scholarly journals COVID-19 and Person-Centered Care: Lessons Learned Through a Statewide Program for Nursing Homes

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 270-271
Author(s):  
Migette Kaup ◽  
Laci Cornelison
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Infection Control ◽  
Pay For Performance ◽  
Control Strategies ◽  
Lessons Learned ◽  
Frail Elders ◽  
Person Centered Care ◽  
Centered Care ◽  
The Impact

Abstract Frail elders in nursing homes are the highest risk group for developing complications of COVID-19. This lead to a response from CMS and state regulators that was heavily focused on protection and safety through segregation and infection control. The purpose of this study was to gather the narrative of this pandemic response and understand the impact on person-centered care and be able to address provider needs in real-time. This qualitative method focused on nursing home providers who are a part of PEAK 2.0, a Medicaid pay-for-performance program in Kansas. Interviews with nursing home staff (n=168) revealed two critical themes of need; mandated responses disregarded elders’ autonomy and self-determination in decision making, and infection control strategies required new approaches to facets of resident care that still maintained dignity. This data, along with COVID-19 guidance were then used to inform feasible resource development and education to maintain PCC practices during the pandemic.

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

Dementia ◽  
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.

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.

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.

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

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.

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.

scholarly journals Determinants of Successful Nursing Home Accreditation

2021 ◽  
Vol 58 ◽  
pp. 004695802110599
Author(s):  
Shu-Chuan Yeh ◽  
Shwu-Feng Tsay ◽  
Wen Chun Wang ◽  
Ying-Ying Lo ◽  
Hon-Yi Shi
Keyword(s):  
Quality Control ◽  
Nursing Home ◽  
Nursing Homes ◽  
Integrated Care ◽  
Organizational Factors ◽  
Minor Role ◽  
Person Centered Care ◽  
Nursing Skills ◽  
Centered Care ◽  
Care Nursing

Objectives: This study examined the factors associated with better accreditation outcomes among nursing homes. Method: A total of 538 nursing homes in Taiwan were included in this study. Measures included accreditation scores, external factors (household income, Herfindahl–Hirschman Index, old-age dependency ratio, population density, and number of older adult households), organizational factors (hospital-based status, chain-affiliated status, occupancy rate, the number of registered nurses or nurse aides per bed, and bed size), and internal factors (accountability, deficiencies, person-centered care, nursing skills, quality control, and integrated care). Results: Bed size, hospital-based status, accountability, deficiencies, person-centered care, nursing skills, quality control, and integrated care were found to predict accreditation. Conclusion: Among all variables in this study, the quality indicators contributed to the most variation, followed by organizational factors. External environmental factors played a minor role in predicting accreditation. A focus on quality of care would benefit not only the residents of a nursing home but also facilitate its accreditation.

scholarly journals A QUALITATIVE STUDY OF NURSING HOME STAFF CONCEPTUALIZATION OF EVERYDAY DECISION-MAKING CAPACITY

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S700-S700
Author(s):  
Whitney L Mills ◽  
Mark E Kunik ◽  
Lea Kiefer ◽  
Hannah Curren-Vo ◽  
Amy Mochel ◽  
...  
Keyword(s):  
Decision Making ◽  
Nursing Home ◽  
Nursing Homes ◽  
Qualitative Content Analysis ◽  
Daily Basis ◽  
Care Providers ◽  
Nursing Home Staff ◽  
Person Centered Care ◽  
Decision Making Capacity ◽  
Centered Care

Abstract Because nursing homes are both a residence and a treatment setting, care providers are faced with the challenge of balancing resident autonomy and safety on a daily basis. While there are standardized approaches for determining a capacity to make larger decisions such as providing consent for medical procedures, there are virtually no methods for assessing capacity to make everyday decisions (e.g., food choices, smoking, navigating outside the nursing home). While it is easier for staff to prevent residents from making decisions they deem risky, to truly offer person-centered care, it is important to support a resident’s right to make decisions if they have the capacity to do so. Currently, little is known about how nursing home staff conceptualize and determine everyday decision-making capacity and how that information is used in care planning. To understand the current processes and language nursing home staff use when considering a resident’s decision-making capacity, we conducted interviews with 37 staff at two Veterans Affairs (VA) Community Living Centers (VA-operated nursing homes; CLCs). Using qualitative content analysis, we coded the transcribed interviews and identified several overarching themes: autonomy vs. safety, communication (e.g., pathways, with caregivers, with residents), determining capacity (e.g., information gathering, assessment, assumptions, indicators, interdisciplinary team member roles, referrals), interventions (e.g., legal and staff-led), and terminology used. We will describe how the findings from this study can be used to tailor development and adaptation of tools to help nursing home staff assess resident everyday decision-making capacity and to incorporate the results into person-centered care approaches.

scholarly journals TIMELY LESSONS FROM A PANDEMIC ON THE BENEFITS OF PERSON CENTRIC CARE IN LONG TERM CARE FACILITIES

2020 ◽  
pp. 1-2
Author(s):  
S.-L. Wee ◽  
P.L.K. Yap
Keyword(s):  
Quality Of Care ◽  
Nursing Homes ◽  
Infection Control ◽  
Long Term Care ◽  
Term Care ◽  
Person Centered Care ◽  
Care Facilities ◽  
Centered Care

Since the outbreak of Coronavirus Disease 2019 (COVID-19), there have been few deadlier places than in nursing homes. As such, several useful guidelines on coping with COVID-19 in nursing homes have emerged. The critical immediate term measures mentioned in the guidelines have longer term implications especially on quality of care. We discuss how these measures instituted for infection control can be synergistic with person-centered care which has been synonymous with quality of care in nursing homes.

scholarly journals PEAK 2.0: OPERATIONALIZING PERSON-CENTERED CARE AIDS NURSING HOMES IMPLEMENT AND SUSTAIN PRACTICES

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S555-S556
Author(s):  
Laci Cornelison ◽  
Gayle Doll ◽  
Maggie Syme ◽  
Migette Kaup
Keyword(s):  
Nursing Homes ◽  
Pay For Performance ◽  
External Evaluation ◽  
Stakeholder Collaboration ◽  
Self Evaluation ◽  
Person Centered Care ◽  
Research Outcomes ◽  
Centered Care ◽  
Key Features ◽  
Definition Of

Abstract Pay-for-performance programs to incentivize quality are on the rise nationally (Werner, Konetzka, & Polsky, 2013 & Arling, Job, & Cooke, 2009). Kansas initiated a Medicaid P4P program to incentivize person-centered care (PCC) beginning in 2012 called PEAK 2.0. This program created an operationalized definition of PCC through stakeholder collaboration and research outcomes (Harris, Poulsen, & Vlangas, 2006). Homes enrolled in the program undergo both self-evaluation and objective external evaluation based on the operationalized definition. These key features inherent in the PEAK 2.0 program make up has aided homes to implement PCC as well as, the ability to research homes that have implemented PCC in a new a different way than ever before.

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