Communicative Coping and Friendship Among Persons Living With Dementia: Findings From Long-Term Care

Abstract The study of identity is central to many disciplines, however there is a special link that connects language and discourse to identities. The way people speak reveals a lot about who they are. Through discourse and communication individuals convey and negotiate their sense of self (de Fina, 2020). Regardless of cognitive status, persons living with dementia (PLWD) use language to construct for themselves a social identity of being included in friendship networks (de Medeiros et al., 2011). This paper uses data from the Friendship Study to examine the use of such communicative coping behavior (CCB) for friendship formation. Ethnographic observations of PLWD were conducted in a Long-Term Care residential setting. Sociolinguistic discourse analysis of verbatim transcripts with reference to the CCB Checklist (Saunders et al., 2016) reveal evidence of CCB use. Results suggest that different types of CCBs were used to construct identity and negotiate friendship challenges in different contexts.

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CNAs’ Ratings of Nursing Home Residents’ Pain: The Role of CNA and Resident Traits

Innovation in Aging ◽

10.1093/geroni/igaa057.1226 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 381-381

Author(s):

Emily Behrens ◽

Hyunjin Noh ◽

A Lynn Snow ◽

Patricia Parmelee

Keyword(s):

Long Term Care ◽

Pain Catastrophizing ◽

Nursing Home Residents ◽

Cognitive Status ◽

Pain Rating ◽

Sources Of Information ◽

Term Care ◽

Rating Accuracy ◽

Lower Accuracy

Abstract Long-term care residents with and without cognitive impairment may experience undertreatment of persistent pain (Fain et. al, 2017). Certified nursing assistants (CNAs) are important sources of information about resident pain as they provide the majority of residents’ hands-on care. Therefore, assessing the accuracy of CNAs’ pain assessments and potential influencing factors may provide insight regarding the undertreatment of pain. Informed by prior research, this study examined resident pain catastrophizing and cognitive status as predictors of CNAs’ pain assessment accuracy. CNA empathy was examined as a moderating variable. Analyses confirmed a relationship between pain catastrophizing and CNA pain rating accuracy (R^2 = .205, p < .01), reflecting lower accuracy of ratings for residents higher in catastrophizing. Hypotheses predicting a relationship between resident cognitive status and CNA pain rating accuracy and moderating effects of empathy were disconfirmed. Challenges of conducting research in long-term care are discussed.

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Frailty Status and Cognitive Function Should Guide Prescribing in Long-term Care Facilities

The Senior Care Pharmacist ◽

10.4140/tcp.n.2021.469 ◽

2021 ◽

Vol 36 (10) ◽

pp. 469-473

Author(s):

Shin J. Liau ◽

J. Simon Bell

Keyword(s):

Clinical Practice ◽

Clinical Practice Guidelines ◽

Practice Guidelines ◽

Long Term Care ◽

Adverse Drug Events ◽

Cognitive Status ◽

Term Care ◽

Care Facilities ◽

Disease Specific

Frailty, dementia and complex multimorbidity are highly prevalent among residents of long-term care facilities (LTCFs). Prescribing for residents of LTCFs is often informed by disease-specific clinical practice guidelines based on research conducted among younger and more robust adults. However, frailty and cognitive impairment may modify medication benefits and risks. Residents with frailty and advanced dementia may be at increased susceptibility to adverse drug events (ADEs) and often have a lower likelihood of achieving long-term therapeutic benefit from chronic preventative medications. For this reason, there is a strong rationale for deprescribing, particularlyamong residents with high medication burdens, swallowing difficulties or limited dexterity. Conversely, frailty and dementia have also been associated with under-prescribing of clinically indicated medications. Unnecessarily withholding treatment based on assumed risk may deprive vulnerable population groups from receiving evidence-based care. There is a need for specific evidence regarding medication benefits and risks in LTCF residents with frailty and dementia. Observational studies conducted using routinely collected health data may complement evidence from randomized controlled trials that often exclude people living with dementia, frailty and in LTCFs. Balancing over- and under-prescribing requires consideration of each resident’s frailty and cognitive status, therapeutic goals, time-to-benefit, potential ADEs, and individual values or preferences. Incorporating frailty screening into medication review may also provide better alignment of medication regimens to changing goals of care. Timely identification of frail residents as part of treatment decision-making may assist with targeting interventions to minimize and monitor for ADEs. Shifting away from rigid application of conventional disease-specific clinical practice guidelines may provide an individualized and more holistic assessment of medication benefits and risks in the LTCF setting.

