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 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 The impact of preference-based, person-centered care on regulatory outcomes

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 837-837
Author(s):  
Xiao Qiu ◽  
Katherine Abbott ◽  
John Bowblis ◽  
Kimberly Van Haitsma
Keyword(s):  
Nursing Home ◽  
Fixed Effects ◽  
Pay For Performance ◽  
Performance Indicator ◽  
Panel Regression ◽  
Fixed Effects Panel Regression ◽  
Centered Care ◽  
The Impact ◽  
Everyday Living

Abstract The Preferences for Everyday Living Inventory (PELI) was mandated as a pay for performance indicator by the Ohio Department of Medicaid in 2015. This study explored the impacts of PELI implementation on regulatory outcomes in 2017. The level of PELI implementation from n=551 Ohio nursing home providers between 2015 and 2017 were linked with Centers for Medicare and Medicaid Services Nursing Home Compare data. Fixed effects panel regression analyses assessed the effects of time-varying PELI implementation on 2015-2017 regulatory outcomes that could be correlated with quality of life including fines, substantiated complaints, health scores, deficiency counts and deficiency scores. Results show a significant increase in substantiated complaints among providers that were slow adopters of the PELI. Overall, the extent of PELI implementation was not associated with regulatory outcomes. The use of the PELI may not impact substantiated complaints suggesting further research is needed to identify person-centered outcomes of interest. Part of a symposium sponsored by the Research in Quality of Care Interest Group.

The impact of person-centered care on residents' perceptions of care quality in nursing homes: an intervention study

2018 ◽  
Vol 7 (2) ◽  
pp. 118-124
Author(s):  
Vigdis Abrahamsen Grøndahl ◽  
Liv Berit Fagerli ◽  
Heidi Karlsen ◽  
Ellen Rosseland Hansen ◽  
Helena Johansson ◽  
...  
Keyword(s):  
Nursing Home ◽  
Intervention Study ◽  
Care Quality ◽  
Legal Rights ◽  
Nursing Home Administrators ◽  
Person Centered Care ◽  
Before And After ◽  
Centered Care ◽  
The Impact ◽  
Perceptions Of Care

Background: The quality of care offered to older people is still poor. Nursing home administrators often claim that they provide person-centered care, but research indicates that institutional goals take precedence. Aim: The aim was to explore the impact of person-centered care on residents’ perceptions of care quality.  Methods: An intervention study was conducted in one nursing home (41 residents). Person-centered care was operationalized into the interventions: greeting the resident on each shift, one-to-one contact (resident – carer) for 30 minutes twice a week, informing the residents continuously about changes in medication, and informing the residents about their legal rights at admission and three months after admission. The interventions were systematically conducted for 12 months. Face-to-face interviews using the Quality from Patient’s Perspective (QPP) questionnaire were conducted both prior to interventions and immediately after the 12-month period. Descriptive and comparative statistics were used to test for differences between care quality perceptions before and after intervention (p ≤ .05). Results: The residents rated all four quality dimensions (caregivers’ medical-technical competence and identity-oriented approach, care organization’s socio-cultural atmosphere, and physical-technical conditions) more highly after the 12-month period, and the socio-cultural atmosphere was rated significantly more highly. At item level, 44 items received higher scores, and, among them, significantly higher scores were given to 6 items. One item received a significantly lower score. Conclusions: Residents’ perceptions of care quality increase when person-centered care is operationalized and takes precedence over the ward’s routines or is part of the ward’s routines. The results indicate that it is possible to design a care system where the residents are at the centre of the health care offered.

Relationships among person-centered care, nursing home adjustment, and life satisfaction: a cross-sectional survey study

2018 ◽  
Vol 30 (10) ◽  
pp. 1519-1530 ◽  
Author(s):  
Ju Young Yoon
Keyword(s):  
Life Satisfaction ◽  
Nursing Home ◽  
Home Environment ◽  
Direct Relationship ◽  
Nursing Home Residents ◽  
Relationship Development ◽  
Path Model ◽  
Survey Study ◽  
Person Centered Care ◽  
Centered Care

ABSTRACTBackground:The purpose of this study was to examine whether a perceived person-centered nursing home environment has a direct relationship with nursing home adjustment and life satisfaction, and whether a perceived person-centered nursing home environment has an indirect relationship with life satisfaction through improved nursing home adjustment.Methods:203 nursing home residents who were able to read and speak English and were physically and cognitively able to respond to questionnaires were included in this study. Data were collected from six nursing homes in the Midwestern US.Results:Higher levels of a perceived person-centered nursing home environment had a significantly direct relationship with increased life satisfaction of residents (β= 0.35), and this relationship was mediated by residents’ improved nursing home adjustment (β= 0.10). In-depth exploration using sub-domains of the main variables demonstrated that “safety” and “everydayness” of a person-centered nursing home environment were directly related to higher levels of life satisfaction (β= 0.15 andβ= 0.16, respectively); and “everydayness” was related to three sub-domains of nursing home adjustment: better “relationship development,” “acceptance of the new residence” (β= 0.32 andβ= 0.24, respectively), and lower “depressed mood” (β= 0.05). The positive relationship between “everydayness” and life satisfaction was partially mediated by the “relationship development” sub-domain of nursing home adjustment (β= 0.07).Conclusions:The findings provide new evidence for the positive association between person-centered care and nursing home adjustment. The findings also provide insights into the mechanism through which the specific sub-domains of person-centered care and nursing home adjustment operate in the path model.

