scholarly journals BEST INTENTIONS OR BEST PRACTICE? HOW DO STAFF PERCEIVE BEST CARE FOR PEOPLE WITH DEMENTIA IN TAIWAN?

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S506-S506
Author(s):  
Chih-ling Liou
Keyword(s):  
Quality Of Life ◽  
Care Delivery ◽  
Participant Observation ◽  
Care Facility ◽  
Care Quality ◽  
Observation Data ◽  
Term Care ◽  
Staff Members ◽  
People With Dementia

Abstract Care of people with dementia is a global issue, and the quality of dementia care in the long-term care facility is of concern internationally. The Taiwanese government seeks to expand the availability of adult day services (ADS) to meet the needs of an aging population with dementia; however, research about care in ADS in Taiwan is limited. This study aims to investigate how ADS staff perceptions of best care affected care delivery and clients’ quality of life. A focused ethnographic method was employed to collect data through 480 hours of participant observation and 31 staff interviews at three centers. Content analysis was used to analyze the data. The findings revealed a contradiction on how staff perceived best care and what they really performed at center. Thirteen staff members who were interviewed identified that in their view the best care is to “put yourself in the shoes of the client,” and another nine staff members chose “keep clients happy” as the best care. From the observation data, however, the staff performed the “good care” by forcing the clients to follow their orders absolutely unless the clients refused violently. Staff-led activities were structured as tasks to be completed rather than activities to be enjoyed. The clients complained about the bureaucratic management that shaped their lives at centers but could only endure or accept. To support clients’ quality of life and improve the care quality, ADS staff need to be educated more with the evidence-based best care for people with dementia.

scholarly journals Not Just How Many but Who is on Shift: The Impact of Workplace Incivility and Bullying on Care Delivery in Nursing Homes

2020 ◽  
Author(s):  
Heather A Cooke ◽  
Jennifer Baumbusch
Keyword(s):  
Power Relations ◽  
Care Delivery ◽  
Participant Observation ◽  
Care Quality ◽  
Workplace Incivility ◽  
Workplace Relationships ◽  
Structured Interviews ◽  
Term Care ◽  
Staff Members ◽  
The Impact

Abstract Background and Objectives Much of the literature examining the staffing-care quality link in long-term care (LTC) homes focuses on staffing ratios; that is, how many staff are on shift. Far less attention is devoted to exploring the impact of staff members’ workplace relationships, or who is on shift. As part of our work exploring workplace incivility and bullying among residential care aides (RCAs), we examined how RCAs’ workplace relationships are shaped by peer incivility and bullying and the impact on care delivery. Research Design and Methods Using critical ethnography, we conducted 100 hours of participant observation and 33 semi-structured interviews with RCAs, licensed practical nurses, support staff and management in two non-profit LTC homes in British Columbia, Canada. Results Three key themes illustrate the power relations underpinning RCAs’ encounters with incivility and bullying that, in turn, shaped care delivery. Requesting Help highlights how exposure to incivility and bullying made RCAs reluctant to seek help from their co-workers. Receiving Help focuses on how power relations and notions of worthiness and reciprocity impacted RCAs receipt of help from co-workers. Resisting Help/ing outlines how workplace relationships imbued with power relations led some RCAs to refuse assistance from their co-workers, led longer-tenured RCAs to resist helping newer RCAs and dictated the extent to which RCAs provided care to residents for whom another RCA was responsible. Discussion and Implications Findings highlight ‘who’ is on shift warrants as much attention as ‘how many’ are on shift, offering additional insight into the staffing-care quality link.

“They don't just disappear”: Acknowledging death in the long-term care setting

2012 ◽  
Vol 10 (4) ◽  
pp. 241-247 ◽  
Author(s):  
Janine Maitland ◽  
Kevin Brazil ◽  
Bill James-Abra
Keyword(s):  
Long Term Care ◽  
Emotional Health ◽  
Family Members ◽  
Care Facility ◽  
Term Care ◽  
Long Term Care Facility ◽  
Qualitative Research Study ◽  
Staff Members

AbstractObjective:The purpose of this study was to describe the value of a formal room blessing ritual held within a long-term care facility, from the perspectives of staff, residents, and family members.Method:A qualitative research study involving interviews with staff, residents, and family members was conducted to examine the perceived value of a room blessing ritual.Results:Twenty-four room blessing attendees participated in the study (nine staff, eight residents, and seven family members). Attendees felt that the room blessing provided an opportunity to formally acknowledge the death of the resident and their grief; the majority felt that this was a positive experience and that it provided an element of closure. Staff members and residents expressed their appreciation for the opportunity to connect with family members of the deceased to express their condolences during the ritual. Participants also identified the inclusivity of the ritual (i.e., an open invitation to all staff, residents, and family members) as a positive aspect that served as a reminder that others shared in their grief. Staff members felt that blessing the room for the new resident was an important component of the ritual, helping to bridge the gap between mourning and welcoming a new person. Staff, residents, and family members felt that the room blessing positively reflected the mission and values of the facility. The most highly valued aspect of the ritual for all attendees was the sharing of stories about the deceased to celebrate that person's life.Significance of results:Long-term care facilities need to recognize that formal supports to manage the bereavement needs of staff and residents, such as a room blessing ritual, should be incorporated into their model for managing end-of-life care, given the relationship between the emotional health of staff and the quality of care provided for residents.

