scholarly journals Negative prompts aimed at maintaining eating independence

2018 ◽  
Vol 26 (7-8) ◽  
pp. 2158-2171 ◽  
Author(s):  
Alvisa Palese ◽  
Silvia Gonella ◽  
Tea Kasa ◽  
Davide Caruzzo ◽  
Mark Hayter ◽  
...  
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Healthcare Professionals ◽  
Psychological Abuse ◽  
Positive Impact ◽  
Nursing Home Residents ◽  
Well Being ◽  
Best Interests ◽  
Ethical Principles ◽  
Verbal Prompts

Background: Psychological abuse of older people is difficult to recognise; specifically, nursing home residents have been documented to be at higher risk of psychological abuse during daily care, such as during feeding. Healthcare professionals adopt positive and negative verbal prompts to maintain residents’ eating independence; however, negative prompts’ purposes and implications have never been discussed to date. Research aims: To critically analyse negative verbal prompts given during mealtimes as forms of abuse of older individuals and violation of ethical principles. Research design: This is a secondary analysis of three cases of negative prompts that emerged in a large descriptive study based upon focus group methodology and involving 13 nursing homes and 54 healthcare professionals. Participants and research context: This study included 3 out of 13 nursing homes caring for residents with moderate/severe functional dependence in self-feeding mainly due to dementia; in these nursing homes, we conducted three focus groups and 13 healthcare professionals participated. Ethical considerations: This study was conducted in accordance with the Human Subject Research Ethics Committee guidelines after being approved by the Review Board of the Trust. Findings: With the intent of maintaining self-feeding independence, negative verbal prompts have been reported as being used by nursing home teams. By critically analysing these negative prompts, it turned out they could trigger intimidation, depression and anxiety and thus could be considered as forms of abuse; moreover, negative prompts can threaten the ethical principles of (1) autonomy using a paternalist approach, (2) beneficence and non-maleficence as with the intent to act in the best interests of residents (to maintain self-feeding independence) they are harmed in their dignity and (3) justice, given that residents who received negative prompts are treated differently from those who received positive prompts. Discussion: Eating should be a pleasant experience with a positive impact on physiological, psychological and social well-being. However, negative prompting can lead to abuse and violation of basic ethical principles, destroying the healthcare professional resident and relative relationships strongly dependent on trust. Conclusion: Negative verbal prompting must be avoided.

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.

scholarly journals A multicomponent exercise intervention to improve physical functioning, cognition and psychosocial well-being in elderly nursing home residents: a study protocol of a randomized controlled trial in the PROCARE (prevention and occupational health in long-term care) project

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Thomas Cordes ◽  
Laura L. Bischoff ◽  
Daniel Schoene ◽  
Nadja Schott ◽  
Claudia Voelcker-Rehage ◽  
...  
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Physical Functioning ◽  
Exercise Intervention ◽  
Controlled Trial ◽  
Nursing Home Residents ◽  
Well Being ◽  
Term Care

Abstract Background Older adults, who are living in nursing homes that provide a high level of long-term nursing care, are characterized by multimorbidity and a high prevalence of dependency in activities of daily living. Results of recent studies indicate positive effects of structured exercise programs during long-term care for physical functioning, cognition, and psychosocial well-being. However, for frail elderly the evidence remains inconsistent. There are no evidence-based guidelines for exercises for nursing home residents that consider their individual deficits and capacities. Therefore, high-quality studies are required to examine the efficacy of exercise interventions for this multimorbid target group. The purpose of this study is to determine the feasibility and efficacy of a multicomponent exercise intervention for nursing home residents that aims to improve physical and cognitive functioning as well as quality of life. Methods A two-arm single-blinded multicenter randomized controlled trial will be conducted, including 48 nursing homes in eight regions of Germany with an estimated sample size of 1120 individuals. Participants will be randomly assigned to either a training or a waiting time control group. For a period of 16 weeks the training group will meet twice a week for group-based sessions (45–60 min each), which will contain exercises to improve physical functioning (strength, endurance, balance, flexibility) and cognitive-motor skills (dual-task). The intervention is organized as a progressive challenge which is successively adapted to the residents’ capacities. Physical functioning, cognitive performance, and quality of life will be assessed in both study groups at baseline (pre-test), after 16-weeks (post-treatment), and after 32-weeks (retention test, intervention group only). Discussion This study will provide information about the efficacy of a multicomponent exercise program in nursing homes (performance, recruitment). Results from this trial will contribute to the evidence of multicomponent exercises, which specifically focus on cognitive-motor approaches in the maintenance of mental and physical functioning. In addition, it will help to encourage older adults to actively engage in social life. Furthermore, the findings will lead to recommendations for health promotion interventions for frail nursing home residents. Trial registration The trial was prospectively registered at DRKS.de with the registration number DRKS00014957 on October 9, 2018.

