scholarly journals Engaging Direct Care Providers in the Implementation of Montessori Programming for Dementia

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 151-151
Author(s):  
Natalie Douglas
Keyword(s):  
Nursing Assistants ◽  
Direct Care ◽  
Certified Nursing Assistants ◽  
Care Providers ◽  
Severe Dementia ◽  
Term Care ◽  
Engagement Strategies ◽  
Direct Care Providers ◽  
New Ideas

Abstract There is a need to engage direct care providers such as certified nursing assistants (CNAs) explicitly in efforts to implement innovative programming in long-term care environments. This presentation will outline engagement strategies that supported the implementation of Montessori programming in a community of 20 individuals living with severe dementia. Examples about positioning the CNA at the center of decision making, negotiating and building trust, cultivating opportunities for mutual consultation, creating spaces for new ideas to emerge, and synthesizing diverse perspectives will be highlighted. Although the program achieved positive outcomes on a number of measures including decreased responsive behaviors from people living with dementia, decreased negative qualities of relationships between CNAs and persons with dementia, and increased positive qualities of relationships between CNAs and persons with dementia, this presentation will focus on the “how” of engagement between the project team and the CNAs by highlighting qualitative data.

scholarly journals Is Long-Term Care Person Centred? A Case Study

2021 ◽  
Author(s):  
Katarina Young
Keyword(s):  
Long Term Care ◽  
Direct Care ◽  
Care Providers ◽  
Term Care ◽  
Study Approach ◽  
Key Stakeholders ◽  
Direct Care Providers ◽  
Government Legislation

In Ontario long-term care (LTC) settings, person-centred care (PCC) is promoted by government legislation, accreditation organizations and professional practice guidelines aiming to integrate this approach. However, there is currently no standardized approach to providing PCC in LTC. The purpose of this study was to examine public policies on PCC in Ontario and explore how they are interpreted and translated into practice in LTC. A qualitative case study approach was used to examine the perspectives of key stakeholders at one LTC facility in Ontario. Focus groups were conducted with residents, family members, direct care providers and managers. Through content analysis, findings were organized into four categories showcasing both overlapping and differential understandings of PCC in practice: 1) conceptualization, 2) barriers, 3) facilitators, and 4) evaluation. Identified tensions between policy and the delivery of PCC highlight systemic issues that must be addressed to enable equitable person-centred LTC rooted in resident-identified priorities.

scholarly journals Is Long-Term Care Person Centred? A Case Study

2021 ◽  
Author(s):  
Katarina Young
Keyword(s):  
Long Term Care ◽  
Direct Care ◽  
Care Providers ◽  
Term Care ◽  
Study Approach ◽  
Key Stakeholders ◽  
Direct Care Providers ◽  
Government Legislation

In Ontario long-term care (LTC) settings, person-centred care (PCC) is promoted by government legislation, accreditation organizations and professional practice guidelines aiming to integrate this approach. However, there is currently no standardized approach to providing PCC in LTC. The purpose of this study was to examine public policies on PCC in Ontario and explore how they are interpreted and translated into practice in LTC. A qualitative case study approach was used to examine the perspectives of key stakeholders at one LTC facility in Ontario. Focus groups were conducted with residents, family members, direct care providers and managers. Through content analysis, findings were organized into four categories showcasing both overlapping and differential understandings of PCC in practice: 1) conceptualization, 2) barriers, 3) facilitators, and 4) evaluation. Identified tensions between policy and the delivery of PCC highlight systemic issues that must be addressed to enable equitable person-centred LTC rooted in resident-identified priorities.

scholarly journals REDUCING ANTIPSYCHOTIC USE IN LONG-TERM CARE: CONSIDERING THE ROLE OF CULTURE OF CARE AND INFORMAL COMMUNICATION

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S434-S434
Author(s):  
Andre Smith ◽  
Sue Kurucz ◽  
Tara Erb ◽  
Ruth Kampen
Keyword(s):  
Health Care ◽  
Long Term Care ◽  
Direct Care ◽  
Care Providers ◽  
Informal Communication ◽  
Term Care ◽  
Culture Of Care ◽  
Direct Care Providers

Abstract Persons living with dementia-related disorders (PwD) can experience challenging behavioural and psychological symptoms (BPSD) as their illness progresses. There is a continued reliance on antipsychotic drugs (APD) in long-term care to manage this issue despite the well-documented risks of adverse events and increased morbidity and mortality. This study examines the role of culture of care in relation to efforts at reducing inappropriate APD use in managing BPSD within long-term care. Culture of care consists of shared norms, beliefs, and cognitive frames which guide clinical practice and inform the development and implementation of care strategies. Findings were obtained from three Canadian long-term care facilities working on reducing inappropriate use of APD. Data came from interviews with 6 nurses, 18 licenced practical nurses, 14 health care assistants, 4 activity leaders, 4 directors of care, 1 chaplain, and 10 physicians. We found that direct care providers initially varied in their perceived ability to develop and use alternate care strategies with health care assistants being most concerned about safety and exposure to violence. Change involved detective work and innovative thinking in assessing possible causes of BPSD beyond psychosis, including pain and feelings of confusion. Informal reciprocal patterns of communication emerged among health care assistants to identify effective non-pharmaceutical strategies to manage BPSD. Overall, the study shows how shared beliefs in the need for and value of alternate care practices among direct care providers along with the existence of effective informal communication can contribute to successful reduction in APD use when managing BPSD in PwD.

scholarly journals Organizational Factors Associated With Retention of Certified Nursing Assistants and Direct Care Workers

