Intimacy between care home residents with dementia: Findings from a review of the literature

Dementia ◽  
2016 ◽  
Vol 18 (1) ◽  
pp. 94-107 ◽  
Author(s):  
Esther Wiskerke ◽  
Jill Manthorpe
Keyword(s):  
Research Question ◽  
Care Home ◽  
Good Practice ◽  
Sexual Intimacy ◽  
Policy And Practice ◽  
Emotional Intimacy ◽  
Care Home Staff ◽  
Care Workers ◽  
Person With Dementia ◽  
Best Responses

Background There is limited research on what family members and frontline care home staff consider to be the best responses to the sexual expression of a person with dementia, whilst at the same time respecting relatives’ feelings, managing their possible distress and conflict, and how good practice should be reflected in care home policy and practice guidance. Methods This literature review explored what is known of the views of relatives and care workers of new relationships or sexual intimacy between care home residents with dementia, whilst still married to another person. It reports the findings of searches of three databases undertaken in August 2014 (Medline, Embase and PsychINFO). Findings Nine papers were found relevant to the research question. The following themes emerged from a synthesis of the papers located: sexuality in old age, dementia and sexuality, hyper-sexuality, views regarding sexuality of older people living in care homes, the law, ethics and consent, relationships and communication between care home and relatives, and new relationships or intimacy between residents with dementia. Conclusion While studies of residents’ expression of sexuality and their engaging in sexual behaviour with other resident(s) may be challenging to manage in care home settings and can be emotionally painful or uncomfortable for families, the review found that studies are few in number and span emotional intimacy and distressing behaviour.

New relationships and intimacy in long-term care: The views of relatives of residents with dementia and care home staff

Dementia ◽  
2016 ◽  
Vol 17 (4) ◽  
pp. 405-422 ◽  
Author(s):  
Esther Wiskerke ◽  
Jill Manthorpe
Keyword(s):  
Qualitative Interviews ◽  
Care Home ◽  
Care Homes ◽  
Sexual Intimacy ◽  
Term Care ◽  
Care Home Staff ◽  
General Terms ◽  
People With Dementia ◽  
The Moment ◽  
Person With Dementia

Background There is limited research on what family members and frontline care home staff consider to be the best responses to the sexual expression of a person with dementia, whilst at the same time respecting relatives’ feelings, managing their possible distress and conflict. Methods This exploratory study investigated the views of relatives and care workers of new relationships or sexual intimacy between care home residents with dementia, whilst still married to another person. It reports the themes that emerged in qualitative interviews with eight relatives of people with dementia and with 12 frontline care home staff working in two English care homes. Interviews took place in 2015 using a hypothetical vignette that unfolded in four stages. Thematic analysis was used to analyse the data. Findings The views of care home staff and relatives had similarities in general terms regarding the problems arising around expressions of sexuality in care homes: indicting that a light-hearted or non-physical connection between residents is deemed acceptable, but the moment it becomes a sexual relationship then decision making becomes more complicated. Staff were inclined to turn to managers for advice and to consider separating residents. They expressed familiarity with distracting residents from situations that were of concern. Relatives were considerate of the difficulties and dilemmas faced by care home staff. Conclusion The use of a vignette facilitated discussion of a potentially sensitive topic. Areas for further research are identified.

scholarly journals Care workers, the unacknowledged persons in person-centred care: A secondary qualitative analysis of UK care home staff interviews

PLoS ONE ◽  
2018 ◽  
Vol 13 (7) ◽  
pp. e0200031 ◽  
Author(s):  
Adam Kadri ◽  
Penny Rapaport ◽  
Gill Livingston ◽  
Claudia Cooper ◽  
Sarah Robertson ◽  
...  
Keyword(s):  
Qualitative Analysis ◽  
Care Home ◽  
Care Home Staff ◽  
Care Workers

scholarly journals The “Cameos of Care Homes” project – care home staff’s Vanguard involvement and reflections

2019 ◽  
Vol 23 (2) ◽  
pp. 107-115
Author(s):  
Jess Harris ◽  
Jill Manthorpe
Keyword(s):  
Design Methodology ◽  
Research Output ◽  
Care Home ◽  
Care Homes ◽  
Content Type ◽  
Care Home Staff ◽  
Learning Cultures ◽  
Care Workers ◽  
The Impact ◽  
Practical Implications

