Person-Centered Care in Nursing Homes: Potential of Complementary and Alternative Approaches and Their Challenges

2021 ◽  
pp. 073346482110236
Author(s):  
Kallol Kumar Bhattacharyya ◽  
Jennifer Craft Morgan ◽  
Elisabeth O. Burgess
Keyword(s):  
Nursing Homes ◽  
Medical Model ◽  
Social Model ◽  
Care Needs ◽  
Person Centered Care ◽  
Wide Range ◽  
Centered Care ◽  
Alternative Approaches ◽  
Traditional Medical Model ◽  
Complementary And Alternative

A person-centered approach to care shifts the mind-set of care partners from a traditional medical model to a social model in managing chronic conditions. Using a qualitative descriptive approach, this study examines the barriers and facilitators to the implementation of person-centered care (PCC) and how the integration of complementary and alternative approaches (CAA) has the potential to improve residents’ quality of life in nursing homes (NHs). Findings indicate that NHs offer a wide range of engagement activities, but these activities are not purposefully integrated into a person-centered plan of care. Factors such as turnover, “working short,” supervisor support, and rising resident care needs make it challenging to implement PCC in NHs. This knowledge of the landscape of activities will help us identify and improve strategies for supporting residents at a deeper, more meaningful level. CAA has the potential to be therapeutic for residents if integrated into collaborative approaches to care.

Servicing the Senior Swallow: A Family-Centered Private Practice Model of Service Delivery

2020 ◽  
pp. 1-4 ◽  
Author(s):  
Yvette M. McCoy
Keyword(s):  
Older Adults ◽  
Medical Model ◽  
Recovery Process ◽  
Swallowing Disorders ◽  
Current Evidence ◽  
Care Needs ◽  
Skilled Nursing ◽  
Person Centered Care ◽  
Centered Care ◽  
Traditional Medical Model

Purpose Person-centered care shifts the focus of treatment away from the traditional medical model and moves toward personal choice and autonomy for people receiving health services. Older adults remain a priority for person-centered care because they are more likely to have complex care needs than younger individuals. Even more specifically, the assessment and treatment of swallowing disorders are often thought of in terms of setting-specific (i.e., acute care, skilled nursing, home health, etc.), but the management of dysphagia in older adults should be considered as a continuum of care from the intensive care unit to the outpatient multidisciplinary clinic. In order to establish a framework for the management of swallowing in older adults, clinicians must work collaboratively with a multidisciplinary team using current evidence to guide clinical practice. Private practitioners must think critically not only about the interplay between the components of the evidence-based practice treatment triad but also about the broader impact of dysphagia on caregivers and families. The physical health and quality of life of both the caregiver and the person receiving care are interdependent. Conclusion Effective treatment includes consideration of not only the patient but also others, as caregivers play an important role in the recovery process of the patient with swallowing disorders.

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.

scholarly journals Using an Interactive App for Symptom Reporting and Management Following Pancreatic Cancer Surgery to Facilitate Person-Centered Care: Descriptive Study

10.2196/17855 ◽  
2020 ◽  
Vol 8 (6) ◽  
pp. e17855 ◽  
Author(s):  
Tina Gustavell ◽  
Kay Sundberg ◽  
Ann Langius-Eklöf
Keyword(s):  
Health Care ◽  
Pancreatic Cancer ◽  
Self Care ◽  
Symptom Burden ◽  
Symptom Reporting ◽  
Activity Levels ◽  
Care Needs ◽  
Person Centered Care ◽  
Centered Care ◽  
Care Activity

Background Pancreatic and periampullary cancers are rare but have high mortality rates. The only hope for cure is surgical removal of the tumor. Following pancreatic surgery, the patients have a great deal of responsibility for managing their symptoms. Patients report a lack of sufficient knowledge of self-care and unmet supportive care needs. This necessitates a health care system responsive to these needs and health care professionals who pay close attention to symptoms. Person-centered care is widely encouraged and means a shift from a model in which the patient is the passive object of care to a model involving the patient as an active participant in their own care. To address the challenges in care following pancreatic cancer surgery, an interactive app (Interaktor) was developed in which patients regularly report symptoms and receive support for self-care. The app has been shown to reduce patients’ symptom burden and to increase their self-care activity levels following pancreaticoduodenectomy due to cancer. Objective The aim of the study was to describe how patients used the Interaktor app following pancreaticoduodenectomy due to cancer and their experience with doing so. Methods A total of 115 patients were invited to use Interaktor for 6 months following pancreaticoduodenectomy. Of those, 35 declined, 8 dropped out, and 46 did not meet the inclusion criteria after surgery, leaving 26 patients for inclusion in the analysis. The patients were instructed to report symptoms daily through the app for up to 6 months following surgery. In case of alerting symptoms, they were contacted by their nurse. Data on reported symptoms, alerts, and viewed self-care advice were logged and analyzed with descriptive statistics. Also, the patients were interviewed about their experiences, and the data were analyzed using thematic analysis. Results The patients’ median adherence to symptom reporting was 82%. Fatigue and pain were the most reported symptoms. Alerting symptoms were reported by 24 patients, and the most common alert was fever. There were variations in how many times the patients viewed the self-care advice (range 3-181 times). The most commonly viewed advice concerned pancreatic enzyme supplements. Through the interviews, the overarching theme was “Being seen as a person,” with the following 3 sub-themes: “Getting your voice heard,” “Having access to an extended arm of health care,” and “Learning about own health.” Conclusions Interaktor proved to be well accepted. It made patients feel reassured at home and offered support for self-care. The app facilitated person-centered care by its multiple features targeting individual supportive care needs and enabled participation in their own care. This supports our recent studies showing that patients using the app had less symptom burden and higher self-care activity levels than patients receiving only standard care.

