Older people’s experiences of their free will in nursing homes

2014 ◽  
Vol 23 (1) ◽  
pp. 22-35 ◽  
Author(s):  
Leena Tuominen ◽  
Helena Leino-Kilpi ◽  
Riitta Suhonen
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Older People ◽  
Free Will ◽  
Social Life ◽  
Institutional Care ◽  
Care Practice ◽  
Home Context ◽  
People’S Attitudes

Background: Older people in institutional care should be allowed to live a meaningful life in a home-like environment consistent with their own free will. Research on actualisation of older people’s own free will in nursing home context is scarce. Objectives: The purpose of this study was to describe older people’s experiences of free will, its actualisation, promoters and barriers in nursing homes to improve the ethical quality of care. Research design: Fifteen cognitively intact older people over 65 years in four nursing homes in Southern Finland were interviewed. Giorgi’s phenomenological method expanded by Perttula was used to analyse the data. Ethical considerations: Chief administrators of each nursing home gave permission to conduct the study. Informants’ written informed consent was gained. Findings: Older people described free will as action consistent with their own mind, opportunity to determine own personal matters and holding on to their rights. Own free will was actualised in having control of bedtime, dressing, privacy and social life with relatives. Own free will was not actualised in receiving help when needed, having an impact on meals, hygiene, free movement, meaningful action and social life. Promoters included older people’s attitudes, behaviour, health, physical functioning as well as nurses’ ethical conduct. Barriers were nurses’ unethical attitudes, institution rules, distracting behaviour of other residents, older people’s attitudes, physical frailty and dependency. Discussion: Promoting factors of the actualisation of own free will need to be encouraged. Barriers can be influenced by educating nursing staff in client-orientated approach and influencing attitudes of both nurses and older people. Conclusion: Results may benefit ethical education and promote the ethical quality of older people’s care practice and management.

scholarly journals Nursing home quality of life in the Lebanon

2017 ◽  
Vol 18 (2) ◽  
pp. 145-156
Author(s):  
Marina Gharibian Adra ◽  
John Hopton ◽  
John Keady
Keyword(s):  
Quality Of Life ◽  
Nursing Home ◽  
Nursing Homes ◽  
Family Caregivers ◽  
Comparative Method ◽  
Nursing Home Residents ◽  
Care Staff ◽  
Care Practice ◽  
Content Type

Purpose The purpose of this paper is to explore perceptions, perspectives and meaning of quality of life for a sample of older residents, care staff and family caregivers in two nursing homes in Lebanon. Design/methodology/approach A classic grounded theory study was conducted between 2010 and 2011 in two nursing homes in Beirut. The semi-structured interviews were undertaken with a theoretical sample of 20 residents, 8 family caregivers and 11 staff. The constant comparative method was used to analyze the data. Findings Three distinct but interrelated properties of quality of life emerged from this process: “maintaining self,” “maintaining identity” and “maintaining continuity”. The dynamics that exist within and between each of these properties provide an indicator about shared and distinct meanings and the implications for care practice. Research limitations/implications The study was conducted in one city in Lebanon; accordingly, the transferability of findings may be challenging. Practical implications Implications for nursing and nursing policy – improving Lebanese national standards and regulations applicable to nursing home residents may help to enhance residents’ care needs and quality of life. Social implications There was limited guidance aimed at helping older residents to voice and increase their choice and control. Originality/value This paper provides new insights into the process of outlining the properties attached to the phenomenon of quality of life in nursing homes in Lebanon. It will be of interest to those in nursing home care as well as to policy makers.

scholarly journals Time in Care for Older People Living in Nursing Homes

2010 ◽  
Vol 2010 ◽  
pp. 1-10 ◽  
Author(s):  
K. B. E. Thorsell ◽  
B. M. Nordström ◽  
L. Fagerström ◽  
B. V. Sivberg
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Older People ◽  
Direct Care ◽  
Need For Care ◽  
Care Needs ◽  
Work Time ◽  
Actual Care ◽  
Care For Older People

