The Preservation of Spousal and Partner Relationships Among Nursing Home Residents

Abstract The decision to seek placement in a nursing home may be especially difficult for spouses or partners of the potential nursing home residents. Disruption of the attachment relationship following placement may influence the psychosocial well-being of nursing home residents. Although the responsibility of nursing home staff is to ensure psychosocial well-being, including awareness of the influence that separation can have on a spousal or partner relationship, little is known about services offered for the maintenance of spousal and partner relationships. This study was conducted to identify nursing home practices that had preservation of spouse/partner relationships as the goal. A mixed methods approach utilized both an online survey (81 respondents) with nursing home social workers in four Southern states and ten telephone interviews (from among the respondents). Survey results revealed that 49% of respondents’ facilities had a written policy to preserve these relationships, however, only 22% reported having a specific formal program to carry this out. In the interviews, participants expanded on survey topics and shared that facilitating outings and encouraging participation in routine facility activities were commonly used to preserve relationships. Privacy was discussed as being important in maintaining relationships and also found to be a barrier to doing so. Nursing home social workers can utilize the results in the design and implementation of specific services to preserve relationships and maintain strong attachment between residents and their spouses/partners. These will be best carried out in a coordinated, collaborative manner among multiple disciplines within the nursing home setting.

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No Visitors Allowed! The Impact of Covid-19 Restrictions on the Psychosocial Well-being of Nursing Home Residents

Innovation in Aging ◽

10.1093/geroni/igab046.2718 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. 736-736

Author(s):

Shanae Shaw ◽

Ellen Csikai

Keyword(s):

Nursing Home ◽

Social Workers ◽

Online Survey ◽

Nursing Home Residents ◽

Well Being ◽

Health Concern ◽

Social Connections ◽

Phone Calls ◽

The Impact ◽

Policies And Practices

Abstract The COVID-19 coronavirus pandemic changed life for everyone, but especially for nursing home residents. In March 2020, the Centers for Medicare and Medicaid Services enacted nursing home restrictions in response to the pandemic regarding visitation from outside family/friends and changes to facility activity programs. Despite the public health concern prompting these restrictions to prevent virus spread, these sudden changes affected nursing home residents’ relationships with their spouses/partners. As part of a larger study to identify the nursing home policies and practices that preserve relationships among nursing home residents with spouses/partners, participants shared facilities’ restrictions, social connection practices, and effect of coronavirus restrictions on residents’ relationships with spouses/partners. The study utilized both an online survey (81 respondents) and ten telephone interviews with nursing home social workers in four Southern states. Twenty-eight percent of participants reported that no visitors were allowed; while 25% allowed couples to visit with one another as usual was reported by 25%. The most noted practices to maintain social connections were phone calls, video calls, and ‘window’ visits between residents and families/friends; however, “it’s just not the same. It’s affected them greatly”. The interviews revealed further details about the detrimental effect of the COVID-19 restrictions on nursing home residents’ overall mental health and attachment relationships with spouses/partners. These results highlight the importance of maintaining social connections between residents and spouses/partners. Nursing home social workers can develop policies and practices that enhance relationships and connections under all circumstances and work with other health care team members to ensure implementation.

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Between Social Inclusion and Exclusion: Integration of Daycare Guests in the Nursing Home Setting

The Gerontologist ◽

10.1093/geront/gnaa157 ◽

2020 ◽

Author(s):

Kerstin Hämel ◽

Gundula Röhnsch

Keyword(s):

Nursing Home ◽

Social Inclusion ◽

Nursing Home Residents ◽

Community Dwelling ◽

Cognitive Capacity ◽

Home Setting ◽

Residential Care Facilities ◽

Care Approach ◽

Nursing Home Setting ◽

Close Relatives

Abstract Background and Objectives In integrated daycare, community-dwelling older people in need of care join existing groups in residential care facilities during the day. This study focuses on how nursing home residents experience the integrative care approach, exploring opportunities for social inclusion and mechanisms of exclusion. Research Design and Methods A purposive sample of residents differing in cognitive capacity and level of (non)conflictual interaction with daycare guests was selected. Episodic interviews with residents (N = 10) and close relatives (N = 2) were conducted in 3 pilot facilities in Germany and analyzed using thematic coding. Results The analysis revealed different orientation patterns towards the presence of daycare guests: respondents (a) demonstrated indifference to the daycare guests, (b) saw bonding with guests as a means to connect to the outside world, and (c) perceived incompatibility between in-group and out-group. Criticisms included disruption of daily routines and loss of privacy. Most interviewees came to terms with the care situation using rational and moral arguments. Discussion and Implications The study reveals the importance of residents’ participation when integrating daycare guests. Institutional procedures are required to prevent exclusion of daycare guests and avoid overtaxing residents.

