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 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.

Nursing home prices and market structure: the effect of assisted living industry expansion

2013 ◽  
Vol 9 (1) ◽  
pp. 95-112 ◽  
Author(s):  
John R. Bowblis
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Home Care ◽  
Market Structure ◽  
Assisted Living ◽  
Nursing Home Care ◽  
Assisted Living Facilities ◽  
Home Market ◽  
Home Prices ◽  
The Relationship

AbstractSince the 1990s, there has been substantial expansion of facility-based alternatives to nursing home care, such as assisted living facilities. This paper analyzes the relationship between expansion of the assisted living industry, nursing home market structure and nursing home private pay prices using a two-year panel of nursing homes in the State of Ohio. Fixed effect regressions suggest that the expansion of assisted living facilities are associated with increased nursing home concentration, but find no effect on private pay nursing home prices. This would be consistent with assisted livings reducing demand for nursing homes by delaying entry into a nursing home, though assisted livings are not direct competitors of nursing homes.

The dark side of Norwegian nursing homes: factors influencing inadequate care

2014 ◽  
Vol 16 (3) ◽  
pp. 133-151 ◽  
Author(s):  
Wenche Malmedal ◽  
Randi Hammervold ◽  
Britt-Inger Saveman
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Nursing Home Care ◽  
Survey Study ◽  
Dark Side ◽  
Content Type ◽  
Care Giving ◽  
Abuse And Neglect ◽  
Different Types ◽  
Inadequate Care

Purpose – The purpose of this paper is to investigate factors that influence the probability that staff will commit acts of inadequate care, abuse, and neglect. Design/methodology/approach – A cross-sectional survey study was carried out in one county in the middle of Norway (Sør-Trøndelag). Random sampling, stratified by size of nursing homes, and location (rural or urban areas), was used to select a variety of nursing homes from a total population of 55 nursing homes. All staff working in 16 nursing homes working were asked to participate in the study. A response rate of 79 per cent was achieved (n=616). Findings – Findings reveal that location and size of the nursing home, age of the staff, education level, job satisfaction, resident aggression, and conflicts between residents and staff predict inadequate care, abuse, and neglect. The most consistent findings are that resident aggression increases the risk for all three types of inadequate care, and that conflicts predict different types of inadequate care depending on whether the conflicts are related to direct care-giving activities or not. Practical implications – Nursing home care is an important part of care for the elderly, and should be characterized by good-quality services. The relation between inadequate care and resident aggression, conflicts, and other factors shown in this study points to the relevance of further improvements in nursing home practices to minimize the occurrence of episodes of inadequate care, abuse, and neglect. Originality/value – This study investigated the relationships between 11 specific factors and different types of inadequate care in a nursing home context.

The High Price of Obesity in Nursing Homes

2015 ◽  
Vol 16 (1) ◽  
pp. 14-19 ◽  
Author(s):  
Cindy L. Marihart ◽  
Ardith R. Brunt ◽  
Angela A. Geraci
Keyword(s):  
Older Adults ◽  
Nursing Home ◽  
Nursing Homes ◽  
Home Care ◽  
The United States ◽  
Nursing Home Care ◽  
Health Concern ◽  
High Price ◽  
Obese Adults ◽  
Obese People

This article provides a commentary on the costs of obese nursing home patients. We conducted a comprehensive literature search, which found 46 relevant articles on obesity in older adults and effects on nursing home facilities. This review indicated obesity is increasing globally for all age groups and older adults are facing increased challenges with chronic diseases associated with obesity more than ever before. With medical advances comes greater life expectancy, but obese adults often experience more disabilities, which require nursing home care. In the United States, the prevalence of obesity in adults aged 60 years and older increased from 9.9 million (23.6%) to 22.2 million (37.0%) in 2010. Obese older adults are twice as likely to be admitted to a nursing home. Many obese adults have comorbidities such as Type 2 diabetes; patients with diabetes incurred 1 in every 4 nursing home days. Besides the costs of early entrance into nursing facilities, caring for obese residents is different than caring for nonobese residents. Obese residents have more care needs for additional equipment, supplies, and staff costs. Unlike emergency rooms and hospitals, nursing homes do not have federal requirements that require them to serve all patients. Currently, some nursing homes are not prepared to deal with very obese patients. This is a public health concern because there are more obese people than ever in history before and the future appears to have even a heavier generation moving forward. Policymakers need to become aware of this serious gap in nursing home care.

scholarly journals Nurse-Patient Interaction: A Vital Salutogenic Resource in Nursing Home Care

2021 ◽  
pp. 117-136
Author(s):  
Gørill Haugan
Keyword(s):  
Older Adults ◽  
Health Promotion ◽  
Nursing Home ◽  
Nursing Homes ◽  
Home Care ◽  
Nursing Home Residents ◽  
Nursing Home Care ◽  
Patient Interaction ◽  
Health Promoting ◽  
To Come

