We're Still Very Much in Limbo: Providers' Perspectives on Implementing a Person-Centered Project

Abstract Background The Preferences for Everyday Living Inventory assists nursing home (NH) providers in assessing residents’ preferences and can be used to make Preferences for Activity and Leisure (PAL) Cards, which are personalized 5x7 laminated cards that reflect a resident’s recreation and leisure preferences. We sought to understand the barriers and facilitators to implementing PAL Cards in NH communities during COVID-19. Methods NH providers from five states (n=29) were recruited to create PAL Cards in their communities. Monthly coaching calls with project champions assessed the implementation process. Calls were recorded, transcribed verbatim, checked for accuracy, and coded via thematic analysis. Results Four themes emerged: Adapting to COVID, Preoccupied with COVID, Future Thinking, and PAL Cards Filling the Gaps. Conclusion Some providers were successful adapting to COVID, while others struggled to implement a new program during the pandemic. Those that were successful expressed how PAL Cards helped promote person-centered care.

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The experiences, priorities, and perceptions of informal caregivers of people with dementia in nursing homes: A scoping review

Dementia ◽

10.1177/14713012211012606 ◽

2021 ◽

pp. 147130122110126

Author(s):

Alexandra E Harper ◽

Lauren Terhorst ◽

Marybeth Moscirella ◽

Rose L Turner ◽

Catherine V Piersol ◽

...

Keyword(s):

Nursing Home ◽

Nursing Homes ◽

Home Care ◽

Scoping Review ◽

Informal Caregivers ◽

Nursing Home Care ◽

Person Centered Care ◽

People With Dementia ◽

Centered Care

Background Person-centered care has been shown to increase desired outcomes for people with dementia, yet informal caregivers’ dissatisfaction with care is often reported. For those living in a nursing home, informal caregivers are uniquely situated to provide key insights into the individual’s care. However, little is known of the informal caregivers’ perspective, which hinders efforts to improve their satisfaction with person-centered nursing home care. Thus, we examined the comprehensive experiences, priorities, and perceptions of informal caregivers of nursing home residents with dementia. Methods In collaboration with stakeholders, a scoping review of Medline (Ovid), EMBASE.com , CINAHL (EBSCO), the Cochrane Library (Wiley), and PsycINFO (Ovid) databases from January 2000 to July 2020 was conducted. Data were extracted reflecting the experiences, priorities, and preferences of caregivers of people with dementia residing in nursing homes. Results We identified 114 articles that revealed nine themes: (1) communication, (2) transition to nursing home, (3) quality of care, (4) quality of life, (5) informal caregiver role, (6) knowledge of dementia, (7) end-of-life preferences, (8) medication use to manage neuropsychiatric behaviors, and (9) finances. Conclusion Informal caregivers described aspects of care that led to both positive and negative experiences with and perceptions of nursing home care. The shortcomings in communication were discussed most frequently, indicating a high priority area. While researchers define the identified themes individually, informal caregivers perceive them to be interwoven as they relate to person-centered care delivery. Although we did not assess the quality of included articles, by identifying themes relevant to caregivers’ perspectives of nursing home care, our findings may help to inform efforts to optimize caregivers’ satisfaction with nursing home care for residents with dementia.

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From Micro to Macro: Exploring Preference-Based Person Centered Care from Multiple Perspectives

Innovation in Aging ◽

10.1093/geroni/igaa057.3062 ◽

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.

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The Mediating Effect of Human Rights Awareness in the Relationship Between Empowerment and Person-Centered Care of Nursing Staff in Nursing Home

Korean Journal of Sports Science ◽

10.35159/kjss.2021.8.30.4.263 ◽

2021 ◽

Vol 30 (4) ◽

pp. 263-275

Author(s):

Aee-Lee Kim

Keyword(s):

Human Rights ◽

Nursing Home ◽

Nursing Staff ◽

Mediating Effect ◽

Person Centered Care ◽

Centered Care ◽

The Relationship

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

The International Journal of Person Centered Medicine ◽

10.5750/ijpcm.v7i2.628 ◽

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.

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

International Psychogeriatrics ◽

10.1017/s1041610218000194 ◽

2018 ◽

Vol 30 (10) ◽

pp. 1519-1530 ◽

Cited By ~ 4

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.