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Nurses' and Social Workers' Perceptions of Elderly Nursing Home Residents' Well-Being

Journal of Gerontological Social Work ◽

10.1300/j083v16n03_11 ◽

1991 ◽

Vol 16 (3-4) ◽

pp. 135-147 ◽

Cited By ~ 2

Author(s):

Jiska Cohen-Mansfield ◽

Beth A. Rabinovich ◽

Marcia S Marx ◽

Judith Braun ◽

Edith Fleshner

Keyword(s):

Nursing Home ◽

Social Workers ◽

Nursing Home Residents ◽

Well Being

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The Grief Experiences of Certified Nursing Assistants: Personal Growth and Complicated Grief

OMEGA - Journal of Death and Dying ◽

10.2190/t14n-w223-7612-0224 ◽

2007 ◽

Vol 54 (4) ◽

pp. 301-318 ◽

Cited By ~ 22

Author(s):

Keith A. Anderson ◽

Joseph E. Gaugler

Keyword(s):

Nursing Home ◽

Personal Growth ◽

Complicated Grief ◽

Nursing Home Residents ◽

Past Research ◽

Nursing Assistants ◽

Certified Nursing Assistants ◽

Disenfranchised Grief ◽

Home Setting ◽

Nursing Home Setting

The grief that certified nursing assistants (CNAs) experience following the deaths of nursing home residents has received scant attention in past research, particularly from an empirical standpoint. The purpose of this quantitative study was to investigate the grief experiences of CNAs in the nursing home setting and to identify and evaluate factors that may mediate or exacerbate grief. Participants ( N = 136) from 12 nursing homes completed self-administered surveys. Regression analyses revealed that CNAs with lower levels of perceived disenfranchised grief reported higher levels of personal growth, while CNAs with greater fear of death and those who experienced fewer deaths on the job reported higher levels of complicated grief. Practitioners and future researchers may benefit from these findings through the construction and implementation of interventions aimed at effectively enfranchising the grief experiences of this important group of healthcare workers.

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Managing the Secrets of Dying Backstage: The Voices of Nursing Home Staff

OMEGA - Journal of Death and Dying ◽

10.2190/3p8g-5jad-j2nf-bkgk ◽

2006 ◽

Vol 53 (3) ◽

pp. 193-207 ◽

Cited By ~ 16

Author(s):

Debra Parker Oliver ◽

Davina Porock ◽

David B. Oliver

Keyword(s):

Nursing Home ◽

End Of Life Care ◽

Interaction Analysis ◽

Nursing Home Residents ◽

Home Setting ◽

Licensed Practical Nurses ◽

Practical Nurses ◽

Interview Guide ◽

Nursing Home Setting ◽

Staff Experiences

The project analyzed staff descriptions of undocumented care given to dying nursing home residents. Registered nurses, licensed practical nurses, certified nurse aids, and social service designees were interviewed using an unstructured interview guide. Transcripts were coded by two members of the team and a thematic analysis was guided with the theoretical framework of Erving Goffman's dramaturgical model of social interaction. Analysis of interview transcripts revealed practices related to end of life care that went undocumented. Viewed through the lens of Goffman's theoretical model, this undocumented care revealed “secrets” related to socialization processes, communication, tension, superstitions, and interactions between staff and dying residents. Findings show that while dying is not formally acknowledged in the nursing home setting, staff experiences the reality of death and informally responds to the special needs of residents.

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Status of Diabetes Management in the Nursing Home Setting in 2008: A Retrospective Chart Review and Epidemiology Study of Diabetic Nursing Home Residents and Nursing Home Initiatives in Diabetes Management

Journal of the American Medical Directors Association ◽

10.1016/j.jamda.2009.02.010 ◽

2009 ◽

Vol 10 (5) ◽

pp. 354-360 ◽

Cited By ~ 52

Author(s):

Stephen M. Feldman ◽

Ronald Rosen ◽

Jonathan DeStasio

Keyword(s):

Nursing Home ◽

Chart Review ◽

Diabetes Management ◽

Nursing Home Residents ◽

Retrospective Chart Review ◽

Epidemiology Study ◽

Home Setting ◽

Nursing Home Setting

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Long-term care

Oxford Textbook of Geriatric Medicine ◽

10.1093/med/9780198701590.003.0037 ◽

2017 ◽

pp. 273-280

Author(s):

Jos M. G. A. Schols ◽

Adam Gordon

Keyword(s):

Nursing Home ◽

Long Term Care ◽

Institutional Care ◽

Nursing Home Residents ◽

Term Care ◽

Home Setting ◽

Nursing Home Setting ◽

Care For Older People

In this chapter, institutional long-term care for older people is addressed from a European perspective. A short historical overview is followed by some thoughts on how long-term institutional care may develop in the future, including a consideration of the role of informal care as a competing and complementary sector. It then describes the clinical profile of nursing home residents including reason(s) for admission, access issues, and length of stay. Thereafter, the types of care offered to nursing home residents will be described, with particular attention given to staffing and financing issues. Special consideration is given to the medical care of nursing home residents. Finally, we consider quality assurance in long-term care and how this is approached in different legislations before closing with a description of relevant themes and issues for research in the nursing home setting.