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Discrepancy between information provided and information required by emergency physicians for long-term care patients

CJEM ◽

10.1017/cem.2017.353 ◽

2017 ◽

Vol 20 (3) ◽

pp. 362-367 ◽

Cited By ~ 1

Author(s):

Richa Parashar ◽

Shelley McLeod ◽

Don Melady

Keyword(s):

Medical History ◽

Long Term Care ◽

Cognitive Status ◽

Care Hospital ◽

Past Medical History ◽

Emergency Physicians ◽

Term Care ◽

Advanced Directives ◽

Contact Information

AbstractObjectivesThe primary objective of this study was to identify information included in long-term care (LTC) transfer documentation and to compare it to the information required by local emergency department (ED) physicians to provide optimal care and make decisions for LTC patients.MethodsA retrospective chart review was conducted for a sample of LTC residents transferred by ambulance to the ED of an academic, tertiary care hospital over a 1-year period. All emergency physicians working at the institution were invited to complete an online questionnaire about information included in LTC transfer documentation and information required by emergency physicians to provide care for LTC patients.ResultsOf the 200 charts reviewed, the most common information transferred to the ED with the LTC patient was the patient’s past medical history (n=184, 92.0%), name of family physician (n=182, 91.0%), a list of known allergies (n=179, 89.5%), the reason for transfer to the ED (n=155, 77.5%), the patient’s emergency contact information (n=152, 76.0%), and medication administration record (n=150, 75.0%). From a physician’s perspective, the most frequently requested pieces of information included reason for transfer, past medical history, cognitive status, advanced directives for level of care and resuscitation, and the patient’s emergency contact information. This information was provided 77.5% (n=155), 92.0% (n=184), 24.0% (n=48), 62.0% (n=124), and 76.0% (n=152) of the time, respectively.ConclusionsOur study demonstrates a clear discrepancy between information provided and information required by emergency physicians for LTC patients. Quality improvement initiatives at the local level may help reduce this discrepancy.

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The Presence of Legionellae in Respiratory Devices

10.18122/td/1697/boisestate ◽

2020 ◽

Author(s):

Andrew Nutting

Keyword(s):

Long Term Care ◽

Positive Airway Pressure ◽

Term Care ◽

The Past ◽

Care Facilities ◽

Different Types ◽

Jet Nebulizers ◽

Respiratory Devices ◽

Made In

Legionella is a bacterium found naturally in moist environments. Persons can become infected when they inhale airborne droplets of water containing such bacteria. Legionellosis cases associated with the use of respiratory devices such as Continuous Positive Airway Pressure (CPAP) units, jet nebulizers, portable room humidifiers, and respiratory ventilation equipment have been identified in context of a Legionellosis outbreak. However, a systematic search for the presence of Legionella bacteria in respiratory devices outside of a Legionellosis outbreak has not been reported. The goal of this study was to carry out such a survey on different types of respiratory devices in long term care facilities. Twenty-four respiratory devices including 9 CPAP, 4 BIPAPs, 5 oxygen humidifiers, and 6 ventilators were included in this study. A total of 72 sampling swabs were obtained for the testing of Legionella bacteria inside the respiratory devices. Culture and PCR tests for Legionella pneumophelia were made in tandem. No legionella pneumophelia bacteria were found in any of the respiratory devices sampled. Although there have been reports in the past of potential legionellosis cases associated with the use of respiratory devices, our data suggest that there are probably no legionella bacteria present inside respiratory devices separate of a Legionellosis outbreak.

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A Comparative Study of Elder Mistreatment Between Community-dwelling Elders and Those Residing in Long-term Care Facilities

European Psychiatry ◽

10.1016/j.eurpsy.2017.01.1127 ◽

2017 ◽

Vol 41 (S1) ◽

pp. S664-S664

Author(s):

B. Saguem ◽

B. Saoussen ◽

B.H.A. Béchir

Keyword(s):

Nursing Home ◽

Comparative Study ◽

Long Term Care ◽

Elder Abuse ◽

Cognitive Status ◽

Community Dwelling ◽

Term Care ◽

Care Facilities ◽

Abuse And Neglect

IntroductionElderly who live in settings other than their own homes or those of relatives have received little attention from researchers in Tunisia.AimsTo compare sociodemographic and clinical factors associated with elder abuse between community-dwelling elders and those residing in nursing home.MethodsA comparative study was conducted, including 50 subjects aged 65 years and older living in the community and 20 age- and sex-matched subjects living in a nursing home. Cognitive status, depressive symptoms and autonomy were assessed using mini-mental state examination (MMSE), geriatric depression scale (GDS) and activities of daily living scale (ADL). Elder abuse was evaluated with Indicators of Abuse Screen (IOA).ResultsElder abuse was more prevalent in elderly residing in nursing home (P = 0.009) with a prevalence of 35% and 8% and a mean IOA score of 12.75 and 7.74. Psychological, physical, financial abuse and neglect were reported by elderly residing in nursing home. Those living in community reported exclusively psychological abuse. The victim's reactions were passive in all cases.Elders living in nursing home were more single or divorced (0.000) and financially independent (0.003). They had lower scores of MMSE (0.002) and ADL (0.014), and higher scores of GDS (0.022). A binary logistic regression confirmed that elder abuse was significantly more prevalent in nursing home after eliminating these confounding variables: age, gender, MMSE, GDS and ADL scores (P = 0.018).ConclusionOur results confirm that elderly who live in long-term care facilities are at particular risk for abuse and neglect.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Accessible Virtual Arts Recreation for Wellbeing Promotion in Long-Term Care Residents

