scholarly journals It takes time: Building relationships and understanding through an intergenerational ballet programme

Dementia ◽  
2018 ◽  
Vol 19 (2) ◽  
pp. 270-284
Author(s):  
Shelley E Canning ◽  
Michael Gaetz ◽  
Darren Blakeborough
Keyword(s):  
Older Adults ◽  
Residential Care ◽  
Long Term Care ◽  
Care Home ◽  
Care Homes ◽  
Term Care ◽  
Negative Stereotypes ◽  
Building Relationships ◽  
Meaningful Relationships

Individuals living in long-term residential care homes are often viewed through a negative lens. These residents have increasingly complex care needs, and their functional, communication and cognitive challenges can support conceptualizations of difference and disability perpetuating negative stereotypes of age and dementia. However, engaging in meaningful activities and relationships with older adults, including those with dementia, has been shown to promote positive attitudes. Specifically, intergenerational programming that provides opportunities for meaningful engagement between children and older adults has been shown to support positive emotional experiences through socializing and building relationships. This qualitative study explored the development of relationships between school-aged children and older adults with dementia living in a long-term residential care home. Residents in long-term care homes and children typically have limited opportunities to interact with each other; in this study, participating in an intergenerational dance programme provided an opportunity for meaningful relationships to develop. This paper focuses on the development of the children’s attitudes and understandings of their much older dance partners. Seven girls between the ages of seven and nine participated in ballet classes with residents in a long-term care home for one hour each week over a six-month period. All of the residents had a diagnosis of moderate to advanced dementia. Further, all of the residents also had other chronic health issues such as cardiac, respiratory and/or neurological diseases. The children were interviewed at the baseline, three- and six-month intervals. Prior to beginning the dance programme, the children anticipated their dance partners to be unwell and unable. However, by the end of six months, the children described the residents much more positively highlighting their abilities and strengths. Over time, through participating in a structured intergenerational programme, the children’s views of disability and difference disappeared as they formed dance partnerships and developed meaningful relationships.

scholarly journals Hearing Screening for Residents in Long-Term Care Homes Who Live with Dementia: A Scoping Review

2021 ◽  
pp. 1-24
Author(s):  
Fiona Höbler ◽  
Katherine S. McGilton ◽  
Walter Wittich ◽  
Kate Dupuis ◽  
Marilyn Reed ◽  
...  
Keyword(s):  
Older Adults ◽  
Hearing Loss ◽  
Nursing Staff ◽  
Scoping Review ◽  
Pure Tone ◽  
Long Term Care ◽  
Pure Tone Audiometry ◽  
Care Homes ◽  
Term Care

Background: Hearing loss is highly prevalent in older adults, particularly among those living with dementia and residing in long-term care homes (LTCHs). Sensory declines can have deleterious effects on functioning and contribute to frailty, but the hearing needs of residents are often unrecognized or unaddressed. Objective: To identify valid and reliable screening measures that are effective for the identification of hearing loss and are suitable for use by nursing staff providing care to residents with dementia in LTCHs. Methods: Electronic databases (Embase, Medline, PsycINFO, CENTRAL, and CINAHL) were searched using comprehensive search strategies, and a stepwise approach based on Arksey & O’Malley’s scoping review and appraisal process was followed. Results: There were 193 scientific papers included in the review. Pure-tone audiometry was the most frequently reported measure to test hearing in older adults living with dementia. However, measures including self- or other-reports and questionnaires, review of medical records, otoscopy, and the whisper test were found to be most suitable for use by nurses working with older adults living with dementia in LTCHs. Conclusion: Although frequently used, the suitability of pure-tone audiometry for use by nursing staff in LTCHs is limited, as standardized audiometry presents challenges for many residents, and specific training is needed to successfully adapt test administration procedures and interpret results. The whisper test was considered to be more suitable for use by staff in LTCH; however, it yields a limited characterization of hearing loss. There remains an urgent need to develop new approaches to screen hearing in LTCHs.