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Role for a Labor-Management Partnership in Nursing Home Person-Centered Care

The Gerontologist ◽

10.1093/geront/gnp123 ◽

2009 ◽

Vol 50 (3) ◽

pp. 340-351 ◽

Cited By ~ 12

Author(s):

W. Leutz ◽

C. E. Bishop ◽

L. Dodson

Keyword(s):

Nursing Home ◽

Labor Management ◽

Person Centered Care ◽

Centered Care

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A Digital Platform for Facilitating Personalized Dementia Care in Nursing Homes: A Formative Evaluation Study (Preprint)

10.2196/preprints.25705 ◽

2020 ◽

Author(s):

GUBING WANG ◽

Armagan Albayrak ◽

Gerd Kortuem ◽

Tischa J. M. van der Cammen

Keyword(s):

Nursing Home ◽

Nursing Homes ◽

User Acceptance ◽

Assistive Technologies ◽

Perceived Usefulness ◽

Technical Feasibility ◽

Digital Platform ◽

Person Centered Care ◽

People With Dementia ◽

Centered Care

BACKGROUND Person-centered care is key to the wellbeing of people with dementia. A large quantity of personal data can be collected with the development of the Internet of Things, which has the potential to facilitate person-centered care for people with dementia. Yet, there are limited assistive technologies developed for this purpose, and the user acceptance for assistive technologies is low in nursing homes. Through a data-enabled design approach, a digital platform was developed for helping the care team to personalize the management of behavioral and psychological symptoms for people with dementia in nursing homes. OBJECTIVE This study aims to evaluate the digital platform from three aspects, in a real-life context with potential users. First, its technical feasibility in collecting sufficient data for pattern analysis; second, the types of insights and actions generated from the potential users by using it, if any; third, its perceived usefulness and its future improvements that potential users would like to see. METHODS The digital platform was deployed in a nursing home for seven weeks, and the data collected were first analyzed by the researchers for a technical feasibility check. The data were then visualized and presented to the potential users via the digital platform. The potential users were asked to analyze the visualizations and were interviewed on 1) the insights and actions generated, if any; 2) the usefulness of the digital platform and 3) what could be improved. RESULTS The data collected in the digital platform demonstrate its technical potential to reveal behavior patterns for PwD. The insights generated by the potential users were categorized into “client level”, “ward level” and “team level”. The actions taken by the potential users were classified into “investigation” and “implementation”. The user acceptance varied across potential users, and three aspects of improvements for the digital platform were identified. CONCLUSIONS This study provides the first evidence for the technical feasibility of the digital platform; besides, it offers future researchers some recommendations on how to integrate assistive technologies in the nursing home context from exploring the types of insights and actions identified, the varied perceived usefulness, and the areas of improvement for the digital platform.

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Evaluating the implementation of a pragmatic person-centered communication tool in the nursing home via the RE-AIM framework.

10.21203/rs.3.rs-103171/v1 ◽

2020 ◽

Author(s):

Katherine Abbott ◽

Alexandra Heppner ◽

Nytasia Hicks ◽

Abigail Hermesch ◽

Kimberly VanHaitsma

Keyword(s):

Nursing Home ◽

Communication Tool ◽

Building Relationships ◽

Team Members ◽

For Profit ◽

Not For Profit ◽

Centered Care ◽

Evidenced Based ◽

Validated Instrument ◽

Everyday Living

Abstract Background: Person-centered care (PCC) is a philosophy that recognizes “knowing the person” and honoring individual preferences. The purpose of this study was to evaluate the implementation of a novel PCC communication tool in nursing homes (NH). The tool is based on an assessment of NH resident likes and dislikes via the Preferences for Everyday Living Inventory (PELI), which is an evidenced-based, validated instrument used to enhance the delivery of PCC. The Preferences for Activity and Leisure (PAL) Card was developed to communicate residents’ preferences for leisure and activities across care team members. Methods: Providers were recruited to utilize the recreation and leisure items from the PELI to assess resident important preferences and create PAL Cards for 15-20 residents. Providers collected data aligned with the RE-AIM framework (Reach, Effectiveness, Adoption, Implementation, Maintenance). Results: Reach and Adoption: A total of n=43 providers registered and n=26 (60%) providers completed the project. Ownership of participating providers included 54% not for profit, 46% for profit, and 8% government owned with an average star rating of 3.7 (SD 1.1) and a range of 1-5. Effectiveness and Implementation: Participants attempted n=424 PAL Cards and completed n=406. The average acceptability of the intervention measure (AIM) was 4.7 (SD 0.4), intervention appropriateness measure (IAM) was 4.5 (SD 0.5), and feasibility of intervention measure (FIM) was 4.6 (SD 0.5). Maintenance: Providers were able to complete 82% of PAL Card placement over the course of 5 months with few cards going missing (<2%). Conclusion: The majority of providers were successful in implementing PAL Cards for residents and reported the intervention as highly acceptable, appropriate, and feasible. The pragmatic PAL Card intervention can assist nursing home providers in meeting PCC regulations and contribute to building relationships between residents, family, and staff.

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