scholarly journals The Influence of Race and Gender on Staff-Resident Interactions in Nursing Homes

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 185-185
Author(s):  
Rachel McPherson ◽  
Barbara Resnick ◽  
Elizabeth Galik
Keyword(s):  
Racial Differences ◽  
Long Term Care ◽  
Analysis Of Covariance ◽  
Positive Interactions ◽  
Term Care ◽  
Race And Gender ◽  
Significant Difference ◽  
And Gender

Abstract Communication and interactions are an integral part of care in long-term care settings. Resident variables, such as race and gender, shape communication and interaction between staff and residents. The Quality of Interactions Schedule (QuIS) was developed to measure the quality of verbal and nonverbal interactions among nursing staff and older adults initially for those in acute care and later used as well in a variety of long term care settings. A quantified measurement of the quality of interactions between residents and staff was created to quantify the QuIS. The purpose of this study was to describe the gender and racial differences in scored quality of interactions. Data for the present study was based on baseline data from the Evidence Integration Triangle for Behavioral and Psychological Symptoms of Dementia (EIT-4-BPSD) implementation study. A total of 535 residents from 55 settings were included in the analyses. An analysis of covariance was conducted to determine a difference in QuIS scores between males and females while controlling for age. The second model tested for differences in QuIS scores between blacks and whites while controlling for age and gender. There was not a statistically significant difference in QuIS scores between male and female residents. There was a significant difference in QuIS scores between those who were black versus white, such that those who were black received more positive interactions from staff than those who were white. Future work should focus on a deeper examination of resident factors and staff factors that may influence these interactions.

scholarly journals Intersections of ageism and gender stigma: Exploring long-term care employees' attitudes towards aging

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 951-951
Author(s):  
Tarah Loy-Ashe ◽  
Brent Hawkins
Keyword(s):  
Long Term Care ◽  
Single Case ◽  
Statistical Significance ◽  
Direct Care ◽  
Positive Interactions ◽  
Term Care ◽  
On Line ◽  
Quantitative Results ◽  
And Gender

Abstract The purpose of this mixed methods, single case study was to explore long-term care (LTC) employees’ attitudes towards age and gender. The intersection of Rosemary Garland-Thomson’s theory of feminist disability (2001) and Hailee Gibbons’ compulsory youthfulness theory (2016) provided the conceptual framework for this project. The sample consisted of 60 LTC direct care employees, all employed at the same organization, who completed an on-line survey during the COVID-19 pandemic. The survey consisted of demographic questions and the Fraboni Scale of Ageism. Twenty-one of these employees participated in a 30-45 minute phone interview. Cultural artifacts were also collected. All data were collected during the COVID-19 pandemic. Although quantitative results showed no statistical significance, qualitative results suggest that employees do exhibit some ageist attitudes towards the residents for whom they care. Despite evidence that most employees felt a deep connection with residents, they detached themselves from the aging process. The theoretical framework lends hand in explaining how both ableism and ageism appeared to contribute to this detachment. Findings indicated employees’ interactions and attitudes towards residents were influenced by themes compassionate ageism, ableism, and identity, which resulted in meta theme caregiver validation and reward. Employees received validation and altruistic reward from positive interactions with what they perceived to be “ideal” residents; those who fit the stereotype of a nursing home resident, such as older, pleasant, and dependent. The perceived “ideal” residents varied by gender. Generally, female residents were expected to be more independent and at times viewed negatively when requesting assistance.

Structural marginalisation among the long-term care workforce in England: evidence from mixed-effect models of national pay data

2012 ◽  
Vol 34 (1) ◽  
pp. 21-41 ◽  
Author(s):  
SHEREEN HUSSEIN ◽  
JILL MANTHORPE
Keyword(s):  
Long Term Care ◽  
Term Care ◽  
Mixed Effect ◽  
Ageing Society ◽  
Job Roles ◽  
Mixed Effect Models ◽  
Pay Differences ◽  
And Gender

