scholarly journals Cultivating a Patient-Centered Environment (CAPE): Renovations in Long-Term Chronic Care

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 882-882
Author(s):  
Elizabeth Howard ◽  
Tammy Retalic
Keyword(s):  
Long Term Care ◽  
Care Facility ◽  
Functional Independence ◽  
Term Care ◽  
Data Set ◽  
Long Term Care Facility ◽  
Person Centered Care ◽  
Centered Care

Abstract Achieving institutional goal of full, person-centered care was encumbered by an outdated structural “hospital model” at one long-term care facility that undertook building renovations, transforming long hallways into “neighborhood” of compact households. Quality of Life Survey and Long-term Care Minimum Data Set generated data at baseline and 1-year follow-up, comparing renovated(RU) and non-renovated unit(NRU) residents (n=36) to evaluate achievement of person-centered care. RU residents indicating they could “eat when I want” increased 75% to 81% at follow-up and decreased 17% for NRU residents. Sixty-seven percent of RU residents reported bathing “when they want” in contrast to 40% of NRU residents. Most RU residents agreed, “staff act on my suggestions.”More RU residents (68% vs 53%) agreed: “I spend time with other like-minded residents” and more RU residents (86% vs 43%) reported opportunity to explore new skills, interests. RU residents more often reported (50% vs 37%) “people ask for my help or advice.” Similar differences were observed with “it is easy to make friends here,” 67% RU residents responding affirmatively. RU residents reporting “feeling down” improved, moving from 46% to 50% disagreeing with this item with while increased number of NRU residents (18% to 22%) reported “feeling down” at follow-up.Improvement with independent performance of bed mobility, transfer, walking, and dressing among RU residents was observed while NRU residents had decreased percentages of independence. Evaluation of resident outcomes demonstrated improvement with personal choice, activities, personal relationships, functional independence and mood. Physical unit renovations appear to enhance implementation of person-centered care model.

scholarly journals BETTER LIVING THROUGH TECH: TECHNOLOGY-MEDIATED RECREATION AND LONG-TERM CARE FACILITY RESIDENTS’ QUALITY OF LIFE

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S442-S442
Author(s):  
Ethan A McMahan ◽  
Marion Godoy ◽  
Abiola Awosanya ◽  
Robert Winningham ◽  
Charles De Vilmorin ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Long Term Care ◽  
Care Facility ◽  
Term Care ◽  
Data Set ◽  
Term Care Facility ◽  
Long Term Care Facility ◽  
Care Facilities

Abstract Empirical research on long-term care facility resident engagement has consistently indicated that increased engagement is associated with more positive clinical outcomes and increased quality of life. The current study adds to this existing literature by documenting the positive effects of technologically-mediated recreational programing on quality of life and medication usage in aged residents living in long-term care facilities. Technologically-mediated recreational programming was defined as recreational programming that was developed, implemented, and /or monitored using software platforms dedicated specifically for these types of activities. This study utilized a longitudinal design and was part of a larger project examining quality of life in older adults. A sample of 272 residents from three long-term care facilities in Toronto, Ontario participated in this project. Resident quality of life was assessed at multiple time points across a span of approximately 12 months, and resident engagement in recreational programming was monitored continuously during this twelve-month period. Quality of life was measured using the Resident Assessment Instrument Minimum Data Set Version 2.0. Number of pharmacological medication prescriptions received during the twelve-month study period was also assessed. Descriptive analyses indicated that, in general, resident functioning tended to decrease over time. However, when controlling for age, gender, and baseline measures of resident functioning, engagement in technologically-mediated recreational programming was positively associated with several indicators of quality of life. The current findings thus indicate that engagement in technology-mediated recreational programming is associated with increased quality of life of residents in long-term care facilities.

Cycling Without Age Program: The Impact for Residents in Long-Term Care

2019 ◽  
Vol 42 (9) ◽  
pp. 728-735 ◽  
Author(s):  
Paula McNiel ◽  
Judith Westphal
Keyword(s):  
Lived Experience ◽  
Long Term Care ◽  
Care Facility ◽  
The United States ◽  
Structured Interviews ◽  
Term Care ◽  
Long Term Care Facility ◽  
Centered Care ◽  
The Impact

Long-term care facilities seek ways to enhance the quality of life for residents. Cycling Without Age (CWA), a new international cycling program, is gaining momentum for older adults. This study explored resident riders’ and trishaw pilots’ lived experience of their participation in the CWA program using a qualitative approach at a long-term care facility in the United States. Researchers conducted 27 face-to-face, semi-structured interviews with riders and pilots. For resident riders, the three themes identified included (a) breath of fresh air; (b) wave, chat, and remember; and (c) sit back and relax. Two themes were identified for the pilots: (a) change in frame of mind, and (b) mental and physical rewards. CWA can be as a new strategy for person-centered care. The CWA program provides nursing an opportunity to advocate, recommend, and obtain an order for residents to participate in the program.

