PHYSICAL ACTIVITY IN NURSING HOME RESIDENTS AND THE ROLE OF NURSING STAFF

ObjectivesTo clarify the process of how caregivers in a nursing home integrate the perspectives of rehabilitation into their responsibilities through working with a physical therapist.DesignThis study was conducted under an action research approach.SettingThe target facility was a nursing home located in Japan. The researcher, a physical therapist, worked at the nursing home once a week from April 2016 to March 2017. During the study period, he created field notes focused on the dialogue and action of caregivers regarding care, responses of caregivers to the physical therapist and reflections as a physical therapist. Caregivers were also given a short informal interview about their relationship with the nursing home residents. For data analysis, two researchers discussed the content based on the field notes, consolidating the findings.ParticipantsThe participants were caregivers who worked at the target facility. Thirty-eight caregivers agreed to participate. Average age was 39.6±11.1 years, 14 (37%) were male and average caregiver experience was 9.8 years.ResultsTwo cycles of action research were conducted during the study period. There were four stages in the process of how caregivers in the nursing home integrated the perspectives of rehabilitation through their work with the physical therapist. First, caregivers resisted having the rehabilitation programme carried out in the unit because they perceived that rehabilitation performed by a physical therapist was a special process and not under their responsibility. However, the caregivers were given a shared perspective on rehabilitation by the physical therapist, which helped them to understand the meaning of care to adapt the residents’ abilities to their daily life. They practised resident-centred care on a trial basis, although with a sense of conflict between their new and previous role, which emphasised the safety of residents’ lives and personhood. The caregivers increased their self-efficacy as their knowledge and skills were supplemented by the physical therapist and his approval of their attempted care. They were then able to commit to their newly conceived specialty of care as a means of supporting the lives of residents.ConclusionsThe process of working with a physical therapist led to a change in caregivers’ perception and behaviours, which occurred in four stages: resistance to incorporation, recapture of other perspectives, conflicts and trials in the role of caregiver and transformation to a resident-centred perspective.

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Nursing Staff Knowledge and Beliefs about Pain in Elderly Nursing Home Residents with Dementia

Pain Research and Management ◽

10.1155/2007/518484 ◽

2007 ◽

Vol 12 (3) ◽

pp. 177-184 ◽

Cited By ~ 53

Author(s):

Sandra MG Zwakhalen ◽

Jan PH Hamers ◽

Rieneke HA Peijnenburg ◽

Martijn PF Berger

Keyword(s):

Nursing Home ◽

Nursing Homes ◽

Nursing Staff ◽

Educational Level ◽

Work Experience ◽

Pain Treatment ◽

Nursing Home Residents ◽

Knowledge And Beliefs ◽

Pain Prevalence ◽

Knowledge Deficits

BACKGROUND: Aging is known to be associated with a high prevalence (up to 80%) of persistent pain among residents of nursing homes. However, even with high pain prevalence rates, nursing home residents are at risk for undertreatment. Knowledge deficits and beliefs among nurses influence staff behaviour in pain assessment and management.OBJECTIVES: To develop a psychometrically sound questionnaire and to gather information about knowledge and beliefs of nursing staff regarding various aspects of pain in elderly patients with dementia. In addition, the differences among several categories of nurses (based on educational level and work experience) with respect to beliefs about pain were investigated.METHODS: Participants were 123 staff members of psychogeriatric wards in two nursing homes in the Netherlands (mean of 11.4 years of experience). Their results were compared with those of two groups of nurses, one consisting of 25 registered nurse PhD students in nursing science and the other consisting of 20 trainee pain nurse specialists.RESULTS: The main findings indicate that nursing home staff respondents showed knowledge deficits about several aspects of pain, even though they were satisfied about the way pain was assessed and treated at their wards. Specific knowledge deficits were found regarding pain treatment and medication in elderly nursing home residents. Staff educational level seemed to influence their beliefs and knowledge about pain in elderly nursing home patients.

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Advocacy for The Mentally Impaired Elderly: A Case Study Analysis

American Journal of Law & Medicine ◽

10.1017/s0098858800007656 ◽

1989 ◽

Vol 14 (4) ◽

pp. 353-376 ◽

Cited By ~ 1

Author(s):

Jeanie Kayser-Jones ◽

Marshall B. Kapp

Keyword(s):

Nursing Home ◽

Nursing Home Residents ◽

Self Advocacy ◽

State Laws ◽

Case Study Analysis ◽

Appropriate Treatment ◽

Mentally Impaired ◽

And Training

The authors present a case study to illustrate how a mentally impaired but socially intact nursing home resident, who had no one to act as an advocate for her, was denied appropriate treatment for an acute illness which ultimately resulted in her death. The case raises important questions about advocacy for the mentally-impaired, acutely-ill institutionalized patient. This Article explores the role of the advocate, how advocates are selected, what qualities and talents they should possess, and what responsibilities should be assigned to them. The authors suggest that nursing home residents should be encouraged to engage in self-advocacy to the greatest extent possible. The competent elderly should be urged to name their preferred advocates. Individuals who serve in advocacy roles should be advised to seek information regarding the patient's wishes from those who know the patient well. Furthermore, there is a need for quality education and training of those who serve in advocacy roles on behalf of nursing home residents, and state laws need to specify the responsibilities of persons who serve as advocates.

