Lessons learned from the statewide implementation of the Music & Memory program in nursing homes in Wisconsin in the USA

Dementia ◽  
2020 ◽  
pp. 147130122096223
Author(s):  
Jung Kwak ◽  
Jung-Hwa Ha ◽  
Katharine O’Connell Valuch
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Behavioral Problems ◽  
Nursing Home Residents ◽  
Lessons Learned ◽  
Direct Care ◽  
Care Staff ◽  
Memory Training ◽  
Positive Effects ◽  
The Usa

The movement of evidence-based interventions into institutional settings such as nursing homes is challenging. Among ecopsychosocial interventions to address behavioral problems of nursing home residents with dementia, Music and Memory, a popular intervention that provides individualized music listening, has shown potential to improve residents’ quality of life. In Wisconsin in the USA, the Music and Memory program has been implemented in nursing home facilities statewide. In the present study, to examine facilitators and barriers related to implementation and sustainability of the Music and Memory program, all nursing homes in Wisconsin were invited to participate in a survey (online or mail). A total of 161 facilities participated, representing a response rate of 41%. Descriptive statistics and content analysis were conducted. Over 80% of responding facilities were providing the Music and Memory program, and 86% of those facilities planned to continue its use. The majority of respondents found Music and Memory to be beneficial to residents, but they also reported that the program was not equally effective for everyone and that it was time and labor intensive. Barriers to sustainability included lack of buy-in by direct care staff, use of technology, costs of equipment, inconsistency of volunteers, and families not supportive or helpful. Facilitators included support of facility personnel, family, and volunteers; observing positive effects of program; Music and Memory training provision and support; and accessibility of equipment. For the program to be successful, facilities must identify the residents most likely to benefit from it, realistically estimate its costs and required labor, and ensure staff buy-in.

scholarly journals Statewide Implementation of the Music & Memory Program: Facilitators, Barriers, and Lessons Learned

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 59-60
Author(s):  
Jung Kwak ◽  
Jung-Hwa Ha ◽  
Katherine Britt
Keyword(s):  
Nursing Homes ◽  
Family Involvement ◽  
Behavioral Problems ◽  
Mail Survey ◽  
Careful Consideration ◽  
Lessons Learned ◽  
Direct Care ◽  
Care Staff ◽  
Music Listening ◽  
Positive Effects

Abstract The movement of evidence-based interventions into routine institutional settings like nursing homes is challenging. Among non-pharmacological interventions to address behavioral problems of residents with dementia, Music and Memory (M&M), a popular individualized music listening program, has been shown to have potential to improve quality of life among residents. To examine facilitators and barriers to implementation and sustainability of the M&M program in nursing facilities, a statewide (online and mail) survey of nursing homes was conducted in Wisconsin where the statewide implementation of the program occurred. The response rate was 41% (N=161). Descriptive statistics and content analysis were conducted. Over 80% of facilities provided the M&M program, and 86% of them planned to continue the program. The majority of respondents found the M&M to be beneficial to residents but also reported that the program was not equally effective for everyone, and M&M was time and labor intensive. Barriers to sustainability were: lack of buy-in by direct care staff, use of technology, costs of equipment, inconsistent volunteers, and families not supportive or helpful. Facilitators were: support of facility personnel, family, and volunteers; observing positive effects of program, M&M training provision and support, family involvement, and accessibility of equipment. Targeted resident selection is needed to identify the residents most likely to benefit from the program to avoid possibility of increased agitation or discomfort. Careful consideration is needed for facilities to identify realistic costs, labor, and staff buy-in to promote success.

scholarly journals Association of care workers’ job satisfaction and global happiness with change of functional performance of severely disabled elderly residents in nursing homes: a cohort and questionnaire study in Japan

BMJ Open ◽  
2020 ◽  
Vol 10 (10) ◽  
pp. e033937
Author(s):  
Shino Ikeda-Sonoda ◽  
Nao Ichihara ◽  
Jiro Okochi ◽  
Arata Takahashi ◽  
Hiroaki Miyata
Keyword(s):  
Job Satisfaction ◽  
Nursing Home ◽  
Nursing Homes ◽  
Functional Performance ◽  
Nursing Home Residents ◽  
Care Staff ◽  
Lower Probability ◽  
Disabled Elderly ◽  
The Impact

