The Predictors of and Motivations for Increased Family Involvement in Nursing Homes

2018 ◽  
Vol 60 (3) ◽  
pp. 535-547 ◽  
Author(s):  
Amy Restorick Roberts ◽  
Karen J Ishler ◽  
Kathryn Betts Adams
Keyword(s):  
Nursing Homes ◽  
Family Member ◽  
Family Involvement ◽  
Qualitative Data ◽  
Family Members ◽  
Nursing Home Residents ◽  
Well Being ◽  
Multilevel Regression ◽  
Relationship Type ◽  
Loved One

Abstract Background and Objectives Quantitative and qualitative data from a statewide survey of family members of nursing home residents were analyzed to determine the predictors of, and motivations for, family involvement. Research Design and Methods We examined 3 types of involvement: visiting, providing personal care, and family–staff communication. Our mixed methods approach used (a) multilevel regression models to examine predictors of family involvement, including family member perceptions and resident, family member, and facility characteristics, and (b) a thematic analysis of qualitative data regarding the experiences of family members and their motivations for involvement. Results Families were more involved when a short-term stay (<3 months) was expected, and when residents were in poorer physical condition. Spouses and female family members were more involved than others, yet the effect of gender varied by relationship type. At the facility level, families of residents in rural facilities reported less family involvement. Aside from these commonalities, predictors of each type of involvement varied. Themes from the qualitative data identify unique motivations for each type of involvement—to enhance residents’ identity, care, or quality of life. Discussion Families visit more and provide more hands-on assistance when they are not confident in the care being provided or the well-being and stability of their resident loved one. Receiving adequate information, perceiving staff as friendly, and residents as looking well cared for promote greater family–staff communication. Implications Findings can inform strategies to increase meaningful family involvement in nursing homes.

scholarly journals From wave to wave: a Dutch national study on the long-term impact of COVID-19 on well-being and family visitation in nursing homes

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ramona Backhaus ◽  
Hilde Verbeek ◽  
Bram de Boer ◽  
Judith H. J. Urlings ◽  
Debby L. Gerritsen ◽  
...  
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Family Members ◽  
Nursing Home Residents ◽  
Well Being ◽  
Study Data ◽  
National Study ◽  
Long Term Effects ◽  
Long Term Impact

Abstract Background To protect nursing home residents, many governments around the world implemented blanket visitor bans in March and April 2020. As a consequence, family caregivers, friends, and volunteers were not allowed to enter nursing homes, while residents were not allowed to go out. Up until now, little is known on the long-term consequences and effects of visiting bans and re-opening of nursing homes. The aim of the study was to assess the long-term effects of the pandemic on residents, family members, and staff, and their preparedness for the next coronavirus wave. Methods A mixed-methods approach was used, consisting of a questionnaire and analyses of documentation (local visiting protocols). Of the 76 nursing home locations that participated in a Dutch national pilot on welcoming visitors back into nursing homes, 64 participated in this follow-up study. Data were collected in September/October 2020. For each nursing home, one contact person completed the questionnaire. Descriptive statistics were calculated for quantitative questionnaire data. Data on open-ended questions, as well as data from the documentation, were analyzed thematically. Results The study demonstrated that the consequences of strict visiting bans do not disappear at the moment the visiting ban is lifted. Although in October 2020, daily life in nursing homes was more “back to normal,” more than one-third of the respondents indicated that they still applied restrictions. Compared to the situation before the pandemic, fewer volunteers were working in the nursing homes, grandchildren visited their relative less often, and visits differed. Conclusions Five months after the visiting ban in Dutch nursing homes had been lifted, it still had an impact on residents, family members, and staff. It is questionable whether nursing homes feel prepared for welcoming visitors in the case of new COVID-19 infections. Nursing homes indicated that they felt prepared for the next wave, while at the same time, they were particularly concerned about staff well-being and vitality. It seems wise to invest in staff well-being. In addition, it seems desirable to think about how to support nursing homes in seeking a balance between infection prevention and well-being of residents, family members, and staff.

The effect of the implementation of a good medical practice booklet on nursing home residents’ drug prescriptions: a difference-in-differences analysis based on data from electronic pill dispensers (Preprint)

2019 ◽  
Author(s):  
Stéphane Sanchez ◽  
Cécile Payet ◽  
Marie Herr ◽  
Anne Dazinieras ◽  
Caroline Blochet ◽  
...  
Keyword(s):  
Nursing Homes ◽  
Medical Practice ◽  
Intervention Group ◽  
Medication Use ◽  
Nursing Home Residents ◽  
Control Group ◽  
Multilevel Regression ◽  
Difference In Differences ◽  
Good Medical Practice ◽  
The Impact