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The Role of Nursing Homes Architectural Design in Mitigating the Risk of COVID-19 Pandemics: The Case of Slovenia

Athens Journal of Architecture ◽

10.30958/aja.8-1-3 ◽

2022 ◽

Vol 8 (1) ◽

pp. 51-66

Author(s):

Vesna Žegarac Leskovar ◽

Vanja Skalicky Klemenčič

Keyword(s):

Nursing Home ◽

Nursing Homes ◽

Older People ◽

Architectural Design ◽

Nursing Home Residents ◽

The Elderly ◽

Evaluation Tool ◽

Negative Effect ◽

Disproportionate Number ◽

Role Of Nursing

Currently, many older people live in institutions for various social and health reasons. In Slovenia, this proportion is almost 5% of the population aged 65 and over. In the COVID-19 pandemic, the elderly proved to be the most vulnerable social group, as they are exposed to a number of comorbidities that increase the risk of mortality. At that time, nursing homes represented one of the most critical types of housing, as seen from a disproportionate number of infections and deaths among nursing home residents worldwide, including Slovenia. During the emergency, a number of safety protocols had to be followed to prevent the spread of infection. Unfortunately, it turned out that while the safety measures protected the nursing home residents, they also had a negative effect on their mental health, mainly due to isolation and social distancing. It follows that especially in times of epidemics of infectious respiratory diseases, the quality of life in nursing homes requires special attention. In this context, it is also necessary to consider whether and how an appropriate architectural design can help mitigating the spread of infections, while at the same time enable older people to live in dignity and with a minimum of social exclusion. To this end, the present study examined 97 nursing homes in Slovenia, analysing the number of infections in nursing homes and their correlation with the degree of infection in the corresponding region in Slovenia. Additionally, 2 nursing homes were studied in more detail with the use of newly developed “Safe and Connected” evaluation tool, analysing the architectural features of each building. The advantages identified so far include living in smaller units, single rooms with balconies, the possibility of using green open spaces and the use of an adequate ventilation. Conclusions of this study are useful for further consideration of design of new nursing homes and the refurbishment of existing ones.

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Restorative Virtual Environment Design for Augmenting Nursing Home Rehabilitation

Journal of Virtual Worlds Research ◽

10.4101/jvwr.v9i3.7224 ◽

2016 ◽

Vol 9 (3) ◽

Cited By ~ 6

Author(s):

Jon Ram Bruun-Pedersen ◽

Stefania Serafin ◽

Lise Busk Kofoed

Keyword(s):

Physical Activity ◽

Nursing Home ◽

Muscle Strength ◽

Intrinsic Motivation ◽

Virtual Environment ◽

Nursing Home Residents ◽

User Preferences ◽

Environment Design ◽

Design Considerations ◽

Home Users

With increasing age, muscle strength decreases excessively rapidly if physical activity is not maintained. However, physical activity is increasingly difficult with aging. This is due to balance, strength or coordination difficulties, arthritis, etc. Moreover, many nursing home residents become unable to experience natural surroundings. Augmenting a conventional biking exercise with a recreational virtual environment (RVE) has shown to serve as an intrinsic motivation contributor to exercise for nursing home residents. RVEs might be able to provide some of the health benefits that regular nature experiences do. More studies on content of proper custom designs for RVEs are necessary. This paper reviews the background for RVE design, describes four custom RVE designs for recreational VE exploration and presents user preferences among nursing home users concerning content and other pivotal design considerations.

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Serum Myostatin Levels Are Higher in Fitter, More Active, and Non-Frail Long-Term Nursing Home Residents and Increase after a Physical Exercise Intervention

Gerontology ◽

10.1159/000494137 ◽

2018 ◽

Vol 65 (3) ◽

pp. 229-239 ◽

Cited By ~ 7

Author(s):

Haritz Arrieta ◽

Gotzone Hervás ◽

Chloe Rezola-Pardo ◽

Fátima Ruiz-Litago ◽

Miren Iturburu ◽

...

Keyword(s):

Physical Activity ◽

Body Composition ◽

Nursing Home ◽

Physical Fitness ◽

Physical Activity Level ◽

Exercise Intervention ◽

Nursing Home Residents ◽

Exercise Program ◽

Activity Level

Background: Myostatin has been proposed as a candidate biomarker for frailty and sarcopenia. However, the relationship of myostatin with these conditions remains inconclusive. Objective: To determine the association of serum myostatin concentration with body composition, physical fitness, physical activity level, and frailty in long-term nursing home residents. We also aimed to ascertain the effect of an exercise program on myostatin levels. Methods: We obtained study data on 112 participants from long-term nursing homes. Participants were randomly assigned to a control or an intervention group and performed a 6-month multicomponent exercise program. Serum myostatin levels were analyzed by ELISA. Assessments also included body composition (anthropometry and bioelectrical impedance), physical fitness (Senior Fitness Test), physical activity level (accelerometry), and frailty (Fried frailty criteria, Clinical Frailty Scale, and Tilburg frailty indicator). Results: The concentration of myostatin at baseline was positively correlated with: a leaner body composition (p < 0.05), and a higher number of steps per day and light and moderate-vigorous physical activity in women (p < 0.005); greater upper and lower limb strength, endurance, and poorer flexibility (p < 0.05) in men; and better performance (less time) in the 8-ft timed up-and-go test in both women (p < 0.01) and men (p < 0.005). We observed higher concentrations of serum myostatin in non-frail than in frail participants (p < 0.05). Additionally, we found that the implemented physical exercise intervention, which was effective to improve physical fitness, increased myostatin concentration in men (p < 0.05) but not in women. The improvements in physical condition were related with increases in serum myostatin only in men (p < 0.05–0.01). Conclusions: Higher serum levels of myostatin were found to be associated with better physical fitness. The improvements in physical fitness after the intervention were positively related to increases in myostatin concentrations in men. These results seem to rule out the idea that high serum myostatin levels are indicative of frailty in long-term nursing home residents. However, although the direction of association was opposite to that expected for the function of myostatin, the use of this protein as a biomarker for physical fitness, rather than frailty, merits further study.

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