ABSTRACTThe long-term care sector is generally characterised by low pay and difficult working conditions. Understanding pay structures and differentials within this sector is important in enhancing recruitment, retention, quality of care and productivity. This article uses new national data on the long-term care workforce in England to investigate employer and individual effects on pay levels and differentials, using mixed-effects modelling controlling for region, sector and employer hierarchical factors. We further examine whether gender and ethnic pay gaps exist among different groups of workers. The results indicate a significant relationship between sector and pay across different job roles. The analysis further identifies ethnic and gender pay differences even after controlling for the effects of sector and individual employers. The implications of this are discussed in relation to sustaining the care workforce in the context of an ageing society and the potential for structural employment marginalisation to reflect the marginalisation of older people receiving care.

scholarly journals Examining Racial and Ethnic Disparities Among Older Adults in Long-Term Care Facilities

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 27-28
Author(s):  
Kathy Lee ◽  
Rebecca Mauldin ◽  
John Connolly ◽  
Weizhou Tang
Keyword(s):  
Quality Of Life ◽  
Older Adults ◽  
Racial Differences ◽  
Long Term Care ◽  
Ethnic Disparities ◽  
Term Care ◽  
Resident Care ◽  
Race Ethnicity

Abstract Background: Nearly half-million older adults from minority racial and ethnic groups in long term care face disparities in quality of life and quality of care. However, there is little information about the associations between a resident’s race/ethnicity and the types of official complaints lodged. Methods: This project was a mixed methods study using a sequential explanatory design to examine ethnic and racial differences in types of complaints and rates of complaint resolution in a local Ombudsman Program. First, resident race/ethnicity and complaint data were collected from the Ombudsman Program and analyzed. Then, we conducted focus groups with Ombudsman Program staff and volunteers to provide a more complete interpretation of findings from the first phase. Results: Residents from ethnic/racial minority groups were less likely to generate Resident Care complaints and more likely to generate Resident Rights complaints, compared to non-Hispanic White residents (p<.05). Resident Rights, Quality of Life, and Administrative complaints were less likely to be disposed satisfactorily, compared to Resident Care complaints (p<.05). Themes emerged from our qualitative findings include language barriers and more efforts required for residents’ rights due to concerns raised more frequently among minority residents. Implications: Cultural competence training for Ombudsmen as well as care professionals should focus on skills and knowledge that value diversity, understand and respond to their unique concerns. Ombudsmen play an important role as they create an avenue for the residents to discuss their concerns. Implementation research may improve our understanding of the development and delivery of the Ombudsman Program.

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 Intersectionality: Mapping Critical Relations for Quality in Long-Term Care Research

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 39-39
Author(s):  
Katie Aubrecht ◽  
Ivy Bourgeault ◽  
Tamara Daly
Keyword(s):  
Long Term Care ◽  
Term Care ◽  
Social Divisions ◽  
Care Workers ◽  
Power Differentials ◽  
Care Relationships ◽  
And Gender ◽  
Relations Of Power ◽  
Status Of Care

Abstract Intersectionality is a useful method (Lutz, 2015) for interdisciplinary long-term care (LTC) research to advance a more critical understanding of how experiences of quality are shaped by mutually reproducing social divisions, identities and relations of power that shape LTC. This paper discusses insights from the “Mapping Care Relationships” stream of the Seniors – Adding Life to Years (SALTY) project, a pan-Canadian program of research examining clinical, social and policy perspectives on quality in LTC. “Mapping Care Relationships” mapped how promising approaches to care relationships are organized and experienced in LTC. From January 2018-August 2019 our team of nine researchers conducted rapid ethnographies in eight nursing homes, two in each of four provinces across Canada. We purposively observed and interviewed workers from a wide variety of positions and backgrounds, informed by an intersectionality approach. We traced how promising approaches in person-centred dementia care (PCDC) in particular may reify the subordinated status of care workers (some more than others) and reinforce inequities within LTC systems. In multiple LTC homes, front-line care workers described experiencing physical and emotional harm in care relationships with residents which caused them distress. However, consistent with a PCDC approach, the harm was attributed to ‘behaviours’ clinically symptomatic of dementia. In framing power differentials from a medical perspective, PCDC makes it possible to interpret harmful experiences as 'part of the job’ and something workers should know to expect, prevent, avoid, redirect, or ignore. Lutz, H. (2015). Intersectionality as method. DiGeSt. Journal of diversity and gender studies, 2(1-2), 39-44.

