scholarly journals Family Advocacy for Residents in Nursing Homes During the COVID-19 Pandemic

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 801-801
Author(s):  
Cristina de Rosa ◽  
Yanjun Zhou ◽  
Amy Lyons ◽  
Yu-Ping Chang
Keyword(s):  
Nursing Homes ◽  
Communicable Disease ◽  
Quality Care ◽  
Family Members ◽  
Nursing Home Residents ◽  
Future Research ◽  
Missed Opportunities ◽  
Individual Interviews ◽  
Psychosocial Wellbeing ◽  
Family Advocacy

Abstract To protect one of the most vulnerable populations from COVID-19, nursing homes enacted and enforced visiting restrictions and other measures to limit the spread of this communicable disease. Family members, many of whom are former caregivers, were suddenly cut off from nursing home residents, and struggled to maintain connection with their loved ones residing in nursing homes. The purpose of this study was to describe the experiences of family members of residents in nursing homes in advocating for residents and themselves during a time of uncertainty and many challenges. This study used a qualitative descriptive approach to conduct individual interviews. Ten family members of residents of two nursing homes in a Northeastern state were interviewed by phone or videoconference using a semi-structured guide. Interviews were transcribed verbatim and analyzed using Braun and Clarke’s Reflexive Thematic Analysis. Family members expressed concerns for the lockdown’s impact on residents’ psychosocial wellbeing in addition to the potential physical dangers of COVID-19. They explored creative means of meeting needs for information and interaction, but often felt that these efforts fell short of replicating the connectedness of in-person visits. Family members identified multiple missed opportunities for involvement in care, and voiced willingness to comply with infection prevention guidelines, such as maintaining distance, to be present with residents. Our findings indicate that family members advocated for residents’ interests to ensure quality care. Future research and policy should consider family members as a potential resource for providing care and companionship during times of crisis.

scholarly journals Perceptions of Antibiotic Therapy Among Nursing Home Residents: Perspectives of Caregivers and Residents in a Mixed Exploratory Study

Antibiotics ◽  
2019 ◽  
Vol 8 (2) ◽  
pp. 66 ◽  
Author(s):  
Mathieu Ahouah ◽  
Corinne Lartigue ◽  
Monique Rothan-Tondeur
Keyword(s):  
Antimicrobial Resistance ◽  
Nursing Homes ◽  
Antibiotic Therapy ◽  
Nursing Home Residents ◽  
End Users ◽  
Antibiotic Prescribing ◽  
Individual Interviews ◽  
Raising Awareness ◽  
Source Of Information

Antimicrobial resistance is a major public health threat worldwide. Some authors have suggested that end-users of nursing homes have an influence on antibiotic prescribing. The objective of this study is to describe the views of end-users and professionals on residents’ behavior towards antibiotic therapy in terms of knowledge, beliefs, and attitudes towards this drug class and its prescribing process. This is a concurrent mixed methodology study using questionnaires and semi-directive individual interviews with nursing homes residents, nurses, and doctors practicing in these facilities. The questionnaires analyzed were collected from 35 residents (24.3%) and 109 nurses (75.7%). The qualitative interview involved 26 of total participants that agreed to be interviewed. We noticed misconceptions being held by the residents regarding the antibiotic resistance phenomenon. Additionally, nurses were not considered as a source of information about antibiotics. Nurses and residents had conflicting opinions about residents requesting antibiotics, and the findings depict a stereotypical view of the nurse profession as a reflection of a cognitive representation. The authors conclude that, despite many campaigns, further efforts are needed to tackle antimicrobial resistance. Initiatives could include raising awareness about antimicrobial resistance, clarifying the role of nurses, and communicating well with residents about their needs in nursing homes.

