scholarly journals A qualitative analysis of trainer/coach experiences of changing care home practice in the Well-being and Health in Dementia randomised control trial

Dementia ◽  
2018 ◽  
Vol 19 (2) ◽  
pp. 237-252 ◽  
Author(s):  
Jane Fossey ◽  
Lucy Garrod ◽  
Azucena Guzman ◽  
Ingelin Testad
Keyword(s):  
Care Home ◽  
Well Being ◽  
Relationship Building ◽  
Randomised Control Trial ◽  
Main Theme ◽  
Training Methods ◽  
Care Home Staff ◽  
People With Dementia ◽  
Health And Social Care

Objectives This study explored the experiences of a range of health and social care professionals employed in the role of trainer/coaches to support care home staff to implement a psychosocial intervention for residents living with dementia. It aimed to identify the factors which are pertinent to these roles, in the context of a cascade model of training. Method A focus group was convened involving dementia trainer/coaches and supervisors who had worked on Well-being and Health for people with Dementia randomised control trial. Twelve participants explored their preparedness for and experiences of their role as ‘Well-being and Health for people with Dementia therapists’. They reflected on their perceptions of the resources and support required. The data were transcribed verbatim and subjected to inductive thematic analysis. Results Three main themes emerged from the data. Within the theme of ‘skills in relationship building’ were two subthemes of developing trust and getting to know individual staff and each care home. In the second main theme of ‘making use of tangible resources’ two subthemes relating to using the Well-being and Health for people with Dementia manuals and the supervision of the therapists arose. The third theme, ‘being an agent for change’ contained three subthemes: effective training methods, creating opportunities for Dementia Champions to reflect and therapists' perceived rewards of their role. Conclusion The findings provide new insights into the trainer/coach role applicable to the practices of services recruiting, training and providing ongoing professional support to practitioners in-reaching into care homes.

Enhanced healthcare in care homes for people with dementia: the Admiral nursing offer

2021 ◽  
Vol 23 (7) ◽  
pp. 1-10
Author(s):  
Karen Harrison Dening ◽  
Zena Aldridge
Keyword(s):  
Primary Care ◽  
Residential Care ◽  
Social Care ◽  
Care Home ◽  
Dementia Care ◽  
Care Homes ◽  
Complex Needs ◽  
Care Home Staff ◽  
People With Dementia ◽  
Health And Social Care

Background The UK older population is higher than the global average. Over the next 20 years, England will see an increase in the number of older people who have higher levels of dependency, dementia and comorbidity, many of whom will require 24-hour residential care. It is estimated that 70% of residents in nursing and residential care homes either have dementia on admission or develop it while residing in the care home, many of who will have complex needs with high levels of multimorbidity. However, there is a lack of consistency in the provision of primary care and specialist services to this population and a known gap in knowledge and skills of dementia care in care home staff and primary care teams. Methods This article considers the current health policy drivers to enhance integrated health and social care provision to care homes and proposes a model of care that would support the aims of the NHS Long Term Plan for care to be delivered closer to home and improve out of hospital care which includes people who live in care homes by introducing Enhanced Health in Care Homes. It is crucial that such a model includes the correct skill mix to meet the needs of the care home population. Conclusions There are currently gaps in service provision to many care homes. Admiral nurse case managers and specialists in dementia care, are well placed to support the delivery of Enhanced Health in Care Homes and improve access to specialist support to care home residents, their families, care home staff and the wider health and social care system.

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.

Sepsis in the older person

2021 ◽  
Vol 23 (8) ◽  
pp. 1-7
Author(s):  
Tony Conner ◽  
Juliana Thompson ◽  
Sue Tiplady
Keyword(s):  
Care Home ◽  
Signs And Symptoms ◽  
Common Condition ◽  
Older Person ◽  
Valuable Contribution ◽  
Older Population ◽  
Care Home Staff ◽  
Treatment And Prevention ◽  
Effective Care

Background: Sepsis is a common condition, with an estimated 30 million cases worldwide each year, resulting in 6 million sepsis-related deaths. Some 60% of all sepsis events and 80% of sepsis-associated deaths occur in the older population. This is because the ageing process, and the presence of multiple comorbidities, make many older people vulnerable to developing, and dying from, sepsis. However, serious illness and death from sepsis can be avoided if the signs and symptoms are identified quickly, and interventions started early. Methods: This article explains current research and guidelines with regard to the causes, recognition, treatment and prevention of sepsis in the older population, and considers the role of care home staff in supporting effective care of residents as risk of developing sepsis. Conclusions: Care home staff are well-positioned to recognise sepsis and contribute to treatment, as their in-depth knowledge of residents makes it easier for them to identify changes in residents' behaviours and health status, which may indicate sepsis. By taking steps to ensure the risk of developing infections is reduced, care home staff can make a valuable contribution to the prevention of sepsis.

