scholarly journals Feasibility Study of a Digital Screen-Based Calming Device for Managing BPSD During Care

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 755-755
Author(s):  
Gloria Gutman ◽  
Avantika Vashisht ◽  
Taranjot Kaur ◽  
Ryan Churchill ◽  
Amir Moztarzadeh ◽  
...  
Keyword(s):  
Usual Care ◽  
Psychological Symptoms ◽  
Care Home ◽  
Routine Care ◽  
Care Staff ◽  
Successful Implementation ◽  
Term Care ◽  
Item Checklist ◽  
And Control

Abstract MindfulGarden (MG) is a digital device resembling a flat screen TV, with touchless sensors that react to voice and motion. In this study 13 long-term care home residents aged 74-100 exhibiting Behavioural and Psychological Symptoms of Dementia (BPSD) were randomized to treatment and control groups. On days 1-3 the treatment group received usual care plus exposure to MG during morning and evening care - events well documented to be problematic for residents and care staff; controls received usual care only. On day 4 both groups were exposed to MG with verbal cueing. A 26-item checklist was used to record frequency and types of disruptive BPSD exhibited; care duration was recorded in minutes. There was a trend toward reduction of BPSD and duration of care during morning care. Findings suggest that verbal cueing may be important for successful implementation of MG in calming residents with dementia during routine care.

scholarly journals A systematic review and meta-analysis of the prevalence and associations of stress and burnout among staff in long-term care facilities for people with dementia

2018 ◽  
Vol 31 (08) ◽  
pp. 1203-1216 ◽  
Author(s):  
Harry Costello ◽  
Sebastian Walsh ◽  
Claudia Cooper ◽  
Gill Livingston
Keyword(s):  
Long Term Care ◽  
Meta Analysis ◽  
Care Home ◽  
Maslach Burnout Inventory ◽  
Personal Accomplishment ◽  
Care Staff ◽  
High Turnover ◽  
Term Care ◽  
People With Dementia

ABSTRACTBackground:Care home staff stress and burnout may be related to high turnover and associated with poorer quality care. We systematically reviewed and meta-analyzed studies reporting stress and burnout and associated factors in staff for people living with dementia in long-term care.Methods:We searched MEDLINE, PsycINFO, Web of Science databases, and CINAHL database from January 2009 to August 2017. Two raters independently rated study validity using standardized criteria. We meta-analyzed burnout scores across comparable studies using a random effects model.Results:17/2854 identified studies met inclusion criteria. Eight of the nine studies reporting mean Maslach Burnout Inventory (MBI) scores found low or moderate burnout levels. Meta-analysis of four studies using the 22-item MBI (n = 598) found moderate emotional exhaustion levels (mean 18.34, 95% Confidence Intervals 14.59–22.10), low depersonalization (6.29, 2.39–10.19), and moderate personal accomplishment (33.29, 20.13–46.46). All three studies examining mental health-related quality of life reported lower levels in carer age and sex matched populations. Staff factors associated with higher burnout and stress included: lower job satisfaction, lower perceived adequacy of staffing levels, poor care home environment, feeling unsupported, rating home leadership as poor and caring for residents exhibiting agitated behavior. There was preliminary evidence that speaking English as a first language and working shifts were associated with lower burnout levels.Conclusions:Most care staff for long-term care residents with dementia experience low or moderate burnout levels. Prospective studies of care staff burnout and stress are required to clarify its relationship to staff turnover and potentially modifiable risk factors.

scholarly journals Impact of a public policy restricting staff mobility between long-term care homes in Ontario, Canada during the COVID-19 pandemic

2020 ◽  
Author(s):  
Aaron Jones ◽  
Alexander G. Watts ◽  
Salah Uddin Khan ◽  
Jack Forsyth ◽  
Kevin A. Brown ◽  
...  
Keyword(s):  
Public Policy ◽  
Long Term Care ◽  
Care Home ◽  
Relative Difference ◽  
Care Staff ◽  
Care Homes ◽  
Term Care ◽  
Undirected Network ◽  
Before And After

