scholarly journals FINDINGS FROM THE ALZHEIMER’S POETRY PROJECT LONG-TERM CARE IMPLEMENTATION STUDY

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S198-S198
Author(s):  
Daniel B Kaplan ◽  
Gary Glazner
Keyword(s):  
Nursing Homes ◽  
Social Engagement ◽  
Care Staff ◽  
Pharmacological Intervention ◽  
Mapping Technique ◽  
Intellectual Stimulation ◽  
Term Care ◽  
Track Record ◽  
Creative Self ◽  
Arts Programming

Abstract Dementia interventions grounded in group participation in the cultural arts (e.g., poetry, storytelling, music, and dance) have been growing in reach in recent decades. Yet this growth has been stymied by a lack of empirical evidence to demonstrate measurable outcomes. In the current IRB-approved research study, the Alzheimer’s Poetry Project (APP), in partnership with 15 Wisconsin nursing homes, provided staff training in an innovative non-pharmacological intervention for people living with dementia. The goal of APP is to facilitate creative self-expression, social and intellectual stimulation, respectful acceptance, validation of personhood, and valued inclusion of people living with Alzheimer's disease and other dementias through the performance and creation of poetry. APP’s proven track record at over 500 facilities in 34 states and six countries internationally, serving over 40,000 people worldwide, demonstrates APP’s ability to bring high-quality creative arts programming to people living with dementia. Through the implementation of APP in three groups of five nursing homes in Wisconsin, activities and care staff were trained to deliver the intervention over three-month periods. After training was completed, researchers evaluated and compared APP to non-arts programming in the same facilities. A novel dementia arts mapping technique was created to document observable impacts of interventions on social engagement, alertness, vocalization, vocabulary, affect, and self-expression. 35 interventions were documented, and variability in participant experiences reveal significantly greater impacts on personhood and creativity during the 11 APP interventions than during the 24 non-arts interventions. Implications for promoting dementia care programming grounded in group participatory arts will be discussed.

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
Keyword(s):  
Quality Of Life ◽  
Nursing Home ◽  
Nursing Homes ◽  
Long Term Care ◽  
Community Dwelling ◽  
Care Staff ◽  
Term Care ◽  
The Impact

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.

scholarly journals Poetry Brings Out the Best in Us: Structured Poetry-Based Group Activity in Long-Term Care

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 692-692
Author(s):  
Daniel Kaplan ◽  
Gary Glazner
Keyword(s):  
Long Term Care ◽  
Dementia Care ◽  
Care Staff ◽  
Creative Arts ◽  
Care Providers ◽  
Term Care ◽  
Indirect Benefits ◽  
Track Record ◽  
Direct Benefits

Abstract The Alzheimer’s Poetry Project has a proven track record at over 500 facilities in 35 states and six countries, serving over 50,000 people worldwide, and has the ability to bring high-quality creative arts programming to people living with dementia in long-term care. We describe how volunteers and recreation and care staff can be trained to deliver the intervention, offering direct benefits for participants and indirect benefits when modeled in the presence of providers and family members. Basic validation techniques are easily learned and incorporated into diverse dementia care strategies. As activity programs based in creative arts help to support self-expression among participants and serve as a vehicle for generating feelings of self-efficacy, we explain how such activities are well suited to fostering the person-centered goals of dementia care programming. Clinicians and other transdisciplinary care providers are encouraged to use and teach validation-focused arts interventions with persons living with dementia.

Programme d'intervention visant à réduire l'utilisation des contentions physiques dans des unités de soins de longue durée — mise en oeuvre et effets sur le personnel soignant

2002 ◽  
Vol 21 (4) ◽  
pp. 559-576 ◽  
Author(s):  
Pierre J. Durand ◽  
Jean-Paul Ouellet ◽  
Line Beauchesne ◽  
André Tourigny ◽  
René Verreault ◽  
...  
Keyword(s):  
Nursing Homes ◽  
Care Staff ◽  
Controlled Clinical Trial ◽  
Staff Perceptions ◽  
Term Care ◽  
Restraint Reduction ◽  
Post Test ◽  
Personnel Soignant