scholarly journals NATIONAL DISSEMINATION OF PERSON-CENTERED CARE IN NURSING HOMES: BARRIERS TO IMPLEMENTATION

2017 ◽  
Vol 1 (suppl_1) ◽  
pp. 760-761
Author(s):  
H.B. Degenholtz ◽  
K. Van Haitsma ◽  
A. Mihelic ◽  
K.M. Abbott ◽  
A. Elliott ◽  
...  
Keyword(s):  
Nursing Homes ◽  
Person Centered Care ◽  
Centered Care ◽  
Barriers To Implementation

scholarly journals A Seat at the Table: The Positioning of Families During Care Conferences in Nursing Homes

2018 ◽  
Author(s):  
Gloria Puurveen ◽  
Heather Cooke ◽  
Rupali Gill ◽  
Jennifer Baumbusch
Keyword(s):  
Nursing Homes ◽  
Care Providers ◽  
Care Needs ◽  
Open Communication ◽  
Structural Inequality ◽  
Resident Care ◽  
Centered Care ◽  
Field Notes ◽  
Design And Methods ◽  
Process Structure

AbstractBackground and ObjectivesCurrent nursing home policy emphasizes the need for collaborative, team-based care planning in which families and/or residents are actively involved. Resident care conferences are common where care providers, families, and/or residents discuss and coordinate resident care needs and evaluate care goals. This study critically examines the process, structure, and content of care conferences to expand our understanding of how resident care is negotiated among care providers and families in this context.Research Design and MethodsThis study was part of a larger critical ethnography examining the negotiation of care work among care providers, families, and residents in three purposively selected nursing homes in British Columbia, Canada. Thirty-seven care conferences were observed. Field notes and interview data were thematically analyzed with a focus on what was said, who said what and to whom, whose voice was privileged, and how power manifested between care providers, families, and/or residents.ResultsAs illustrated by three key themes, Exclusion by Process—Following Script, Exclusion by Content—Scripted Reports, and Exclusion through Devalued Knowledge, families were overtly and covertly excluded from contributing to the care conferences. As such, families’ presence did not guarantee open communication or active solicitation of their perspectives.Discussion and ImplicationsThe use of predetermined agendas and processes, clinically generic reporting, and technical jargon reproduced the structural inequality between care providers and families making collaboration difficult to effectively negotiate. For care conferences to meaningfully contribute to person-centered care, it is imperative that mutual exchange be promoted and families empowered to participate as equals.

Mealtimes in Nursing Homes: Striving for Person-Centered Care

2009 ◽  
Vol 28 (4) ◽  
pp. 327-347 ◽  
Author(s):  
Holly D. Reimer ◽  
Heather H. Keller
Keyword(s):  
Nursing Homes ◽  
Person Centered Care ◽  
Centered Care

scholarly journals Creating, Recruiting, and Developing: Key Tasks and Their Challenges

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 433-433
Author(s):  
Faith Helm ◽  
Edward Ansello
Keyword(s):  
Best Practices ◽  
Educational Philosophy ◽  
Service Providers ◽  
Direct Service ◽  
Time Limits ◽  
Person Centered Care ◽  
Wide Range ◽  
Direct Service Providers ◽  
Centered Care ◽  
Paid Caregivers

Abstract The ECHO model is uniquely suited to developing education for a wide range of agencies and providers serving the needs of older adults with IDD. The program’s structure and its educational philosophy depend on modeling teamwork in both the hub and the spokes. Recruitment of participants included paid caregivers, healthcare practitioners, and direct service providers, focusing on team participation at each site. In developing the curriculum, it was critical to recognize the roles played by each sector, as well as the complementary contributions of others. Consequently, curriculum content needed to be multidisciplinary and multifocal, and recognize both the breadth of contributors and time limits in selecting content for each session. Didactic presentations and case studies embodied these features. Priorities included best practices in person-centered care; differential diagnoses; and physical, social, and environmental factors. The facilitators of, and challenges to, these priorities offer implications for advancing educational programs with similar objectives.

