scholarly journals THE CARE RECIPIENT’S PERSPECTIVE ON QUALITY OF CARE: DIFFERENT APPROACHES IN NURSING HOMES

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S73-S73
Author(s):  
Hilde Verbeek ◽  
Kimberly Van Haitsma
Keyword(s):  
Quality Of Care ◽  
Nursing Homes ◽  
The United States ◽  
Care Recipient ◽  
Term Care ◽  
People With Dementia ◽  
Centered Care ◽  
Specialist Health Care ◽  
Assess Quality

Abstract In long-term care, there has been an ongoing shift focused on person-centered care, positioning the care recipient at the core of good quality of care. This has resulted in more emphasis on care recipients’ preferences and experiences with the care they receive. In the Netherlands, Germany and the United States the need to focus on and assess quality from the care recipient’s perspective has emerged. This symposium presents four different approaches to quality of care from the care recipient’s perspective. The first speaker will focus on a narrative approach to assess experienced quality of care in nursing homes. The second speaker will present an observational method to assess the level of autonomy provided to people with dementia in nursing homes. The third speaker will present findings about the use of specialist health care in nursing homes as an indicator for quality of care. The last presentation will address the importance of preferences in quality of care. Defining, assessing and improving experienced quality of care from the care recipient’s perspective is an ongoing challenge, as each care recipient’s preferences and needs differ. It is important to assess in order to monitor that care is being tailored to the care recipient and to identify possible interventions that can enhance experienced quality of care.

scholarly journals Person-Centred Care Transformation in a Nursing Home for Residents with Dementia

2021 ◽  
pp. 1-9
Author(s):  
Peiyan Ho ◽  
Rachel Chin Yee Cheong ◽  
Siew Pei Ong ◽  
Carol Fusek ◽  
Shiou Liang Wee ◽  
...  
Keyword(s):  
Nursing Home ◽  
Quality Of Care ◽  
Nursing Homes ◽  
Quality Care ◽  
Well Being ◽  
Care Quality ◽  
Care Recipient ◽  
Staff Retention ◽  
Term Care

<b><i>Background:</i></b> Conventional nursing homes in Singapore adopt an institutional and medical model of care with a focus on safety and risk management. As such, less regard is placed on upholding the dignity and autonomy of the resident, which compromises quality of care and the well-being of the resident. Today, person-centred care (PCC) has become synonymous with high-quality care that sustains the well-being and personhood of the care recipient. <b><i>Objectives:</i></b> To describe the model of PCC adopted by a nursing home, Apex Harmony Lodge (AHL), with a logic model and evaluate outcomes on residents’ well-being, care quality, and staff attrition by comparing pre-PCC initiation (2015) to post-implementation (2016). <b><i>Methods:</i></b> Male residents in a 30-bed assisted living facility for persons with dementia in AHL were assessed using Dementia Care Mapping. Residents’ well-being and staff attrition were measured before and after PCC implementation. <b><i>Results:</i></b> There were statistically significant improvements in resident well-being (Δ = 0.44, <i>p</i> = 0.029), Positive Engagement Potential (Δ = 0.17, <i>p</i> = 0.002), and Occupational Diversity (Δ = 0.12, <i>p</i> = 0.014) in 2016. Withdrawal and Passive Engagement in the residents were reduced significantly as were Care Detractors. There was also a 55% reduction in staff attrition rates post-PCC. <b><i>Conclusions:</i></b> Post-PCC implementation, the outcomes indicate a superior quality of care, enhanced resident well-being, and better staff retention. The AHL PCC model could serve as a roadmap for other nursing homes aspiring to raise the quality of care and influence long-term care standards and regulations for policy makers and legislators.

scholarly journals TIMELY LESSONS FROM A PANDEMIC ON THE BENEFITS OF PERSON CENTRIC CARE IN LONG TERM CARE FACILITIES

2020 ◽  
pp. 1-2
Author(s):  
S.-L. Wee ◽  
P.L.K. Yap
Keyword(s):  
Quality Of Care ◽  
Nursing Homes ◽  
Infection Control ◽  
Long Term Care ◽  
Term Care ◽  
Person Centered Care ◽  
Care Facilities ◽  
Centered Care

Since the outbreak of Coronavirus Disease 2019 (COVID-19), there have been few deadlier places than in nursing homes. As such, several useful guidelines on coping with COVID-19 in nursing homes have emerged. The critical immediate term measures mentioned in the guidelines have longer term implications especially on quality of care. We discuss how these measures instituted for infection control can be synergistic with person-centered care which has been synonymous with quality of care in nursing homes.

