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.

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 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 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 EVACUATING OR SHELTERING IN PLACE DURING A DISASTER: HOW ASSISTED LIVING ADMINISTRATORS MAKE THE DECISION

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S699-S699
Author(s):  
Lindsay J Peterson ◽  
Kathryn Hyer ◽  
David Dosa ◽  
Joseph June ◽  
Debra J Dobbs ◽  
...  
Keyword(s):  
Assisted Living ◽  
Long Term Care ◽  
Lessons Learned ◽  
Structured Interviews ◽  
Term Care ◽  
Nursing Home Administrators ◽  
Axial Coding ◽  
Storm Characteristics ◽  
Hurricane Irma

Abstract The decision to evacuate or shelter in place during a natural disaster such as a hurricane is complicated and poses risks to long-term care residents. While research has documented the difficulty of the evacuation decision for nursing home administrators, little is known about how assisted living residence (ALR) administrators make this decision. This is a concern given the physical and cognitive impairment level of many ALR residents, the increasing number of ALRs in the U.S., and the frequency of natural disasters. The purpose of this paper was to explore the factors that influenced whether assisted living administrators evacuated their ALRs for Hurricane Irma, a large hurricane that made landfall on Florida’s Southwest coast in September, 2017. This qualitative study used semi-structured interviews and focus groups with ALR owners or administrative staff (N=60) with questions including how they prepared for Hurricane Irma, their experiences during the hurricane, including whether they evacuated or sheltered in place, and lessons learned. The sample includes small (< 25 beds) and large ALRs in the multiple Florida counties affected by the hurricane. A content analysis approach was used. Atlas.ti version 7 was used for initial and axial coding. Prevalent themes included “emergency management planning”, “logistics”, “pressure”, “storm characteristics,” and “staffing”. The results of this study have implications for long-term care policy and training, potentially leading to changes in how ALR leaders prepare for and respond to disasters to improve the safety of residents.

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 MEANINGFUL ENGAGEMENT AND QUALITY OF LIFE AMONG ASSISTED LIVING RESIDENTS WITH DEMENTIA: EMERGENT FINDINGS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S943-S944
Author(s):  
Joy Ciofi ◽  
Candace L Kemp ◽  
Alexis A Bender ◽  
Elisabeth O Burgess ◽  
Jennifer C Morgan ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Assisted Living ◽  
Personal Characteristics ◽  
Future Research ◽  
Structured Interviews ◽  
Care Partners ◽  
Meaningful Engagement ◽  
Physical Abilities ◽  
Community Staff

Abstract This poster provides an overview of the aims, methods, and emergent findings from an ongoing five-year NIA-funded project (R01AG062310) examining meaningful engagement and quality of life among assisted living (AL) residents with dementia. The overall goal of this project is to determine how opportunities for meaningful engagement can best be recognized, created, and maintained for individuals with different dementia types and varying levels of functional ability. Guided by grounded theory, this qualitative study will involve 12 diverse AL communities in and around Atlanta, Georgia, USA. Presently, our interdisciplinary team is collecting data in four communities using ethnographic observations, semi-structured interviews, and resident record review. We are studying daily life in each community, following 30 resident participants, and actively recruiting and interviewing their formal and informal care partners. Based on ongoing analysis, we offer key emergent findings. First, meaningful engagement is highly individualized and dynamic. Differing personal interests, along with wide variations in cognitive and physical abilities, can present challenges for AL community staff and other care partners when trying to recognize what constitutes meaningful engagement for residents. Second, multiple complex factors interplay to shape the experience of meaningful engagement among persons living with dementia, such as personal characteristics, care partner background and training, AL community design and philosophy, and state/corporate regulations. Finally, flexibility and ‘meeting the resident where they are at’ appear to be critical to identifying and fostering meaningful engagement for persons living with dementia. We discuss the implications of these preliminary findings for translation, dissemination, and future research.

Ethical Considerations in the Conduct of Electronic Surveillance Research

2006 ◽  
Vol 34 (3) ◽  
pp. 611-619 ◽  
Author(s):  
Ashok J. Bharucha ◽  
Alex John London ◽  
David Barnard ◽  
Howard Wactlar ◽  
Mary Amanda Dew ◽  
...  
Keyword(s):  
Assisted Living ◽  
Long Term Care ◽  
The United States ◽  
Assisted Living Facilities ◽  
Ethical Considerations ◽  
Term Care ◽  
Baby Boomer Generation ◽  
Demographic Shifts

Nearly 2.5 million Americans currently reside in nursing homes and assisted living facilities in the United States, accounting for approximately five percent of persons sixty-five and older. The aging of the “Baby Boomer” generation is expected to lead to an exponential growth in the need for some form of long-term care (LTC) for this segment of the population within the next twenty-five years. In light of these sobering demographic shifts, there is an urgency to address the profound concerns that exist about the quality-of-care (QoC) and quality-of-life (QoL) of this frailest segment of our population.