Purpose The Cameos of Care Homes project is an opportunity to use the medium of film to showcase the experiences and reflections of frontline care home staff whose employers participated in the National Health Service (NHS) England Vanguard programme. Reflecting on their involvement in one of the Enhanced Health in Care Homes Vanguards, 12 staff describe, in front of the camera, the impact on themselves and their colleagues, on their care for their older residents, and on the wider culture of the care home. The paper aims to discuss this initiative. Design/methodology/approach The paper reports the experiences of care home staff that were purposefully recorded on film about their participation in a care home Vanguard. The recruitment of the care homes and staff is described, as are the development of interview questions and approaches needed when filming is considered as a research method. Findings Participating care home staff reported that their involvement in the Vanguard programme had improved knowledge, confidence, morale, communication skills and the homes’ learning cultures. They were enthusiastic about reporting their experiences on film. Examples were given of proactive early support from local NHS staff leading to improvements in care, thereby reducing demand on the NHS. However, participation was resource intensive for care homes. Care home staff hoped the support that accompanied the Vanguard programme would continue but were uncertain to what degree this would happen once the Vanguard programme ceased. Research limitations/implications The interviews were undertaken with a self-selecting group of care home staff from two care homes operating in one of the six Vanguard sites in England. By their very nature, interviews for a public film cannot provide anonymity. Practical implications Researchers seeking the views of care home staff may wish to consider filming interviews and presenting the film as a research output that is engaging and informative for care home and wider audiences. Originality/value The paper presents an analysis of filmed interviews with care home managers and care workers working with older people. Their views on the Vanguard initiative have not been widely considered, in contrast to the sizeable literature relating to NHS activity and expenditure.

scholarly journals How do we provide good mealtime care for people with dementia living in care homes? A systematic review of carer–resident interactions

Dementia ◽  
2021 ◽  
pp. 147130122110020
Author(s):  
James Faraday ◽  
Clare Abley ◽  
Fiona Beyer ◽  
Catherine Exley ◽  
Paula Moynihan ◽  
...  
Keyword(s):  
Systematic Review ◽  
Hospital Admissions ◽  
Care Home ◽  
Good Practice ◽  
Oral Intake ◽  
Care Homes ◽  
Synthesis Process ◽  
Future Research ◽  
Care Home Staff ◽  
People With Dementia

People with dementia who live in care homes often depend on care home staff for help with eating and drinking. It is essential that care home staff have the skills and support they need to provide good care at mealtimes. Good mealtime care may improve quality of life for residents, and reduce hospital admissions. The aim of this systematic review was to identify good practice in mealtime care for people with dementia living in care homes, by focusing on carer-resident interactions at mealtimes. Robust systematic review methods were followed. Seven databases were searched: AgeLine, BNI, CENTRAL, CINAHL, MEDLINE, PsycINFO and Web of Science. Titles, abstracts, and full texts were screened independently by two reviewers, and study quality was assessed with Joanna Briggs Institute tools. Narrative synthesis was used to analyse quantitative and qualitative evidence in parallel. Data were interrogated to identify thematic categories of carer-resident interaction. The synthesis process was undertaken by one reviewer, and discussed throughout with other reviewers for cross-checking. After title/abstract and full-text screening, 18 studies were included. Some studies assessed mealtime care interventions, others investigated factors contributing to oral intake, whilst others explored the mealtime experience. The synthesis identified four categories of carer-resident interaction important to mealtime care: Social connection, Tailored care, Empowering the resident, and Responding to food refusal. Each of the categories has echoes in related literature, and provides promising directions for future research. They merit further consideration, as new interventions are developed to improve mealtime care for this population.

scholarly journals What makes a good handover in a care home for older people?

2019 ◽  
Vol 23 (3) ◽  
pp. 167-176
Author(s):  
Jo Moriarty ◽  
Caroline Norrie ◽  
Jill Manthorpe ◽  
Valerie Lipman ◽  
Rekha Elaswarapu
Keyword(s):  
Care Home ◽  
Care Homes ◽  
Care Plan ◽  
Handheld Devices ◽  
Small Scale ◽  
Content Type ◽  
Care Home Staff ◽  
Care Workers ◽  
Good Contrast ◽  
Practical Implications