ABSTRACTThis study aimed at (a) developing a restraint reduction program, (b) describing its implementation in long-term care units, and (c) examining its effects on care staff's perceptions of and knowledge about the use of restraints. The program was composed of three parts: consciousness-raising meetings, staff education, and clinical follow-up. The study was a randomized, controlled clinical trial with eight intervention care units (five nursing homes) and 11 controls (five additional nursing homes). Care staff was surveyed at two time intervals over a 7-month period (pre- and post-test intervention; intervention care units: N = 171 [T0] and N = 158 [T1]; controls: N = 181 [T0] and N = 166 [T1]). The implementation of the program was successful and results showed significant changes in care staff perceptions of and knowledge about the use of restraints.

scholarly journals 468 - Can a Robotic Seal Called PARO Manage Chronic Pain in People with Dementia Living in Nursing Homes?

2020 ◽  
Vol 32 (S1) ◽  
pp. 190-190
Author(s):  
Lihui Pu ◽  
Wendy Moyle ◽  
Cindy Jones ◽  
Michael Todorovic
Keyword(s):  
Chronic Pain ◽  
Nursing Home ◽  
Nursing Homes ◽  
Usual Care ◽  
Rating Scale ◽  
Nursing Home Residents ◽  
Care Staff ◽  
Term Care ◽  
Randomized Controlled ◽  
People With Dementia

AbstractObjective: To evaluate the effect of interaction with a robotic seal (PARO) for pain management in nursing home residents living with dementia.Methods: Registered with the Australian New Zealand Clinical Trials Registry (ACTRN 12618000082202), a pilot randomized controlled trial followed by semi-structured interviews were conducted between January 2018 and January 2019. Forty-three residents aged ?65 years living with dementia and chronic pain were recruited from three nursing homes in Australia. Participants were randomized to either a PARO group (individual, non-facilitated, 30-minute sessions, five days per week for six weeks) or a usual care group using a computer-generated random number. Observational pain behaviors were rated by researchers using the Pain Assessment in Advanced Dementia (PAINAD) scale and staff-rated pain levels were measured by the numeric rating scale. Medications regularly prescribed and as needed were quantified by the Medication Quantification Scale-III (MQS-III). Generalized estimating equation model and thematic analysis were used to analyze the data.Results: Participants in the PARO group had significantly lowered level of observed pain (-0.514, 95% confidence interval [CI] -0.774 to -0.254, p<0.001) and used fewer PRN medications (-1.175, 95% CI - 2.205 to -0.145, p=0.025) than those in usual care after controlling for age, gender, cognitive function and medications at baseline. There were no significant differences in staff-rated pain levels and regularly scheduled medications between the two groups. Interviews also indicated that the PARO intervention may reduce the pain experience through distraction and reminiscence of previous positive memories. Limitations of weight, voice and characteristics of PARO were identified.Conclusions and Implications: PARO shows promise in reducing pain and medications for nursing home residents living with dementia and chronic pain. This intervention might be incorporated into daily practice as an alternative to manage pain in people with dementia. Care staff need to balance the benefits and limitations of incorporating social robots into their clinical practice and residents’ individualized preferences need to be considered. Larger randomized controlled trials with longer time frames are warranted to further test the use of PARO in long-term care settings.

scholarly journals A NARRATIVE STUDY TO CONNECT THE GERONTOLOGY: THE ELDERLY CHARACTERS IN NURSING HOMES FIRE NEWS IN TAIWAN

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S197-S198
Author(s):  
Sheng-Chin HSU
Keyword(s):  
Nursing Homes ◽  
Care Center ◽  
The Elderly ◽  
Care Staff ◽  
Term Care ◽  
Narrative Study ◽  
Fire Accidents ◽  
Fire Accident ◽  
Taking Care

Abstract There are more than 30 civilian deaths in 10 fire accidents in nursing homes since 2008 in Taiwan. Due to the collective space of nursing homes, the damages of fires in a facility are much worse than in a personal house. Since the type of family changed after The Chinese Civil War, the elderly members, retired from the labor market, like to choose to live in nursing homes, or hospitals. According to the Ministry of Interior, R.O.C., Taiwan turned into an Aged society in 2018. In those fire news, the duties of families are seldom discussed, but the duties of care center are emphasized. The narrative of a fire accident in nursing homes is composed of many elements. These elements have been connected with old people and various arrangements. It is important to understand how the duties shifting from families to nursing homes, and what characters and relationship disappear in a fire accident. This study adopts the narrative theory to analyze the characters in fire report about Nursing Homes. Three findings are discovered: first, the duties of taking care of elders in a nursing home fire are connecting to Care Facilities but not families nor government. Second, the role of taking care of older people is played by Care-Staff more than family members in a fire narrative. Finally, the duty of fire and the duty of taking care of elders are interwoven into a complicated narrative: the role of Long-Term Care Center emerges but family and government disappear.

