING RACIAL-ETHNIC HEALTH DISPARITIES IN U.S. LONG-TERM CARE FACILITIES

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S161-S161
Author(s):  
Rebecca L Mauldin ◽  
Kathy Lee ◽  
Antwan Williams
Keyword(s):  
Long Term Care ◽  
Federal Policy ◽  
Care Facility ◽  
Well Being ◽  
The United States ◽  
Term Care ◽  
Long Term Care Facility ◽  
Care Facilities

Abstract Older adults from racial and ethnic minority groups face health inequities in long-term care facilities such as nursing homes and assisted living facilities just as they do in the United States as a whole. In spite of federal policy to support minority health and ensure the well-being of long-term care facility residents, disparities persist in residents’ quality of care and quality of life. This poster presents current federal policy in the United States to reduce racial and ethnic health disparities and to support long-term care facility residents’ health and well-being. It includes legislation enacted by the Patient Protection and Affordable Care Act of 2010 (ACA), regulations of the U.S. Department of Health and Human Services (DHHS) for health care facilities receiving Medicare or Medicare funds, and policies of the Long-term Care Ombudsman Program. Recommendations to address threats to or gaps in these policies include monitoring congressional efforts to revise portions of the ACA, revising DHHS requirements for long-term care facilities staff training and oversight, and amending requirements for the Long-term Care Ombudsman Program to mandate collection, analysis, and reporting of resident complaint data by race and ethnicity.

scholarly journals END-OF-LIFE CARE PREFERENCES AND WELL-BEING IN LONG-TERM CARE RESIDENTS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S669-S669
Author(s):  
Kelly Shryock ◽  
Jacinta Dickens ◽  
Anisha Thomas ◽  
Suzanne Meeks
Keyword(s):  
Quality Of Life ◽  
Positive Affect ◽  
End Of Life ◽  
End Of Life Care ◽  
Long Term Care ◽  
Well Being ◽  
Life Care ◽  
Term Care

Abstract Research on end-of-life care in nursing homes comes largely from the viewpoint of staff or family members. We examined patient perspectives on end-of-life care, preferences for care, and quality of life in long-term care settings. We hypothesized that fulfillment of the Self Determination Theory (SDT) needs of autonomy, competence, and relatedness would be related to better well-being and that the degree to which end-of-life care preferences are seen as possible in the setting would be related to SDT need fulfillment and well-being. Preliminary data, collected from older individuals at the end of life (over 55, presence of significant chronic disease, in long term care setting) (n= 72), demonstrated that autonomy, competence, and relatedness measures were moderately and significantly correlated with well-being as measured by life satisfaction, higher positive affect, lower negative affect, and overall quality of life measures The degree to which residents believed that their end-of-life care preferences could be honored in the setting was also significantly correlated with autonomy, competence, relatedness, positive affect, and psychological quality of life. These results are consistent with SDT and suggest that if long term care settings can promote autonomy, connection, and competence in making end of life decisions, possibly by discovering and fulfilling preferences for end of life care, individuals who end their lives on those settings have potential for greater satisfaction and happiness. These results suggest that SDT is a useful framework for ongoing research on how to improve the end of life experiences of older adults in long term care.

Economic Well-Being of the Chronically Disabled Elderly: Practice and Policy Implications

1993 ◽  
Vol 74 (8) ◽  
pp. 460-467 ◽  
Author(s):  
Jean W. Bauer ◽  
Marlene S. Stum ◽  
Paula J. Delaney
Keyword(s):  
Stepwise Regression ◽  
Long Term Care ◽  
Well Being ◽  
Policy Implications ◽  
Term Care ◽  
Disabled Elderly ◽  
The Disabled ◽  
Care Survey ◽  
Economic Well Being

The 1982 Long-Term Care Survey (N = 5,670) was used to gain an understanding of predisposing, need, and enabling variables that influence the economic well-being of disabled elderly. Stepwise regression results suggest that a combination of enabling and predisposing factors best explained differences in economic well-being. Implications of the findings for practitioners are discussed within the context of practice and policy for the disabled elderly.

scholarly journals The association between employment status and QOL among foreign origin populations in Finland

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
S Nyk'nen
Keyword(s):  
Quality Of Life ◽  
Secondary Data ◽  
Well Being ◽  
Labour Markets ◽  
Policy Implications ◽  
Equal Access ◽  
Foreign Origin ◽  
Perceived Quality Of Life ◽  
Gender Groups