Choosing to live in a nursing home: a culturally and linguistically diverse perspective

2015 ◽  
Vol 21 (2) ◽  
pp. 239
Author(s):  
Cecilia A. Yeboah
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Older People ◽  
Cultural History ◽  
Nursing Home Residents ◽  
Linguistically Diverse ◽  
Culturally And Linguistically Diverse ◽  
Individual Interviews ◽  
Cultural Origins ◽  
Diverse Perspective

As part of the findings of a study on culturally and linguistically diverse older people relocating to a nursing home, this paper contributes to our understanding of how older people draw on their cultural history to explain their decisions to relocate. Family reciprocity was identified by most participants as central to their decisions, regardless of their specific cultural origins. Using the grounded theory methodology, data were collected through progressive, semi-structured, repeated, in-person, individual interviews with 20 residents of four nursing homes in the northern suburbs of Melbourne, Australia. Culturally and linguistically diverse (CALD) older people, regardless of specific cultural origin, make relocation decisions based on the importance and meaning of reciprocity within families. Understanding their decisions as reflecting a culturally valued reciprocity offered a sense of cultural continuity to the relocation and was comforting to the older adults involved in the study. This study also suggests that culturally and linguistically diverse older people are much more active participants in the decision to relocate to a nursing home than is commonly recognised. The four nursing homes in the northern suburbs of Melbourne and the 20 participants studied constitute only a small proportion of all culturally and linguistically diverse older nursing home residents in Australia. Therefore, the findings may not be pertinent to other culturally and linguistically diverse elderly. Nonetheless, this study makes an important contribution to future discussions regarding cultural diversity in the nursing home relocation of culturally and linguistically diverse older Australians. The study findings provide some insight into the conditions and contexts that impact nursing home relocation.

What makes a nursing home a home? Insights from family members and friends

2017 ◽  
Vol 20 (4) ◽  
pp. 152-163 ◽  
Author(s):  
Lori Weeks ◽  
Stephanie Chamberlain ◽  
Janice Keefe
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Survey Data ◽  
Family Members ◽  
Nursing Home Residents ◽  
Models Of Care ◽  
Decision Makers ◽  
Public And Private ◽  
Content Type ◽  
Physical Spaces

Purpose The purpose of this paper is to explore the concept of homelikeness from the perspective of family members and friends of nursing home residents across different models of nursing homes. Design/methodology/approach This mixed-methods study examined survey data collected from 397 family members and friends of residents living in 23 nursing homes representing three models of care (traditional, new augmented, and full scope). Participants completed a homelikeness scale and a measure of the importance of nursing home spaces to family members and friends. This study also involved conducting three focus groups with 20 family members and friends to provide further insights into the findings. Findings Analysis of survey data indicated quite high levels of homelikeness overall. Significant differences did emerge between traditional model nursing homes compared to new full-scope and new augmented models for all items in the homelikeness scale and for many items about nursing home spaces. Qualitative results provided insights into how homelikeness can be fostered through public and private spaces and through care and relationships. Research limitations/implications As this study was conducted in one Canadian province, the results may not be applicable to other geographic areas. In addition, there are limitations in survey response rate. Practical implications Homelikeness can be supported across models of care by fostering relationships between residents and staff, ensuring that that family and friends feel welcome, and creating public and private physical spaces that are conducive to new and ongoing relationships. Originality/value The results provide evidence to nursing home decision makers about how to foster a homelike environment in various models of nursing homes.

scholarly journals Recruiting Resident Participants from Nursing Homes During the COVID Pandemic: Challenges and Solutions

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 988-989
Author(s):  
Leena Almasri ◽  
Barbara Carlson ◽  
Julie Myers ◽  
Rebecca Koszalinski ◽  
Melissa Franklin ◽  
...  
Keyword(s):  
Infectious Disease ◽  
Nursing Homes ◽  
Nursing Home Residents ◽  
Future Research ◽  
Research Staff ◽  
Healthcare Leadership ◽  
Daily Monitoring ◽  
The Face ◽  
Staff Research ◽  
Antigen Tests