Use of vitamin and mineral supplements in long-term care home residents

2012 ◽  
Vol 37 (1) ◽  
pp. 100-105 ◽  
Author(s):  
Navita Viveky ◽  
Lynda Toffelmire ◽  
Lilian Thorpe ◽  
Jennifer Billinsky ◽  
Jane Alcorn ◽  
...  
Keyword(s):  
Older Adults ◽  
Vitamin D ◽  
Long Term Care ◽  
Care Home ◽  
Care Facility ◽  
Dementia Diagnosis ◽  
Term Care ◽  
Supplement Use ◽  
Supplement Usage

Vitamin–mineral supplementation may offer older adults health and cognition-related benefits but overuse may contribute to polypharmacy. We examined the prevalence of supplement usage in long-term care facility (LTC) residents (≥65 years of age). As cognition may be affected by nutrition, we also examined use in those with diagnosis of dementia and those with no dementia diagnosis. The prevalence of supplement usage and overall “pill count” from pharmaceutical use was assessed in 189 LTC residents and a subsample of 56 older adults with dementia diagnosis, respectively. Participants were residing in an LTC facility of a mid-size metropolitan area during 2009. The average use of supplements was 1.0 per day for all residents, with 35% taking vitamin D supplements, 20% multivitamins, and 26% calcium. Supplement use was similar (p ≥ 0.05) for those with dementia diagnosis (53%, average 2.0 per day) and for those without such diagnosis (45%, average 2.2 per day). Usage ranged between 1–6 supplements per day. In both of these groups, ∼73% of users were taking vitamin D. The number of prescribed medications ranged from 4 to 24 (average 10.2) in a subsample of residents whose supplement intake was 0 to 6 (average 2). These findings suggest an overall low rate of supplement use, with no significant differences (p ≥ 0.05) in use between residents with and without dementia diagnosis. However, some residents were at risk for supplement overuse.

scholarly journals Places of living and places of dying: the case for preventing suicide in residential long-term care

2020 ◽  
pp. 1-16
Author(s):  
Briony Jain ◽  
Viktoryia Kalesnikava ◽  
Joseph E. Ibrahim ◽  
Briana Mezuk
Keyword(s):  
Older Adults ◽  
Suicide Prevention ◽  
Residential Care ◽  
Long Term Care ◽  
Public Health Problem ◽  
Future Research ◽  
Term Care ◽  
The Impact ◽  
Residential Long Term Care

Abstract This commentary addresses the increasing public health problem of suicide in later life and presents the case for preventing suicide in residential long-term care settings. We do so by examining this issue from the perspective of three levels of stakeholders – societal, organisational and individual – considering the relevant context, barriers and implications of each. We begin by discussing contemporary societal perspectives of ageing; the potential impact of ageism on prevention of late-life suicide; and the roles of gender and masculinity. This is followed by a historical analysis of the origin of residential long-term care; current organisational challenges; and person-centred care as a suicide prevention strategy. Finally, we consider suicide in long-term care from the perspective of individuals, including the experience of older adults living in residential care settings; the impact of suicide on residential care health professionals and other staff; and the impact of suicide bereavement on family, friends and other residents. We conclude with recommendations for policy reform and future research. This commentary aims to confront the often unspoken bias associated with preventing suicide among older adults, particularly those living with complex medical conditions, and invoke an open dialogue about suicide prevention in this population and setting.

scholarly journals Examining Consequences Related to Unmet Care Needs Across the Long-Term Care Continuum

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 90-90
Author(s):  
Meghan Jenkins Morales ◽  
Stephanie Robert
Keyword(s):  
Older Adults ◽  
Activities Of Daily Living ◽  
Residential Care ◽  
Informal Care ◽  
Daily Living ◽  
Long Term Care ◽  
Community Care ◽  
Term Care ◽  
Care Arrangement