scholarly journals 102 Online Supportive Conversations & Reflection Sessions [OSCARS] with Care Home Staff Following A Resident’s Death: Improving Coping Mechanisms, Team Cohesion and Communication

2021 ◽  
Vol 50 (Supplement_1) ◽  
pp. i12-i42
Author(s):  
J Hockley ◽  
L Johnston ◽  
J Watson ◽  
S D Shenkin
Keyword(s):  
Care Home ◽  
Coping Mechanisms ◽  
Team Cohesion ◽  
Online Support ◽  
Frontline Staff ◽  
Care Home Staff ◽  
Team Working ◽  
Staff Wellbeing ◽  
Future Education

Abstract Introduction COVID-19 Trauma Guidance suggests opportunities for structured, time-limited discussions about challenging experiences should be offered. It is unknown if such discussions can be effectively delivered online by palliative care specialists to support care home (CH) staff in relation to death/dying. Funded by Scotland’s Chief Scientist Office COVID-19 “rapid research” fund, online OSCaRS is being piloted. Methods Fortnightly OSCaRS delivered to small groups of CH staff via a secure online platform in three local CHs over 10 weeks. Sessions are digitally recorded. The shortened version of the Chesney coping self-efficacy questionnaire is completed by all staff pre/post. Additional post-study questions asked of OSCaRS participants and in-depth staff interviews will be undertaken (n = 10). Thematic analysis of the recorded sessions and interviews will be undertaken and related to the staff questionnaire and context of each CH. Results New learning on the feasibility and acceptability of providing OSCaRS to frontline staff. The benefit of OSCaRS to CH staff coping mechanisms, team cohesion and communicaton with relatives during the COVID-19 pandemic will be presented. Initial results show that OSCaRS are feasible, valued by all care home staff and support staff in coping with the challenges of COVID-19/. Key Conclusions The analysis will inform future practice, and an Implementation Guide for OSCaRS in CHs will be produced. Key learning on the potential for online support in relation to death/dying during the pandemic and beyond will contribute to future education, training and staff wellbeing resources. It will also inform the role of such sessions in developing individual coping mechanisms and team working alongside communication with relatives during lockdown.

scholarly journals Preparing care home staff to manage challenging behaviours among residents living with dementia: A mixed-methods evaluation

2020 ◽  
Vol 7 (2) ◽  
pp. 205510292093306
Author(s):  
Niyah Campbell ◽  
Ian D Maidment ◽  
Emma Randle ◽  
Rachel L Shaw
Keyword(s):  
Care Home ◽  
Medium Effect ◽  
Power Calculation ◽  
Framework Analysis ◽  
Post Intervention ◽  
Care Home Staff ◽  
Mixed Methods Evaluation ◽  
People With Dementia ◽  
Main Effect ◽  
Challenging Behaviours

We evaluated an intervention designed to manage challenging behaviours of people with dementia. Framework analysis of interviews ( n = 21) showed the intervention modified practice and perceptions. The intervention ( n = 58; power calculation proposed n = 160 for medium effect) had no significant effect on attitudes to dementia for time ( p = .42) or care home ( p = .15). The Maslach burnout scores did not change significantly for person-centredness for time ( p = .83) or care home ( p = .29). Hope scores showed a significant effect post-intervention ( p = .004), but this was not maintained. No significant main effect was found for care home ( p = .36). Experiential learning enabled staff to experience benefits of person-centred care firsthand.

scholarly journals An evaluation of group reminiscence arts sessions for people with dementia living in care homes

Dementia ◽  
2018 ◽  
Vol 19 (3) ◽  
pp. 805-821 ◽  
Author(s):  
Frank Keating ◽  
Laura Cole ◽  
Robert Grant
Keyword(s):  
Quality Of Life ◽  
Social Inclusion ◽  
Care Home ◽  
Well Being ◽  
Care Homes ◽  
Primary Data ◽  
Evaluation Team ◽  
People With Dementia ◽  
Group Reminiscence