scholarly journals Impact of Frailty on Medical and Long-Term Care Expenditures for the Elderly Age 75 or Over in Japan

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 176-176
Author(s):  
Hiroto Yoshida ◽  
Yuriko Kihara
Keyword(s):  
Long Term Care ◽  
The Elderly ◽  
Elderly Age ◽  
Term Care ◽  
Intentional Weight Loss ◽  
Long Term Care Insurance ◽  
And Gender ◽  
The Impact

Abstract This study examined the impact of frailty on medical and long-term care expenditures in an older Japanese population. The subjects were those aged 75 years and over who responded to the survey (March 2018) in Bibai, Hokkaido, Japan (n=1,203) and have never received certification of long-term care insurance at the survey. We followed up 867 individuals (72.1%) until the end of December 2018 (10 month-period). We defined frailty as a state in performing 4 items and over of 15 items which were composed of un-intentional weight loss, history of falls, etc. Among 867 subjects, 233 subjects (26.9%) were judged to be frailty group, and 634 subjects (73.1%) non-frailty group. We compared period to the new certification of long-term care insurance (LTCI), accumulated medical and long-term care expenditures adjusted for age and gender between the two groups during the follow-up period. Cox proportional hazard models were used to examine the association between baseline frailty and the new certification of LTCI. The relative hazard ratio (HR) was higher in frailty group than non-frailty group (HR=3.51, 95% CI：1.30-9.45, P=.013). The adjusted mean accumulated medical and long-term care expenditures per capita during the follow-up were significantly (P=.002) larger for those in the frailty group (629,699 yen), while those in the non-frailty group were 450,995 yen. We confirmed strong economic impact of frailty in the elderly aged 75 or over in Japan.

scholarly journals Psychometric validation of the Chinese version of the PaArticular Scales among elderly residents in long-term care facilities with joint contractures

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yi-chang Chen ◽  
Keh-chung Lin ◽  
Chen-Jung Chen ◽  
Shu-Hui Yeh ◽  
Ay-Woan Pan ◽  
...  
Keyword(s):  
World Health Organization ◽  
Long Term Care ◽  
Chinese Version ◽  
World Health ◽  
Term Care ◽  
Joint Contractures ◽  
The World ◽  
Health Organization

Abstract Background Joint contractures, which affect activity, participation, and quality of life, are common complications of neurological conditions among elderly residents in long-term care facilities. This study examined the reliability and validity of the Chinese version of the PaArticular Scales in a population with joint contractures. Methods A cross-sectional study design was used. The sample included elderly residents older than 64 years with joint contractures in an important joint who had lived at one of 12 long-term care facilities in Taiwan for more than 6 months (N = 243). The Chinese version of the PaArticular Scales for joint contractures was generated from the English version through five stages: translation, review, back-translation, review by a panel of specialists, and a pretest. Test-retest reliability, internal consistency reliability, construct validity, and criterion validity were evaluated, and the results were compared with those for the World Health Organization Quality of Life scale and the World Health Organization Disability Assessment Schedule. Results The Chinese version of the PaArticular Scales had excellent reliability, with a Cronbach α coefficient of 0.975 (mean score, 28.98; standard deviation, 17.34). An exploratory factor analysis showed three factors and one factor with an eigenvalue > 1 that explained 75.176 and 62.83 % of the total variance in the Activity subscale and Participation subscale, respectively. The subscale-to-total scale correlation analysis showed Pearson correlation coefficients of 0.881 for the Activity subscale and 0.843 for the Participation subscale. Pearson’s product-moment correlation revealed that the correlation coefficient (r) between the Chinese version of the PaArticular Scales and the World Health Organization Disability Assessment Schedule was 0.770, whereas that for the World Health Organization Quality of Life scale was − 0.553; these values were interpreted as large coefficients. Conclusions The underlying theoretical model of the Chinese version of the PaArticular Scales functions well in Taiwan and has acceptable levels of reliability and validity. However, the Chinese version must be further tested for applicability and generalizability in future studies, preferably with a larger sample and in different clinical domains.