scholarly journals 414 - Supporting staff delivering person-centered care to people with dementia in Dutch nursing homes

2021 ◽  
Vol 33 (S1) ◽  
pp. 37-38
Author(s):  
Henriëtte van der Roest ◽  
Milan van der Kuil ◽  
Anouk Overbeek ◽  
Egbert Hartstra
Keyword(s):  
Nursing Homes ◽  
Living Arrangements ◽  
Online Survey ◽  
Dementia Care ◽  
Person Centered Care ◽  
People With Dementia ◽  
Modifiable Factors ◽  
Centered Care ◽  
Organizational Features

BackgroundPositive evidence has been found for person-centered care provisioning (PCC), the level of person- centeredness of care is positively associated with residents’ quality of life, quality of care an wellbeing.When providing PCC, care and support are provided in line with the needs, preferences and capacities of people with dementia. PCC is seen as the golden standard for dementia care. However, in nursing homes, needs and preferences of people with dementia are not always obvious, due to the relatively high levels of cognitive impairment. This, and amongst others time constraints might hinder high PCC by care professionals. Limited evidence show that certain organizational and environmental conditions, such as satisfactory leadership, interdisciplinary collaboration, and continuing education, lead to higher PCC. In order to facilitate care professionals as much as possible in providing PCC, more insight is desirable.ObjectiveThis study aims to provide more insight into the modifiable factors that contribute to PCC for people with dementia in Dutch nursing homes.MethodsA cross-sectional design was applied. Data were collected during the fifth assessment of the Living Arrangements for people with Dementia (LAD)-study from April 2019 until February 2020. Care professionals working in psychogeriatric units in nursing homes filled in an online survey. Organizational characteristics of participating nursing homes were inventoried.The level of PCC was assessed with the Dutch version of the ‘Person-centred care questionnaire’ (PCCq). Modifiable factors potentially impacting the level of provided PCC with regard to staff characteristics (e.g. autonomy, education), organizational features (e.g. size, involvement of family in care), and culture (e.g. learning climate) were included in multiple linear modelling.Preliminary resultsIn total 58 nursing home facilities were included in the study, and 814 care professionals completed the survey. Average PCCq score was 3.2 (SD = 0.4; range 0 to 4, higher scores indicating higher PCC).ConclusionFactors related to staff, and organizational features and culture, that contribute to PPC will be presented. The outcomes of the study will provide input for the optimal organization of dementia care, in order to support care professionals working in nursing homes to provide PCC.

scholarly journals A Digital Platform for Facilitating Personalized Dementia Care in Nursing Homes: A Formative Evaluation Study (Preprint)

2020 ◽  
Author(s):  
GUBING WANG ◽  
Armagan Albayrak ◽  
Gerd Kortuem ◽  
Tischa J. M. van der Cammen
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
User Acceptance ◽  
Assistive Technologies ◽  
Perceived Usefulness ◽  
Technical Feasibility ◽  
Digital Platform ◽  
Person Centered Care ◽  
People With Dementia ◽  
Centered Care

BACKGROUND Person-centered care is key to the wellbeing of people with dementia. A large quantity of personal data can be collected with the development of the Internet of Things, which has the potential to facilitate person-centered care for people with dementia. Yet, there are limited assistive technologies developed for this purpose, and the user acceptance for assistive technologies is low in nursing homes. Through a data-enabled design approach, a digital platform was developed for helping the care team to personalize the management of behavioral and psychological symptoms for people with dementia in nursing homes. OBJECTIVE This study aims to evaluate the digital platform from three aspects, in a real-life context with potential users. First, its technical feasibility in collecting sufficient data for pattern analysis; second, the types of insights and actions generated from the potential users by using it, if any; third, its perceived usefulness and its future improvements that potential users would like to see. METHODS The digital platform was deployed in a nursing home for seven weeks, and the data collected were first analyzed by the researchers for a technical feasibility check. The data were then visualized and presented to the potential users via the digital platform. The potential users were asked to analyze the visualizations and were interviewed on 1) the insights and actions generated, if any; 2) the usefulness of the digital platform and 3) what could be improved. RESULTS The data collected in the digital platform demonstrate its technical potential to reveal behavior patterns for PwD. The insights generated by the potential users were categorized into “client level”, “ward level” and “team level”. The actions taken by the potential users were classified into “investigation” and “implementation”. The user acceptance varied across potential users, and three aspects of improvements for the digital platform were identified. CONCLUSIONS This study provides the first evidence for the technical feasibility of the digital platform; besides, it offers future researchers some recommendations on how to integrate assistive technologies in the nursing home context from exploring the types of insights and actions identified, the varied perceived usefulness, and the areas of improvement for the digital platform.

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