scholarly journals “We are Scapegoats”: Front-Line Nursing Home Staff Experiences During the COVID-19 Pandemic

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 965-966
Author(s):  
Elizabeth White ◽  
Terrie Wetle ◽  
Ann Reddy ◽  
Rosa Baier
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Organizational Communication ◽  
Media Coverage ◽  
Direct Care ◽  
Care Staff ◽  
Term Care ◽  
Convenience Sample ◽  
Nursing Home Staff

Abstract The COVID-19 pandemic is an unprecedented challenge for nursing homes, where staff have faced rapidly evolving circumstances to care for a vulnerable resident population. To document these healthcare professionals’ experiences during the pandemic, we used social media and professional networks to disseminate an electronic survey with closed- and open-ended questions to a convenience sample of long-term care staff from May 11 through June 4, 2020. Four investigators identified themes from qualitative responses for 152 nursing home staff respondents from 32 states. Key themes included: constraints on personal protective equipment (PPE) and testing; burdensome regulations and guidance; concern for self, family, and residents; workforce burnout; organizational communication and teamwork; and public lack of recognition. Respondents described ongoing constraints on testing, and reliance on crisis standards for extended use and reuse of PPE. Administrators discussed implementing sometimes confusing or contradictory guidance from numerous agencies. Direct-care staff expressed fears of infecting themselves and their families, and expressed empathy and concern for their residents. They described burnout due to increased workloads and the emotional burden of caring for residents facing isolation, illness, and death. Respondents cited the presence or lack of organizational communication and teamwork as factors influencing their ability to work under challenging circumstances. They also described the demoralizing impact of negative media coverage of nursing homes, contrasting this with the heroic public recognition given to hospital staff. These challenges added significant burden to an already strained workforce and are likely to contribute to increased burnout, turnover, and staff shortages in the long-term.

scholarly journals Exploring Barriers and Facilitators to the Implementation of Pet Robots for People With Dementia in Nursing Homes: A Qualitative Research Protocol

2021 ◽  
Vol 20 ◽  
pp. 160940692110470
Author(s):  
Wei Qi Koh ◽  
Elaine Toomey ◽  
Dympna Casey
Keyword(s):  
Nursing Homes ◽  
Social Engagement ◽  
Research Process ◽  
Barriers And Facilitators ◽  
Framework Analysis ◽  
Term Care ◽  
People With Dementia ◽  
Key Stakeholders ◽  
Multi Level

People living with dementia, especially those who live in nursing homes, are susceptible to social isolation and activity disengagement. Pet robots are technology-based substitutes to animal-assisted therapy that have demonstrated positive impacts on people with dementia in long term care settings, such as reducing agitation, improving mood and increasing social engagement. Nevertheless, knowledge about the issues influencing their implementation is lacking, as there is a scarcity of research that have explicitly investigated the barriers and facilitators influencing their implementation in real-world practice. The objective of this study is to understand the multi-level barriers and facilitators to the implementation of pet robots for people with living dementia in nursing homes, from the perspectives of key stakeholders. A qualitative study employing a descriptive qualitative approach will be used. The Consolidated Framework of Implementation Research (CFIR) will be used to guide the research process. Multi-level stakeholders, including people living with dementia, healthcare professionals and organisational decision makers in nursing homes, will be recruited for one-to-one interviews. Data will be analysed through framework analysis, using a combination of both deductive (based on the constructs and domains in the CFIR) and inductive approaches. To the best of our knowledge, this will be the first study to explore multi-level determinants to the implementation of pet robots in nursing homes for people living with dementia. Findings will be used to inform the identification of strategies that may be used to guide the implementation of pet robots for people living with dementia in nursing homes.