scholarly journals Understanding the Link between Family Caregiver Quality of Life and the Care Provided to Older People With Dementia

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 153-154
Author(s):  
Afeez Hazzan
Keyword(s):  
Quality Of Life ◽  
Quality Of Care ◽  
Older People ◽  
Family Caregivers ◽  
Family Caregiver ◽  
Well Being ◽  
The United States ◽  
People With Dementia ◽  
The Impact

Abstract Dementia is one of the most rapidly growing diseases in the United States. In 2018, the direct costs to American society of caring for older people with dementia was approximately $277 billion. Primary informal caregivers are mainly responsible for the care of older people with dementia including Alzheimer’s disease. Caregivers perform a myriad of duties ranging from shopping for their loved ones’ groceries, helping with medications, and managing finances. The caregiving role becomes more demanding as the disease progresses over time, and studies have shown that the quality-of-life (QoL) experienced by caregivers of older adults who have dementia is lower than the QoL of caregivers for older people who do not have dementia. To the best of our knowledge, there has been no research conducted to investigate whether lower caregiver QoL affects the level or quality of care that caregivers provide to persons with dementia. In the current study, we interviewed family caregivers living in Rochester, New York to inquire about their quality of life and the care provided to older people living with dementia. Further, caregivers completed the 36-item Short Form Health Survey (SF-36) as well as a draft questionnaire for measuring the quality of care provided to older people living with dementia. Both quantitative and qualitative findings from this study reveals important relationships between family caregiver QoL and the care provided, including the impact of social support and financial well-being. The study findings could have significant impact, particularly for the provision of much needed support for family caregivers.

The experiences, priorities, and perceptions of informal caregivers of people with dementia in nursing homes: A scoping review

Dementia ◽  
2021 ◽  
pp. 147130122110126
Author(s):  
Alexandra E Harper ◽  
Lauren Terhorst ◽  
Marybeth Moscirella ◽  
Rose L Turner ◽  
Catherine V Piersol ◽  
...  
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Home Care ◽  
Scoping Review ◽  
Informal Caregivers ◽  
Nursing Home Care ◽  
Person Centered Care ◽  
People With Dementia ◽  
Centered Care

Background Person-centered care has been shown to increase desired outcomes for people with dementia, yet informal caregivers’ dissatisfaction with care is often reported. For those living in a nursing home, informal caregivers are uniquely situated to provide key insights into the individual’s care. However, little is known of the informal caregivers’ perspective, which hinders efforts to improve their satisfaction with person-centered nursing home care. Thus, we examined the comprehensive experiences, priorities, and perceptions of informal caregivers of nursing home residents with dementia. Methods In collaboration with stakeholders, a scoping review of Medline (Ovid), EMBASE.com , CINAHL (EBSCO), the Cochrane Library (Wiley), and PsycINFO (Ovid) databases from January 2000 to July 2020 was conducted. Data were extracted reflecting the experiences, priorities, and preferences of caregivers of people with dementia residing in nursing homes. Results We identified 114 articles that revealed nine themes: (1) communication, (2) transition to nursing home, (3) quality of care, (4) quality of life, (5) informal caregiver role, (6) knowledge of dementia, (7) end-of-life preferences, (8) medication use to manage neuropsychiatric behaviors, and (9) finances. Conclusion Informal caregivers described aspects of care that led to both positive and negative experiences with and perceptions of nursing home care. The shortcomings in communication were discussed most frequently, indicating a high priority area. While researchers define the identified themes individually, informal caregivers perceive them to be interwoven as they relate to person-centered care delivery. Although we did not assess the quality of included articles, by identifying themes relevant to caregivers’ perspectives of nursing home care, our findings may help to inform efforts to optimize caregivers’ satisfaction with nursing home care for residents with dementia.

scholarly journals Understanding contributors to quality of care in long-term care and changes under COVID-19

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 960-960
Author(s):  
Sara Luck ◽  
Katie Aubrecht
Keyword(s):  
Quality Of Care ◽  
Long Term Care ◽  
The United States ◽  
Control Measures ◽  
Qualitative Description ◽  
Care Staff ◽  
Term Care ◽  
The Impact

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.

scholarly journals 414 - Supporting staff delivering person-centered care to people with dementia in Dutch nursing homes