Journal of Applied Gerontology ◽

10.1177/0733464820967195 ◽

2020 ◽

pp. 073346482096719

Author(s):

Kelly J. Murphy ◽

Swathi Swaminathan ◽

Elizabeth Howard ◽

Aviva Altschuler ◽

Jessica Rogan ◽

...

Keyword(s):

Long Term Care ◽

Cognitive Status ◽

Term Care ◽

The Arts ◽

Lower Baseline ◽

Younger Age ◽

Health Related ◽

Traditional Arts ◽

Probability Of Improvement

The efficacy of a technology-driven visual arts recreation activity, delivered virtually, was evaluated for its potential to achieve positive impacts, similar to traditional arts-interventions, on wellbeing in long-term care residents. Thirty-one residents (average age 86.8 years; SD = 9.4) engaged with the arts-intervention for 30-minutes, twice weekly, for 6 weeks with either a partner or as part of a group. Wellbeing indicators included self-reported psychological and health-related wellness, and attention capacity. Binomial tests of postintervention change revealed a significant above-chance probability of improvement in one or more wellbeing indicators ( p < .05). Postparticipation feedback survey scores were positive ( p < .05). Cognitive status did not influence outcome; however, other participant characteristics such as younger age, higher openness-to-experience (personality trait), and lower baseline mood were significantly associated with positive response to the intervention ( p < .05). Findings demonstrate technology may be an effective platform for promoting accessibility to beneficial arts-interventions for older adults.

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Death of an Institutionalized Parent: Predictors of Bereavement

OMEGA - Journal of Death and Dying ◽

10.2190/b9a6-4mnq-6l8j-n5dq ◽

1995 ◽

Vol 31 (2) ◽

pp. 99-119 ◽

Cited By ~ 8

Author(s):

Rachel A. Pruchno ◽

Miriam S. Moss ◽

Christopher J. Burant ◽

Sandra Schinfeld

Keyword(s):

Nursing Home ◽

Length Of Stay ◽

Predictive Power ◽

Long Term Care ◽

Care Facility ◽

Cognitive Status ◽

Multidimensional Analysis ◽

Term Care ◽

Long Term Care Facility

A multidimensional analysis of bereavement experienced by eighty-four adult children whose parents died following a stay in a long term care facility indicated that pre-death indicators of strain (length of stay, parent's cognitive status, child's feelings about parent living in a nursing home, depression) had varying levels of predictive power regarding the extent to which the child reported feeling sad, experiencing persistent thoughts about the parent, feeling a sense of comfort in memories about the parent, feeling that the parent was a buffer to the child's mortality, and having a sense of relief.

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Perceptions of Mental Health Clinicians Working in Long-Term Care Facilities During the COVID-19 Pandemic

Innovation in Aging ◽

10.1093/geroni/igab046.772 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. 202-202

Author(s):

Rachel Ward ◽

Savannah Rose ◽

Lisa Lind ◽

Roma Hanks ◽

Lisa Brown

Keyword(s):

Mental Health ◽

Long Term Care ◽

Cognitive Status ◽

Mental Health Clinicians ◽

Term Care ◽

Care Facilities ◽

Provision Of Services ◽

Negative Effect ◽

The Impact

Abstract During the COVID-19 pandemic, mental health clinicians were initially not considered essential workers, and most were prevented from entering long-term care (LTC) facilities. This study investigated the perceptions and experiences of licensed clinicians who were providing services in LTC settings before and during the pandemic. Respondents included 126 clinicians from 31 states who completed a 90-item survey to assess the impact of COVID-19. Visitor restrictions were perceived to have had a negative effect on patients' emotional, behavioral, and cognitive status. The pandemic adversely impacted clinicians financially, personally, and emotionally, with more than half (67%) reporting that they experienced burnout. This study found that the COVID-19 pandemic adversely impacted clinicians working in LTC settings, their patients' wellbeing, and the delivery of mental health services. Understanding the impact that the COVID-19 pandemic has had on LTC patients and clinicians alike has implications for the provision of services during future pandemics.

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