scholarly journals INTEREST GROUP SESSION—RESEARCH IN QUALITY OF CARE: LIVING IN AND LEAVING NURSING HOMES: THE FACTORS THAT CONTRIBUTE TO QUALITY OF LIFE, HEALTH, AND SAFETY OUTCOMES

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S359-S359
Author(s):  
Nancy Kusmaul ◽  
Mercedes Bern-Klug

Abstract Nursing homes house some of the most vulnerable older adults. They often have complex medical conditions and/or cognitive impairments that put them at risk for negative outcomes and poor quality of life. These outcomes can be altered through incorporating evidence-based practices aimed to improve care and residents’ life experiences. In this symposium we will explore factors that are shown to influence outcomes and quality of life for people that live in and are discharged from, long term care settings. Amy Roberts and colleagues will explore the influences of nursing home social service staff qualifications on residents’ discharge outcomes. Colleen Galambos and colleagues will present findings on advance directives and their impact on reducing potentially avoidable hospitalizations. Kelsey Simons and colleagues will discuss the potential for unmet needs for mental health services as part of nursing home care transitions, and will discuss a model of quality improvement that addresses this gap in care. Vivian Miller will present findings on the impact transportation access has on the ability of community-dwelling family members to visit and provide social support to their family member residents in long-term care. Finally, Nancy Kusmaul and Gretchen Tucker report the findings of their study comparing perceptions of nursing home residents, direct care staff, management, and families on the care practices that influence resident health and quality of life while they live in a long term care setting.

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 960-960
Author(s):  
Sara Luck ◽  
Katie Aubrecht

Abstract Nursing home facilities are responsible for providing care for some of the most vulnerable groups in society, including the elderly and those with chronic medical conditions. In times of crisis, such as COVID-19 or other pandemics, the delivery of ‘regular’ care can be significantly impacted. In relation to COVID-19, there is an insufficient supply of personal protective equipment (PPE) to care for residents, as PPE not only protects care staff but also residents. Nursing homes across the United States and Canada have also taken protective measures to maximize the safety of residents by banning visitors, stopping all group activities, and increasing infection control measures. This presentation shares a research protocol and early findings from a study investigating the impact of COVID-19 on quality of care in residential long-term care (LTC) in the Canadian province of New Brunswick. This study used a qualitative description design to explore what contributes to quality of care for residents living in long-term care, and how this could change in times of crisis from the perspective of long-term care staff. Interviews were conducted with a broad range of staff at one LTC home. A semi-structured interview guide and approach to thematic analysis was framed by a social ecological perspective, making it possible to include the individual and proximal social influences as well as community, organizations, and policy influencers. Insights gained will improve the understanding of quality of care, as well as potential barriers and facilitators to care during times of crisis.


Author(s):  
Feliciano Villar ◽  
Rodrigo Serrat ◽  
Annette Bilfeldt ◽  
Joe Larragy

AbstractLiving in a long-term care (LTC) institution provides older people experiencing health and social problems with a comprehensive range of support services that address their quality of life. Despite access to such services, challenges arise in relation to their participation in key activities both within and outside the institution. This chapter examines such challenges, reviewing and describing ways to prevent exclusion along various domains, specifically social relationships, civic participation and socio-cultural life. Firstly, we discuss ways in which bio-medical models of care and the quality control systems, which are dominant in LTC services, standardise care, tending to put decisions exclusively in hands of staff, taking away residents’ autonomy, and ultimately curtailing rights and citizenship status. Secondly, we examine how LTC services might prevent such exclusion and promote older people’s participation in at least four respects: (1) prompting and supporting residents’ ability to take decisions on their own care, (2) favouring the maintenance and creation of social relationships, (3) enabling residents’ participation in the activities and management of the institution, and (4) guaranteeing residents’ rights and full access to citizenship. We discuss the impact and limitations of recent initiatives put into practice in these areas of practice.


2018 ◽  
Vol 40 (6) ◽  
pp. 1291-1308 ◽  
Author(s):  
Thijs van den Broek ◽  
Emily Grundy

AbstractThe impact that providing care to ageing parents has on adult children's lives may depend on the long-term care (LTC) context. A common approach to test this is to compare whether the impact of care-giving varies between countries with different LTC coverage. However, this approach leaves considerable room for omitted variable bias. We use individual fixed-effects analyses to reduce bias in the estimates of the effects of informal care-giving on quality of life, and combine this with a difference-in-difference approach to reduce bias in the estimated moderating impact of LTC coverage on these effects. We draw on longitudinal data for Sweden and Denmark from the Survey of Health, Ageing and Retirement in Europe (SHARE) collected between 2004 and 2015. Both countries traditionally had generous LTC coverage, but cutbacks were implemented at the end of the 20th century in Sweden and more recently in Denmark. We use this country difference in the timing of the cutbacks to shed light on effects of LTC coverage on the impact care-giving has on quality of life. Our analyses show that care-giving was more detrimental for quality of life in Sweden than in Denmark, and this difference weakened significantly when LTC coverage was reduced in Denmark, but not in Sweden. This suggests that LTC coverage shapes the impact of care-giving on quality of life.