Abstract Recruiting nursing home residents as participants in research is challenging. In early 2021, Covid-19 cases rose rapidly in nursing homes, prompting the rapid deployment of infectious disease protocols and ultimately, facility lockdowns to control the spread of the virus. By September, 2020, many research projects were delayed or cancelled, and future research was jeopardized. During this period, as well as prior to and after the administration of the COVID vaccine, we enrolled residents in a complex protocol involving administration of two Shingles vaccines (0- and 90 days) and three separate blood samples. Here, we present the strategies we used to recruit 216 residents, from 23 homes, over a 9-month period. We faced many challenges. Our research staff faced weekly COVID-19 antigen tests prior to entering the facility, adhering to strict protocols on travel, as well as packaging of materials that entered and left the facility. N95 masks and face shields further made it difficult to communicate with residents. For homes, COVID protocols required residents to be transported to specified areas to meet with research staff. Daily monitoring of COVID and Shingrix vaccine symptoms became part of daily care. To minimize resident harm and interruption of workflow in nursing homes, we utilized principles of stakeholder engagement, healthcare leadership, infectious disease/immunology, and staff (research and nursing homes) empowerment. In the face of crisis, like the COVID-19 pandemic, we have gained the trust and commitment of these facilities; thus, establishing a sustainable partnership that is prepared for what comes next.

Communicating With Nursing Home Residents About End of Life

2021 ◽  
pp. 104990912110648
Author(s):  
Janet Sopcheck ◽  
Ruth M. Tappen
Keyword(s):  
Nursing Home ◽  
End Of Life ◽  
End Of Life Care ◽  
Family Members ◽  
Secondary Analysis ◽  
Nursing Home Residents ◽  
Future Research ◽  
Life Care ◽  
Older Individuals ◽  
Past Experiences

Approximately 33% of the 1.2 million older individuals residing in nursing homes have the capacity to discuss their preferences for end-of-life care, and 35% will die within their first year in the nursing home. These conversations necessary to promote care consistent with the resident’s preferences are often limited and most often occur when the resident is actively dying. The purpose of this secondary analysis was to understand the resident’s perspectives on end-of-life communication in the nursing home and suggest approaches to facilitate this communication. We interviewed 46 participants (16 residents, 10 family members, and 20 staff) in a Southeast Florida nursing home from January to May 2019. The data were analyzed using descriptive and pattern coding and matrices to decipher preliminary categories and thematic interpretation within and across each participant group. Two themes emerged from this secondary analysis that residents assume others know their end-of-life preferences, and past experiences may predict future end-of-life choices. Residents and family members were willing to discuss end-of-life care. Study findings also suggested that past experiences with the end-of-life and critical illness of another could impact residents’ and family members’ end-of-life care decisions, and that nurses’ recognition of subtle signs of a resident’s decline may trigger provider-initiated end-of-life conversations. Future research should focus on strategies to promote earlier end-of-life discussions to support independent decision-making about end-of-life care in this relatively dependent population of older adults.

scholarly journals Does using the interRAI Palliative Care instrument reduce the needs and symptoms of nursing home residents receiving palliative care?

2017 ◽  
Vol 16 (1) ◽  
pp. 32-40 ◽  
Author(s):  
Kirsten Hermans ◽  
Johanna De Almeida Mello ◽  
Nele Spruytte ◽  
Joachim Cohen ◽  
Chantal Van Audenhove ◽  
...  
Keyword(s):  
Palliative Care ◽  
Nursing Homes ◽  
Prior Experience ◽  
Nursing Home Residents ◽  
Assessment Instrument ◽  
Future Research ◽  
Term Care ◽  
Quasi Experimental ◽  
One Year

