Event-Specific Emotional Expression of Persons Living With Dementia in Long-term Care: A 6 Months Follow-up Study

This longitudinal study aimed to explore the event-specific emotional expressions of persons living with dementia in long-term care during a 6-month period with repeated observations. Emotional expressions at three specific events (mealtime, personal care, and social activity) were videotaped at the beginning, month 3, and month 6. Thirty participants were enrolled, and nine observations were made for each participant. Mixed-effect models were used for statistical analysis. The type of care events, the person who provides care, and the facility type were associated with emotional expressions. Specifically, personal care, interaction with non-nursing providers, and facility type were associated with positive emotional expressions. Negative emotional expressions were related to personal care, interaction with family or volunteer, and facility type. This study provides a better understanding of event-specific emotional expressions and knowledge to support the development of emotion-oriented intervention programs to improve the psychological well-being of persons living with dementia.

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EVENT-SPECIFIC EMOTIONAL EXPRESSION OF PERSONS WITH DEMENTIA IN LONG-TERM CARE: PRELIMINARY RESULTS

Innovation in Aging ◽

10.1093/geroni/igz038.1570 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S420-S420

Author(s):

Kyung Hee Lee ◽

Ji Yeon Lee ◽

Bora Kim ◽

Marie Boltz

Keyword(s):

Health Care Providers ◽

Emotional Expression ◽

Long Term Care ◽

Well Being ◽

Emotional Expressions ◽

Care Providers ◽

Personal Care ◽

Term Care ◽

Meal Time

Abstract Although dementia-related language, comprehension, and memory deficits occur fairly early stage in dementia, persons with dementia retain the ability to express their emotion even in the late stage of disease. However, health care providers do not know how to interpret emotional expressions that could be utilized as important signals of underlying needs and care preferences in persons with dementia. The purpose of this study was to explore the event-specific emotional expressions of persons with dementia in long-term care over a 6-month period. This was a longitudinal study using repeated observations. Emotional expressions were videotaped when three specific events (personal care, meal time, and activity) occurred at baseline, month 3 and month 6. A total of nine observations was made for each participant. We enrolled 13 participants so far; ten participants were completed 6 month follow up. The mean score of MMSE at baseline was 4.38; that of ADL was 16.62. On average, persons with dementia showed 9.93 episodes of positive emotional expression (PEE) per minute and 1.81 episodes of negative emotional expression (NEE) per minute. We found between person variations for both PEE and NEE. PEE and NEE were different by three types of events. Specifically, persons with dementia showed more PEE with activity than personal care and meal time and more NEE with personal care than the other two events. This study will provide better understanding of event-specific emotional expressions, and inform the development of emotion-oriented interventions programs to improve the psychological well-being of persons with dementia.

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Structural marginalisation among the long-term care workforce in England: evidence from mixed-effect models of national pay data

Ageing and Society ◽

10.1017/s0144686x12000785 ◽

2012 ◽

Vol 34 (1) ◽

pp. 21-41 ◽

Cited By ~ 13

Author(s):

SHEREEN HUSSEIN ◽

JILL MANTHORPE

Keyword(s):

Long Term Care ◽

Term Care ◽

Mixed Effect ◽

Ageing Society ◽

Job Roles ◽

Mixed Effect Models ◽

Pay Differences ◽

And Gender

ABSTRACTThe long-term care sector is generally characterised by low pay and difficult working conditions. Understanding pay structures and differentials within this sector is important in enhancing recruitment, retention, quality of care and productivity. This article uses new national data on the long-term care workforce in England to investigate employer and individual effects on pay levels and differentials, using mixed-effects modelling controlling for region, sector and employer hierarchical factors. We further examine whether gender and ethnic pay gaps exist among different groups of workers. The results indicate a significant relationship between sector and pay across different job roles. The analysis further identifies ethnic and gender pay differences even after controlling for the effects of sector and individual employers. The implications of this are discussed in relation to sustaining the care workforce in the context of an ageing society and the potential for structural employment marginalisation to reflect the marginalisation of older people receiving care.