Purpose The purpose of this paper is to investigate the content, purpose and effectiveness of the handover of information between care home staff beginning and completing a shift. Design/methodology/approach This was an exploratory study drawing on ethnographic methods. A total of 27 interviews with a range of care home staff, including managers, registered nurses, senior care workers and care workers were undertaken in five care homes selected to give a good contrast in terms of size, ownership, shift patterns and type of handover. Findings Most handovers were short – lasting 15 min or so – and were held in the office or secluded area in which staff could talk privately. They lasted longer in one home in which the incoming and outgoing shifts physically visited each resident’s room and the communal spaces. Staff felt that handovers were important for the efficient running of the home as well as to alert everyone to changes in a resident’s health or important events, such as a hospital appointment. In one home, handheld devices enabled staff to follow a resident’s care plan and update what was happening in real time. Research limitations/implications This was a small scale study based on data from a limited number of care homes. Practical implications The increasing popularity of 12 h shifts means that many homes only hold two short handovers early in the morning and in the evening when the night staff arrive. There appears to be a trend to reduce the number of staff paid to attend handover. Despite this, handovers remain an important component of the routine of a care home. The information contained in handover relates to the running of the care home, as well as residents’ wellbeing, suggesting that, while their content overlaps with written records in the home, they are not superfluous. Originality/value Although the literature on handovers in hospitals is extensive, this appears to be the first published study of handover practices in care homes.

scholarly journals ‘Waiting and Wanting’: older peoples’ initial experiences of adapting to life in a care home: a grounded theory study

2020 ◽  
pp. 1-25 ◽  
Author(s):  
Marie O'Neill ◽  
Assumpta Ryan ◽  
Anne Tracey ◽  
Liz Laird
Keyword(s):  
Grounded Theory ◽  
Data Analysis ◽  
Social Care ◽  
Care Home ◽  
Theory Approach ◽  
Structured Interviews ◽  
Policy And Practice ◽  
Senior Member ◽  
Care Home Staff ◽  
Health And Social Care

Abstract A grounded theory approach, consistent with the work of Strauss and Corbin, was used to undertake semi-structured interviews with 17 older people, to explore their experiences of living in a care home, during the four- to six-week period following the move. Purposive sampling was initially adopted, thereafter, theoretical sampling was employed to recruit individuals identified by care managers within older peoples’ community teams and care home managers within a large Health and Social Care Trust in the United Kingdom. Consistent with grounded theory methodology, data collection and analysis occurred simultaneously. Constant comparative analysis underpinned data analysis and data management techniques. Data analysis revealed five distinct categories that captured these experiences. These were: (a) wanting to connect – ‘I am so lost here’, (b) wanting to adapt – ‘Well mentally you have to make the best of it’, (c) waiting for assistance – ‘it's a frustration for me’, (d) ‘waiting on the end’ – I am making no plans’ and (e) wanting to re-establish links with family and home – ‘I love getting home and I like getting out to the town’. Together these five categories formed the basis of the core category, ‘Waiting and Wanting’, which encapsulates the initial adaptation experiences of the men and women in the study. Findings indicate that individuals were dependent on others to create a sense of belonging, independence and wellbeing. Moreover, risk aversive practices were perceived as a threat to individuals’ independence and autonomy. Recommendations include the need to amend policy and practice for the development of a bespoke induction programme for each resident facilitated by a senior member of the care home staff working in partnership with individuals and families, in addition to the health and social care team, to support a more positive transition for new residents, relatives and care home staff.

scholarly journals 37 Factors Influencing Mealtime Care for People with Dementia Living in Care Homes: An Ethnographic Study

2021 ◽  
Vol 50 (Supplement_1) ◽  
pp. i7-i11
Author(s):  
J Faraday ◽  
C Abley ◽  
C Exley ◽  
J Patterson
Keyword(s):  
Social Care ◽  
Hospital Admissions ◽  
Care Home ◽  
Good Practice ◽  
Ethnographic Study ◽  
Care Homes ◽  
Care Home Staff ◽  
Factors Influencing ◽  
People With Dementia ◽  
Health And Social Care

Abstract Introduction More and more people with dementia are living in care homes. Often they depend on care home staff for help with eating and drinking. It is essential that care home staff are able to provide good care at mealtimes. This study used ethnography to identify factors influencing mealtime care for this population. Methods Over twenty-five hours of mealtime observations were conducted in two UK care homes with diverse characteristics. Observations focused on interactions between care home staff and residents living with dementia. Twenty-two semi-structured interviews were carried out with care home staff, family carers, and visiting health and social care professionals, to explore mealtime care from their perspectives. The study used a constant comparison approach, so that data from early observations and interviews were explored in more depth subsequently. Results Five factors were identified which influenced mealtime care for people with dementia living in care homes. These were: environment (such as background music and building layout); kitchen and food (including connectivity between kitchen staff and others); staffing (for example: staff ratios and allocation); knowledge and support (including training, resources and supportive culture); and relationship with wider care team (such as family involvement, and the role of visiting health and social care professionals). Conclusions This study is part of a bigger project which will develop a staff training intervention to improve mealtime care for people with dementia living in care homes. The intervention will be informed by these findings, and by complementary evidence on good practice in mealtime care (from primary and secondary studies). It is anticipated that good mealtime care may improve quality of life for care home residents, and reduce hospital admissions.