ABSTRACTObjective:This study aimed to evaluate whether using the interRAI Palliative Care instrument (the interRAI PC) in nursing homes is associated with reduced needs and symptoms in residents nearing the end of their lives.Method:A quasi-experimental pretest–posttest study using the Palliative care Outcome Scale (POS) was conducted to compare the needs and symptoms of residents nearing the end of their lives in the control and intervention nursing homes. Care professionals at the intervention nursing homes filled out the interRAI PC over the course of a year for all residents aged 65 years and older who were nearing the end of their lives. This intervention was not implemented in the control nursing homes.Results:At baseline, POS scores in the intervention nursing homes were lower (more favorable) than in the control nursing homes on the items “pain”, “other symptoms”, “family anxiety”, and the total POS score. Posttest POS scores for “wasted time” were higher (less favorable) than pretest scores in the intervention nursing homes. In the intervention nursing homes where care professionals did not have prior experience with the interRAI Long-Term Care Facilities (LTCF) assessment instrument (n = 8/15), total POS scores were lower (more favorable) at posttest.Significance of results:One year after introducing the interRAI PC, no reduction in residents' needs and symptoms were detected in the intervention nursing homes. However, reductions in needs and symptoms were found in the subgroup of intervention nursing homes without prior experience with the interRAI LTCF instrument. This may suggest that the use of an interRAI instrument other than the interRAI PC specifically can improve care. Future research should aim at replicating this research with a long-term design in order to evaluate the effect of integrating the use of the interRAI PC in the day-to-day practices at nursing homes.

Advance directives and physicians’ orders in nursing home residents with dementia in Flanders, Belgium: prevalence and associated outcomes

2012 ◽  
Vol 24 (7) ◽  
pp. 1133-1143 ◽  
Author(s):  
An Vandervoort ◽  
Lieve van den Block ◽  
Jenny T. van der Steen ◽  
Robert Vander Stichele ◽  
Johan Bilsen ◽  
...  
Keyword(s):  
Palliative Care ◽  
Nursing Home ◽  
Nursing Homes ◽  
Quality Care ◽  
Nursing Home Residents ◽  
Care Plan ◽  
Care Planning ◽  
Legal Representative ◽  
Cross Sectional ◽  
Diagnosis Of Dementia

ABSTRACTBackground: Advance care planning (ACP) is an important element of high-quality care in nursing homes, especially for residents having dementia who are often incompetent in decision-making toward the end of life. The aim of this study was describe the prevalence of documented ACP among nursing home residents with dementia in Flanders, Belgium, and associated clinical characteristics and outcomes.Methods: All 594 nursing homes in Flanders were asked to participate in a retrospective cross-sectional postmortem survey in 2006. Participating homes identified all residents who had died over the last two months. A structured questionnaire was mailed to the nurses closely involved in the deceased resident's care regarding the diagnosis of dementia and documented care planning, i.e. advance patient directives, authorization of a legal representative, and general practitioners’ treatment orders (GP orders).Results: In 345 nursing homes (58% response rate), nurses identified 764 deceased residents with dementia of whom 62% had some type of documented care plan, i.e. advance patient directives in 3%, a legal representative in 8%, and GP orders in 59%. Multivariate logistic regression showed that the presence of GP orders was positively associated with receiving specialist palliative care in the nursing home (OR 3.10; CI, 2.07–4.65). Chances of dying in a hospital were lower if there was a GP order (OR 0.38; CI, 0.21–0.70).Conclusions: Whereas GP orders are relatively common among residents with dementia, advance patient directives and a legal representative are relatively uncommon. Nursing home residents receiving palliative care are more likely to have a GP order. GP orders may affect place of death.

scholarly journals Sounds in nursing homes and their effect on health in dementia: a systematic review

2020 ◽  
pp. 1-18
Author(s):  
Sarah I. M. Janus ◽  
Janouk Kosters ◽  
Kirsten A. van den Bosch ◽  
Tjeerd C. Andringa ◽  
Sytse U. Zuidema ◽  
...  
Keyword(s):  
Systematic Review ◽  
Nursing Homes ◽  
Cognitive Abilities ◽  
Nursing Home Residents ◽  
Sound Intensity ◽  
Future Research ◽  
Negative Effects ◽  
Sound Sources ◽  
Cross Sectional ◽  
Nighttime Sleep