scholarly journals 106 - Environmental Influences on the Cognitive and Psychological Well Being of Older Adults with Dementia

2020 ◽  
Vol 32 (S1) ◽  
pp. 15-16
Author(s):  
William E. Reichman ◽  
L. Bradford Perkins ◽  
Hilde Verbeek
Keyword(s):  
Quality Of Life ◽  
Older Adults ◽  
Physical Environment ◽  
Culture Change ◽  
Long Term Care ◽  
Small Scale ◽  
Term Care

This symposium will review the latest data on the influence of environmental design and its attributes on the cognitive and psychological wellbeing of older adults living with dementia. The presenters will cover the myriad ways in which the physical environment of care can adapt to the changing demands of older adults with sensory, motor and cognitive deficits and foster optimal functioning and quality of life. The role of emerging technologies will also be reviewed as they complement the contribution of the design of the physical environment to the wellbeing of older adults with cognitive impairment. Information will be offered through a review of the existing research literature as well as case studies that illustrate the impact of environmental modification on fostering wellbeing and minimizing the emergence of the behavioral and psychological symptoms of dementia. The presenters will represent and integrate sensibilities that have emerged from the fields of architecture, cognitive neuroscience and psychology.How the Principles of the Culture Change Movement Inform Environmental Design and the Application of Technology in the Care of Older Adults Living with DementiaWilliam E. ReichmanThe culture change movement informs a number of principles that have been applied to more contemporary design concepts for the congregate care of older adults living with dementia. This talk will review the core tenets of the Culture Change Movement as exemplified by the Greenhouse, Dementia Village and other innovative models of congregate long-term care. Specific reference will be made to how these tenets have been operationalized around the world into the design of programming and the creation of residential care environments that foster a better quality of life for older adults and an enhanced work environment for care providers. This talk will also include the emerging role of technologies that complement innovative design of the environment and which foster optimized social and recreational functioning of older adults living with dementia.A Better Life Through a Better Nursing Home DesignL. Bradford PerkinsOver the last 20 years there has been extensive experimentation related to the role of the environment in the housing, care and treatment of persons with Alzheimer’s and other age related dementias. Prior to that time the typical housing and care environment was a locked unit in a skilled nursing or other restrictive senior living facility. In 1991 the Presbyterian Association on Aging in Western Pennsylvania opened Woodside Place on its Oakmont campus. This small 36 bed facility was designed to incorporate the latest research and care experience with persons suffering from these issues. This one small project, as well as the long post occupancy research led by Carnegie Mellon University, clearly demonstrated that individuals with Alzheimer’s and related forms of dementia could lead a healthier, happier, higher quality of life in a more residential, less restrictive environment. Not everything in this pioneering project worked, and five generations of living and care models have followed that have refined the ideas first demonstrated by Woodside Place. Bradford Perkins, whose firm designed Woodside Place and over 100 other related projects, will discuss what was learned from Woodside Place as well as the five generations of projects (and post occupancy research) that followed.Innovative dementia care environments as alternatives for traditional nursing homes: evidence and experiences from the NetherlandsHilde VerbeekKey goals of the dementia care environment focus on increasing autonomy, supporting independence and trying to enable one’s own lifestyle for as long as possible. To meet these goals, innovative, small-scale and homelike care environments have been developed that have radically changed the physical, social and organizational aspects of long-term care in the Netherlands. This presentation discusses various Dutch models that have implemented small-scale and homelike care environments, including green care farms, dementia village and citizen initiatives. The models reflect a common care concept, focusing on residents’ remaining strengths, providing opportunity for choice and aiming to sustain a sense of self and control. A small number of residents (usually 6 to 8) live together in a homelike environment and nursing staff are part of the household. Residents are encouraged to participate in daily household activities, emphasizing normalization of daily life with person-centred care. The physical environment resembles an archetypal home. This talk presents the scientific evidence on the impact and effects of these small-scale, homelike models on residents, their family caregivers and staff. Furthermore, the presentation will highlight working approaches and how these initiatives have positively influenced routine care across the long-term care spectrum.

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