scholarly journals The Implementation of the Right to Live in the Families for the Children from the Child Care Home: Approach of the Workers of Child Care Home

Pedagogika ◽  
2015 ◽  
Vol 118 (2) ◽  
pp. 217-238 ◽  
Author(s):  
Kristina Samašonok
Keyword(s):  
Child Care ◽  
Foster Parents ◽  
Care Home ◽  
Care Homes ◽  
Foster Families ◽  
Care Home Staff ◽  
Care Workers ◽  
The Family ◽  
The Right ◽  
Home Care Workers

The importance of family and quality of relations between its members is very important to the process of personal development. The child’s separation from his parents and placement in care homes have long-term consequences to the development of the child. After evaluation of the importance of family for psychosocial development of personality, the attention should be drawn to improve the system of child care for children without parental care. Increasingly it is considered to ensure the child’s right to live the family life, also to return children living in child care homes to their biological parents and to integrate families of foster parents. According to the current situation, the article reveals what trends prevail in practice of home care workers in order to ensure that children live in the families of the biological parents or foster parents. Also the article helps to evaluate the strengths of achievements in performance of employee as well as perceive the existing problems and provide the prospects for improvement of the situation and possible changes. In order for the children not to live at the child care homes, but in families with their parents or guardians, the question arises: what kind of effort has been made by care home staff to ensure the rights of children to live with parents or with a foster family? The aim of the study is to assess the context of the situation from the position of home care workers in order to ensure the right of children to live in the families of parents or foster parents. The peculiarities of the implementation of the right for children from care home to live in the family were analyzed. The study involved 17 care home staff and was based on their view and personal work experience. A semi-standardized interview method has been applied to get to know the strengths of performance achievements of care home staff also to reveal the problems and shortcomings impeding the right of children from care home to live in the family with parents or foster parents and to provide the improvement techniques for the implementation of the child care system. Interviews revealed that the care home staff admits the importance of the relationship between the child and his parents and other family members for the psychosocial development of the child and try to strengthen the relationship between children and their parents .Child care home staff constructs situations for children to meet with parents as often as possible, activate and support communication with the relatives and the loved ones of the ward. The external resources are searched to solve the problems of the wards: children are incorporated into foster families, stimulate foster families to take care of the wards for weekends or holidays, also wards visit the families of home care workers. However, the analysis of activities and experiences of care home staff revealed that not enough attention is paid to solve the problems of wards’ right to live in the family. According to the current situation, care home staff express concerns about the passivity of foster parents and indifference to their children. The care home staff recognizes that usually the one-way communication takes place with families. The employees of child care home dominate by promoting parents to visit their children, while parents remain passive. On the other hand, care home staff believe that solving child custody issues is not enough to provide material support to families of social risk or to record the facts about child neglect, as well as to distinguish it from the destructive social environment and to provide public care. Comments of the research suggest that while solving the questions of welfare of wards and their right to live in the family, it is necessary to improve the work with families that pass on their children’s care to the state custody. It is important to provide parents of wards social-psychological support, to involve them in educational work and solution of relationship problems between ward and his family also it is necessary to include a range of institutions that work with parents. Workers believe that parents need to be given impetus to reform and strengthen their self-confidence and their own capabilities to care of their child and take the responsibility; also it is necessary to encourage parents to get the children back and bring them up the family, to emphasize their importance and necessity to the child. While discussing the opportunities for wards to live in the family, care home staff emphasize the importance of short-term assistance and full care as well as the need to integrate wards into adequate families. It is considered that the integration of the wards into foster families increase the opportunities for children deprived of parental care to build successfully strong families and construct a family relationship. The care home staff agree that living in a care home, foster children form a distorted perception of the family. It is possible to notice the lack of perspective regarding the preparation of foster children and teenagers for their future family life because usually the solutions of problems are restricted to oral remarks or conversations in care homes. Workers of care home believe that the absence of a real family model for wards will impede them to build strong families in the future. Some of the most successful assumptions that could help to reduce rising number of child care institutions are: social assistance and support system in targeting prevention work; provision of services to families by encouraging parents to get the child back to a family; to ensure that social risk families could integrate into the labor market; education and social assistance programs that help to restore a positive family experience, thereby educating the orphans, that grew up in foster homes; education about a family life; the integration and preparation of children psychologically and educationally; taking care of the child’s, families morally and legally.