ObjectivesThere is growing concern regarding quality of work life (QWL) among care staff in nursing homes. However, little is known about the impact of QWL on nursing home residents’ functional performance. Recent literature suggests that job satisfaction and happiness of healthcare workers reflect their perceived QWL and impact the quality of their care. This study examined the association between job satisfaction and global happiness with change in functional performance of severely disabled elderly residents in nursing homes.DesignA retrospective cohort study of nursing home residents combined with a questionnaire survey of their care staff.SettingEighteen nursing homes in Japan.ParticipantsData were collected from 1000 residents with a required care level of 3–5 and from 412 care staff in nursing homes between October 2017 and March 2018.Outcomes and explanatory variablesFunctional performance was structurally assessed with ICF (International Classification of Functioning, Disability and Health) staging, composed of 52 items concerning activities of daily life, cognitive function and social participation, at baseline and 6 months later. Deterioration and improvement of functional performance were dichotomously defined as such change in any of the items. QWL of care staff was evaluated with a questionnaire including questions about job satisfaction and global happiness.ResultsFunctional performance deteriorated and improved in 23.0% and 12.7% of residents, respectively. Global happiness of care staff was associated with lower probability of residents’ deterioration (adjusted OR, 0.61; CI 0.44 to 0.84). There was no significant correlation between job satisfaction or happiness of care staff and improvement of residents’ functional performance.ConclusionThese results suggest that QWL of care staff is associated with changes in functional performance of elderly people with severe disabilities in nursing homes.

Resilience and Challenges among Staff of Gulf Coast Nursing Homes Sheltering Frail Evacuees following Hurricane Katrina, 2005: Implications for Planning and Training

2009 ◽  
Vol 24 (1) ◽  
pp. 54-62 ◽  
Author(s):  
Sarah B. Laditka ◽  
James N. Laditka ◽  
Carol B. Cornman ◽  
Courtney B. Davis ◽  
Jane V.E. Richter
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Hurricane Katrina ◽  
Well Being ◽  
Direct Care ◽  
Care Staff ◽  
Direct Care Staff ◽  
Staff Members ◽  
And Training ◽  
Physical Care

AbstractPurpose:The purpose of this study was to: (1) explore experiences and responses of staff in caring for sheltered, frail, Hurricane Katrina evacuees; and (2) identify how planning and training can be enhanced for staff who may care for frail older populations during and after disasters.Methods:Individual, in-person, semi-structured interviews were conducted with 38 staff members in four nursing homes in Mississippi, sheltering 109 evacuees in November 2005, nine weeks after Hurricane Katrina.Twenty-four were direct care staff, including certified nursing assistants, licensed nurses, dietary aides, and social workers; 14 were support staff, including maintenance and business managers. The number interviewed in each nursing home averaged 9.5 (range 6–15). Using a discussion guide and focusing on their experiences caring for nursing home evacuees, staff were asked to describe: (1) experiences; (2) problems; (3) what helped; and (4) what was learned. Data were processed using grounded theory and thematic analysis. Responses of direct care staff differed in emphasis from those of support staff in several areas; responses from these groups were analyzed separately and together. Three of the researchers identified recurring themes; two organized themes conceptually.Results:Staff emphasized providing emotional reassurance to evacuees as well as physical care. Many described caring for evacuees as “a blessing,” saying the experience helped them bond with residents, evacuees, and other staff. However, caring for evacuees was difficult because staff members were extremely anxious and in poor physical condition after an arduous evacuation. Challenges included communicating with evacuees' families, preventing dehydration, lack of personal hygiene supplies, staff exhaustion, and emotional needs of residents, evacuees, and staff. Teamwork, community help, and having a well-organized disaster plan, extra supplies, and dependable staff helped personnel cope with the situation.Conclusions:Staff of nursing homes that sheltered Katrina evacuees demonstrated resilience in the disaster's aftermath. Many placed the well-being of residents as their first priority. Results underscore the importance of planning, teamwork, and adequate supplies and staffing. Training for long-term care staff should emphasize providing emotional support as well as physical care for residents and evacuees during and following disasters. Nurses, social workers, and other staff members responsible for promoting emotional well-being for nursing home residents should be prepared to respond to disasters.

scholarly journals Nursing home quality of life in the Lebanon

2017 ◽  
Vol 18 (2) ◽  
pp. 145-156
Author(s):  
Marina Gharibian Adra ◽  
John Hopton ◽  
John Keady
Keyword(s):  
Quality Of Life ◽  
Nursing Home ◽  
Nursing Homes ◽  
Family Caregivers ◽  
Comparative Method ◽  
Nursing Home Residents ◽  
Care Staff ◽  
Care Practice ◽  
Content Type