Abstract At some point in our lives, approximately 70% of us will need support to help with daily care. Without adequate assistance we may experience unmet care need consequences (UCNC) – such as skipping meals, going without clean clothes, or taking the wrong medication. This study examines the likelihood of experiencing UCNC related to gaps in assistance with activities of daily living (ADL) and instrumental activities of daily living (IADL) across long-term care arrangements: informal community care, paid community care, residential care, and nursing homes. We examine a sample of older adults receiving assistance in a care arrangement (N=2,499) from the nationally representative 2015 National Health and Aging Trends Study. Cross-sectional and longitudinal regression models, adjusting for differences in demographic and health/functioning characteristics, examine if type of care arrangement in 2015 is associated with UCNC in 2015 and change in UCNC by 2017. Holding all else constant, there were no significant differences in UCNC related to ADLs in 2015 across care arrangements. However, those receiving paid community care were more likely to experience UCNC related to IADLs (going without clean clothes, groceries, or a hot meal and making medication errors) compared to those receiving only informal care (OR=1.64, p<.05) or residential care (OR=2.19, p<.01). By 2017, paid care was also significantly associated with continued UCNC, but older adults in informal care arrangements were most likely to experience a new UCNC. Results suggest improving/expanding assistance with IADLs among community-dwelling older adults, and promoting equitable access to residential care, to reduce UCNC.

scholarly journals Impact of a public policy restricting staff mobility between long-term care homes in Ontario, Canada during the COVID-19 pandemic

2020 ◽  
Author(s):  
Aaron Jones ◽  
Alexander G. Watts ◽  
Salah Uddin Khan ◽  
Jack Forsyth ◽  
Kevin A. Brown ◽  
...  
Keyword(s):  
Public Policy ◽  
Long Term Care ◽  
Care Home ◽  
Relative Difference ◽  
Care Staff ◽  
Care Homes ◽  
Term Care ◽  
Undirected Network ◽  
Before And After

AbstractObjectivesTo assess changes in the mobility of staff between long-term care homes in Ontario, Canada before and after enactment of public policy restricting staff from working at multiple homes.DesignPre-post observational study.Setting and Participants623 long-term cares homes in Ontario, Canada between March 2020 and June 2020.MethodsWe used anonymized mobile device location data to approximate connectivity between all 623 long-term care homes in Ontario during the 7 weeks before (March 1 – April 21) and after (April 22 – June 13) the policy restricting staff movement was implemented. We visualized connectivity between long-term care homes in Ontario using an undirected network and calculated the number of homes that had a connection with another long-term care home and the average number of connections per home in each period. We calculated the relative difference in these mobility metrics between the two time periods and compared within-home changes using McNemar’s test and the Wilcoxon rank-sum test.ResultsIn the period preceding restrictions, 266 (42.7%) long-term care homes had a connection with at least one other home, compared to 79 (12.7%) homes during the period after restrictions, a drop of 70.3% (p <0.001). The average number of connections in the before period was 3.90 compared to 0.77 in after period, a drop of 80.3% (p < 0.001). In both periods, mobility between long-term care homes was higher in homes located in larger communities, those with higher bed counts, and those part of a large chain.Conclusions and ImplicationsMobility between long-term care homes in Ontario fell sharply after an emergency order by the Ontario government limiting long-term care staff to a single home, though some mobility persisted. Reducing this residual mobility should be a focus of efforts to reduce risk within the long-term care sector during the COVID-19 pandemic.

Implementation of eHealth to support assessment and decision-making for residents with dementia in long-term care: systematic review (Preprint)

2021 ◽  
Author(s):  
Juliet Gillam ◽  
Nathan Davies ◽  
Jesutofunmi Aworinde ◽  
Emel Yorganci ◽  
Janet E Anderson ◽  
...  
Keyword(s):  
Decision Making ◽  
Long Term Care ◽  
Care Home ◽  
End Users ◽  
Care Homes ◽  
Successful Implementation ◽  
Key Factors ◽  
Term Care ◽  
Care Assessment