In order to measure actual care needs in relation to resources required to fulfill these needs, an instrument (Time in Care) with which to evaluate care needs and determine the time needed for various care activities has been developed with the aim of assessing nursing intensity in municipal care for older people. Interreliability (ICC=0.854) of time measurements (n=10'546) of 32 nursing activities in relation to evaluated care levels in two nursing homes (staffn=81) has been determined. Nursing intensity for both periods at the two nursing homes comprised on average a direct care time of 75 (45%) and 101 (42%) minutes, respectively. Work time was measured according to actual schedule (462 hours per nursing home during two weeks). Given that the need for care was high, one must further investigate if the quality of care the recipients received was sufficiently addressed.

scholarly journals A Comparison between independent living elders and residents in 25 German Nursing Homes following the Group-Living Principle. An empirical study focusing on the subjective perspective of quality of live

2020 ◽  
Author(s):  
Anke Simon
Keyword(s):  
Quality Of Life ◽  
Nursing Home ◽  
Nursing Homes ◽  
Older People ◽  
Independent Living ◽  
Care Setting ◽  
Group Living ◽  
Age Group ◽  
Subjective Quality Of Life

Abstract Objective. The purpose of this study was to analyse the subjective quality of life (QoL) perceived by older people in German nursing homes following the group-living principle.Methods. The Nottingham Health Profile (NHP) as health-related QoL measuring instrument was employed in 25 nursing homes (n=404 participants). A comparison with the national German representative sub-sample of independent living elders (age-group over 75) was conducted. Psychometric properties and appropriateness were analysed.Results. Our findings indicate an acceptable perception of residents’ QoL. The mean NHP scale scores show, that the perceived QoL of residents in group-living nursing home reached nearly the same level as independently living elders (national German reference values, age group over 75 years, except for the NHP sub-scale physical mobility). QoL related results on life satisfaction and feeling of happiness confirm the NHP findings. The preliminary pilot study protocol could be replicated, according to good scientific practice.Conclusions and implications. The report presents the first major investigation in the research field of subjective quality of life in group-living nursing homes. The study focused on people over 75 years of age with age-specific reduced physical and mental abilities. The NHP should also be considered as a reliable, valid and for older people appropriate instrument. Due to the lack of research on residents’ perspectives, further studies should follow to establish age-specific and care setting-specific reference data for nursing home residents. In particular, more research is needed to answer the question, which care setting best meets people’s essential needs in older age.

Real-time location systems in nursing homes: state of the art and future applications

2018 ◽  
Vol 12 (2) ◽  
pp. 45-56 ◽  
Author(s):  
C.E. Oude Weernink ◽  
E. Felix ◽  
P.J.E.M. Verkuijlen ◽  
A.T.M. Dierick-van Daele ◽  
J.K. Kazak ◽  
...  
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Real Time ◽  
Process Efficiency ◽  
Healthcare Applications ◽  
Content Type ◽  
Asset Tracking ◽  
Home Context ◽  
Location Systems

PurposeIn the domain of healthcare, both process efficiency and the quality of care can be improved through the use of dedicated pervasive technologies. Among these applications are so-called real-time location systems (RTLS). Such systems are designed to determine and monitor the location of assets and people in real time through the use of wireless sensor networks. Numerous commercially available RTLS are used in hospital settings. The nursing home is a relatively unexplored context for the application of RTLS and offers opportunities and challenges for future applications. The paper aims to discuss these issues.Design/methodology/approachThis paper sets out to provide an overview of general applications and technologies of RTLS. Thereafter, it describes the specific healthcare applications of RTLS, including asset tracking, patient tracking and personnel tracking. These overviews are followed by a forecast of the implementation of RTLS in nursing homes in terms of opportunities and challenges.FindingsBy comparing the nursing home to the hospital, the RTLS applications for the nursing home context that are most promising are asset tracking of expensive goods owned by the nursing home in order to facilitate workflow and maximise financial resources, and asset tracking of personal belongings that may get lost due to dementia.Originality/valueThis paper is the first to provide an overview of potential application of RTLS technologies for nursing homes. The paper described a number of potential problem areas that can be addressed by RTLS.

scholarly journals The COVID-19 pandemic and resident-family and caregivers’ relationships in nursing home: A case study