BACKGROUND The elderly are particularly exposed to adverse events from medication. Among the various strategies to reduce polypharmacy, educational approaches have shown promising results. OBJECTIVE We aimed to evaluate the impact of the implementation of a good medical practice booklet on polypharmacy in nursing homes. METHODS We identified nursing homes belonging to a geriatric care provider that had launched a policy of proper medication use using a good medical practice booklet delivered to prescribers and pharmacists. Data were derived from electronic pill dispensers. The effect of the intervention on polypharmacy was assessed with multilevel regression models, with a control group to account for natural trends over time. The main outcomes were the average daily number of times when medication was administered and the number of drugs with different presentation identifier codes per resident per month. RESULTS 96,216 residents from 519 nursing homes were included between 1 January 2011 and 31 December 2014. The intervention group and the control group both decreased their average daily use of medication (-0.05 and -0.06). The good medical practice booklet did not have a statistically significant effect (exponentiated difference-in-differences coefficient 1.00, 95% confidence interval 0.99-1.02, P=.45). CONCLUSIONS Although the good medical practice booklet itself did not seem effective in decreasing medication use, our data show the effectiveness of a higher-level policy to decrease polypharmacy.

Cognitive Decline and the Changing Self in Relationship

2015 ◽  
pp. 61-75
Author(s):  
Darby Morhardt ◽  
Marcia Spira
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Cognitive Decline ◽  
Family Member ◽  
Family Members ◽  
Well Being ◽  
Family Roles ◽  
The Family ◽  
Person With Dementia ◽  
The Impact

When a member of a family is diagnosed with Alzheimer's disease, the impact of the disease reverberates throughout the relationships within the family. This paper explores the challenges and strengths within one family as members manage and cope with Alzheimer's disease. The person with dementia and his family members are individually interviewed and each person explores the consequences of the disease on personal well-being as well as the relationships within the family. The family demonstrates how dementia in one family member demands flexibility in family roles as they navigate life through the challenges of living with dementia.

How Substance Problems Affect the Family Unit

2019 ◽  
pp. 72-78
Author(s):  
Dennis C. Daley ◽  
Antoine Douaihy
Keyword(s):  
Family Member ◽  
Family Life ◽  
Family Members ◽  
Emotional Pain ◽  
Loved One ◽  
Family Unit ◽  
The Family

A family unit is a system in which various parts have an impact on other parts. This chapter looks at how families, concerned others, and friends are affected by a loved one’s SUD. Any family member may be hurt by a loved one with an SUD. The effects may vary among families and among members within the same family, but emotional pain and disruption of family life are common. Attention often centers on the member with the SUD, while overall family pain and distress are ignored. Individuals with SUDs often “underfunction,” which means that other members of the family have to pick up the slack and “overfunction.” This dynamic may change how family members communicate or relate to one another. The effects on families vary from mild to severe—in which a family is torn apart by an SUD.

scholarly journals A Visual Analysis on How the Physical Environment Conditions Relatives’ Involvement in Nursing Homes

SAGE Open ◽  
2017 ◽  
Vol 7 (4) ◽  
pp. 215824401774039
Author(s):  
Jessica Holmgren
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Physical Environment ◽  
Visual Analysis ◽  
Nursing Home Residents ◽  
Well Being ◽  
Care Environment ◽  
Cultural Symbols ◽  
Information Displays ◽  
Physical Care

This study seeks to describe how the composition of the physical care environment conditions relatives’ involvement in nursing home institutions. It is well known that the physical care environment in institutions has a significant impact on the well-being of residents and the work satisfaction of nursing staff. Less explored is how physical care environmental factors are related to the involvement of relatives in nursing homes. A visual analysis of 52 photographs from three nursing homes in Sweden shows how the physical environment acts to condition the involvement of relatives through the use of design, information displays, and cultural symbols. Although various aspects of the physical environment promoted participation of relatives, that engagement was based on certain limited concepts of involvement. This suggests that other conceptual frameworks of involvement in nursing homes are possible, and that these might encourage other aspects of involvement from the relatives of nursing home residents.

Pain and symptoms of depression in older adults living in community and in nursing homes: the role of activity restriction as a potential mediator and moderator

2014 ◽  
Vol 26 (10) ◽  
pp. 1679-1691 ◽  
Author(s):  
Almudena López-Lopez ◽  
José L. González ◽  
Miriam Alonso-Fernández ◽  
Noelia Cuidad ◽  
Borja Matías
Keyword(s):  
Older Adults ◽  
Depressive Symptoms ◽  
Nursing Homes ◽  
Older People ◽  
Pain Intensity ◽  
Nursing Home Residents ◽  
Well Being ◽  
Community Dwelling ◽  
Activity Restriction

ABSTRACTBackground:Chronic pain is likely to lead to depressive symptoms, but the nature of this relationship is not completely clear. The aim of the present study is to analyze the role of activity restriction in the pain-depression relationship in older people, and to test the hypothesis that this role is more relevant in community-dwelling older people than in nursing home residents.Method:Depressive symptoms, pain intensity, and activity restriction were measured in a sample of 208 older adults with osteoarthritis, 102 living in nursing homes (NH), and 106 in the community. Analyses were carried out using moderation and moderated mediation analyses approach, treating activity restriction as a confounder.Results:Results showed a significant confounding effect of activity restriction, interaction effect between pain intensity and activity restriction on depression, and modifying effect of pain intensity on depression by adding activity restriction into the model. These results suggest a potential mediating and moderating effects of activity restriction. Moreover, analyses suggest that, surprisingly, the strength of the mediation could be higher in nursing homes.Conclusions:Overall, it may be that what is really important to emotional well-being is not so much pain itself, but rather the way in which the pain alters older people's lives. The greater strength of the mediation in NH might be understood within the scope of self-determination theory. Generally speaking, the NH context has been considered as a coercive setting, promoting non-autonomous orientation. In this context, when events are objectively coercive, people may lack perceived autonomy and hence be at greater risk of depression.

