Ethics and quality care in nursing homes: Relatives’ experiences

2017 ◽  
Vol 26 (3) ◽  
pp. 767-777 ◽  
Author(s):  
Rita Jakobsen ◽  
Gerd Sylvi Sellevold ◽  
Veslemøy Egede-Nissen ◽  
Venke Sørlie
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Nursing Staff ◽  
Quality Care ◽  
Science Data ◽  
Data Services ◽  
Nursing Home Patients ◽  
Positive Experiences ◽  
Close Relatives

Background: A total of 71,000 people in Norway suffer from some form of dementia in 2013, of whom approximately 30,000 are in nursing homes. Several studies focus on the experiences of those who have close relatives and who are staying in a nursing home. Results show that a greater focus on cooperation between nursing staff and relatives is a central prerequisite for an increased level of care. Benefits of developing systematic collaboration practices include relief for nursing staff, less stress, and greater mutual understanding. Going through studies focusing on the experiences of nursing home patients’ relatives, negative experiences are in the majority. In this study, relatives are invited to share positive experiences regarding the care of their loved ones; a slightly different perspective, in other words. Aim: The aim of the study is to investigate relatives of persons with dementia’s experiences with quality care in nursing homes. Method: The study is a part of a larger project called Hospice values in the care for persons with dementia and is based on a qualitative design where data are generated through narrative interviews. The chosen method of analysis is the phenomenological–hermeneutical method for the study of lived experiences. Participants and research context: Participants in the project were eight relatives of persons with dementia who were living in nursing homes, long-term residences. The sampling was targeted, enrolment happened through collective invitation. All relatives interested were included. Ethical considerations: The Norwegian Regional Ethics Committee and the Norwegian Social Science Data Services approve the study. Findings: Findings show that relatives have certain expectations as to how their loved ones ought to be met and looked after at the nursing home. The results show that in those cases where the expectations were met, the relatives’ experiences were associated with engagement, inclusion and a good atmosphere. When the expectations were not met, the relatives experienced powerlessness, distrust and guilt. Discussion: The results are discussed considering the concepts of trust, power and asymmetry. Conclusion: When asked about experiences with quality care, the relatives spoke both of expectations met and of expectations not met. Results in this study are important knowledge for developing units where performing quality care is the overall aim.

Fostering dignity in the care of nursing home residents through slow caring

2016 ◽  
Vol 24 (7) ◽  
pp. 778-788 ◽  
Author(s):  
Vibeke Lohne ◽  
Bente Høy ◽  
Britt Lillestø ◽  
Berit Sæteren ◽  
Anne Kari Tolo Heggestad ◽  
...  
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Nursing Home Residents ◽  
Healthcare Personnel ◽  
Focus Group Interviews ◽  
Ethical Considerations ◽  
Science Data ◽  
Data Services ◽  
The Social ◽  
Group Interviews

Background: Physical impairment and dependency on others may be a threat to dignity. Research questions: The purpose of this study was to explore dignity as a core concept in caring, and how healthcare personnel focus on and foster dignity in nursing home residents. Research design: This study has a hermeneutic design. Participants and research context: In all, 40 healthcare personnel from six nursing homes in Scandinavia participated in focus group interviews in this study. Ethical considerations: This study has been evaluated and approved by the Regional Ethical Committees and the Social Science Data Services in the respective Scandinavian countries. Findings: Two main themes emerged: dignity as distinction (I), and dignity as influence and participation (II). Discussion: A common understanding was that stress and business was a daily challenge. Conclusion: Therefore, and according to the health personnel, maintaining human dignity requires slow caring in nursing homes, as an essential approach.

Physical Health and Cognitive Ability Among Married Long-Term-Care Patients and Among Their Spouses—A Comparison Between Home Care and Nursing Home Care

1993 ◽  
Vol 5 (2) ◽  
pp. 157-168 ◽  
Author(s):  
Ann-Christine Löfgren ◽  
Gösta Bucht ◽  
Sture Eriksson ◽  
Tage Lundström
Keyword(s):  
Nursing Home ◽  
Cognitive Function ◽  
Nursing Homes ◽  
Home Care ◽  
Physical Health ◽  
Long Term Care ◽  
Nursing Home Care ◽  
Term Care ◽  
Nursing Home Patients

The purpose of this study was to establish whether physical health and cognitive function in married long-term patients or in their spouses determines why some patients are cared for in home care while others reside in nursing homes. Out of 38 married couples with a sick spouse cared for in a nursing home, 23 couples were studied; out of 34 couples with a sick spouse cared for in home care, 22 patients and 25 spouses were studied. The results showed no significant differences in physical health score either between the two groups of patients, or between the two groups of spouses. Both home-care patients and nursing home patients had low cognitive function scores, but nursing home patients had significantly lower scores. A multivariate analysis showed that physical health and cognitive function explained only 20% of patients' residence. Between the two groups of spouses there was no difference in cognitive function score. The conclusion is that physical health status and cognitive function explain only to a small extent why married long-term care patients are cared for in nursing homes or in home care.