Development of the Care Environment Scale–Long-Term Care

2018 ◽  
Vol 29 (3) ◽  
pp. 169-176
Author(s):  
Marie Boltz ◽  
Kyung Hee Lee ◽  
Joseph Shuluk ◽  
Michelle Secic
Keyword(s):  
Nursing Homes ◽  
Performance Improvement ◽  
Content Validity ◽  
Long Term Care ◽  
Care Staff ◽  
Term Care ◽  
Care Environment ◽  
Environment Scale ◽  
K 12

A critical dimension of Quality Assurance and Performance Improvement (QAPI) activity in long-term care is an analysis of the care environment, that is, the way care and services are organized. The purpose of this study was to develop and pilot test a psychometrically sound tool that long-term care staff could use to assess the care environment and guide performance improvement activity. Focus groups with 57 interdisciplinary participants in five nursing homes developed initial items, with excellent content validity (item content validity index = 1.0) evaluated by an expert panel. Pilot testing of internal consistency of the Care Environment Scale–Long-Term Care (CES-LTC) was conducted in a web-based administration of the items by 425 interdisciplinary staff members in 30 nursing homes and four assisted living facilities. The CES-LTC is internally consistent (Cronbach’s alpha = .90) and accounts for approximately 71.6% of the total variance. The three factors extracted from the exploratory factor analysis are Institutional Values ( k = 6), Access to Resources ( k = 10), and Person-Centered Approaches ( k = 12). Intrarater reliability in a subsample of 66 registered nurses revealed good test-retest results (overall intraclass correlation coefficients [ICC] = 0.78). The CES-LTC appears to be a valid and reliable measure of staff perceptions of the care environment and may be used to actively engage staff in QAPI endeavors including root cause analyses and improvement activity.

Pharmacology Issues Related to Dementia Syndrome of Depression in Elderly Residents of Long-Term Care Settings

2015 ◽  
Vol 25 (2) ◽  
pp. 61-69
Author(s):  
Angel L. Ball ◽  
Adina S. Gray
Keyword(s):  
Depressive Symptoms ◽  
The Elderly ◽  
Environmental Communication ◽  
Pharmacological Intervention ◽  
Team Approach ◽  
Discussion Paper ◽  
Term Care ◽  
Anticholinergic Medications ◽  
Inappropriate Treatment ◽  
Dementia Syndrome

Pharmacological intervention for depressive symptoms in institutionalized elderly is higher than the population average. Among the patients on such medications are those with a puzzling mix of symptoms, diagnosed as “dementia syndrome of depression,” formerly termed “pseudodementia”. Cognitive-communicative changes, potentially due to medications, complicate the diagnosis even further. This discussion paper reviews the history of the terminology of “pseudodementia,” and examines the pharmacology given as treatment for depressive symptoms in the elderly population that can affect cognition and communication. Clinicians can reduce the risk of misdiagnosis or inappropriate treatment by having an awareness of potential side effects, including decreased attention, memory, and reasoning capacities, particularly due to some anticholinergic medications. A team approach to care should include a cohesive effort directed at caution against over-medication, informed management of polypharmacology, enhancement of environmental/communication supports and quality of life, and recognizing the typical nature of some depressive signs in elderly institutionalized individuals.

Communication Disordered: Program Implementation in Long-Term Care

2016 ◽  
Vol 1 (15) ◽  
pp. 64-67
Author(s):  
George Barnes ◽  
Joseph Salemi
Keyword(s):  
Program Implementation ◽  
Long Term Care ◽  
Family Satisfaction ◽  
Regulatory Compliance ◽  
Care Staff ◽  
Term Care ◽  
Staff Members ◽  
Change Policy

The organizational structure of long-term care (LTC) facilities often removes the rehab department from the interdisciplinary work culture, inhibiting the speech-language pathologist's (SLP's) communication with the facility administration and limiting the SLP's influence when implementing clinical programs. The SLP then is unable to change policy or monitor the actions of the care staff. When the SLP asks staff members to follow protocols not yet accepted by facility policy, staff may be unable to respond due to confusing or conflicting protocol. The SLP needs to involve members of the facility administration in the policy-making process in order to create successful clinical programs. The SLP must overcome communication barriers by understanding the needs of the administration to explain how staff compliance with clinical goals improves quality of care, regulatory compliance, and patient-family satisfaction, and has the potential to enhance revenue for the facility. By taking this approach, the SLP has a greater opportunity to increase safety, independence, and quality of life for patients who otherwise may not receive access to the appropriate services.

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