scholarly journals Nursing homes during the COVID-19 pandemic: a scoping review of challenges and responses

2021 ◽  
Author(s):  
Shamik Giri ◽  
Lee Minn Chenn ◽  
Roman Romero-Ortuno
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Scoping Review ◽  
Nursing Home Residents ◽  
Well Being ◽  
External Factors ◽  
Related Factors ◽  
Nursing Home Population ◽  
Mesh Terms ◽  
Health And Social Care

Abstract Introduction COVID-19 has caused unprecedented challenges in nursing homes. In this scoping review, we aimed to describe factors that contributed to the spread and mortality of COVID-19 in nursing homes and provide an overview of responses that were implemented to try to overcome such challenges. Methods The MeSH terms “Nursing homes” and “COVID-19” were searched in MEDLINE Ovid, and English language articles were retrieved that were published between 1 March 2020 and 31 January 2021. Article titles and abstracts were screened by two reviewers, and the results of included articles were grouped by themes. Results The search retrieved 348 articles, of which 76 were included in the thematic review. 8 articles related to COVID-19 disease characteristics (e.g. asymptomatic transmission), 24 to resident-related factors (e.g. comorbidities, nutrition, cognition), 13 to facility characteristics (e.g. physical space, occupancy, for-profit status), 21 to staffing (e.g. staffing levels, staff-to-resident ratio, staff multi-employment), and 10 to external factors (e.g. availability of personal protective equipment, prevailing health and social care policies). In terms of responses, identified themes included widespread testing, isolation and cohorting of residents, staff protection and support, promotion of residents’ well-being, and technological innovations. Conclusion COVID-19 exerted severe challenges on the nursing home population and its staff. Both internal and external factors predisposed nursing homes to an increased propensity of spread. Numerous strategies were employed to attempt to mitigate the negative impacts. Substantial learning occurred that may not only aid future pandemic preparedness but improve quality of care for nursing home residents at all times.

scholarly journals Nursing home care quality: a cluster analysis

2017 ◽  
Vol 30 (1) ◽  
pp. 25-36 ◽  
Author(s):  
Vigdis Abrahamsen Grøndahl ◽  
Liv Berit Fagerli
Keyword(s):  
Cluster Analysis ◽  
Nursing Home ◽  
Nursing Homes ◽  
Nursing Home Residents ◽  
Well Being ◽  
Care Quality ◽  
Nursing Home Care ◽  
Healthcare Personnel ◽  
Content Type ◽  
Quality Perceptions

Purpose The purpose of this paper is to explore potential differences in how nursing home residents rate care quality and to explore cluster characteristics. Design/methodology/approach A cross-sectional design was used, with one questionnaire including questions from quality from patients’ perspective and Big Five personality traits, together with questions related to socio-demographic aspects and health condition. Residents (n=103) from four Norwegian nursing homes participated (74.1 per cent response rate). Hierarchical cluster analysis identified clusters with respect to care quality perceptions. χ2 tests and one-way between-groups ANOVA were performed to characterise the clusters (p<0.05). Findings Two clusters were identified; Cluster 1 residents (28.2 per cent) had the best care quality perceptions and Cluster 2 (67.0 per cent) had the worst perceptions. The clusters were statistically significant and characterised by personal-related conditions: gender, psychological well-being, preferences, admission, satisfaction with staying in the nursing home, emotional stability and agreeableness, and by external objective care conditions: healthcare personnel and registered nurses. Research limitations/implications Residents assessed as having no cognitive impairments were included, thus excluding the largest group. By choosing questionnaire design and structured interviews, the number able to participate may increase. Practical implications Findings may provide healthcare personnel and managers with increased knowledge on which to develop strategies to improve specific care quality perceptions. Originality/value Cluster analysis can be an effective tool for differentiating between nursing homes residents’ care quality perceptions.

scholarly journals Advance care planning in nursing homes: new conversation and documentation tools