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 384-385
Author(s):  
Katherine Kennedy ◽  
Robert Applebaum ◽  
John Bowblis ◽  
Jane Straker
Keyword(s):  
Long Term Care ◽  
Response Rate ◽  
Nursing Assistants ◽  
Direct Care ◽  
Retention Rates ◽  
Direct Care Workers ◽  
Certified Nursing Assistants ◽  
Term Care ◽  
Care Workers

Abstract Low retention of certified nursing assistants (CNAs) and direct care workers (DCWs) continues to be an unresolved problem for nursing homes (NH) and assisted living (AL) settings. While numerous studies have examined predictors of CNA retention in NHs, little attention has been paid to differences between settings of long-term care. To inform practice and policy related to growth in the AL industry, this study compares the predictors of CNA and DCW retention rates. The 2017 Ohio Biennial Survey of Long-Term Care Facilities provides facility-level information from 968 NHs (91% response rate) and 708 ALs (88% response rate). Using regression analysis, we compare the factors that predict retention rates among providers with complete data on retention and controls. The same covariates relating to structural and financial characteristics, as well as staffing, management, and a number of retention best practices are used. Average DCW and CNA retention rates were 66% and 61% in ALs and NHs, respectively, with some settings reporting very low (and even 0%) retention over a year. AL and NH providers rated the problem’s severity highest (6 out of 10) compared to retaining other licensed nurses. Similar and different predictors were found across financial, environmental, and managerial practices supporting retention. CNA and DCW retention strategies may not be equivalently meaningful between settings, given differing working environments, resources, and regulations. Aging services managers should be attuned to practices supporting retention in their industry.

scholarly journals The Development and Testing of KNACC: Knowledgeable Nursing Assistants as Creative Caregivers

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 675-675
Author(s):  
Jacqueline Eaton ◽  
Kristin Cloyes ◽  
Brooke Paulsen ◽  
Connie Madden ◽  
Lee Ellington
Keyword(s):  
Focus Groups ◽  
Long Term Care ◽  
Family Members ◽  
Nursing Assistants ◽  
Direct Care ◽  
Term Care ◽  
Memory Care

Abstract Nursing assistants (NAs) provide 80% of direct care in long-term care settings, yet are seldom viewed as skilled professionals. Empowering NAs is linked to improved resident outcomes. In this study, we collaborate with NAs to adapt and test the feasibility and acceptability of arts-based creative caregiving techniques (CCG) for use in long-term care. We held a series of focus groups (n=14) to adapt, refine, and enhance usability. We then evaluated implementation in two waves of testing (n=8). Those working in memory care units were more likely to use all techniques, while those working in rehabilitation were more hesitant to implement. Participants reported using CCG to distract upset residents. Family members were excited about implementation, and NAs not participating wanted to learn CCG. Nursing assistants have the potential to become experts in creative caregiving but may require in-depth training to improve use.

scholarly journals Certified Nursing Assistants’ Experiences of Workplace Violence Caring for Persons With Dementia

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 260-261
Author(s):  
Chunhong Xiao ◽  
Vicki Winstead ◽  
Corteza Townsend ◽  
Rita Jablonski
Keyword(s):  
Workplace Violence ◽  
Physical Violence ◽  
Nursing Assistants ◽  
Direct Care ◽  
Cognitively Impaired ◽  
Certified Nursing Assistants ◽  
Snowball Sampling ◽  
Term Care ◽  
Face To Face ◽  
Emerging Risk

Abstract Problem: Certified nursing assistants (CNAs) are the primary providers of direct care to persons residing in long term care facilities (LTCFs), many of whom have dementia. The need to deliver direct and intimate care increases CNAs’ exposure to verbal and physical workplace violence. Purpose: To describe CNAs’ experiences of physical and verbal workplace violence experienced during direct care activities in LTCFs. Design: Qualitative. Sample & Procedure: Ten African-American CNAs (9 female, 1 male) were recruited using snowball sampling from multiple LTCFs. Interviews were recorded and transcribed. NVivo12 software was used to manage the thematic analyses. Results: The identified themes were: 1) CNAs’ perception that verbal and physical abuse was “part of the job” and unavoidable; 2) CNAs’ feelings of minimization of the abuse by administration; and 3) inadequate CNA training to recognize and de-escalate triggers of verbal and physical violence, notably care-resistant behavior. Conclusion: The combination of institutional tolerance of workplace violence, coupled with CNAs’ insufficient training in de-escalating volatile interactions with cognitively-impaired residents, is creating an unfavorable, possibly dangerous, workplace environment for CNAs. Implications: As more states elevate assaults on healthcare workers to felony crimes, there is an emerging risk of criminalizing dementia-related behavior in an attempt to address workplace violence. Interventions focused on helping CNAs recognize and de-escalate care-resistant behavior are necessary for violence prevention programs in LTCFs. Limitations: CNAs may have self-censored and under-described the severity of their experiences during face-to-face interviews, even with confidentiality protocols and the practice of off-site interviews.

Meaning making in long-term care: what do certified nursing assistants think?

2016 ◽  
Vol 23 (3) ◽  
pp. 244-252 ◽  
Author(s):  
Michelle Gray ◽  
Barbara Shadden ◽  
Jean Henry ◽  
Ro Di Brezzo ◽  
Alishia Ferguson ◽  
...  
Keyword(s):  
Long Term Care ◽  
Meaning Making ◽  
Nursing Assistants ◽  
Certified Nursing Assistants ◽  
Term Care
Sign in / Sign up

Export Citation Format

Share Document