Autonomy and dignity of patients with dementia: Perceptions of multicultural caretakers

2016 ◽  
Vol 25 (1) ◽  
pp. 37-53 ◽  
Author(s):  
Miriam Ethel Bentwich ◽  
Nomy Dickman ◽  
Amitai Oberman
Keyword(s):  
Human Dignity ◽  
Ethics Committees ◽  
The Other ◽  
World Health ◽  
Cultural Groups ◽  
Structured Interviews ◽  
Centered Care ◽  
The Common ◽  
Person Centered Approach

Background: A key message in the World Health Organization’s report on dementia emphasizes the need to improve public and professional attitudes to dementia and its understanding, while acknowledging the fact that the workforce in dementia care is becoming increasingly diverse culturally. Objectives: To explore possible differences among formal caretakers from varied cultural background in their attitudes toward the autonomy and human dignity of patients with dementia. Research design: Semi-structured interviews and content analysis, utilizing two fictional vignettes for eliciting caretakers’ attitudes toward dignity and autonomy of their patients. Participants and context: A total of 20 formal caretakers of patients with dementia from three different cultural groups in Israel (“Sabras,” “Arabs,” and “Russians”), working in nursing homes and a hospital. Ethical consideration: Approvals of relevant research ethics committees were obtained and followed. Findings: In comparison with the other groups, most Arab caretakers offer markedly richer perceptions of human dignity and autonomy. Their human dignity’s conceptualization emphasizes “person-centered approach,” and their perception of patients’ autonomy includes provision of explanations and preservation and encouragement of independence. Discussion: The differences found in the attitudes toward the meaning of autonomy and human dignity between the Arab caretakers and the other caretakers stand in contrast to previous studies regarding human dignity, emphasizing the common nature of these attitudes. Offering a linkage (theoretical and empirical) between the Arab perceptions of dignity and autonomy, the study strengthen and further the importance attributed in existing literature to person-centered care in enhancing the quality of care for patients with dementia. Conclusion: The conceptualization of human dignity may vary among different cultural groups. It may also influence the extent to which the caretaker holds a full-fledged perception of the patients’ autonomy.

scholarly journals Satisfaction With Outdoor Activities Over Time Among Long-Term Services and Supports Recipients

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 189-190
Author(s):  
Justine Sefcik ◽  
Karen Hirschman ◽  
Darina Petrovsky ◽  
Liming Huang ◽  
Nancy Hodgson ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Older Adults ◽  
Assisted Living ◽  
Term Care ◽  
Chronic Health ◽  
Outdoor Activities ◽  
Services And Supports ◽  
Over Time

Abstract Approximately 85% of older adults have at least one chronic health condition. The onset of chronic health conditions and mobility issues can constrain activities, including outdoor recreation. There is limited knowledge of older adults receiving long-term services and supports (LTSS) and their satisfaction with outdoor activities over time after enrolling in services. This study examined predictors of change in ratings of satisfaction with outdoor activities. A secondary analysis was conducted of data involving structured interviews with older adults (N=470) over the first two years of receiving LTSS (Health-Related Quality of Life: Elders in Long-Term Care; R01AG025524). Participants lived in assisted living communities, nursing homes, or their home. A single item on satisfaction with outdoor activities (assessed using a 5-point Likert scale: not at all to extremely satisfied) was the primary outcome. Mixed effects linear regression modeling using a backward elimination process was used for building a final multivariable model. In the final model, older age (p<0.001) and higher overall quality of life ratings (p<0.001) at baseline were associated with slower rates of increase in outdoor satisfaction over time. Higher education level (p=0.035) at baseline was associated with a faster rate of increase in outdoor satisfaction over time. Additionally, those who moved into an assisted living community (p=0.024) or nursing home (p=0.016) at baseline were associated with faster rates of increase in outdoor satisfaction over time compared to those in the home. Knowledge of factors influencing satisfaction with outdoor activities can assist interdisciplinary teams implement interventions for individual or organizational changes.

scholarly journals CARE FOR THE PERSON WHO LIVES WITH HIV/AIDS IN PRIMARY HEALTH CARE

2019 ◽  
Vol 28 ◽  
Author(s):  
Aline Daiane Colaço ◽  
Betina Hörner Schlindwein Meirelles ◽  
Ivonete Teresinha Schülter Buss Heidemann ◽  
Mariana Vieira Villarinho
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
People Living With Hiv ◽  
Structured Interviews ◽  
Term Care ◽  
Descriptive Research ◽  
Primary Health ◽  
Centered Care ◽  
Living With Hiv ◽  
Hiv Aids

ABSTRACT Objective: to understand the process of caring for the person with HIV/AIDS in the Primary Health Care of a capital in southern Brazil. Method: qualitative, exploratory and descriptive research, carried out in the Health Centers of this city, from March to August 2015. Sixteen nurses participated through semi-structured interviews, which were organized and codified with the help of the software QSR Nvivo®, version 10. Afterwards, the data were analyzed through comparative analysis. Results: results were described in two categories: “The inter-subjective encounter given the vulnerability to HIV/AIDS”, and, “Accepting needs and formulating actions given the reality”. Potentialities and weaknesses were evidenced through these categories, such as: reception, long-term care, active search, home visits, and, in return, lacking a formal flow of care for people living with HIV/ AIDS, lack of HIV/AIDS line of care and medical/centered care. Conclusion: the need to implement HIV/AIDS management in primary care was verified, as well as to overcome the fragilities in this care with the aid of implementing a formal care flow, establishing managerial processes and permanent education for the professionals. Then, expanding and qualifying care in HIV/AIDS, with important contributions of the nurse in the perspective of integral care in the process of living with HIV/AIDS.

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