2021 ◽  
pp. bmjspcare-2021-003008
Author(s):  
Annelien Wendrich-van Dael ◽  
Joni Gilissen ◽  
Liesbeth Van Humbeeck ◽  
Luc Deliens ◽  
Robert Vander Stichele ◽  
...  
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Advance Care Planning ◽  
Healthcare Professionals ◽  
Nursing Home Residents ◽  
Care Staff ◽  
Care Planning ◽  
Nursing Home Staff ◽  
Advance Care ◽  
Context Specific

Although advance care planning (ACP) is highly relevant for nursing home residents, its uptake in nursing homes is low. To meet the need for context-specific ACP tools to support nursing home staff in conducting ACP conversations, we developed the ACP+intervention. At its core, we designed three ACP tools to aid care staff in discussing and documenting nursing home resident’s wishes and preferences for future treatment and care: (1) an extensive ACP conversation guide, (2) a one-page conversation tool and (3) an ACP document to record outcomes of conversations. These nursing home-specific ACP tools aim to avoid a purely document-driven or ‘tick-box’ approach to the ACP process and to involve residents, including those living with dementia according to their capacity, their families and healthcare professionals.

scholarly journals Nothing to complain about? Residents’ and relatives’ views on a “good life” and ethical challenges in nursing homes

2014 ◽  
Vol 23 (2) ◽  
pp. 142-153 ◽  
Author(s):  
Georg Bollig ◽  
Eva Gjengedal ◽  
Jan Henrik Rosland
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Good Life ◽  
Ethical Issues ◽  
Nursing Home Residents ◽  
Well Being ◽  
Ethical Challenges ◽  
Staff Members ◽  
Group Interviews ◽  
The Relationship

Background: Nursing home residents are a vulnerable population. Most of them suffer from multi-morbidity, while many have cognitive impairment or dementia and need care around the clock. Several ethical challenges in nursing homes have been described in the scientific literature. Most studies have used staff members as informants, some have focused on the relatives’ view, but substantial knowledge about the residents’ perspective is lacking. Objective: To study what nursing home residents and their relatives perceive as ethical challenges in Norwegian nursing homes. Research design: A qualitative design with in-depth interviews with nursing home residents, and focus-group interviews with relatives of nursing home residents. The digitally recorded interviews were transcribed verbatim. Analysis was based on Interpretive Description. Participants and research context: A total of 25 nursing home residents from nine nursing homes in Norway, and 18 relatives of nursing home residents from three of these nursing homes. Ethical considerations: This study was reported to and approved by the Regional Ethics Committee in Oslo, Norway. Findings and discussion: The main ethical challenges in Norwegian nursing homes from the residents’ and relatives’ perspective were as follows: (a) acceptance and adaptation, (b) well-being and a good life, (c) autonomy and self-determination, and (d) lack of resources. The relationship with the staff was of outmost importance and was experienced as both rewarding and problematic. None of the residents in our study mentioned ethical challenges connected to end-of-life care. Conclusion: Residents and relatives experience ethical challenges in Norwegian nursing homes, mostly connected to “everyday ethical issues.”

scholarly journals Besøk på sykehjem. En kvantitativ studie av sykehjemsbeboeres besøkshyppighet

2018 ◽  
Vol 14 (1) ◽  
Author(s):  
Joanna Galek ◽  
Morten Simonsen ◽  
Ellen-Karine Grov ◽  
Anne Marie Sandvoll
Keyword(s):  
Nursing Home ◽  
Nursing Students ◽  
Nursing Homes ◽  
Length Of Stay ◽  
Nursing Home Residents ◽  
Social Contact ◽  
Well Being ◽  
Cross Sectional ◽  
Visit Frequency ◽  
Number Of Visits

Social contact is essential for the well-being of the nursing home residents.Visiting frequency in nursing homes is rarely investigated. The purpose of this study was to map the number of visits for nursing home residents. Nursing students collected data during their nursing home practice. 355 residents were included in this cross-sectional study. We explored the association between visit frequency and age, gender, type of department, activities of daily living (ADL) and length of stay. Data was analyzed using statistical analysis. The average number of visits was 8,8 per month. However, there were differences in visit frequency among the 15 institutions. Residents in the long-term department received fewer visits compared to the dementia and short-term department. Significant correlations between ADL function, gender, length of stay, age and frequency of visits were not found. More research to identify causes for the differences in visit frequency between different institutions is needed.Keywords: nursing homes; visiting; visit frequency; sykehjem; besøk; besøkshyppighet

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.

scholarly journals Nurse-Patient Interaction and Self-Transcendence: Assets for a Meaningful Life in Nursing Home Residents?