2020 ◽  
Vol 8 (3) ◽  
pp. 31
Author(s):  
Marie Laure Kuhnel ◽  
Claude Yvonne Ferrand
Keyword(s):  
Quality Of Life ◽  
Nursing Home ◽  
Nursing Homes ◽  
Older People ◽  
French Population ◽  
Psychological Consequences ◽  
Physical Deterioration ◽  
Very High

The COVID-19 pandemic bewildered the French population by its impact and particularly affected nursing homes. Older people living in nursing homes were at very high risk of being affected by COVID-19. This case study highlights its impact on resident-family dyad and caregivers’ relationships. The suffering and anger manifested by all, the difficulty in managing the stress of the caregivers, the cognitive and physical deterioration of the residents and their social isolation show us that this unexpected pandemic has not only had psychological consequences on all those involved, but also calls into question the foundations of support for the older people. This pandemic is an opportunity to step back from what has happened and to ask ourselves how we can preserve residents’ quality of life. Organization and measures need to be re-invented to limit and prevent the effects of this COVID-19 pandemic in the event of a resurgence of the virus.

scholarly journals A tablet-based intervention for activating nursing home residents with dementia: results from a cluster-randomized controlled trial

2021 ◽  
pp. 1-13
Author(s):  
Julie L. O’Sullivan ◽  
Sonia Lech ◽  
Paul Gellert ◽  
Ulrike Grittner ◽  
Jan-Niklas Voigt-Antons ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Randomized Controlled Trial ◽  
Nursing Home ◽  
Nursing Homes ◽  
Psychotropic Medication ◽  
Controlled Trial ◽  
Nursing Home Residents ◽  
Randomized Controlled ◽  
Cluster Randomized

Abstract Objectives: To investigate global and momentary effects of a tablet-based non-pharmacological intervention for nursing home residents living with dementia. Design: Cluster-randomized controlled trial. Setting: Ten nursing homes in Germany were randomly allocated to the tablet-based intervention (TBI, 5 units) or conventional activity sessions (CAS, 5 units). Participants: N = 162 residents with dementia. Intervention: Participants received regular TBI (n = 80) with stimulating activities developed to engage people with dementia or CAS (n = 82) for 8 weeks. Measurements: Apathy Evaluation Scale (AES-I, primary outcome), Quality of Life in Alzheimer’s Disease scale, QUALIDEM scale, Neuropsychiatric Inventory, Geriatric Depression Scale, and psychotropic medication (secondary outcomes). Momentary quality of life was assessed before and after each activity session. Participants and staff were blinded until the collection of baseline data was completed. Data were analyzed with linear mixed-effects models. Results: Levels of apathy decreased slightly in both groups (mean decrease in AES-I of .61 points, 95% CI −3.54, 2.33 for TBI and .36 points, 95% CI −3.27, 2.55 for CAS). Group difference in change of apathy was not statistically significant (β = .25; 95% CI 3.89, 4.38, p = .91). This corresponds to a standardized effect size (Cohen’s d) of .02. A reduction of psychotropic medication was found for TBI compared to CAS. Further analyses revealed a post-intervention improvement in QUALIDEM scores across both groups and short-term improvements of momentary quality of life in the CAS group. Conclusions: Our findings suggest that interventions involving tailored activities have a beneficial impact on global and momentary quality of life in nursing home residents with dementia. Although we found no clear advantage of TBI compared to CAS, tablet computers can support delivery of non-pharmacological interventions in nursing homes and facilitate regular assessments of fluctuating momentary states.