A follow‐up study of change in quality of life among persons with dementia residing in a long‐term care facility

2003 ◽  
Vol 18 (4) ◽  
pp. 275-281 ◽  
Author(s):  
Constantine G. Lyketsos ◽  
Teresa Gonzales‐Salvador ◽  
Jing Jih Chin ◽  
Alva Baker ◽  
Betty Black ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Long Term Care ◽  
Care Facility ◽  
Term Care ◽  
Term Care Facility ◽  
Long Term Care Facility ◽  
Follow Up Study

Follow-Up of ESBL Positive Residents in a Long Term Care Facility

2011 ◽  
Vol 39 (5) ◽  
pp. E160-E161
Author(s):  
Zoran Pikula ◽  
Sumit Raybardhan ◽  
Wil Ng ◽  
Gladys George ◽  
Diane White ◽  
...  
Keyword(s):  
Long Term Care ◽  
Care Facility ◽  
Term Care ◽  
Term Care Facility ◽  
Long Term Care Facility

scholarly journals Factors associated with mortality and sequelae in patients living in long-term facilities hospitalized for COVID-19: a longitudinal 6-month follow-up study

2021 ◽  
Vol 106 (106(812)) ◽  
pp. 121-133
Author(s):  
M. Rivera-Izquierdo ◽  
A. Romero-Duarte ◽  
A. Cárdenas-Cruz
Keyword(s):  
Nursing Homes ◽  
Long Term Care ◽  
Care Facility ◽  
Term Care ◽  
Long Term Care Facility ◽  
Factors Associated ◽  
Causes Of Mortality ◽  
Main Factors

Objectives: To evaluate the main factors associated with prognosis (mortality, sequelae at 6 months and readmissions) of patients admitted for COVID-19 at the Hospital Clínico San Cecilio who live in a long-term care facility. Methods: Longitudinal observational study carried out on the cohort of 441 patients admitted for COVID-19 confirmed by PCR at the Hospital Clínico San Cecilio between 01/03/20 and 15/04/20. These patients were followed up, through their medical records, for 6 months after discharge. Sociodemographic, admission, clinical, therapeutic and sequelae variables were collected. Descriptive and bivariate analyses and multivariate logistic regression models were performed with R statistical software, through its R Commander tool. Results: The mean age of the cohort was 66.4 years (s=15.3), with 55.1% male. In-hospital mortality was 18.1%. Patients living in nursing homes had higher mean age and higher frequencies of comorbidities, mortality and hospital readmissions. During the 6 months after discharge, they had a high frequency of sequelae (59%), and a higher frequency of confusion, hematologic and nephrological problems, and superinfections. The main factors associated with mortality were advanced age, male sex, admission to the ICU and vulnerability at admission measured with clinical prognostic scales. Conclusions: Living in a long-term care facility was not an independent factor of mortality, but it did bring together a group of special vulnerability to COVID-19. The causes of mortality analysed in this study could be similar to the causes of mortality of elderly people in nursing homes during the first months of the pandemic. These data should serve to optimize strategies for in-hospital management and follow-up of the elderly during the months following hospital discharge, and to try to reduce the unrecorded mortality due to COVID-19 in this population.

scholarly journals Does the Person-Centered Care Model Support the Needs of Long-Term Care Residents With Serious Mental Illness and Intellectual and Developmental Disabilities?

2021 ◽  
Vol 12 ◽  
Author(s):  
Elizabeth P. Howard ◽  
Lynn Martin ◽  
George A. Heckman ◽  
John N. Morris
Keyword(s):  
Psychotic Disorders ◽  
Long Term Care ◽  
Intellectual And Developmental Disabilities ◽  
Care Model ◽  
Term Care ◽  
Person Centered Care ◽  
Physical Wellbeing ◽  
Centered Care

Person-centered care approaches continue to evolve in long-term care (LTC). At the same time, these settings have faced increased challenges due to a more diverse and complex population, including persons with intellectual and developmental disabilities (IDD) and serious mental illness (SMI). This study examined the mental, social, and physical wellbeing of residents with different diagnoses, within a person-centered care model. It was hypothesized that individual wellbeing would be comparable among all residents, regardless of primary diagnosis. The study cohort was drawn from all admissions to long-term care facilities in the USA from 2011 to 2013. Data are based on admission, 3 and 6 month follow-up Minimum Data Set (MDS) 3.0 assessments. The groups examined included: schizophrenia, other psychotic disorders, IDD, dementia, and all others (i.e., none of the above diagnoses). The wellbeing outcomes were depression (mental), pain (physical), and behaviors (social). All residents experienced improvements in pain and depression, though the group without the examined diagnoses experienced the greatest gains. Behaviors were most prevalent among those with psychotic disorders; though marked improvements were noted over time. Improvement also was noted among persons with dementia. Behavior worsened over time for the three other groups. In particular, those with IDD experienced the highest level of worsening at 3-month follow-up, and continued to worsen. The results suggest person-centered care in US nursing homes provides the necessary foundation to promote mental and physical wellbeing in persons with complex needs, but less so for social wellbeing.