Dementia has been identified as one of the major challenges in the 21st Century. The detrimental effects of dementia can jeopardise personhood, thus person-centred interventions including reminiscence and arts practice have been recommended as tools to promote social inclusion and improve the quality of life. This study aimed to evaluate the effectiveness of group reminiscence arts sessions for people living with dementia in care homes (residential and nursing homes) using a comparative and time series design to collect data on quality of life. The intervention was conducted in six care homes in London over a period of 24 weeks and compared with six care homes not receiving the intervention (control). Dementia Care Mapping was used as the primary data collection instrument to measure positive behaviours and rate quality of life before, during and after group reminiscence arts sessions. The evaluation team observed the sessions at three-weekly intervals. Statistical modelling found that positive behaviours and quality of life of care home residents participating in group reminiscence arts sessions increased over the 24-week period. Well-being increased sharply during each session and plateaued at 50 minutes with a sustained positive effect after the sessions. On a longer timescale, well-being and quality of life increased slowly and steadily from one session to the next. The findings were statistically significant ( p < 0.001). The study concludes that group reminiscence arts sessions can have a positive and sustained impact on the quality of life of people with dementia. However, the evidence on the sustainability of the effect over time remains unknown. More research is needed to assess in much greater depth the association between quality of life and group reminiscence arts sessions.

scholarly journals Restraints and Restrictive Interventions during Essential Personal Care in Elderly People Living with Dementia in Care Homes

2021 ◽  
pp. 26-38
Author(s):  
Matthew Crooks ◽  
Katherine Wakenshaw ◽  
Julie Young ◽  
Kayleigh Purvis ◽  
Karin Smith ◽  
...  
Keyword(s):  
Care Home ◽  
Legal Framework ◽  
Care Staff ◽  
Care Homes ◽  
Personal Care ◽  
Personal Assistance ◽  
Care Home Staff ◽  
People With Dementia ◽  
Training Materials ◽  
Materials Used

Care home staff are frequently required to provide invasive personal care for their residents, and on occasions need to use restraint and restrictive practices with people with dementia. This often occurs in situations where the residents no longer have the insight that they require help and may misperceive the personal assistance as an assault. On a practical level, a significant number of people with dementia are currently being admitted to inpatient units due to their level of resistance around essential personal care. Often these same people are settled at all other times. This paper provides practical advice on how to support residents and their caregivers, and gives clinical, legal and ethical guidance. Previous work undertaken by the present authors have shown that care staff require supervision and coaching on this topic. The paper includes training materials used by the authors.  This includes a composite, fictitious case example that illustrates approaches that are compliant with UK guidelines.  It addresses the training of staff working in care homes. As such this paper provides a review and practical example of the appropriate use of restraint for residents unable to consent to the ‘intimate’ care they are receiving. It describes a method delivered in a person-centred manner and within a legal framework.  Having read this paper, care home staff should feel more confident, competent and secure in the assistance they are providing in this contentious area.

scholarly journals Admiral Nurse Case Management within Enhanced Health in Care Homes

2021 ◽  
Vol 05 (02) ◽  
pp. 1-1
Author(s):  
Zena Aldridge ◽  
◽  
Karen Harrison Dening ◽  
◽  
◽  
...  
Keyword(s):  
Service Provision ◽  
Quality Care ◽  
Care Home ◽  
Care Homes ◽  
Care Home Staff ◽  
Nurse Case Management ◽  
Specialist Services ◽  
Health And Social Care ◽  
Improve Access

The United Kingdom’s (UK) older population is higher than the global average. Over the next 20 years, England will see an increase in the number of older people who have higher levels of dependency, dementia, and comorbidity many of whom may require 24-hour care. Currently it is estimated that 70% of residents in nursing and residential care homes either have dementia on admission or develop it whilst residing in the care home. The provision of high-quality care for this population is a challenge with a lack of consistency in the provision of primary care and specialist services and a known gap in knowledge and skills. The NHS Long Term Plan aims to move care closer to home and improve out of hospital care which includes people who live in care homes by introducing Enhanced Health in Care Homes (EHCH). However, such services need to be equipped with the correct skill mix to meet the needs of the care home population. Admiral Nurses are specialists in dementia care and are well placed to support the delivery of EHCH and improve access to specialist support to care home residents, their families, care home staff and the wider health and social care system. This paper discusses current gaps in service provision and how both the EHCH framework, and the inclusion of Admiral Nurses, might redress these and improve outcomes.

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