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Mental well‐being of staff in long‐term care facilities at risk

Geriatrics and Gerontology International ◽

10.1111/ggi.14260 ◽

2021 ◽

Author(s):

Chiaki Ura ◽

Tsuyoshi Okamura ◽

Akinori Takase ◽

Masaya Shimmei ◽

Yukan Ogawa

Keyword(s):

At Risk ◽

Long Term Care ◽

Well Being ◽

Term Care ◽

Care Facilities ◽

Mental Well Being

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Digital Technologies To Enhance Social Connectedness in Long-Term Care Facilities During COVID-19: A Review

Innovation in Aging ◽

10.1093/geroni/igaa057.3451 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 942-943

Author(s):

Shannon Freeman ◽

Aderonke Abgoji ◽

Alanna Koopmans ◽

Christopher Ross

Keyword(s):

Social Isolation ◽

Rural Areas ◽

Social Connectedness ◽

Long Term Care ◽

Care Facility ◽

Well Being ◽

Sufficient Information ◽

Term Care ◽

Care Facilities

Abstract A consequence of the strict visitor restrictions implemented by many Long-term Care Facilities (LTCFs), during the COVID-19 pandemic, was the exacerbation of loneliness and social isolation felt by older adult residents. While there had been a shift by some persons to utilize digital solutions to mitigate the effects of the imposed social isolation, many facilities did not have sufficient information regarding available solutions to implement institutional strategies to support social connectedness through digital solutions. To support our partners in evidence-based policy-making we conducted a scoping review to identify existing virtual technology solutions, apps, and platforms feasible to promote social connectedness among persons residing in a long-term care facility context during times of lockdown such as experienced during the COVID-19 pandemic. Initial identification of relevant literature involved a combination of keywords and subject headings searches within 5 databases (PubMed, CINAHL EBSCO, PsychINFO EBSCO, Embase OVIDSP, and Web of Science ISI). DistillerSR was used to screen, chart and summarize the data. There is growth in the availability of technologies focused on promoting health and well-being in later life for persons in long-term care facilities however a gap remains in widespread uptake. We will describe the breadth of technologies identified in this review and discuss how they vary in utility in smaller scale facilities common in rural areas. Of the technologies that can be used to mitigate the impacts of social isolation felt by long-term care residents, many “solutions” depend on stable highspeed internet, which remains a challenge in rural and northern areas.

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Informal carer in Portugal: moving towards political recognition in Portugal

European Journal of Public Health ◽

10.1093/eurpub/ckz187.178 ◽

2019 ◽

Vol 29 (Supplement_4) ◽

Author(s):

I Fronteira ◽

J Simoes ◽

G Augusto

Keyword(s):

Informal Care ◽

Long Term Care ◽

Well Being ◽

Oecd Countries ◽

Low Fertility ◽

Informal Carer ◽

Term Care ◽

System Perspective ◽

Informal Carers

Abstract Informal care represents around 80% of all long term care provided in EU countries. Nevertheless, the needs for this type of care are expected to increase in the coming years in all OECD countries. Portugal is among the OECD countries with the highest ageing index (21.5% of the population was older than 65 years in 2017) due to high life expectancy and low fertility rates. As this demographic trend establishes, Portugal is expected to have more than 40% of the population over 65 years in 2037, and the expected prevalence of dementia is 3%, in 2050. In 2015 there were 2.1% of people over 65 receiving long-term care, representing 52% of all long-term care users. Around 38% were receiving care at home. It is estimated that 287,000 people in Portugal depend on informal carers. The agenda towards the official recognition of informal cares has been push forward in the country. Since 2015, several recommendations have been issued by the Parliament as well as legislative initiatives and a proposal for a Status of the Informal Carer is currently under discussion. We analyse the process of formulation of this policy in terms of sectors and stakeholders involved, definition and scope of informal carer, rights and obligations, role of the person being cared for, formal protection (e.g., labor, social, financial, training) and implementation. Recognition of the informal carer is a sector wide approach. One of the main features is the economic, social and labor protection mainly through reconciliation between work life and caring activities and promotion of the carer’s well being. Notwithstanding, and from a health system perspective, community health teams are to be the focal point for informal carers, supporting and providing specific training whenever needed. Despite its relevance, informal care should not be professionalized and responsibility of care should not be shifted from health services to informal carers. Key messages Needs for informal care are expected to increase in the coming years in OECD countries. Recognition of the informal carer is a sector wide approach.

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#MoreThanAVisitor: Families as “Essential” Care Partners During COVID-19

The Gerontologist ◽

10.1093/geront/gnaa161 ◽

2020 ◽

Author(s):

Candace L Kemp

Keyword(s):

Family Involvement ◽

Long Term Care ◽

Research Policy ◽

Well Being ◽

Direct Care ◽

Negative Consequences ◽

Public Health Response ◽

Term Care ◽

Care Partners

Abstract The public health response to the current Coronavirus pandemic in long-term care communities, including assisted living, encompasses prohibiting visitors. This ban, which includes family members, has been criticized for being unfair, unhealthy, and unsafe. Against this backdrop, I examine the roles family play in residents’ daily lives and care routines. I argue that classifying family as “visitors” rather than essential care partners overlooks their critical contributions and stems from taken-for-granted assumption about gender, families, and care work, and I demonstrate why families are more than visitors. Policies that ban family visits also reflect a narrow understanding of health that focuses on mitigating infection risk, but neglects overall health and well-being. This policy further stems from a limited comprehension of care relations. Research shows that banning family visits has negative consequences for residents, but also families themselves, and direct care workers. I argue that identifying ways to better understand and support family involvement is essential and demonstrate the utility of the Convoys of Care model for guiding the reconceptualization of family in long-term care research, policy, and practice during and beyond the pandemic.