2021 ◽  
Vol 33 (S1) ◽  
pp. 37-38
Author(s):  
Henriëtte van der Roest ◽  
Milan van der Kuil ◽  
Anouk Overbeek ◽  
Egbert Hartstra
Keyword(s):  
Nursing Homes ◽  
Living Arrangements ◽  
Online Survey ◽  
Dementia Care ◽  
Person Centered Care ◽  
People With Dementia ◽  
Modifiable Factors ◽  
Centered Care ◽  
Organizational Features

BackgroundPositive evidence has been found for person-centered care provisioning (PCC), the level of person- centeredness of care is positively associated with residents’ quality of life, quality of care an wellbeing.When providing PCC, care and support are provided in line with the needs, preferences and capacities of people with dementia. PCC is seen as the golden standard for dementia care. However, in nursing homes, needs and preferences of people with dementia are not always obvious, due to the relatively high levels of cognitive impairment. This, and amongst others time constraints might hinder high PCC by care professionals. Limited evidence show that certain organizational and environmental conditions, such as satisfactory leadership, interdisciplinary collaboration, and continuing education, lead to higher PCC. In order to facilitate care professionals as much as possible in providing PCC, more insight is desirable.ObjectiveThis study aims to provide more insight into the modifiable factors that contribute to PCC for people with dementia in Dutch nursing homes.MethodsA cross-sectional design was applied. Data were collected during the fifth assessment of the Living Arrangements for people with Dementia (LAD)-study from April 2019 until February 2020. Care professionals working in psychogeriatric units in nursing homes filled in an online survey. Organizational characteristics of participating nursing homes were inventoried.The level of PCC was assessed with the Dutch version of the ‘Person-centred care questionnaire’ (PCCq). Modifiable factors potentially impacting the level of provided PCC with regard to staff characteristics (e.g. autonomy, education), organizational features (e.g. size, involvement of family in care), and culture (e.g. learning climate) were included in multiple linear modelling.Preliminary resultsIn total 58 nursing home facilities were included in the study, and 814 care professionals completed the survey. Average PCCq score was 3.2 (SD = 0.4; range 0 to 4, higher scores indicating higher PCC).ConclusionFactors related to staff, and organizational features and culture, that contribute to PPC will be presented. The outcomes of the study will provide input for the optimal organization of dementia care, in order to support care professionals working in nursing homes to provide PCC.

scholarly journals Dementia is Associated With Poorer Quality of Care and Outcomes After Stroke: An Observational Study

2020 ◽  
Author(s):  
Michele L Callisaya ◽  
Tara Purvis ◽  
Katherine Lawler ◽  
Amy Brodtmann ◽  
Dominique A Cadilhac ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Quality Of Care ◽  
Confidence Interval ◽  
Odds Ratio ◽  
Adjusted Odds Ratio ◽  
Processes Of Care ◽  
Pooled Data ◽  
People With Dementia ◽  
Assess Quality

Abstract Background To determine whether preexisting dementia is associated with poorer quality of care and outcomes after stroke in the acute hospital phase. Method This was a retrospective analysis of pooled data from the Australian Stroke Foundation national audit conducted in 2015 and 2017. Dementia status was obtained from the medical records. Processes of care to assess quality included: stroke unit care, time-dependent therapy, nursing/allied health assessments, and preparation for discharge. Outcomes included in-hospital complications, independence on discharge, and destination. Logistic regression was used to examine associations between dementia status and processes of care. Multilevel random effects logistic regression, with level defined as hospital, was used to examine associations between dementia status and outcomes. Results There were 683/7,070 (9.7%) audited patients with dementia included. Patients with dementia were less likely to be treated in stroke units (58.3% vs 70.6%), receive thrombolysis if an ischemic stroke (5.8% vs 11.1%), have access within 48 hours to physiotherapy (56.4% vs 69.7%) or occupational therapy (46.8% vs 55.6%), see a dietitian if problems with nutrition (64.4% vs 75.9%), or have mood assessed (2.6% vs 12.3%). Patients with dementia were more likely to receive no rehabilitation (adjusted odds ratio 1.88, 95% confidence interval 1.25, 2.83) and be discharged to residential care (adjusted odds ratio 2.36, 95% confidence interval 1.50, 3.72). Conclusion People with dementia received poorer quality of care and had worse outcomes after stroke. Our findings raise questions regarding equity and the need for better understanding of why the quality of care differs after stroke for people with dementia.

