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.

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.

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 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.

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.

scholarly journals Appropriate leadership in nursing home care: a narrative review

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Nick Zonneveld ◽  
Carina Pittens ◽  
Mirella Minkman
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Home Care ◽  
Leadership Behaviors ◽  
Narrative Review ◽  
Nursing Home Care ◽  
Added Value ◽  
Future Research ◽  
Content Type ◽  
Definition Of

Purpose The purpose of this paper is to synthesize the existing evidence on leadership that best matches nursing home care, with a focus on behaviors, effects and influencing factors. Design/methodology/approach A narrative review was performed in three steps: the establishment of scope, systematic search in five databases and assessment and analysis of the literature identified. Findings A total of 44 articles were included in the review. The results of the study imply that a stronger focus on leadership behaviors related to the specific context rather than leadership styles could be of added value in nursing home care. Research limitations/implications Only articles applicable to nursing home care were included. The definition of “nursing home care” may differ between countries. This study only focused on the academic literature. Future research should focus on strategies and methods for the translation of leadership into behavior in practice. Practical implications A broader and more conceptual perspective on leadership in nursing homes – in which leadership is seen as an attribute of all employees and enacted in multiple layers of the organization – could support leadership practice. Originality/value Leadership is considered an important element in the delivery of good quality nursing home care. This study provides insight into leadership behaviors and influencing contextual factors specifically in nursing homes.

The Netherlands

2019 ◽  
pp. 195-202
Author(s):  
Marcel Olde Rikkert
Keyword(s):  
Nursing Home ◽  
The Netherlands ◽  
Ad Hoc ◽  
Dementia Care ◽  
Nursing Home Care ◽  
Great Promise ◽  
Dementia Patients ◽  
Care At Home ◽  
Fragmentation Of Care

In the Netherlands, there is currently an ongoing transition whereby a relevant part of long-term institutionalized care for dementia patients is being shifted to care at home. Legislation was changed in 2015 to achieve this goal. However, primary and nursing home care still needs to be redesigned to meet the needs of dementia patients and society. Improving network care holds great promise for this transition, as current dementia care in the Netherlands still falls short in terms of fragmentation of care, ad hoc collaboration, lack of feedback on quality and efficiency of care to healthcare professionals involved, and inadequate implementation of established multidisciplinary guidelines.

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.

scholarly journals DESCRIBING A CONCEPT OF NURSE INTUITION AND IMPLICATIONS FOR DEMENTIA CARE IN NURSING HOMES

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S838-S838 ◽  
Author(s):  
Rebekah Perkins ◽  
Katherine Supiano’katherine supiano@hsc utah edu’ kather
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Psychological Symptoms ◽  
Empirical Studies ◽  
Dementia Care ◽  
Limited Information ◽  
Mentor Programs ◽  
Home Setting ◽  
Nurse Residency ◽  
Nursing Home Setting

Abstract The purpose of this concept analysis was to explore nurse intuition historically and in current literature, appraise the value of nurse intuition to research and practice, and discuss implications for practice in caring for residents with behavioral and psychological symptoms of Dementia (BPSD) in nursing homes. To date, no research has examined the presence or utility of nurse intuition in the nursing home setting. A conceptual analysis using pragmatic utility was chosen and based on the work of Walker and Avant (2005). In the literature, nurse intuition is characterized by attributes of knowledge not preceded by inference, knowledge that is holistic in nature, independent of linear thinking, and drawn from synthesis instead of analysis. Nurse intuition is based on preconditions of experience, empathy, limited information, and limited time to make vital decisions about patient care. Studies on nurse intuition have been criticized for their lack of rigor and empirical evidence of the effect of nurse intuition on positive patient outcomes. The attributes of intuitive nursing practice have important implications in nursing applied to residents with BPSD. The nursing home nurse with extensive educational and experiential knowledge is well-situated to understand the complex, changing needs of residents exhibiting various forms of BPSD in an effort to communicate their needs. Future studies on nurse intuition should focus on early education in dementia care, nurse residency-mentor programs to enhance intuitive thinking in the management of BPSD, and more empirical studies on the use of intuition in the context of dementia care.

scholarly journals LESSONS LEARNED FROM NURSING HOME CIVIL MONETARY PENALTY PROJECTS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S770-S770
Author(s):  
Diana L Sturdevant ◽  
Kathleen C Buckwalter
Keyword(s):  
Nursing Home ◽  
Quality Of Care ◽  
Nursing Homes ◽  
Nursing Home Residents ◽  
Lessons Learned ◽  
Federal State ◽  
Future Research ◽  
Term Care ◽  
Home Setting

Abstract Nursing homes must comply with numerous federal/state regulations to receive Medicare and Medicaid funding. Failure to comply with these regulations can result in deficiency citations, and depending on the severity of the deficiency, a resulting Civil Monetary Penalty (CMP). Through the Centers for Medicare and Medicaid Services (CMS) Civil Monetary Penalty Reinvestment Program, CMP funds are reinvested to support activities that benefit nursing home residents and that protect or improve their quality of life or quality of care. This symposium presents some of the unique challenges, successes, failures, and surprise findings from CMP-funded nursing home quality improvement projects in two, predominantly rural Midwestern states: Oklahoma and Kansas. Dr. Williams presents findings of a pilot-study testing an adaptation of a successful family caregiver telehealth support intervention in the nursing home setting and implications for future research. Dr. Sturdevant shares successes, challenges, and unanticipated results from the “It’s Not OK to Fall” project, a comprehensive, 3 year fall prevention project implemented in Oklahoma nursing homes. Lastly, Ms. Round’s paper describes the implementation and findings of a Long-term Care Leadership Academy aimed at improving leadership and team building skills of three levels of nursing home staff, including Administrators/Directors’ of Nursing, RN/LPN charge nurses and certified nursing assistants. Discussant, Dr. Kathleen Buckwalter Ph.D., FAAN, RN, will discuss how principles of nursing home culture change provides a common framework for these projects and conclude by offering suggestions on how promotion of these principles might improve the quality of care provided by nursing homes.

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