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FEDERAL POLICY SUPPORTS AND GAPS IN ADDRESSING RACIAL-ETHNIC HEALTH DISPARITIES IN U.S. LONG-TERM CARE FACILITIES

Innovation in Aging ◽

10.1093/geroni/igz038.576 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S161-S161

Author(s):

Rebecca L Mauldin ◽

Kathy Lee ◽

Antwan Williams

Keyword(s):

Long Term Care ◽

Federal Policy ◽

Care Facility ◽

Well Being ◽

The United States ◽

Term Care ◽

Long Term Care Facility ◽

Care Facilities

Abstract Older adults from racial and ethnic minority groups face health inequities in long-term care facilities such as nursing homes and assisted living facilities just as they do in the United States as a whole. In spite of federal policy to support minority health and ensure the well-being of long-term care facility residents, disparities persist in residents’ quality of care and quality of life. This poster presents current federal policy in the United States to reduce racial and ethnic health disparities and to support long-term care facility residents’ health and well-being. It includes legislation enacted by the Patient Protection and Affordable Care Act of 2010 (ACA), regulations of the U.S. Department of Health and Human Services (DHHS) for health care facilities receiving Medicare or Medicare funds, and policies of the Long-term Care Ombudsman Program. Recommendations to address threats to or gaps in these policies include monitoring congressional efforts to revise portions of the ACA, revising DHHS requirements for long-term care facilities staff training and oversight, and amending requirements for the Long-term Care Ombudsman Program to mandate collection, analysis, and reporting of resident complaint data by race and ethnicity.

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TRAINING STAFF IN LONG-TERM CARE FACILITIES – EFFECTS ON RESIDENTS’ SYMPTOMS, PSYCHOLOGICAL WELL-BEING, AND PROXY SATISFACTION

Journal of Pain and Symptom Management ◽

10.1016/j.jpainsymman.2021.03.020 ◽

2021 ◽

Author(s):

Pauli J Lamppu ◽

Marja-Liisa Laakkonen ◽

Harriet Finne-Soveri ◽

Hannu Kautiainen ◽

Jouko V Laurila ◽

...

Keyword(s):

Long Term Care ◽

Well Being ◽

Term Care ◽

Psychological Well Being ◽

Care Facilities

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END-OF-LIFE CARE PREFERENCES AND WELL-BEING IN LONG-TERM CARE RESIDENTS

Innovation in Aging ◽

10.1093/geroni/igz038.2474 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S669-S669

Author(s):

Kelly Shryock ◽

Jacinta Dickens ◽

Anisha Thomas ◽

Suzanne Meeks

Keyword(s):

Quality Of Life ◽

Positive Affect ◽

End Of Life ◽

End Of Life Care ◽

Long Term Care ◽

Well Being ◽

Life Care ◽

Term Care

Abstract Research on end-of-life care in nursing homes comes largely from the viewpoint of staff or family members. We examined patient perspectives on end-of-life care, preferences for care, and quality of life in long-term care settings. We hypothesized that fulfillment of the Self Determination Theory (SDT) needs of autonomy, competence, and relatedness would be related to better well-being and that the degree to which end-of-life care preferences are seen as possible in the setting would be related to SDT need fulfillment and well-being. Preliminary data, collected from older individuals at the end of life (over 55, presence of significant chronic disease, in long term care setting) (n= 72), demonstrated that autonomy, competence, and relatedness measures were moderately and significantly correlated with well-being as measured by life satisfaction, higher positive affect, lower negative affect, and overall quality of life measures The degree to which residents believed that their end-of-life care preferences could be honored in the setting was also significantly correlated with autonomy, competence, relatedness, positive affect, and psychological quality of life. These results are consistent with SDT and suggest that if long term care settings can promote autonomy, connection, and competence in making end of life decisions, possibly by discovering and fulfilling preferences for end of life care, individuals who end their lives on those settings have potential for greater satisfaction and happiness. These results suggest that SDT is a useful framework for ongoing research on how to improve the end of life experiences of older adults in long term care.

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