scholarly journals TRAJECTORIES OF PERSON-CENTERED CARE PLANNING IN NURSING HOME RESIDENTS: DATA VISUALIZATION

2017 ◽  
Vol 1 (suppl_1) ◽  
pp. 1354-1355
Author(s):  
K.N. Corazzini ◽  
K. Scales ◽  
R.A. Anderson ◽  
Y. Song ◽  
B. Kang ◽  
...  
Keyword(s):  
Nursing Home ◽  
Data Visualization ◽  
Nursing Home Residents ◽  
Care Planning ◽  
Person Centered Care ◽  
Centered Care

scholarly journals The Impact of Changes in Direct Care Staffing Policies and Outcomes for Assisted Living Residents With Dementia

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 716-717
Author(s):  
Kali Thomas ◽  
Portia Cornell ◽  
Wenhan Zhang ◽  
Paula Carder ◽  
Lindsey Smith ◽  
...  
Keyword(s):  
Assisted Living ◽  
Staff Training ◽  
Fixed Effects ◽  
Direct Care ◽  
Probability Models ◽  
Training Requirements ◽  
Staffing Levels ◽  
Percentage Points ◽  
Linear Probability ◽  
The Impact

Abstract We identified a cohort of 410,413 Medicare beneficiaries residing in 10,623 large (25+bed) assisted living (AL) communities between 2007 and 2017. We conducted linear probability models with a difference-in-difference framework to examine the association between hospitalization and changes in regulations pertaining to staff training (model 1) and staffing levels (model 2), adjusting for time trends, resident characteristics, and state-license fixed effects. During this 11-year period, six states changed their staff training requirements and two states introduced/increased direct care staffing levels. A change in regulations related to staffing levels was associated with a reduction in the probability of hospitalization during the month of -0.0056 percentage points (95%CI=-0.008,-0.003). A change in regulations related to staff training was associated with a reduction in the probability of hospitalization during the month of -0.0035 percentage points (95%CI=-0.006,-0.002). The policy effects represent clinically important differences of approximately 21% in the mean monthly hospitalization rate. Part of a symposium sponsored by Assisted Living Interest Group.

scholarly journals Challenges Faced by Nursing Home Direct Care Workers During the COVID-19 Pandemic: A Comparison Across Care Settings

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 248-248
Author(s):  
Verena Cimarolli ◽  
Robyn Stone ◽  
Natasha Bryant
Keyword(s):  
Nursing Home ◽  
Assisted Living ◽  
Direct Care ◽  
Direct Care Workers ◽  
Health Crisis ◽  
Work Related ◽  
Care Workers ◽  
Direct Care Workforce ◽  
The Impact

Abstract The COVID-19 pandemic has generated awareness of the value of the direct care workforce to provide care in settings serving those most at risk from the disease. However, few studies have gauged the impact of COVID-19 on this workforce and their pandemic-related challenges. The purpose of this study was to examine the challenges and stress experienced by direct care workers (N=1,414) and their perceptions of preparation and quality of employer communication during this health crisis. Nursing home (NH) workers reported separation from family members and understaffing as the top external and work-related challenges. They felt adequately prepared and gave their employers high marks for communicating with them during the pandemic. NH direct care workers were more likely to report increased workload and understaffing as a challenge compared to workers in home and community-based settings. They also experienced a significantly higher number of work-related challenges compared to workers in assisted living.

Family Involvement in Nursing Homes: Are Family Caregivers Getting What They Want?

2015 ◽  
Vol 36 (8) ◽  
pp. 993-1015 ◽  
Author(s):  
R. Colin Reid ◽  
Neena L. Chappell
Keyword(s):  
Nursing Home ◽  
Family Caregivers ◽  
Family Involvement ◽  
Family Caregiver ◽  
Nursing Home Residents ◽  
Future Research ◽  
Canadian Study ◽  
Person Centered Care ◽  
Centered Care ◽  
Caregiver Involvement

The provision of person-centered care for nursing home residents with dementia suggests the need for family caregiver involvement. In this article, we argue that optimal family involvement differs by family caregiver and therefore depends on the degree to which family caregivers consider their own involvement to be important. In this Canadian study, we compare the importance that 135 family caregivers of residents with dementia place on 20 kinds of involvement with the degree to which they perceive opportunities for involvement. Family Involvement Congruence Scores are calculated in three ways: those for whom involvement is important, those for whom involvement is not important, and an overall congruence score. Congruence scores varied by involvement type. These scores show promise for use in future research on family caregiver involvement and as tools for use by facilities as they endeavor to meet family caregiver expectations for involvement.

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