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 Analyzing Nursing Home Complaints: From Substantiated Allegation to Deficiency Citations

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 82-83
Author(s):  
Kallol Kumar Bhattacharyya ◽  
Lindsay Peterson ◽  
John Bowblis ◽  
Kathryn Hyer
Keyword(s):  
Nursing Home ◽  
Quality Of Care ◽  
Nursing Homes ◽  
Staff Training ◽  
Policy And Practice ◽  
Abuse And Neglect ◽  
The Relationship ◽  
Investigation Process

Abstract Complaints provide important information to consumers about nursing homes (NHs). Complaints that are substantiated often lead to an investigation and potentially a deficiency citation. The purpose of this study is to understand the relationship between substantiated complaints and deficiency citations. Because a complaint may contain multiple allegations, and the data do not identify which allegation(s) lead to a complaint’s substantiation, we identified all substantiated single allegation complaints for NHs in 2017. Our data were drawn from federally collected NH complaint and inspection records. Among the 369 substantiated single-allegation complaints, we found most were categorized as quality of care (31.7%), resident abuse (17.3%), or resident neglect (14.1%). Of the deficiency citations resulting from complaints in our sample, 27.9% were categorized as quality of care and 19.5% were in the category of resident behavior and facility practices, which includes abuse and neglect. While two-thirds (N=239) of the substantiated complaints generated from 1 to 19 deficiency citations, nearly one third had no citations. Surprisingly, 28% of substantiated abuse and neglect allegations resulted in no deficiency citations. More surprisingly, a fifth of complaints that were categorized as “immediate jeopardy” at intake did not result in any deficiency citations. We also found a number of asymmetries in the allegation categories suggesting different processes by Centers for Medicare and Medicaid Services (CMS) region. These results suggest that the compliant investigation process warrants further investigation. Other policy and practice implications, including the need for better and more uniform investigation processes and staff training, will be discussed.

scholarly journals Improving Quality of Life in Nursing Homes: The Structured Resident Interview Approach

2014 ◽  
Vol 2014 ◽  
pp. 1-8 ◽  
Author(s):  
Howard B. Degenholtz ◽  
Abby L. Resnick ◽  
Natalie Bulger ◽  
Lichun Chia
Keyword(s):  
Quality Of Life ◽  
Nursing Home ◽  
Nursing Homes ◽  
Planning Process ◽  
Intervention Group ◽  
Nursing Home Residents ◽  
Care Plan ◽  
Control Group ◽  
Improvement Programs

The quality of life (QOL) of the approximately 1.5 million nursing facility (NF) residents in the US is undoubtedly lower than desired by residents, families, providers, and policy makers. Although there have been important advances in defining and measuring QOL for this population, there is a need for interventions that are tied to standardized measurement and quality improvement programs. This paper describes the development and testing of a structured, tailored assessment and care planning process for improving the QOL of nursing home residents. The Quality of Life Structured Resident Interview and Care Plan (QOL.SRI/CP) builds on a decade of research on measuring QOL and is designed to be easily implemented in any US nursing home. The approach was developed through extensive and iterative pilot testing and then tested in a randomized controlled trial in three nursing homes. Residents were randomly assigned to receive the assessment alone or both the assessment and an individualized QOL care plan task. The results show that residents assigned to the intervention group experienced improved QOL at 90- and 180-day follow-up, while QOL of residents in the control group was unchanged.

How Important Are Choice, Autonomy, and Relationships in Predicting the Quality of Life of Nursing Home Residents?

2021 ◽  
pp. 073346482098397
Author(s):  
Marita McCabe ◽  
Jessica Byers ◽  
Lucy Busija ◽  
David Mellor ◽  
Michelle Bennett ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Nursing Home ◽  
Nursing Homes ◽  
Social Relationships ◽  
Daily Living ◽  
Nursing Home Residents ◽  
Predictor Variables ◽  
Social Connections ◽  
Hierarchical Regression

Older people face major challenges when they move into nursing homes, particularly in relation to independence and their ability to influence their activities of daily living (ADLs). This study evaluated the contribution of resident choice, as well as the staff–resident relationship, to promoting resident quality of life (QoL). A total of 604 residents from 33 nursing homes in Australia completed measures of QoL, perceived levels of choice in various ADLs, and the staff–resident relationship. A hierarchical regression demonstrated that the predictor variables accounted for 25% of the variance in QoL. Two of the four predictor variables (resident choice over socializing and the staff–resident relationship) significantly contributed to resident QoL. These findings reinforce the important contribution of autonomy and social relationships to resident QoL. Nursing home staff have a key role to play in supporting resident autonomy as a means of building residents’ chosen social connections, and thereby promoting QoL.

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