Nurses' Typifications of Nursing Home Patients

1984 ◽  
Vol 4 (1) ◽  
pp. 45-67 ◽  
Author(s):  
Nancy Gilliland ◽  
Anne Brunton
Keyword(s):  
Nursing Home ◽  
Middle Class ◽  
Nursing Staff ◽  
Significant Influence ◽  
Chronically Ill ◽  
American Midwest ◽  
The Poor ◽  
Nursing Home Patients ◽  
Custodial Care

ABSTRACTPrevious studies of the attitudes of nursing staff towards patients in hospitals have suggested that those who were mentally alert, young, acutely ill and in need of medical (not custodial) care, middle class, appreciative and co-operative were labelled ‘good’. Conversely the old, the poor, the chronically ill and the mentally disturbed were labelled ‘bad’. In the study reported here, of a single nursing home situated in the American midwest, these stereotypes are shown not to operate. A subset of these attitudes is none the less to be found which rewards cheerfulness, wittiness and appreciativeness. Favouritism amongst patients is examined as a significant influence on the care of residents who are all elderly and long-term sick.

Dementia Syndromes in Nursing Home Patients

1992 ◽  
Vol 4 (2) ◽  
pp. 241-252 ◽  
Author(s):  
M. Andersson ◽  
C. G. Gottfries
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Depressed Mood ◽  
Long Term Care ◽  
Psychiatric Symptoms ◽  
The Elderly ◽  
Minor Importance ◽  
Term Care ◽  
Nursing Home Patients

Patients (n = 191) living in four comparable somaic nursing homes (NH) (nursing homes for physical illness) were studied in order to evaluate dementia syndromes. Dementia and symptoms of depressed mood occurred frequently (72% and 63%, respectively). Dementia was often undiagnosed at admittance. Neither the length of time spent in institutions, nor marital status, age, or sex seemed to be of more than minor importance to the prevalence of dementia syndromes. Concerning functional impairment, convergence of findings across the societies studied indicates that psychiatric symptoms and psychopathology are intrinsic parts of long-term care of the elderly.

Uitbraak COVID-19 in de verpleeghuiszorg

2020 ◽  
Keyword(s):  
Older Adults ◽  
Nursing Home ◽  
Nursing Homes ◽  
Long Term Care ◽  
Informal Caregivers ◽  
Rapid Review ◽  
Daily Routine ◽  
Term Care ◽  
Care Facilities

Long-term care for older adults is highly affect by the COVID-19 outbreak. The objective of this rapid review is to understand what we can learn from previous crises or disasters worldwide to optimize the care for older adults in long term care facilities during the outbreak of COVID-19. We searched five electronic databases to identify potentially relevant articles. In total, 23 articles were included in this study. Based on the articles, it appeared that nursing homes benefit from preparing for the situation as best as they can. For instance, by having proper protocols and clear division of tasks and collaboration within the organization. In addition, it is helpful for nursing homes to collaborate closely with other healthcare organizations, general practitioners, informal caregivers and local authorities. It is recommended that nursing homes pay attention to capacity and employability of staff and that they support or relieve staff where possible. With regard to care for the older adults, it is important that staff tries to find a new daily routine in the care for residents as soon as possible. Some practical tips were found on how to communicate with people who have dementia. Furthermore, behavior of people with dementia may change during a crisis. We found tips for staff how to respond and act upon behavior change. After the COVID-19 outbreak, aftercare for staff, residents, and informal caregivers is essential to timely detect psychosocial problems. The consideration between, on the one hand, acute safety and risk reduction (e.g. by closing residential care facilities and isolating residents), and on the other hand, the psychosocial consequences for residents and staff, were discussed in case of other disasters. Furthermore, the search of how to provide good (palliative) care and to maintain quality of life for older adults who suffer from COVID-19 is also of concern to nursing home organizations. In the included articles, the perspective of older adults, informal caregivers and staff is often lacking. Especially the experiences of older adults, informal caregivers, and nursing home staff with the care for older adults in the current situation, are important in formulating lessons about how to act before, during and after the coronacrisis. This may further enhance person-centered care, even in times of crisis. Therefore, we recommend to study these experiences in future research.

Predictors of Mortality in Board and Care Homes

1997 ◽  
Vol 36 (1) ◽  
pp. 77-87 ◽  
Author(s):  
Nicholas G. Castle
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Social Services ◽  
Long Term Care ◽  
Significant Proportion ◽  
The Elderly ◽  
Term Care ◽  
Care Facilities ◽  
Board And Care

Long-term care institutions have emerged as dominant sites of death for the elderly. However, studies of this trend have primarily examined nursing homes. The purpose of this research is to determine demographic, functional, disease, and facility predictors and/or correlates of death for the elderly residing in board and care facilities. Twelve factors are found to be significant: proportion of residents older than sixty-five years of age, proportion of residents who are chair- or bed-fast, proportion of residents with HIV, bed size, ownership, chain membership, affiliation with a nursing home, number of health services provided other than by the facility, the number of social services provided other than by the facility, the number of social services provided by the facility, and visits by Ombudsmen. These are discussed and comparisons with similar studies in nursing homes are made.