Recognition by family members that relatives with neurodegenerative disease are likely to die within a year: A meta-ethnography

2011 ◽  
Vol 26 (2) ◽  
pp. 108-122 ◽  
Author(s):  
G Hubbard ◽  
K McLachlan ◽  
L Forbat ◽  
D Munday
Keyword(s):  
Multiple Sclerosis ◽  
Palliative Care ◽  
Family Member ◽  
Health Professionals ◽  
Family Members ◽  
Well Being ◽  
Functional Abilities ◽  
Thematic Synthesis ◽  
To Receive ◽  
Health And Well Being

Objective: To synthesize evidence of family members recognizing that their relative is likely to die within the year, and identifying the need for palliative care. Design: A meta-ethnography of studies of family members in multiple sclerosis (MS), Parkinson’s disease (PD) and motor neuron disease (MND). Review methods: Systematic search in electronic databases; thematic synthesis guided by the principles of meta-ethnography, which is a method for thematic synthesis of qualitative studies. Results: Nine articles were included. The results of the synthesis identified two key themes. First, family members are intimately aware of changes in their relative’s health and well-being. Sub-themes include family member awareness of different and progressive stages of the disease, noticing deterioration, noticing decline in functional abilities and recognizing that their relative will die. The second key theme is dilemmas of being involved in prognostication. Sub-themes include family member ambivalence toward hearing about prognostication, health professionals not being knowledgeable of the disease and family reluctance to receive palliative care. Conclusions: Family members monitor and recognize changes in their relative with PD, MND and MS and in themselves. Thus, drawing on the expertise of family members may be a useful tool for prognostication.

What makes a nursing home a home? Insights from family members and friends

2017 ◽  
Vol 20 (4) ◽  
pp. 152-163 ◽  
Author(s):  
Lori Weeks ◽  
Stephanie Chamberlain ◽  
Janice Keefe
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Survey Data ◽  
Family Members ◽  
Nursing Home Residents ◽  
Models Of Care ◽  
Decision Makers ◽  
Public And Private ◽  
Content Type ◽  
Physical Spaces

Purpose The purpose of this paper is to explore the concept of homelikeness from the perspective of family members and friends of nursing home residents across different models of nursing homes. Design/methodology/approach This mixed-methods study examined survey data collected from 397 family members and friends of residents living in 23 nursing homes representing three models of care (traditional, new augmented, and full scope). Participants completed a homelikeness scale and a measure of the importance of nursing home spaces to family members and friends. This study also involved conducting three focus groups with 20 family members and friends to provide further insights into the findings. Findings Analysis of survey data indicated quite high levels of homelikeness overall. Significant differences did emerge between traditional model nursing homes compared to new full-scope and new augmented models for all items in the homelikeness scale and for many items about nursing home spaces. Qualitative results provided insights into how homelikeness can be fostered through public and private spaces and through care and relationships. Research limitations/implications As this study was conducted in one Canadian province, the results may not be applicable to other geographic areas. In addition, there are limitations in survey response rate. Practical implications Homelikeness can be supported across models of care by fostering relationships between residents and staff, ensuring that that family and friends feel welcome, and creating public and private physical spaces that are conducive to new and ongoing relationships. Originality/value The results provide evidence to nursing home decision makers about how to foster a homelike environment in various models of nursing homes.

Deathbed Visions from the Republic of Moldova: A Content Analysis of Family Observations

2012 ◽  
Vol 64 (4) ◽  
pp. 303-317 ◽  
Author(s):  
Allan Kellehear ◽  
Vadim Pogonet ◽  
Rodica Mindruta-Stratan ◽  
Victor Gorelco
Keyword(s):  
Content Analysis ◽  
Family Member ◽  
Well Being ◽  
Loved One ◽  
Republic Of Moldova ◽  
The Republic ◽  
Deathbed Visions ◽  
And Control ◽  
Significant Support

This is an interview-based study of 102 families and their observations of the last weeks and days of a dying family member. Forty-one families reported hearing about “visions,” “hallucinations,” or “dreams” from their dying loved one before their death. Of these 41 mixed cases, 37 cases demonstrated classic features of deathbed visions—reports of seeing dead relatives or friends communicating to the dying person. This article reports a content analysis of these 37 cases in order to identify the major psychosocial themes that seem to be conveyed by these kinds of experiences. Six major themes are identified. These themes are: support, comfort, companionship, reunion, prognosis, and choice and control. Implications of these themes are discussed in relation to their role in providing significant support for the psychological morale and social well being of dying people.

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