AbstractWe are now witnessing a major change in the world’s population. Many people globally grow very old: 80, 90, and 100 years. Increased age is followed by an increased incidence of functional and chronic comorbidities and diverse disabilities, which for many leads to the need for long-term care in a nursing home. Quality of life and health promotive initiatives for older persons living in nursing homes will become ever more important in the years to come. Therefore, this chapter focuses on health promotion among older adults living in nursing homes. First, this chapter clarifies the concepts of health, salutogenesis, and pathogenesis, followed by knowledge about health promotion. Then insight and knowledge about the nursing home population is provided; what promotes health and well-being in nursing home residents?Health promotion in the health services should be based on integrated knowledge of salutogenesis and pathogenesis. The salutogenic understanding of health is holistic and considers man as a wholeness including physical, mental, social, and spiritual/existential dimensions. Research indicates that various health-promoting interventions, specifically the nurse–patient interaction, influence on older adults in nursing homes as a wholeness of body–soul–spirit, affecting the whole being. Hence, dimensions such as pain, fatigue, dyspnea, nausea, loneliness, anxiety, and depressive symptoms will be influenced through health-promoting approaches. Therefore, two separate studies on the health-promoting influences of nurse–patient interaction in nursing home residents were conducted. In total, nine hypotheses of directional influence of the nurse–patient interaction were tested, all of which finding support.Along with competence in pain and symptom management, health-promoting nurse–patient interaction based on awareness and attentional skills is essential in nursing home care. Thus, health care workers should be given the opportunity to further develop their knowledge and relational skills, in order to “refine” their way of being present together with residents in nursing homes. Health professionals’ competence involves the “being in the doing”; that is, both the doing and the way of being are essential in health and nursing care.

scholarly journals Challenges in Current Nursing Home Care in Rural Germany and How They Can Be Reduced by Telehealth - an Exploratory Pre-post Study

2021 ◽  
Author(s):  
Susann May ◽  
Kai Jonas ◽  
Thomas Zahn ◽  
Martin Heinze ◽  
Felix Mühlensiepen
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Home Care ◽  
Rural Areas ◽  
Qualitative Content Analysis ◽  
Nursing Home Residents ◽  
Nursing Home Care ◽  
Alternative Form ◽  
Supporting Evidence ◽  
Existing Structures

Abstract BackgroundTelemedical care of nursing home residents in Germany, especially in rural areas, is limited to a few pilot projects and is rarely implemented as part of standard care. The possible merits of implementing video consultations in longer-term nursing care currently lack supporting evidence. In particular, there is little documentation of experiences and knowledge about the effects and potential benefits of the implementation in presently existing structures. ObjectiveThe goal was to assess the effect of implement medical video consultations into nursing home care addressing the following research questions:- How is medical care currently provided to nursing home residents, and where do problems in its implementation arise? - How can video consultations be used to reduce difficulties arising in everyday care? - How does implementation of video consultations impact day-to-day nursing home care delivery?MethodsTwenty-one guided interviews (pre-implementation n=13; post-implementation n=8) were conducted with a total of 13 participants (physicians, nurses and medical technical assistants). Narratives were analysed using qualitative content analysis. The results were contrasted in a pre-post analysis.ResultsChallenges described by the participants before implementation included a requirement for additional organisational and administrative efforts, interruptions in the daily care routine or delayed treatments, and risk for loss of patient-relevant information due to process diversity. After implementation, communication was facilitated upon introduction of assigned time slots for video consultations. Clinical information was less likely to be lost, additional work was spared, and medication and therapeutic and assistive devices were provided more quickly.ConclusionsTelehealth cannot replace physical, in-person visits, but does offer an alternative form of service delivery when properly integrated into existing structures. Our results suggest that the use of video consultations in nursing homes can reduce the burden and additional workload, and increase the efficiency of care provision for nursing home residents. Video consultations can complement in-person visits to nursing homes, especially to address the shortage of medical specialists in rural areas in Germany. To promote implementation and acceptance of video consultation in nursing homes, we need to increase awareness of its benefits and undertake further evaluation of video consultations in nursing home care.

The Ties That Bind: Life Care Contracts and Nursing Homes

1982 ◽  
Vol 8 (2) ◽  
pp. 152-173
Author(s):  
Lawrence R. Leonard
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Home Care ◽  
Living Conditions ◽  
Nursing Home Care ◽  
Financial Instability ◽  
Life Care ◽  
Potential Problems

AbstractApproximately 1.3 million of our nation's elderly live in nursing homes. Despite the increasingly important role of Medicare and Medicaid, many must bear the costs of their care. This Note examines one means of financing nursing home care—the life care contract. These require residents to pay an entrance fee and transfer to the nursing home all or part of their property in return for the home's promise to provide care for the remainder of the resident's life. The Note discusses the potential problems a life care resident may face, such as substandard living conditions or a home's financial instability. It concludes by delineating steps that potential residents can take in constructing life care contracts to ensure protection of their rights and needs.

Amazing numbers and bottom rankings: the reporting of nursing home resident user surveys in the press

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Elisabeth Carlstedt ◽  
Håkan Jönson
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Media Representations ◽  
Nursing Home Care ◽  
User Survey ◽  
Content Type ◽  
User Perceptions ◽  
Nursing Home Quality ◽  
Survey Results ◽  
Media Reports

PurposeMedia reporting is one of many circumstances that nursing homes have to relate to, because of the reputational risks. The aim of this article is to investigate media representations of Swedish nursing homes in relation to reports on an annual national user survey.Design/methodology/approachThe empirical data consist of 381 Swedish newspaper articles about the survey results. The questions guiding the analysis were: what messages on nursing homes are communicated, and how are claims organized in order to appear factual?FindingsThe data show that press reports focus on comparisons of care units' survey results, eldercare representatives' explanations of the results, and what improvements will be made in order to do better in the next year's survey. With their use of truth-making rhetoric, press articles construct survey results as credible and valid, thus mirroring user perceptions and ultimately nursing home quality. The selection of nursing home representatives' comments equally reinforces the validity of claims.Originality/valueGiven nursing homes' problems with demonstrating success, the authors argue that media reports on the user survey is a way for eldercare organizations to achieve results in an otherwise resultless field, and while media reports might be seen as prompting change in nursing home care, what is ultimately achieved is the legitimation of a costly survey with low response rate.

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