BACKGROUND As dementia progresses, symptoms and concerns increase causing considerable distress for the person and caregivers. Integration of care between care homes and healthcare services is vital to meet increasing care needs and maintain quality of life. However, access to high-quality healthcare is inequitable. eHealth offers a potential solution, by supporting remote specialist input on care processes like clinical assessment and decision-making, and streamlining care on site. How best to implement eHealth in the care home setting is unclear. OBJECTIVE This review aimed to identify key factors that influence implementation of eHealth for people living with dementia in long-term care. METHODS A systematic search of EMBASE, PsychInfo, MEDLINE and CINHAL was conducted to identify studies published between 2000-2020. Studies were eligible if they focused on eHealth interventions to improve treatment and care assessment or decision-making for residents with dementia in care homes. Data were thematically analysed and deductively mapped onto the six constructs of the adapted Consolidated Framework for Implementation Research (CFIR). Results are presented as a narrative synthesis. RESULTS 29 studies were included, focusing on a variety of eHealth interventions including remote video-consultations and clinical decision support tools. Key factors which influenced eHealth implementation were identified across all six constructs of the CFIR. Most concerned the Inner Setting construct about requirements for implementation in the care home, such as providing a conducive learning climate, engaged leadership and sufficient training and resources. Four novel subconstructs were identified to inform implementation requirements to meet resident needs and engage end-users. CONCLUSIONS Implementing eHealth in care homes for people with dementia is multi-factorial and complex, involving interaction between the resident, staff and organisation. Application of the CFIR for care homes requires an emphasis on the needs of residents and the engagement of end users in the implementation process. A novel conceptual model of the key factors was developed, and translated into 18 practical recommendations on implementation of eHealth in long-term care to guide implementers or innovators in care homes. The policy imperative for integrated health and social care demands successful implementation of eHealth, to maximise uptake and drive improvements.

scholarly journals COVID-19 and Ageism: Has the Pandemic Allowed Prevailing Ageist Attitudes to Go Viral?

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Paul Rooprai ◽  
Neel Mistry
Keyword(s):  
Older Adults ◽  
Older People ◽  
Older Persons ◽  
Long Term Care ◽  
Care Homes ◽  
Term Care ◽  
Vaccine Administration ◽  
Human Worth

Current perceptions of older adults are often met with prejudice and misconceptions that constitute what has been characterized as ‘ageism’. Rarely are older persons considered indispensable members of the population who deserve our respect and support. While it is unclear if and when this pandemic will end, what is clear is how COVID-19 has unveiled the prevalent ageist attitudes against older people, underscoring an unsettling discourse about age and human worth that has allowed us to easily question the value of older adults. In this commentary, we highlight specific recommendations that can be made to combat ageism during and after the COVID-19 pandemic, with exploration of vaccine administration and inequities across long-term care homes.

scholarly journals Environment Still Matters: Examining Person-Place-Relationships in the Old and the New Normal Across Settings

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 531-531
Author(s):  
Frank Oswald ◽  
Habib Chaudhury ◽  
Amanda Grenier
Keyword(s):  
Long Term Care ◽  
Care Home ◽  
Risk Groups ◽  
Care Homes ◽  
Term Care ◽  
Environmental Interventions ◽  
Research Issues ◽  
New Normal ◽  
Environmental Gerontology

Abstract In environmental gerontology, the home and the neighborhood have always been of particular interest for empirical research. Issues such as orientation and safety, place attachment and biographical bonding, have proven to be important for community dwellings older adults and for those living in care homes. However, with Covid-19, the seemingly stable person-place-relationships have been challenged. This symposium provides a set of applied research contributions that demonstrate the persistent salience of the environment by examining person-place-relationships in the old and the new normal in private homes and care homes. Contributions draw from ideas of “precarious ageing” (Grenier & Phillipson) and “pandemic precarity”, for instance to understand housing insecurity, while concepts from environmental gerontology are used to explain processes of environmental agency and belonging. The first contribution by Mahmood and colleagues introduces an environmental audit tool for people at risk of homelessness to assess built environmental features of housing and neighborhood that support housing stability in the face of insecurity. Second, Wanka provides data from people framed as ‘risk-groups’ through the Covid-19 pandemic and how they dealt with contact restrictions, showing the role of intergenerational neighborhood relations to mediate risks of pandemic precariousness. Third, Elkes examined mobility and wayfinding challenges for residents in a long-term care home and subsequent environmental interventions to improve orientation. Forth, Leontowitsch and colleagues present findings from long-term care home residents during the pandemic to gain understanding of their experiences of social isolation and a biographical sense of resilience. Finally, Amanda Grenier will serve as the session’s discussant.

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