Evolution of quality of life in patients with Korsakoff's syndrome in a long-term care facility

2014 ◽  
Vol 26 (12) ◽  
pp. 2073-2079 ◽  
Author(s):  
Erik Oudman ◽  
Jan W. Wijnia
Keyword(s):  
Quality Of Life ◽  
Long Term Care ◽  
Care Facility ◽  
Term Care ◽  
Term Care Facility ◽  
Long Term Care Facility ◽  
Over Time

ABSTRACTBackground:Korsakoff's syndrome (KS) is a neuropsychiatric disorder characterized by severe amnesia. Quality of life (QoL) is becoming an increasingly used outcome measure in clinical practice but little is known about QoL in KS and how it may change over time. The purpose of this study was therefore to assess the QoL in patients with KS at baseline and with a 20-month follow-up.Methods:The current study is a longitudinal study on the QoL in patients with KS living in two long-term care facilities for KS patients in the Netherlands. QoL was scored with the proxy-based QUALIDEM scale with a 20-month follow-up.Results:Of the 72 KS patients included at baseline, 57 KS patients had a follow-up QoL score (79.2%). On the subscales “Feeling at home,” “Positive affect,” and “Care relationship” of the QUALIDEM, there was a better QoL in the follow-up, although effects were relatively small. Other subscales indicated a stable QoL over time. There were inter-relations between changes in subscales.Conclusions:The main finding of this study is that patients with KS on average do show a relatively stable moderate to good QoL despite the severity of the syndrome. On specific subscales, there is a small increase in QoL over time. Results do suggest that prolonged stay in a long-term care facility for KS patients does have a neutral to a positive effect on QoL in KS.

Acquisition of Clostridium difficile Colonization and Infection After Transfer From a Veterans Affairs Hospital to an Affiliated Long-Term Care Facility

2017 ◽  
Vol 38 (9) ◽  
pp. 1070-1076 ◽  
Author(s):  
Suresh Ponnada ◽  
Dubert M. Guerrero ◽  
Lucy A. Jury ◽  
Michelle M. Nerandzic ◽  
Jennifer L. Cadnum ◽  
...  
Keyword(s):  
Clostridium Difficile ◽  
Long Term Care ◽  
Care Facility ◽  
Veterans Affairs ◽  
Term Care ◽  
Long Term Care Facility ◽  
Asymptomatic Patients ◽  
Care Facilities

BACKGROUNDClostridium difficile infection (CDI) and asymptomatic carriage of toxigenic C. difficile are common in long-term care facilities (LTCFs). However, whether C. difficile is frequently acquired in the LTCF versus during acute-care admissions remains unknown.OBJECTIVETo test the hypothesis that LTCF residents often acquire C. difficile colonization and infection in the LTCFDESIGNThis 5-month cohort study was conducted to determine the incidence of acquisition of C. difficile colonization and infection in asymptomatic patients transferred from a Veterans Affairs hospital to an affiliated LTCF.METHODSRectal swabs were cultured for toxigenic C. difficile at the time of transfer to the LTCF and weekly for up to 6 weeks. We calculated the proportion of LTCF-onset CDI cases within 1 month of transfer that occurred in residents colonized on admission versus those with new acquisition in the LTCF.RESULTSOf 110 patients transferred to the LTCF, 12 (11%) were asymptomatically colonized with toxigenic C. difficile upon admission, and 4 of these 12 patients (33%) developed CDI within 1 month, including 3 recurrent and 1 initial CDI episode. Of 82 patients with negative cultures on transfer and at least 1 follow-up culture, 22 (27%) acquired toxigenic C. difficile colonization, and 4 developed CDI within 1 month, including 1 recurrent and 3 initial CDI episodes.CONCLUSIONLTCF residents frequently acquired colonization with toxigenic C. difficile after transfer from the hospital, and 3 of 4 initial CDI cases with onset within 1 month of transfer occurred in residents who acquired colonization in the LTCF.Infect Control Hosp Epidemiol 2017;38:1070–1076

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