AbstractObjectivesTo assess changes in the mobility of staff between long-term care homes in Ontario, Canada before and after enactment of public policy restricting staff from working at multiple homes.DesignPre-post observational study.Setting and Participants623 long-term cares homes in Ontario, Canada between March 2020 and June 2020.MethodsWe used anonymized mobile device location data to approximate connectivity between all 623 long-term care homes in Ontario during the 7 weeks before (March 1 – April 21) and after (April 22 – June 13) the policy restricting staff movement was implemented. We visualized connectivity between long-term care homes in Ontario using an undirected network and calculated the number of homes that had a connection with another long-term care home and the average number of connections per home in each period. We calculated the relative difference in these mobility metrics between the two time periods and compared within-home changes using McNemar’s test and the Wilcoxon rank-sum test.ResultsIn the period preceding restrictions, 266 (42.7%) long-term care homes had a connection with at least one other home, compared to 79 (12.7%) homes during the period after restrictions, a drop of 70.3% (p <0.001). The average number of connections in the before period was 3.90 compared to 0.77 in after period, a drop of 80.3% (p < 0.001). In both periods, mobility between long-term care homes was higher in homes located in larger communities, those with higher bed counts, and those part of a large chain.Conclusions and ImplicationsMobility between long-term care homes in Ontario fell sharply after an emergency order by the Ontario government limiting long-term care staff to a single home, though some mobility persisted. Reducing this residual mobility should be a focus of efforts to reduce risk within the long-term care sector during the COVID-19 pandemic.

Implementation of eHealth to support assessment and decision-making for residents with dementia in long-term care: systematic review (Preprint)

2021 ◽  
Author(s):  
Juliet Gillam ◽  
Nathan Davies ◽  
Jesutofunmi Aworinde ◽  
Emel Yorganci ◽  
Janet E Anderson ◽  
...  
Keyword(s):  
Decision Making ◽  
Long Term Care ◽  
Care Home ◽  
End Users ◽  
Care Homes ◽  
Successful Implementation ◽  
Key Factors ◽  
Term Care ◽  
Care Assessment

BACKGROUND As dementia progresses, symptoms and concerns increase causing considerable distress for the person and caregivers. Integration of care between care homes and healthcare services is vital to meet increasing care needs and maintain quality of life. However, access to high-quality healthcare is inequitable. eHealth offers a potential solution, by supporting remote specialist input on care processes like clinical assessment and decision-making, and streamlining care on site. How best to implement eHealth in the care home setting is unclear. OBJECTIVE This review aimed to identify key factors that influence implementation of eHealth for people living with dementia in long-term care. METHODS A systematic search of EMBASE, PsychInfo, MEDLINE and CINHAL was conducted to identify studies published between 2000-2020. Studies were eligible if they focused on eHealth interventions to improve treatment and care assessment or decision-making for residents with dementia in care homes. Data were thematically analysed and deductively mapped onto the six constructs of the adapted Consolidated Framework for Implementation Research (CFIR). Results are presented as a narrative synthesis. RESULTS 29 studies were included, focusing on a variety of eHealth interventions including remote video-consultations and clinical decision support tools. Key factors which influenced eHealth implementation were identified across all six constructs of the CFIR. Most concerned the Inner Setting construct about requirements for implementation in the care home, such as providing a conducive learning climate, engaged leadership and sufficient training and resources. Four novel subconstructs were identified to inform implementation requirements to meet resident needs and engage end-users. CONCLUSIONS Implementing eHealth in care homes for people with dementia is multi-factorial and complex, involving interaction between the resident, staff and organisation. Application of the CFIR for care homes requires an emphasis on the needs of residents and the engagement of end users in the implementation process. A novel conceptual model of the key factors was developed, and translated into 18 practical recommendations on implementation of eHealth in long-term care to guide implementers or innovators in care homes. The policy imperative for integrated health and social care demands successful implementation of eHealth, to maximise uptake and drive improvements.

scholarly journals Dexamethasone and oxygen therapy in care home residents with diabetes: a management guide and algorithm for treatment: a rapid response action statement from the European Diabetes Working Party for Older People (EDWPOP) and European Geriatric Medicine Society (EuGMS)