scholarly journals Facilitators and barriers to implement nurse-led interventions in long-term dementia care: a qualitative interview study with Swiss nursing experts and managers

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Julian Hirt ◽  
Melanie Karrer ◽  
Laura Adlbrecht ◽  
Susi Saxer ◽  
Adelheid Zeller
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Public Perception ◽  
Dementia Care ◽  
Term Care ◽  
Face To Face ◽  
People With Dementia ◽  
Qualitative Interview Study ◽  
Facilitators And Barriers

Abstract Background To support the implementation of nurse-led interventions in long-term dementia care, in-depth knowledge of specific supporting factors and barriers is required. Conditions and structures of caring for people with dementia differ widely, depending on the country and the care context. Our study aimed to describe the experiences and opinions of nursing experts and managers with regard to facilitators and barriers to the implementation of nurse-led interventions in long-term dementia care. Methods We conducted a qualitative descriptive study using individual interviews based on qualitative vignettes as a useful stimulus to generate narrations allowing to study peoples’ perceptions and beliefs. The study took place in nursing homes in the German-speaking part of Switzerland and in the Principality of Liechtenstein using purposive sampling. We intended to conduct the interviews face-to-face in a quiet room according to the participant’s choice. However, due to the lockdown of nursing homes during the COVID-19 pandemic in spring 2020, we performed interviews face-to-face and by video. We analysed data thematically following Braun and Clarke to achieve a detailed, nuanced description. To verify our interpretation and to ensure congruence with participants’ perspectives, we conducted member checks. The Standards for Reporting Qualitative Research (SRQR) served to structure our manuscript. Results Six dyads of nursing home managers and nursing experts from six nursing homes took part in our study (n = 12). Our thematic analysis yielded seven themes reflecting facilitators and barriers to implementing nurse-led interventions in long-term dementia care: «A common attitude and cohesion within the organization», «Commitment on several levels», «A needs-oriented implementation», «The effect and the public perception of the intervention», «A structured and guided implementation process», «Supporting knowledge and competencies», as well as «Resources for implementing the intervention». Conclusions To support the implementation of nurse-led interventions in long-term dementia care, active commitment-building seems essential. It is necessary that the value of the intervention is perceptible.Commitment-building is the precondition to reach the persons involved, such as nursing home managers, nursing staff, residents and relatives. Furthermore, nurses should precisely inform about the intervention. It is necessary that the value of the intervention is perceptible. In addition, nurses should adjust the interventions to the situational needs of people with dementia, thus. Therefore, it is important to support dementia-specific competencies in long-term care. Findings indicate that the barrier is determined by the intervention and its implementation – and not by the behaviour of the person with dementia.

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

2007 ◽  
Vol 12 (3) ◽  
pp. 177-184 ◽  
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.

The Alchoholic Patient in the Nursing Home

1972 ◽  
Vol 3 (3) ◽  
pp. 273-277 ◽  
Author(s):  
Margaret W. Linn ◽  
Bernard S. Linn ◽  
Shayna R. Greenwald
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Social Workers ◽  
Diagnostic Data ◽  
Nursing Home Patients ◽  
Diabetes Outcome ◽  
Specific Illness

There are indications that more alcoholics are being placed in nursing homes than ever before. To determine in what ways these patients differ from others going to nursing homes, all alcoholics (72) placed from hospital to nursing homes were studied prior to placement and followed 6 months in 35 homes. Seventy-one nonalco-holics placed during the same period were randomly selected for comparison. Hospital disability ratings from physicians, evaluations from social workers, and diagnostic data from records indicated no significant differences in levels of disability or impairment. Alcoholics were less likely to be currently married and had less income. Although they were younger, they had a significantly higher number of diagnoses than other nursing home patients (P< .01); however, with the exception of cirrhosis and brain syndrome, they had fewer serious illnesses such as cancer and diabetes. Outcome after 6 months showed 28 percent left the nursing home, 45 percent were still in the home, 10 percent were hospitalized, and 16 percent had expired. These outcomes were not significantly different from other nursing home patients. Results indicate alcoholics are as much in need of nursing home services as other patients, even though they differ along social and specific illness patterns *

It Is Not Your Parents’ Long-Term Services System: Nursing Homes in a Changing World

2018 ◽  
Vol 39 (8) ◽  
pp. 898-901
Author(s):  
Robert Applebaum ◽  
Shahla Mehdizadeh ◽  
Diane Berish
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Length Of Stay ◽  
Older Person ◽  
Home Practice ◽  
Data Set ◽  
Study Results ◽  
Utilization Data ◽  
First Time

The long-term services system has changed substantially since the mid-1970s, when the landmark book Last Home for the Aged argued that the move to the nursing home was the last move an older person would make until death. Using detailed nursing home utilization data from the Minimum Data Set, this study tracks three cohorts of first-time nursing home admissions in Ohio from 1994 through 2014. Each cohort was followed for a 3-year period. Study results report dramatic reductions in nursing home length of stay between the 1994 and 2011 cohorts. Reduction in length of stay has important implications for nursing home practice and quality monitoring. The article argues that administrative and regulatory practices have not kept pace with the dramatic changes in how nursing homes are now being used in the long-term services system.

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