scholarly journals The behaviours that dementia care home staff in South Africa find challenging: An exploratory study

Dementia ◽  
2016 ◽  
Vol 16 (7) ◽  
pp. 865-877 ◽  
Author(s):  
Adele van Wyk ◽  
Jill Manthorpe ◽  
Charlotte Clark
Keyword(s):  
South Africa ◽  
Exploratory Study ◽  
Care Home ◽  
Good Practice ◽  
Unmet Need ◽  
Care Staff ◽  
Care Practice ◽  
Behavioural Symptoms ◽  
Care Home Staff ◽  
People With Dementia

Background Behavioural and psychological symptoms of dementia are often the reasons for moving to a care home. Care staff, often with limited dementia training, may have to support residents with distressed behaviour on a daily basis. Evidence about the support of residents with distressed or challenging behaviour in the South African context is lacking. This exploratory study aimed to gain an understanding of what care home staff perceived to be distressed behaviour, their coping strategies and how they learned to work with residents with behavioural symptoms of dementia. Methods An exploratory study was conducted among 17 participants working in four care homes in the Western Cape province of South Africa in 2014. Semi-structured interviews were audio-recorded. Data were analysed thematically. Findings Findings reflected the literature with regard to examples of behavioural symptoms of people with dementia that staff find challenging to manage. Overall, the majority of staff reported holding positive feelings about working with people with dementia. All preferred interpersonal approaches to manage distressed behaviour above medication although a small minority noted the use of medication in some cases. Dementia training was considered by most participants as an unmet need. Conclusion This exploratory study identified care home workers’ desires for training about dementia and their preferences for interpersonal as opposed to pharmacological approaches to managing residents’ distressed behaviour. The legacy of race and cultural perspectives in South Africa appears to still influence care practice and provision. Staff commitment, their interest in advancing their practice and their aspirations to offer more person-centred care were evident. Dementia training was identified as potentially helpful to care home staff who manage residents’ distressed behaviour. Training should be developed in South Africa to promote good practice.

scholarly journals Care homes, their communities, and resilience in the face of the COVID-19 pandemic: interim findings from a qualitative study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Fiona Marshall ◽  
Adam Gordon ◽  
John R. F. Gladman ◽  
Simon Bishop
Keyword(s):  
Central Government ◽  
Resource Constraints ◽  
Care Delivery ◽  
Care Home ◽  
Third Sector ◽  
Care Homes ◽  
Framework Analysis ◽  
Local Networks ◽  
Care Home Staff ◽  
East Midlands

Abstract Background From late February 2020, English care homes rapidly adapted their practices in response to the COVID-19 pandemic. In addition to accommodating new guidelines and policies, staff had to adjust to rapid reconfiguration of services external to the home that they would normally depend upon for support. This study examined the complex interdependencies of support as staff responded to COVID-19. The aim was to inform more effective responses to the ongoing pandemic, and to improve understanding of how to work with care home staff and organisations after the pandemic has passed. Methods Ten managers of registered care homes in the East Midlands of England were interviewed by videoconference or phone about their experiences of the crisis from a structured organisational perspective. Analysis used an adapted organisational framework analysis approach with a focus on social ties and interdependencies between organisations and individuals. Results Three key groups of interdependencies were identified: care processes and practice; resources; and governance. Care home staff had to deliver care in innovative ways, making high stakes decisions in circumstances defined by: fluid ties to organisations outside the care home; multiple, sometimes conflicting, sources of expertise and information; and a sense of deprioritisation by authorities. Organisational responses to the pandemic by central government resulted in resource constraints and additional work, and sometimes impaired the ability of staff and managers to make decisions. Local communities, including businesses, third-sector organisations and individuals, were key in helping care homes overcome challenges. Care homes, rather than competing, were found to work together to provide mutual support. Resilience in the system was a consequence of dedicated and resourceful staff using existing local networks, or forging new ones, to overcome barriers to care. Conclusions This study identified how interdependency between care home organisations, the surrounding community, and key statutory and non-statutory organisations beyond their locality, shaped decision making and care delivery during the pandemic. Recognising these interdependencies, and the expertise shown by care home managers and staff as they navigate them, is key to providing effective healthcare in care homes as the pandemic progresses, and as the sector recovers afterwards.

Sign in / Sign up

Export Citation Format

Share Document