Evaluation of Ceiling Lifts in Health Care Settings

AAOHN Journal ◽  
2009 ◽  
Vol 57 (9) ◽  
pp. 374-380 ◽  
Author(s):  
Hasanat Alamgir ◽  
Olivia Wei Li ◽  
Erin Gorman ◽  
Catherine Fast ◽  
Shicheng Yu ◽  
...  
Keyword(s):  
Health Care ◽  
Patient Care ◽  
Pressure Ulcer ◽  
Care Facility ◽  
Care Quality ◽  
Patient Perceptions ◽  
Term Care ◽  
Health Care Settings ◽  
The Relationship

Ceiling lifts have been introduced into health care settings to reduce manual patient lifting and thus occupational injuries. Although growing evidence supports the effectiveness of ceiling lifts, a paucity of research links indicators, such as quality of patient care or patient perceptions, to the use of these transfer devices. This study explored the relationship between ceiling lift coverage rates and measures of patient care quality (e.g., incidence of facility-acquired pressure ulcers, falls, urinary infections, urinary incontinence, and assaults [patient to staff] in acute and long-term care facilities), as well as patient perceptions of satisfaction with care received while using ceiling lifts in a complex care facility. Qualitative semi-structured interviews were used to generate data. A significant inverse relationship was found between pressure ulcer rates and ceiling lift coverage; however, this effect was attenuated by year. No significant relationships existed between ceiling lift coverage and patient outcome indicators after adding the “year” variable to the model. Patients generally approved of the use of ceiling lifts and recognized many of the benefits. Ceiling lifts are not detrimental to the quality of care received by patients, and patients prefer being transferred by ceiling lifts. The relationship between ceiling lift coverage and pressure ulcer rates warrants further investigation.

scholarly journals Value-Based HIV Care: A Method to Improve Quality of HIV Care.

2020 ◽  
Author(s):  
Guido van den berk ◽  
Daoud Ait Moha ◽  
Janneke Stalenhoef ◽  
Marie-Jose Kleene ◽  
Narda van der Meche ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Care Delivery ◽  
Population Level ◽  
Care Quality ◽  
Hiv Care ◽  
First Year ◽  
Outcome Indicators ◽  
Number Of Patients ◽  
Care Path

Abstract Background : To support our goal of providing optimal HIV care to our patients, we started applying the value-based health care principle to the HIV care that we offer in our HIV center, measuring relevant health outcomes and costs to allow continuous implementation of improvements (Value-Based HIV Care; VBHiC). Methods : In line with the principles of Michael Porter, our approach consisted of the following steps: 1) Organizing into integrated practice units / describing the HIV care path; 2) Defining an HIV outcome indicator set; 3) Building an enabling information technology platform; 4) Integrating care delivery across separate facilities; 5) Moving to bundled payments for care cycles and 6) Expanding excellent services and interventions for improvement across geographic boundaries. Results : The following set of 9 outcome indicators was developed: undetectable HIV load within the first year of care; quality of life within the first year of care; mortality within the first year of care; retention in care; therapy effectiveness; therapy tolerance; cardiovascular risk; quality of life for every subsequent year and overall annual mortality. These indicators, which were evaluated retrospectively, are shown in figures 1-5. Collection of the underlying data started in January 2016. The HIV care path was also integrated into the electronic file system. Creation of the ability to monitor outcome indicators at patient level, population level and process level allowed us to implement a quality cycle (plan-do-study-act). Conclusion : Our Value-Based HIV Care approach facilitated structured evaluation of parameters that are of value to the patient. It also boosted the quality of the HIV care that we provide and allowed us to increase the number of patients to whom we can offer high quality HIV care.

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.

Depression and mental health in care homes for older people

2009 ◽  
Vol 10 (1) ◽  
pp. 40-46 ◽  
Author(s):  
Tom Dening ◽  
Alisoun Milne
Keyword(s):  
Quality Of Life ◽  
Mental Health ◽  
Older People ◽  
Good Practice ◽  
Life Quality ◽  
Psychosocial Interventions ◽  
Care Quality ◽  
Care Homes ◽  
Term Care

About five per cent of ‐ generally very frail ‐ older people live in long‐term care in the UK; approximately a fifth of all deaths occur in care homes. Depression and dementia are prevalent mental health conditions in care homes; depression is reported in around a third of residents and dementia in two thirds. While there is some evidence about efficacy of medication in treating psychiatric and behavioural symptoms among residents, much less is known about the potential role of psychosocial interventions in enhancing mental health and quality of life. Quality of care varies widely across the carehome sector including support from primary and specialist health and quality and level of training. In terms of enhancing care quality, there is evidence that investing in staff training and conditions, establishing good links with healthcare providers, and developing care standards that genuinely promote good practice are likely to improve resident quality of life. This is an exciting area for research development and practice innovation for the future; taking account of users perspective, holds particular potential.