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The Impact of a Cycled Lighting Intervention on Nursing Home Residents: A Pilot Study

Gerontology and Geriatric Medicine ◽

10.1177/2333721419897453 ◽

2019 ◽

Vol 5 ◽

pp. 233372141989745 ◽

Cited By ~ 1

Author(s):

Oonagh M. Giggins ◽

Julie Doyle ◽

Ken Hogan ◽

Mable George

Keyword(s):

Older Adults ◽

Nursing Home ◽

Nursing Home Residents ◽

Activity Monitor ◽

Circadian System ◽

Activity Levels ◽

Home Setting ◽

Nursing Home Setting ◽

Robust Measurements ◽

The Impact

Purpose: Achieving adequate levels of illumination to stimulate the circadian system can be difficult in a nursing home. The aim of this study was to examine the impact that a 4-week cycled lighting intervention had on activity, sleep, and mood in older adults living in a nursing home. Patients and methods: Ten residents were given an activity monitor to objectively measure activity and sleep, and subjective mood scores were also recorded during the study period. The cycled lighting intervention was designed to mimic normal natural daylight. Results: Some participants responded positively to the lighting intervention showing improvements in activity levels, sleep, and mood, while others showed no change or a continued decline. Conclusion: Although the results are inconclusive, a cycled lighting intervention remains a potentially promising intervention in the nursing home setting. Further studies with more robust measurements and a larger, more homogeneous cohort are required to investigate this further.

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Early Multidrug Outpatient Treatment of SARS-CoV-2 Infection (COVID-19) and Reduced Mortality Among Nursing Home Residents

10.1101/2021.01.28.21250706 ◽

2021 ◽

Author(s):

Paul E Alexander ◽

Robin Armstrong ◽

George Fareed ◽

Kulvinder K. Gill ◽

John Lotus ◽

...

Keyword(s):

At Risk ◽

Nursing Home ◽

Early Treatment ◽

Therapeutic Option ◽

Nursing Home Residents ◽

The Elderly ◽

Hospital Treatment ◽

Home Setting ◽

Inhaled Steroids ◽

Nursing Home Setting

AbstractThe outbreak of COVID-19 from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has spread all over the world with tremendous morbidity and mortality in the elderly. In-hospital treatment addresses the multifaceted nature of the illness including viral replication, cytokine storm, and endothelial injury with thrombosis. We identified nine reports of early treatment outcomes in COVID-19 nursing home patients. Multi-drug therapy including hydroxychloroquine with one or more anti-infectives, corticosteroids, and antithrombotic agents can be extended to seniors in the nursing home setting without hospitalization. Data from nine studies found multidrug regimens relying on the use of hydroxychloroquine as well as other agents including doxycycline were associated with a statistically significant and >60% reductions in mortality. Going forward, we theorize and based on the evidence, that early empiric treatment for the elderly with COVID-19 in the nursing home setting (or similar congregated settings with elderly residents/patients) has a genuine probability of success and acceptable safety. This group remains our highest at-risk group and warrants acute treatment focus that will prevent the development and/or worsening of problems associated with COVID-19, most particularly isolation, hospitalization, and death. In fact, with the rapidity and severity of SARS-CoV-2 outbreaks in nursing homes, in-center treatment of patients with acute COVID-19 is possibly the most rational and importantly feasible strategy to reduce the risks of hospitalization and death. If the approach remains ‘wait-and-see’ and elderly high-risk patients in such congregated nursing room type settings are allowed to worsen with no early treatment, they may be too sick and fragile to benefit from in-hospital therapeutics and are at risk for pulmonary failure, life-ending micro-thrombi of the lungs, kidneys etc. We put forth the notion that the most important factor in this regard, is making available early therapeutic intervention as described here. These drugs include and under supervision by skilled doctors, combination/sequenced ivermectin, hydroxychloroquine, colchicine, azithromycin, doxycycline, bromhexine hydrochloride, and favipiravir (outside the US), along with inhaled steroids such as budesonide and oral steroids including dexamethasone and prednisone, and anti-thrombotic anti-clotting drugs such as heparin). As the clinical trials data on treatments for COVID-19 mature, this early treatment therapeutic option deserves serious, urgent, and sober consideration by the medical establishment and respective decision-makers.

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