2019 ◽  
Author(s):  
Gørill Haugan ◽  
Britt Moene Kuven ◽  
Wenche Mjanger Eide ◽  
Siw Eriksen Tåsen ◽  
Eva Rinnan ◽  
...  
Keyword(s):  
Older Adults ◽  
Nursing Home ◽  
Nursing Homes ◽  
Meaning In Life ◽  
Nursing Home Residents ◽  
Well Being ◽  
Nursing Home Care ◽  
Patient Interaction ◽  
Self Transcendence

Abstract Background. Today, we face a shift to an older population worldwide and its consequences; a noteworthy part of older adults will need 24-hours nursing home care at the end of life. Finding new and alternative approaches to increase wellbeing among nursing home residents is highly warranted. Knowledge about nurse-patient-interaction, self-transcendence and meaning-in-life seems vital in order to guide clinical practice in how to best and efficiently boost wellbeing among older adults in nursing homes. Methods In a cross-sectional design, 188 (92% response rate) out of 204 long-term NH patients representing 27 NHs responded to the nurse-patient interaction, self-transcendence, and the purpose-and-meaning-in-life scales. Inclusion criteria were: (1) municipality authority’s decision of long-term NH care; (2) residential time three months or longer; (3) informed consent competency recognized by responsible doctor and nurse; and (4) capable of being interviewed. The hypothesized relations (five hypotheses) between the latent constructs were tested by means of structural equation modelling (SEM) using Stata 15.1. Results The SEM-model yielded a good fit (χ2=146.824, p=0.021, df=114, χ2 /df=1.29 RMSEA=0.040, p-close 0.811, CFI=0.97, TLI=0.96, and SRMR=0.063), showing significant relationships between the constructs of nurse-patient interaction, inter- and intra-personal self-transcendence and meaning-in-life. Nurse-patient interaction significantly relates with both inter- and intra-personal self-transcendence and meaning in NH patients. Self-transcendence revealed a fundamental influence on perceived meaning, while nurse-patient interaction demonstrated a significant influence on meaning, mediated by self-transcendence Conclusion According to the rapidly growing number of people over 65 in the world, and the growing segment of people 80-100, the present results are significant in their suggestions that nurse-patient-interaction is a crucial resource in relation to nursing home residents’ wellbeing. Knowledge of how nurse-patient-interaction, self-transcendence and meaning relate to each other among older adults in NHs is important for researchers, nurses, caregivers, nursing educators, and clinicians. Health professionals in nursing homes should learn how to competently use the nurse-patient interaction as a health promoting asset for self-transcendence, meaning and thus well-being. Nursing home nurses should be given more time for interacting with the residents, continuity and mutuality in nurse-patient relationships should be prioritized and facilitated.

scholarly journals Visitation Access to U.S. Nursing Homes: An Analysis of Facility Locations, Ratings, and Disparities

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 114-114
Author(s):  
Mary Helander
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Nursing Home Residents ◽  
Population Data ◽  
Well Being ◽  
Care Quality ◽  
Term Care ◽  
Facility Locations ◽  
Research Findings ◽  
Regular Family

Abstract Research findings suggest that family visits to nursing home residents are important for countering depression, increasing residents’ well-being and quality of life (Miller, 2019; Durkin et al., 2014), maintaining physical function (Shankar et al., 2017), and improving general health (Parmenter et al., 2012). Presence by family can directly impact a resident’s care quality, since family members may take a role in monitoring their older relative’s status (Miller, 2019). Unfortunately, regular family visits to nursing homes may be difficult, or impossible, due to challenges that include distance, travel time, lack of transportation, and cost (Fields et al., 2019) (Miller, 2019). These same challenges may translate to socio-economic barriers for families, eliminating long-term-care as an option for older relatives (Ferraro et al., 2017), (Angel and Berlinger, 2018). This paper considers the issue of nursing home visitation access and examines related disparities through spatial and demographic analysis of 15,000+ US facilities monitored by the Centers for Medicare the Medicaid Services. Mathematical models are used to analyze facility and population data, using access measures adapted from the geography discipline (Lou and Wang, 2003; Paez et al., 2019). Analysis explores whether higher rated nursing homes are more likely to be closer to affluent populations, and whether socioeconomic status is a significant factor in overall access. Analysis reveals patterns of access disparity with respect to nursing home ratings and geographies. For example, proximity to higher rated facilities increases monotonically with median household income. Specific policy recommendations are discussed.

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