How organizational factors interact to influence the quality of care of older people in the care home sector

2013 ◽  
Vol 18 (1_suppl) ◽  
pp. 14-22 ◽  
Author(s):  
Anne Killett ◽  
Paula Hyde ◽  
Diane Burns ◽  
Richard Gray ◽  
Fiona Poland
2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 153-154
Author(s):  
Afeez Hazzan

Abstract Dementia is one of the most rapidly growing diseases in the United States. In 2018, the direct costs to American society of caring for older people with dementia was approximately $277 billion. Primary informal caregivers are mainly responsible for the care of older people with dementia including Alzheimer’s disease. Caregivers perform a myriad of duties ranging from shopping for their loved ones’ groceries, helping with medications, and managing finances. The caregiving role becomes more demanding as the disease progresses over time, and studies have shown that the quality-of-life (QoL) experienced by caregivers of older adults who have dementia is lower than the QoL of caregivers for older people who do not have dementia. To the best of our knowledge, there has been no research conducted to investigate whether lower caregiver QoL affects the level or quality of care that caregivers provide to persons with dementia. In the current study, we interviewed family caregivers living in Rochester, New York to inquire about their quality of life and the care provided to older people living with dementia. Further, caregivers completed the 36-item Short Form Health Survey (SF-36) as well as a draft questionnaire for measuring the quality of care provided to older people living with dementia. Both quantitative and qualitative findings from this study reveals important relationships between family caregiver QoL and the care provided, including the impact of social support and financial well-being. The study findings could have significant impact, particularly for the provision of much needed support for family caregivers.


2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 152-152
Author(s):  
Afeez Hazzan

Abstract Family caregivers of older people living with dementia are relatives, friends, or neighbors who provide assistance related to this condition, but who are unpaid for the services they provide. Although caregiving could be personally rewarding, many caregivers report a high level of strain. Compared to caregivers of older adults who do not have dementia, family caregivers of older people living with dementia report lower quality-of-life (QoL). In a published systematic review examining the relationship between family caregiver QoL and the quality of care provided, only one study was found to be somewhat relevant. The study suggested that the primary reason for an absence of research into the link between family caregiver QoL and quality of care was the absence of a questionnaire for measuring quality of care in dementia. Therefore, any attempt to investigate the impact of caregiver QoL on the care provided to older people with dementia must first address the lack of an instrument to measure quality of care. To address this issue, we interviewed approximately 20 family caregivers in order to elicit feedback on measurements and interpretation of the quality of care provided by family caregivers of older people living with dementia. Content analysis of the interview transcripts revealed that the quality of relationships with family, caregiver availability to provide or supervise care, and availability of paid or volunteer help are important for the quality of care provided. These results have important implications, particularly for the development of an instrument to measure quality of care in dementia.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Annette Keuning-Plantinga ◽  
Evelyn J. Finnema ◽  
Wim Krijnen ◽  
David Edvardsson ◽  
Petrie F. Roodbol

Abstract Background Person-centred care is the preferred model for caring for people with dementia. Knowledge of the level of person-centred care is essential for improving the quality of care for patients with dementia. The person-centred care of older people with cognitive impairment in acute care (POPAC) scale is a tool to determine the level of person-centred care. This study aimed to translate and validate the Dutch POPAC scale and evaluate its psychometric properties to enable international comparison of data and outcomes. Methods After double-blinded forward and backward translations, a total of 159 nurses recruited from six hospitals (n=114) and via social media (n=45) completed the POPAC scale. By performing confirmatory factor analysis, construct validity was tested. Cronbach’s alpha scale was utilized to establish internal consistency. Results The confirmatory factor analysis showed that the comparative fit index (0.89) was slightly lower than 0.9. The root mean square error of approximation (0.075, p=0.012, CI 0.057–0.092) and the standardized root mean square residual (0.063) were acceptable, with values less than 0.08. The findings revealed a three-dimensional structure. The factor loadings (0.69–0.77) indicated the items to be strongly associated with their respective factors. The results also indicated that deleting Item 5 improved the Cronbach’s alpha of the instrument as well as of the subscale ‘using cognitive assessments and care interventions’. Instead of deleting this item, we suggest rephrasing it into a positively worded item. Conclusions Our findings suggest that the Dutch POPAC scale is sufficiently valid and reliable and can be utilized for assessing person-centred care in acute care hospitals. The study enables nurses to interpret and compare person-centred care levels in wards and hospital levels nationally and internationally. The results form an important basis for improving the quality of care and nurse-sensitive outcomes, such as preventing complications and hospital stay length.


Author(s):  
Bob Woods

This chapter documents the developments in Wales relating to a National Dementia Vision and Strategy. A new Strategy is to appear by December 2016. While activity and progress are evident in many areas, much remains to be done. Wales benefits from having an Older People’s Commissioner, a statutory voice for older people, including those living with dementia, and from its rich cultural, linguistic, and artistic heritage, with active third-sector organizations. Like many countries, Wales has had well-publicized scandals in relation to quality of care in hospitals and care homes, which have provided learning and impetus for development. Compared with other parts of the United Kingdom, dementia diagnosis rates in Wales appear low and are now the subject of government targets. The new Strategy will need to fully engage with people living with dementia in order to address these challenges, while building on the growing social movement of dementia-friendly communities.


2019 ◽  
Vol 25 (7) ◽  
pp. 326-332
Author(s):  
Kanyanat Supaporn ◽  
Sang-arun Isaramalai ◽  
Wandee Suttharangsee

Background: Older people in Thailand receive general medical and social care at the end of life, and many rarely access palliative services. In light of this, improving the quality of care for the ageing population relies on addressing the needs of family caregivers, who provide the majority of care in a home setting. Understanding caregivers' perspectives when caring for a friend or relative will help to improve the quality of care that they provide. Aim: To explore caregivers' perspectives on improving care for older people in Thailand in the palliative stage. Methods: A qualitative study using in-depth interviews and observation of 10 older people in the palliative stage and their caregivers was undertaken. Data were analysed using content analysis. Findings: Data analysis revealed three themes: caregivers cared to repay the older person's previous kindness, caregivers cared and changed their caregiving behaviour to minimise the older person's perception of being abandoned or being a burden, and to follow Thai ancestral traditions, so that the older person could die peacefully. Conclusion: This study provides specific instructions for those who provide care for older Thai people in the palliative stage. Finding ways to address caregivers' perspectives on improving care quality could enhance the experience of care recipients.


2017 ◽  
Vol 3 (4) ◽  
Author(s):  
Alessandra Anzuini ◽  
Francesca Massariello ◽  
Giuseppe Bellelli

Delirium is a geriatric syndrome, characterized by acutely altered mental status with inattention, fluctuating course and global cognitive dysfunction, which is associated with a significant burden in terms of negative outcomes and costs of care. Delirium is frequently undetected despite its prevalence and incidence are relevant. In this brief report, we report the state of the art in terms of prevention for both medical and surgical patients. A non-pharmacological approach seems to be the more promising method to prevent delirium and improve quality of care for people at risk.


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