scholarly journals Feasibility of an Innovative Rehabilitation Program Adapted for the Post-acute Nursing Home Setting

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 947-947
Author(s):  
Addie Middleton ◽  
Jane Driver ◽  
Marcus Ruopp ◽  
Lindsay Lefers ◽  
Jessica Rawlins ◽  
...  
Keyword(s):  
Nursing Home ◽  
Rehabilitation Program ◽  
Demonstration Project ◽  
Nursing Home Care ◽  
Future Research ◽  
Minimal Detectable Change ◽  
Health Administration ◽  
Post Discharge ◽  
Home Setting ◽  
Nursing Home Setting

Abstract Live Long Walk Strong is a rehabilitation program that produces large clinically meaningful improvements in mobility when implemented as an outpatient program for older adults. We adapted Live Long Walk Strong for the post-acute nursing home setting within the Veterans Health Administration as a clinical demonstration project. The adapted version includes novel elements and bridges the inpatient stay and three months post-discharge. The inpatient phase focuses on maximizing functional recovery and includes activities focused on timing and coordination of gait, leg strength and power, and trunk muscle endurance. The care transition and virtual (telehealth) post-discharge phase focuses on case management and engagement in physical activity programs. Coaching and behavior change are a consistent focus throughout the program. To date, 13 Veterans (mean age 67.9, SD 11.7 years) have completed the inpatient phase, and of those Veterans, six have completed the entire program, five are still active, one was lost to follow-up, and one was rehospitalized. The program demonstrates feasibility, 91% of all inpatient sessions and 81% of all post-discharge sessions were completed. Regarding preliminary efficacy, 83% of Veterans who completed the program exceeded the minimal detectable change score (4 points) on the Activity Measure for Post-Acute Care (AM-PAC) Mobility scale from program enrollment to completion (mean change 6.5, SD 6.9 points). Based on findings from this clinical demonstration project, the program is feasible. However, future research is needed to further examine the program’s impact on mobility and other outcomes important to older Veterans receiving post-acute nursing home care.

scholarly journals The Burden of a Remote Trial in a Nursing Home Setting: Qualitative Study (Preprint)

2017 ◽  
Author(s):  
Susie Donnelly ◽  
Brenda Reginatto ◽  
Oisin Kearns ◽  
Marie Mc Carthy ◽  
Bill Byrom ◽  
...  
Keyword(s):  
Nursing Home ◽  
Data Collection ◽  
Lived Experience ◽  
Personal Space ◽  
Future Research ◽  
Home Setting ◽  
Research Engagement ◽  
Research Activities ◽  
Key Characteristics ◽  
Nursing Home Setting

BACKGROUND Despite an aging population, older adults are typically underrecruited in clinical trials, often because of the perceived burden associated with participation, particularly travel associated with clinic visits. Conducting a clinical trial remotely presents an opportunity to leverage mobile and wearable technologies to bring the research to the patient. However, the burden associated with shifting clinical research to a remote site requires exploration. While a remote trial may reduce patient burden, the extent to which this shifts burden on the other stakeholders needs to be investigated. OBJECTIVE The aim of this study was to explore the burden associated with a remote trial in a nursing home setting on both staff and residents. METHODS Using results from a grounded analysis of qualitative data, this study explored and characterized the burden associated with a remote trial conducted in a nursing home in Dublin, Ireland. A total of 11 residents were recruited to participate in this trial (mean age: 80 years; age range: 67-93 years). To support research activities, we also recruited 10 nursing home staff members, including health care assistants, an activities co-ordinator, and senior nurses. This study captured the lived experience of this remote trial among staff and residents and explored the burden associated with participation. At the end of the trial, a total of 6 residents and 8 members of staff participated in semistructured interviews (n=14). They reviewed clinical data generated by mobile and wearable devices and reflected upon their trial-related experiences. RESULTS Staff reported extensive burden in fulfilling their roles and responsibilities to support activities of the trial. Among staff, we found eight key characteristics of burden: (1) comprehension, (2) time, (3) communication, (4) emotional load, (5) cognitive load, (6) research engagement, (7) logistical burden, and (8) product accountability. Residents reported comparatively less burden. Among residents, we found only four key characteristics of burden: (1) comprehension, (2) adherence, (3) emotional load, and (4) personal space. CONCLUSIONS A remote trial in a nursing home setting can minimize the burden on residents and enable inclusive participation. However, it arguably creates additional burden on staff, particularly where they have a role to play in locally supporting and maintaining technology as part of data collection. Future research should examine how to measure and minimize the burden associated with data collection in remote trials.

scholarly journals NOT READY FOR PRIME TIME: A FAILED STUDY TESTING A TECHNOLOGICAL INTERVENTION IN NURSING HOME CARE

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S771-S771
Author(s):  
Kristine N Williams ◽  
Clarissa Shaw
Keyword(s):  
Nursing Home ◽  
Challenging Behaviors ◽  
Dementia Care ◽  
Nursing Home Care ◽  
Future Research ◽  
Home Setting ◽  
Support Intervention ◽  
Video Record ◽  
Technological Intervention ◽  
Implementation Failure

Abstract This pilot-study tested an adaptation of a successful family caregiver telehealth support intervention in nursing home settings. The goal was to support staff in managing challenging behaviors of residents with dementia. Nursing homes were provided with an iPad mini equipped with a special application to video record staff-resident challenging care situations. Videos were uploaded to a secure site for review by dementia care experts who provided feedback to improve care. Despite efforts to engage staff, only four videos were submitted. Factors including privacy, workload, and fear of documenting abuse contributed to implementation failure. The same intervention was successfully implemented in the home setting; differences in engagement and utilization will be discussed. Understanding the unique environments of nursing home dementia care is needed to successfully implement technology-based interventions to improve care. Evaluation of factors predicting the failure of this intervention may inform future research.