ABSTRACT Objectives: Nursing home residents with dementia are sensitive to detrimental auditory environments. This paper presents the first literature review of empirical research investigating (1) the (perceived) intensity and sources of sounds in nursing homes, and (2) the influence of sounds on health of residents with dementia and staff. Design: A systematic review was conducted in PubMed, Web of Science and Scopus. Study quality was assessed with the Mixed Methods Appraisal Tool. We used a narrative approach to present the results. Results: We included 35 studies. Nine studies investigated sound intensity and reported high noise intensity with an average of 55–68 dB(A) (during daytime). In four studies about sound sources, human voices and electronic devices were the most dominant sources. Five cross-sectional studies focused on music interventions and reported positives effects on agitated behaviors. Four randomized controlled trials tested noise reduction as part of an intervention. In two studies, high-intensity sounds were associated with decreased nighttime sleep and increased agitation. The third study found an association between music and less agitation compared to other stimuli. The fourth study did not find an effect of noise on agitation. Two studies reported that a noisy environment had negative effects on staff. Conclusions: The need for appropriate auditory environments that are responsive to residents’ cognitive abilities and functioning is not yet recognized widely. Future research needs to place greater emphasis on intervention-based and longitudinal study design.

scholarly journals Facility Characteristics and Quality Deficiencies of Florida Nursing Homes With COVID-19 Cases and Deaths

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 945-945
Author(s):  
Xiaochuan Wang ◽  
Courtney Wilson
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Infection Control ◽  
Nursing Home Residents ◽  
The United States ◽  
Future Research ◽  
Staffing Level ◽  
Policy And Practice ◽  
Staff Shortage ◽  
Facility Size

Abstract The Coronavirus disease 2019 (COVID-19) has been disproportionately affecting nursing homes throughout the United States, resulting elevated risk for COVID-19 morbidity and mortality to nursing home residents. Given the high percentage of aging population, large number of nursing homes, and staggering surge of COVID-19 cases in Florida, it’s critical to understand factors that may affect Florida nursing homes’ vulnerability to the COVID-19 pandemic. Using Nursing Home COVID-19 Dataset as of July 26, 2020 obtained through Centers for Medicare and Medicaid Services (CMS), and Provider Info Dataset and Health Deficiencies Dataset available through CMS Nursing Home Compare data, we constructed a database of Florida nursing facilities with confirmed COVID-19 cases and deaths, with corresponding facility characteristics and quality deficiencies. We examined the facility characteristics (e.g. facility size, ownership state, chain affiliation, staffing level) and quality deficiencies (e.g. infection control deficiencies) of Florida nursing homes with and without publicly reported COVID-19 cases and deaths. Results indicated that, as of July 26, 2020, 73.3% and 40.8% of Florida nursing homes had resident COVID-19 cases and death, respectively (N=701). Findings also suggested that Florida nursing homes of large facility size, chain affiliated, and for profit, were significantly more likely to have documented resident COVID-19 cases (p<.05). Larger facility size (120 beds or more), staff shortage, and having prior infection control deficiency citation, were significantly related to the odds of having resident COVID-19 deaths (p<.05). Policy and practice implications and future research directions will be addressed to better protect the at-risk nursing home residents.

Expectations and Needs of Families in Nursing Homes: An Integrative Review

2020 ◽  
pp. 107755872090718
Author(s):  
Charlotte Havreng-Théry ◽  
Julie Giner-Perot ◽  
Philippe Zawieja ◽  
François Bertin-Hugault ◽  
Joël Belmin ◽  
...  
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Quality Care ◽  
Nursing Home Residents ◽  
Integrative Review ◽  
Mutual Trust ◽  
Review Of The Literature ◽  
Strength Based ◽  
New Type ◽  
Relationship Of

A better understanding of the expectations and needs of the families of nursing home residents is needed for a constructive and sustainable relationship of mutual trust. The objective of this study was to understand the expectations of families of nursing home residents described in the literature. A systematic integrative review of the literature was conducted. After a rigorous selection made by two researchers, independently, 53 articles were selected out of 1,094 results. The expectations of families are quality care, consideration complying with human dignity of the resident, collaboration, honesty, and mutual confidence that ties together families, staff, and physicians. This study reveals that families consider themselves as a strength for a resident’s support services, in line with Gottlieb’s strength-based approach. This approach offers promising implications for practice and for a new type of management in nursing homes based on strong values.

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