2021 ◽  
Vol 33 (4) ◽  
pp. 895-900
Author(s):  
Alan James Sinclair ◽  
Stefania Maggi ◽  
Ahmed Hassan Abdelhafiz ◽  
Nicola Veronese ◽  
Leocadio Rodriguez-Manas ◽  
...  
Keyword(s):  
Older People ◽  
Oxygen Therapy ◽  
Long Term Care ◽  
Care Home ◽  
Geriatric Medicine ◽  
Working Party ◽  
Care Staff ◽  
Term Care ◽  
Practical Guidance

AbstractThis statement addresses the need to provide clinically relevant and practical guidance for long-term care staff working in care homes and other stakeholders engaged in the care of residents who require consideration for dexamethasone and oxygen therapy. It had been provided following a series of consensus discussions between the EDWPOP and the EuGMS in January and February 2021. Its main aim is to minimise morbidity and mortality from serious acute illnesses including COVID-19 requiring these treatments within the long-term care sector.

scholarly journals Challenges in caring for people with dementia during COVID-19: Findings from long-term care facilities across Japan

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 720-720
Author(s):  
Tomoko Ikeuchi ◽  
Mizue Suzuki ◽  
Kazunori Kikuchi ◽  
Akiko Kan ◽  
Chiho Shimada
Keyword(s):  
Long Term Care ◽  
Psychological Symptoms ◽  
Care Staff ◽  
Term Care ◽  
Staff Members ◽  
Phone Calls ◽  
People With Dementia ◽  
Care Facilities ◽  
Second Wave

Abstract Long-term care facilities for older adults have been profoundly affected by the coronavirus disease 2019 (COVID-19) pandemic in Japan. This study investigated the challenges that care staff members faced by the height of the first wave (i.e., April 2020) and the height of the second wave (i.e., October 2020) of the pandemic at long-term care facilities in Japan. We mailed questionnaires in October 2020 to 5,895 care facilities throughout Japan. A total of 22.7% of the questionnaires were returned. Of those, 87.4% had at least one resident with dementia. Based on the results, 65.2% reported having restricted all visitors during the first wave. Although 42.8% reported continuing to restrict all visitors during the second wave, more than 54% allowed visitors while limiting the number of visitors or the time of each visit. Nearly 76% reported that restrictions on visitations may have exacerbated the behavioral and psychological symptoms of dementia (BPSD) among residents. In place of visitations, over 50% used video calls or phone calls to communicate with the family members, and 45.7% reported that the virtual visits were efficacious in alleviating the BPSD. However, more than 70% reported not having adequate Internet services and computer equipment at their facilities, and nearly 90% reported insufficient staffing. Our findings suggest that the pandemic may have pressed for a change of direction for dementia care with the introduction of virtual visitations and other initiatives. Nevertheless, facilities may face difficulties with implementing such changes due to inadequacies in the availability of resources.

scholarly journals Virtual Reality Experience In Long Term Care Resident Older Adults With Dementia: A Case Series 

2020 ◽  
Author(s):  
Munira Sultana ◽  
Karen Campbell ◽  
Morgan Jennings ◽  
Manuel Montero-Odasso ◽  
Joseph. B. Orange ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Long Term Care ◽  
Psychological Symptoms ◽  
Care Home ◽  
Case Series ◽  
Recruitment Rate ◽  
Adherence Rate ◽  
Term Care ◽  
Convenience Sample

Abstract BACKGROUND: Behavioural and Psychological Symptoms of Dementia (BPSD) worsens as dementia progresses, intensifies caregiver distress and consequent institutionalization. We wanted to evaluate feasibility of Virtual Reality (VR) as non-pharmacologic intervention for BPSD in a long-term care home. METHODS: A single site (Henley Place at London, Ontario) case series with a convenience sample (24 older adult residents with moderate to severe dementia). Intervention was 30 minutes of VR experience with Broomx©, five days a week for two weeks. RESULTS: Implementing VR experience was possible at Henley Place (recruitment rate=40%, the adherence rate=21%, and the attrition=0%) and participants could tolerate it. No adverse events and one-to-one staff use were recorded during the intervention period. CONCLUSION: VR experience can be implemented in a care home. TRIAL REGISTRATION: The study was not registered as clinical trial. We obtained ethics approval from ADVARRA Canada Ethics Board before recruiting participants for the study.