Quality of dying of nursing home residents with dementia as judged by relatives

2013 ◽  
Vol 25 (10) ◽  
pp. 1697-1707 ◽  
Author(s):  
Nicole van Uden ◽  
Lieve Van den Block ◽  
Jenny T. van der Steen ◽  
Bregje D. Onwuteaka-Philipsen ◽  
An Vandervoort ◽  
...  
Keyword(s):  
Nursing Home ◽  
Quality Of Care ◽  
Retrospective Study ◽  
Nursing Homes ◽  
The Netherlands ◽  
Nursing Home Residents ◽  
Quality Of Dying ◽  
People With Dementia ◽  
Number Of Patients

ABSTRACTBackground:Providing good quality care for the growing number of patients with dementia is a major challenge. There is little international comparative research on how people with dementia die in nursing homes. We compared the relative's judgment on quality of care at the end of life and quality of dying of nursing home residents with dementia in Belgium and the Netherlands.Methods:This was a Belgian cross-sectional retrospective study (2010) combined with a prospective and retrospective study from the Netherlands (January 2007–July 2011). Relatives of deceased residents of 69 Belgian and 34 Dutch nursing homes were asked to complete questionnaires. We included 190 and 337 deceased nursing home residents with dementia in Belgium and the Netherlands, respectively.Results:Of all identified deceased nursing home residents with dementia, respectively 53.2% and 74.8% of their relatives in Belgium and the Netherlands responded. Comfort while dying (CAD-EOLD, range 14–42) was rated better for Dutch nursing home residents than for Belgian nursing homes residents (26.1 vs. 31.1, OR 4.5, CI 1.8–11.2). We found no differences between countries regarding Satisfaction With Care (SWC-EOLD, range 10–40, means 32.5 (the Netherlands) and 32.0 (Belgium)) or symptom frequency in the last month of life (SM-EOLD, range 0–45, means 26.4 (the Netherlands) and 27.2 (Belgium)).Conclusion:Although nursing home structures differ between Belgium and the Netherlands, the quality of care in the last month of life for residents with dementia is similar according to their relatives. However, Dutch residents experience less discomfort while dying. The results suggest room for improved symptom management in both countries and particularly in the dying phase in Belgium.

scholarly journals Monitoring changes in the organization of Dutch long-term care and their effects on the mental health and wellbeing of people with dementia

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
H van der Roest ◽  
M Prins ◽  
J van Erp ◽  
E Hartstra ◽  
A van der Schot
Keyword(s):  
Quality Of Life ◽  
Cognitive Impairment ◽  
Nursing Homes ◽  
Long Term Care ◽  
Behavioral Symptoms ◽  
Term Care ◽  
People With Dementia ◽  
Over Time

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.

scholarly journals Themes Related to Experienced Quality of Care in Nursing Homes From the Resident’s Perspective: A Systematic Literature Review and Thematic Synthesis

2020 ◽  
Vol 6 ◽  
pp. 233372142093196
Author(s):  
Katya Y. J. Sion ◽  
Hilde Verbeek ◽  
Sandra M. G. Zwakhalen ◽  
Gaby Odekerken-Schröder ◽  
Jos M. G. A. Schols ◽  
...  
Keyword(s):  
Nursing Home ◽  
Quality Of Care ◽  
Nursing Homes ◽  
Literature Review ◽  
Systematic Literature Review ◽  
Social Engagement ◽  
Centered Care ◽  
Meaningful Relationships ◽  
And Coping

Background: The culture change from task-centered care to person- and relationship-centered care has resulted in the resident’s voice gaining importance when assessing experienced quality of care in nursing homes. This review aimed to identify which factors contribute to experienced quality of care in nursing homes worldwide from the resident’s perspective. Method: A systematic literature review and thematic data synthesis were performed. The databases PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsycInfo, and Business Source Complete were searched to identify qualitative studies aimed at retrieving factors related to residents’ experienced quality of care in nursing homes. Only studies in which residents themselves were interviewed were included. Results: This literature review included 27 publications covering 14 countries. Thematic analysis revealed three overarching themes related to residents’ care experiences: (a) The nursing home environment consisted of the physical environment and caring environment, (b) individual aspects of living in the nursing home consisted of personhood and coping with change, and (c) social engagement consisted of meaningful relationships and care provision. Discussion: To achieve high experienced quality of care in nursing homes, residents’ care experiences need to be assessed and used in quality management.

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