Abstract Introduction In Finland the employment rate of people with foreign origin backgrounds appear to be 10% lower than in general population (73.7%). Contradictory, higher levels of self-perceived quality of life (QOL) has been reported among the same population. This secondary data analysis aims to examine the association between level of employment and quality of life from the survey on work and well-being among people of foreign origin in Finland (UTH, 2014). Methods People of foreign foreign origin, living in Finland were included in statistical analysis (n = 2,987). Pearson Chi-squared (χ2) and likelihood ratio (LR) testing as well as logistic regression analysis were used to study the association between independent variable 'employment' and the dependent variable of 'quality of life'. Results Employment showed increased odds for 'good' QOL. However, when comparing the two gender groups, the odds of having 'good' QOL in employed men were higher (OR: 2.17 CI 2.11 - 2.24) compared to employed women (OR: 1.50 CI 1.45 - 1.53) respectively. When adjusted for sociodemographic and confounding factors, the levels of strength of the association between employment and quality of life remained. Conclusions Women with foreign origin backgrounds seem not to have equal benefits of employment and/or equal access to labour markets in Finland. Validation about barriers of entering the labour market in Finland are further needed. Policy implications and actions are needed to improve equal access and benefits of employment for better well-being for women with foreign origin backgrounds. Key messages Women with foreign origin backgrounds seem not to have equal benefits of employment and/or equal access to labour markets in Finland. Policy implications and actions are needed to improve equal access and benefits of employment for better well-being for women with foreign origin backgrounds.

Dementia friendly initiatives: A state of the science review

Dementia ◽  
2017 ◽  
Vol 18 (5) ◽  
pp. 1858-1895 ◽  
Author(s):  
Catherine A Hebert ◽  
Kezia Scales
Keyword(s):  
Interdisciplinary Collaboration ◽  
Well Being ◽  
Evidence Base ◽  
Research Literature ◽  
Current Evidence ◽  
Future Research ◽  
Current Evidence Base ◽  
Centered Care ◽  
State Of The Science

Background Dementia friendly initiatives share similarities with the age-friendly movement in a focus on active engagement and creating a good quality of life for older adults. Dementia friendly initiatives offer a welcoming optimistic narrative in dementia studies by embracing dignity, empowerment, and autonomy to enable well-being throughout the dementia trajectory. Purpose The purpose of this review is to explore the current science of dementia friendly initiatives, identify gaps, and inform future research. Method Quantitative, qualitative, and conceptual/theoretical peer-reviewed dementia friendly research literature were evaluated for their current evidence base and theoretical underpinnings. Results The dementia friendly initiatives research base is primarily qualitative and descriptive focused on environmental design, dementia awareness and education, and the development of dementia friendly communities. Person-centered care principles appear in dementia friendly initiatives centered in care settings. Strong interdisciplinary collaboration is present. Research is needed to determine the effect of dementia friendly initiatives on stakeholder-driven and community-based outcomes. Due to the contextual nature of dementia, the perspective of persons with dementia should be included as dementia friendly initiatives are implemented. Theory-based studies are needed to confirm dementia friendly initiative components and support rigorous evaluation. Dementia friendly initiatives broaden the lens from which dementia is viewed.

The Contribution of Hope to the Quality of Life among Aging African Americans: 1980–1992

2000 ◽  
Vol 50 (4) ◽  
pp. 279-295 ◽  
Author(s):  
Virgil H. Adams ◽  
James S. Jackson
Keyword(s):  
Quality Of Life ◽  
Life Satisfaction ◽  
African Americans ◽  
Well Being ◽  
Family Satisfaction ◽  
Hierarchical Regression ◽  
Personal Efficacy ◽  
Age Cohorts ◽  
Frequency Of Contact

This study examined age differences between 1979–80 and 1992 in the quality of life of African Americans using panel data from the National Survey of Black Americans. Of particular interest was the role of the hope dimension of personal efficacy in accounting for variance in general well-being, beyond that contributed by social demographic and economic indicators. Hierarchical regression analyses revealed that hope and family satisfaction in 1980 consistently accounted for significant amounts of variance in general life satisfaction in the 1992 fourth wave of data among all three cohorts. For older respondents, increased frequency of contact with friends and family help were the most important contributors to high satisfaction. Across waves in all age cohorts family satisfaction and contact with friends were most important in contributing to life satisfaction. Implications for further research on well-being among African Americans were discussed.

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