Halting Antipsychotic Use in Long-Term care (HALT): a single-arm longitudinal study aiming to reduce inappropriate antipsychotic use in long-term care residents with behavioral and psychological symptoms of dementia

2017 ◽  
Vol 29 (8) ◽  
pp. 1391-1403 ◽  
Author(s):  
Tiffany Jessop ◽  
Fleur Harrison ◽  
Monica Cations ◽  
Brian Draper ◽  
Lynn Chenoweth ◽  
...  
Keyword(s):  
Antipsychotic Medication ◽  
Long Term Care ◽  
Psychological Symptoms ◽  
Care Staff ◽  
Secondary Outcome ◽  
Term Care ◽  
Antipsychotic Medications ◽  
Inappropriate Use ◽  
Behavioral And Psychological Symptoms

ABSTRACTBackground:Inappropriate use of antipsychotic medications to manage Behavioral and Psychological Symptoms of Dementia (BPSD) continues despite revised guidelines and evidence for the associated risks and side effects. The aim of the Halting Antipsychotic Use in Long-Term care (HALT) project is to identify residents of long-term care (LTC) facilities on antipsychotic medications, and undertake an intervention to deprescribe (or cease) these medicines and improve non-pharmacological behavior management.Methods:LTC facilities will be recruited across Sydney, Australia. Resident inclusion criteria will be aged over 60 years, on regular antipsychotic medication, and without a primary psychotic illness or very severe BPSD, as measured using the Neuropsychiatric Inventory (NPI). Data collection will take place one month and one week prior to commencement of deprescribing; and 3, 6 and 12 months later. During the period prior to deprescribing, training will be provided for care staff on how to reduce and manage BPSD using person-centered approaches, and general practitioners of participants will be provided academic detailing. The primary outcome measure will be reduction of regular antipsychotic medication without use of substitute psychotropic medications. Secondary outcome measures will be NPI total and domain scores, Cohen-Mansfield Agitation Inventory scores and adverse events, including falls and hospitalizations.Conclusion:While previous studies have described strategies to minimize inappropriate use of antipsychotic medications in people with dementia living in long-term care, sustainability and a culture of prescribing for BPSD in aged care remain challenges. The HALT project aims to evaluate the feasibility of a multi-disciplinary approach for deprescribing antipsychotics in this population.

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.

“Music First”

GeroPsych ◽  
2018 ◽  
Vol 31 (1) ◽  
pp. 17-30 ◽  
Author(s):  
Dane L. Shiltz ◽  
Tara T. Lineweaver ◽  
Tim Brimmer ◽  
Alex C. Cairns ◽  
Danielle S. Halcomb ◽  
...  
Keyword(s):  
Usual Care ◽  
Psychological Symptoms ◽  
Care Facility ◽  
Care Group ◽  
Music Listening ◽  
Term Care ◽  
Antipsychotic Medications ◽  
Risk Of Death ◽  
Extended Care ◽  
Individualized Music

Abstract. Existing research has primarily evaluated music therapy (MT) as a means of reducing the negative affect, behavioral, and/or cognitive symptoms of dementia. Music listening (ML), on the other hand, offers a less-explored, potentially equivalent alternative to MT and may further reduce exposure to potentially harmful psychotropic medications traditionally used to manage negative behavioral and psychological symptoms of dementia (BPSD). This 5-month prospective, naturalistic, interprofessional, single-center extended care facility study compared usual care (45 residents) and usual care combined with at least thrice weekly personalized ML sessions (47 residents) to determine the influence of ML. Agitation decreased for all participants (p < .001), and the ML residents receiving antipsychotic medications at baseline experienced agitation levels similar to both the usual care group and the ML patients who were not prescribed antipsychotics (p < .05 for medication × ML interaction). No significant changes in psychotropic medication exposure occurred. This experimental study supports ML as an adjunct to pharmacological approaches to treating agitation in older adults with dementia living in long-term care facilities. It also highlights the need for additional research focused on how individualized music programs affect doses and frequencies of antipsychotic medications and their associated risk of death and cerebrovascular events in this population.

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