Residency training in the nursing home setting

1990 ◽  
Vol 80 (5) ◽  
pp. 236-237
Author(s):  
CA Lund
Keyword(s):  
Nursing Home ◽  
Home Care ◽  
Residency Training ◽  
Residency Program ◽  
Nursing Home Care ◽  
Home Setting ◽  
Nursing Home Setting

The author discusses the establishment of the Nursing Home Care Unit at the Tampa Veterans Hospital. The role of the podiatric resident and the residency program in the care of the patients in the facility is presented.

Defining Safety in the Nursing Home Setting: Implications for Future Research

2016 ◽  
Vol 17 (6) ◽  
pp. 473-481 ◽  
Author(s):  
Sandra F. Simmons ◽  
John F. Schnelle ◽  
Nila A. Sathe ◽  
Jason M. Slagle ◽  
David G. Stevenson ◽  
...  
Keyword(s):  
Nursing Home ◽  
Future Research ◽  
Home Setting ◽  
Nursing Home Setting

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

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.

The Herth Hope Index—A Psychometric Study Among Cognitively Intact Nursing Home Patients

2013 ◽  
Vol 21 (3) ◽  
pp. 378-400 ◽  
Author(s):  
Gørill Haugan ◽  
Britt Karin Støen Utvær ◽  
Unni Karin Moksnes
Keyword(s):  
Factor Analysis ◽  
Nursing Home ◽  
Home Care ◽  
Well Being ◽  
Nursing Home Care ◽  
Cross Sectional ◽  
Home Setting ◽  
Nursing Home Patients ◽  
Herth Hope Index ◽  
Cognitively Intact

Background and Purpose: Hope is seen as the act by which the temptation of despair is actively overcome and has thus been interpreted as an inner strength and an available resource for living in the present. An understanding of hope and its meaning in the lives of institutionalized older adults may aid in developing interventions to enhance hope and well-being in the nursing home setting. This study aimed to investigate the psychometric properties of the Norwegian version of the Herth Hope Index among cognitively intact nursing home patients. Methods: Cross-sectional data was obtained in 2008 and 2009 from 202 of 250 patients who met the inclusion criteria in 44 different nursing homes. Results: Exploratory factor analysis revealed 3 internal consistent dimensions of hope, explaining 51.2% of the variance. The 1-factor, 2-factor, and the originally 3-factor solutions of the Herth Hope Index were tested by means of confirmatory factor analysis. A 2-factor construct comprising 11 items came out with the best model fit. Conclusions: The Herth Hope Index was found to be a reliable and valid instrument for assessing hope in nursing home patients. The 2-factor structure was psychometrically superior the original 3-factor construct of hope in this particular sample. The Herth Hope Index might be used to assess hope and changes in the hope process during long-term nursing home care. An enhanced understanding of hope in this population might contribute to increased quality of nursing home care.

scholarly journals To what extent is clinical and laboratory information used to perform medication reviews in the nursing home setting? the CLEAR study

2015 ◽  
pp. 767 ◽  
Author(s):  
Carlota Gonzalvo ◽  
Kim Hurkens ◽  
Hugo de Wit ◽  
Brigit van Oijen ◽  
Rob Janknegt ◽  
...  
Keyword(s):  
Nursing Home ◽  
Home Setting ◽  
Nursing Home Setting ◽  
Medication Reviews

Families, Alzheimer's Disease, and Nursing Homes

1988 ◽  
Vol 7 (3) ◽  
pp. 331-349 ◽  
Author(s):  
Nathan L. Linsk ◽  
Baila Miller ◽  
Roberta Pflaum ◽  
Anna Ortigara-Vicik
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Nursing Home ◽  
Nursing Homes ◽  
Care Center ◽  
Family Members ◽  
Nursing Home Care ◽  
Demonstration Program ◽  
Home Setting

The Alzheimer's Disease Family Care Center program was established within an intermediate care teaching nursing home as a demonstration program to investigate ways to involve families in care of their relatives. In total, 45 family members participated in a program including an orientation session; a preliminary family involvement interview; contracts with family members, in which they chose specific tasks to engage in during visits; a five-session course on Alzheimer's disease and how families may be partners in care within the facility; and an ongoing family support group. Evaluation data sources include a baseline and 9-month follow-up questionnaire completed by families, preliminary and follow-up family interviews conducted by project codirectors, records of family visits, and family choices on contracts. Findings from the 23 family members who contracted for tasks during their visits and from the follow-up questionnaire completed by 25 family members showed that most sought social and emotional interactions with relatives, some maintained direct personal care activities, and only a few identified interest in extensive involvement with staff and facility. At follow-up, family members involved in the program reported they continued to feel close to their relatives. Many felt that their relatives were generally stable or improved with regard to cognitive function, but over a third noted difficulties in communicating. Participating family members reported that the program of staff supports helped them to feel more integral to the unit. They expressed a need for more education and support for their involvement in the nursing home setting. Project findings confirm previous studies recommending that programming at nursing homes needs to include specific institutional and staff supports to maintain and enhance family contributions to the long-term nursing home care of their relatives.

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