Perceptions of family and staff on the role of the environment in long-term care homes for people with dementia

2012 ◽  
Vol 24 (5) ◽  
pp. 753-765 ◽  
Author(s):  
Linda J. Garcia ◽  
Michèle Hébert ◽  
Jean Kozak ◽  
Isabelle Sénécal ◽  
Susan E. Slaughter ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Focus Groups ◽  
Long Term Care ◽  
Disruptive Behaviors ◽  
Well Being ◽  
Care Homes ◽  
Term Care ◽  
Staff Members

ABSTRACTBackground: Disruptive behaviors are frequent and often the first predictor of institutionalization. The goal of this multi-center study was to explore the perceptions of family and staff members on the potential contribution of environmental factors that influence disruptive behaviors and quality of life of residents with dementia living in long-term care homes.Methods: Data were collected using 15 nominal focus groups with 45 family and 59 staff members from eight care units. Groups discussed and created lists of factors that could either reduce disruptive behaviors and facilitate quality of life or encourage disruptive behaviors and impede the quality of life of residents. Then each participant individually selected the nine most important facilitators and obstacles. Themes were identified from the lists of data and operational categories and definitions were developed for independent coding by four researchers.Results: Participants from both family and staff nominal focus groups highlighted facility, staffing, and resident factors to consider when creating optimal environments. Human environments were perceived to be more important than physical environments and flexibility was judged to be essential. Noise was identified as one of the most important factors influencing behavior and quality of life of residents.Conclusion: Specialized physical design features can be useful for maintaining quality of life and reducing disruptive behaviors, but they are not sufficient. Although they can ease some of the anxieties and set the stage for social interactions, individuals who make up the human environment are just as important in promoting well-being among residents.

Multiple perspectives on quality of life for residents with dementia in long term care facilities: protocol for a comprehensive Australian study

2015 ◽  
Vol 27 (10) ◽  
pp. 1739-1747 ◽  
Author(s):  
Elizabeth Beattie ◽  
Maria O’Reilly ◽  
Wendy Moyle ◽  
Lynn Chenoweth ◽  
Deirdre Fetherstonhaugh ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Long Term Care ◽  
Self Report ◽  
Care Staff ◽  
National Study ◽  
Term Care ◽  
People With Dementia ◽  
Care Facilities

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.

Art Activities and Quality of Life for People With Dementia in the Long Term Care Setting: A Case Series

2014 ◽  
Vol 15 (3) ◽  
pp. B3
Author(s):  
Rebecca S. King-Tucker ◽  
Rebecca S. King-Tucker ◽  
Maria Knupp ◽  
Terry Edwards ◽  
Elizabeth Walters
Keyword(s):  
Quality Of Life ◽  
Care Setting ◽  
Long Term Care ◽  
Case Series ◽  
Term Care ◽  
People With Dementia ◽  
Art Activities

scholarly journals The effects of placement on dementia care recipients’ and family caregivers’ quality of life: a literature review

2017 ◽  
Vol 18 (1) ◽  
pp. 44-57 ◽  
Author(s):  
Heehyul Moon ◽  
Peggye Dilworth-Anderson ◽  
Johannes Gräske
Keyword(s):  
Quality Of Life ◽  
Long Term Care ◽  
Research Literature ◽  
Term Care ◽  
Content Type ◽  
Care Recipients ◽  
People With Dementia ◽  
Care Facilities

Purpose The purpose of this paper is to review and synthesize the research literature on the quality of life (QoL) of both caregivers (CGs) and care recipients (CRs) with dementia after admission to long-term care facilities. Design/methodology/approach Four databases – AgeLine, Medline, EBSCO, and PyscINFO – were searched and the relevant literature from 2002 onwards was reviewed. Findings The review of 12 studies (five studies, including only family CGs; six studies including residents; one study including both family CGs and CRs) reveals a discrepancy regarding the effects of institutionalization on the CRs’ and CGs’ QoL. Among seven studies on CRs’ QoL change, some reviewed studies found a significant decline in CRs’ QoL after placement with others showing that CRs’ QoL was improved or stable. While some reports indicated that some family CGs benefited from placement, others showed that CGs merely maintained their QoL. However, family CGs in the reviewed studies were more likely to report improved QoL than were their CRs after institutionalization. Research limitations/implications The authors recommend that future studies should focus on understanding the individual’s adaptation to placement, dyadic changes in QoL (including mediators/moderators). They emphasize the need for a comprehensive longitudinal study with more than one wave and includes diverse groups including racial/ethnic minority CGs and CRs. Originality/value This study reviewed and synthesized the research literature on the QoL of both caregiver and the people with dementia they cared for after those they cared for were admitted to long-term care facilities. The conclusions drawn about influences on QoL provide guidance for identifying best practices and research.

Sign in / Sign up

Export Citation Format

Share Document