2009 ◽  
Vol 14 (2) ◽  
pp. 37-41 ◽  
Author(s):  
Margaret P. Calkins ◽  
Jennifer Brush

Abstract The entire field of long-term care is under tremendous pressure to change. Traditional environmental approaches based on staff-centric or medical models are no longer considered appropriate in long-term care settings. The new emphasis is on person-centered or self-directed care. This is reflected in settings where people can live comfortably and feel at home, as opposed to feeling like they are in a hospital. Increasingly, nursing homes are working to be more like assisted living facilities, which emphasize privacy, dignity, and choice. These changes affect all aspects of care from structure of governance to staff training to management structure and facility design. This article will cover the issues and the possible solutions to ensuring that long-term care living is more like a home than a hospital.


2015 ◽  
Vol 27 (10) ◽  
pp. 1739-1747 ◽  
Author(s):  
Elizabeth Beattie ◽  
Maria O’Reilly ◽  
Wendy Moyle ◽  
Lynn Chenoweth ◽  
Deirdre Fetherstonhaugh ◽  
...  

ABSTRACTBackground:Dementia is a chronic illness without cure or effective treatment, which results in declining mental and physical function and assistance from others to manage activities of daily living. Many people with dementia live in long term care facilities, yet research into their quality of life (QoL) was rare until the last decade. Previous studies failed to incorporate important variables related to the facility and care provision or to look closely at the daily lives of residents. This paper presents a protocol for a comprehensive, multi-perspective assessment of QoL of residents with dementia living in long term care in Australia. A secondary aim is investigating the effectiveness of self-report instruments for measuring QoL.Methods:The study utilizes a descriptive, mixed methods design to examine how facility, care staff, and resident factors impact QoL. Over 500 residents with dementia from a stratified, random sample of 53 facilities are being recruited. A sub-sample of 12 residents is also taking part in qualitative interviews and observations.Conclusions:This national study will provide a broad understanding of factors underlying QoL for residents with dementia in long term care. The present study uses a similar methodology to the US-based Collaborative Studies of Long Term Care (CS-LTC) Dementia Care Study, applying it to the Australian setting.


2014 ◽  
Vol 143 (12) ◽  
pp. 2588-2595 ◽  
Author(s):  
J. M. GROSHOLZ ◽  
S. BLAKE ◽  
J. D. DAUGHERTY ◽  
E. AYERS ◽  
S. B. OMER ◽  
...  

SUMMARYThe US Center for Medicare and Medicaid Services (CMS) requires nursing homes and long-term-care facilities to document residents' vaccination status on the Resident Assessment Instrument (RAI). Vaccinating residents can prevent costly hospital admissions and deaths. CMS and public health officials use RAI data to measure vaccination rates in long-term-care residents and assess the quality of care in nursing homes. We assessed the accuracy of RAI data against medical records in 39 nursing homes in Florida, Georgia, and Wisconsin. We randomly sampled residents in each home during the 2010–2011 and 2011–2012 influenza seasons. We collected data on receipt of influenza vaccination from charts and RAI data. Our final sample included 840 medical charts with matched RAI records. The agreement rate was 0·86. Using the chart as a gold standard, the sensitivity of the RAI with respect to influenza vaccination was 85% and the specificity was 77%. Agreement rates varied within facilities from 55% to 100%. Monitoring vaccination rates in the population is important for gauging the impact of programmes and policies to promote adherence to vaccination recommendations. Use of data from RAIs is a reasonable approach for gauging influenza vaccination rates in nursing-home residents.


2017 ◽  
Vol 27 (3) ◽  
pp. e43-e58
Author(s):  
Julien Forder ◽  
Florin Vadean ◽  
Stacey Rand ◽  
Juliette Malley

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
H van der Roest ◽  
M Prins ◽  
J van Erp ◽  
E Hartstra ◽  
A van der Schot

Abstract Background The 'Living Arrangements for People with Dementia (LAFD)' monitor-study aims to provide insight into effects of changes in the organization of Dutch long-term care for people with dementia. The objective of this study is to evaluate changes over time in the level of cognitive impairment, the frequency and severity of behavioral symptoms, and quality of life of residents with dementia, and changes in staffing levels. The study allows for detection of trends and developments that are relevant for the quality of nursing home care. Methods The LAFD-study is a repeated cross-sectional study. Since 2008, assessments have been conducted in participating nursing homes every two year. Up to 2020, five assessments have been completed. The number of participating nursing homes over time ranged from 47 to 144 and a sample of one third of residents was included in the study. Data collection was performed by care professionals. Cognitive impairment was assessed with the Cognitive Performance Scale, frequency and severity of behavioral symptoms were assessed with the Neuropsychiatric Inventory; quality of life was assessed with de Qualidem. Per nursing home, the amount of direct provided care was inventoried. Results Assessments up to 2017/2018 showed an improvement in cognitive functioning and quality of life in Dutch nursing homes. The amount of behavioral problems did not change, as did the amount of direct care. However, the level of professional caregivers increased slightly. In the last assessment, 53 nursing homes participated, and 668 residents were included. The fast majority of participants was over 80 years of age (67.1%) and 68.5% were female. The data are currently being further analyzed and presented at the conference. Conclusions There is a trend of improvement in cognitive functioning and quality of life up to 2018. The most recent assessment will indicate whether these positive trends continue.


Sign in / Sign up

Export Citation Format

Share Document