Purpose The purpose of this paper is to explore perceptions, perspectives and meaning of quality of life for a sample of older residents, care staff and family caregivers in two nursing homes in Lebanon. Design/methodology/approach A classic grounded theory study was conducted between 2010 and 2011 in two nursing homes in Beirut. The semi-structured interviews were undertaken with a theoretical sample of 20 residents, 8 family caregivers and 11 staff. The constant comparative method was used to analyze the data. Findings Three distinct but interrelated properties of quality of life emerged from this process: “maintaining self,” “maintaining identity” and “maintaining continuity”. The dynamics that exist within and between each of these properties provide an indicator about shared and distinct meanings and the implications for care practice. Research limitations/implications The study was conducted in one city in Lebanon; accordingly, the transferability of findings may be challenging. Practical implications Implications for nursing and nursing policy – improving Lebanese national standards and regulations applicable to nursing home residents may help to enhance residents’ care needs and quality of life. Social implications There was limited guidance aimed at helping older residents to voice and increase their choice and control. Originality/value This paper provides new insights into the process of outlining the properties attached to the phenomenon of quality of life in nursing homes in Lebanon. It will be of interest to those in nursing home care as well as to policy makers.

scholarly journals LESSONS LEARNED FROM NURSING HOME CIVIL MONETARY PENALTY PROJECTS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S770-S770
Author(s):  
Diana L Sturdevant ◽  
Kathleen C Buckwalter
Keyword(s):  
Nursing Home ◽  
Quality Of Care ◽  
Nursing Homes ◽  
Nursing Home Residents ◽  
Lessons Learned ◽  
Federal State ◽  
Future Research ◽  
Term Care ◽  
Home Setting

Abstract Nursing homes must comply with numerous federal/state regulations to receive Medicare and Medicaid funding. Failure to comply with these regulations can result in deficiency citations, and depending on the severity of the deficiency, a resulting Civil Monetary Penalty (CMP). Through the Centers for Medicare and Medicaid Services (CMS) Civil Monetary Penalty Reinvestment Program, CMP funds are reinvested to support activities that benefit nursing home residents and that protect or improve their quality of life or quality of care. This symposium presents some of the unique challenges, successes, failures, and surprise findings from CMP-funded nursing home quality improvement projects in two, predominantly rural Midwestern states: Oklahoma and Kansas. Dr. Williams presents findings of a pilot-study testing an adaptation of a successful family caregiver telehealth support intervention in the nursing home setting and implications for future research. Dr. Sturdevant shares successes, challenges, and unanticipated results from the “It’s Not OK to Fall” project, a comprehensive, 3 year fall prevention project implemented in Oklahoma nursing homes. Lastly, Ms. Round’s paper describes the implementation and findings of a Long-term Care Leadership Academy aimed at improving leadership and team building skills of three levels of nursing home staff, including Administrators/Directors’ of Nursing, RN/LPN charge nurses and certified nursing assistants. Discussant, Dr. Kathleen Buckwalter Ph.D., FAAN, RN, will discuss how principles of nursing home culture change provides a common framework for these projects and conclude by offering suggestions on how promotion of these principles might improve the quality of care provided by nursing homes.

scholarly journals Advance care planning in nursing homes: new conversation and documentation tools

2021 ◽  
pp. bmjspcare-2021-003008
Author(s):  
Annelien Wendrich-van Dael ◽  
Joni Gilissen ◽  
Liesbeth Van Humbeeck ◽  
Luc Deliens ◽  
Robert Vander Stichele ◽  
...  
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Advance Care Planning ◽  
Healthcare Professionals ◽  
Nursing Home Residents ◽  
Care Staff ◽  
Care Planning ◽  
Nursing Home Staff ◽  
Advance Care ◽  
Context Specific

Although advance care planning (ACP) is highly relevant for nursing home residents, its uptake in nursing homes is low. To meet the need for context-specific ACP tools to support nursing home staff in conducting ACP conversations, we developed the ACP+intervention. At its core, we designed three ACP tools to aid care staff in discussing and documenting nursing home resident’s wishes and preferences for future treatment and care: (1) an extensive ACP conversation guide, (2) a one-page conversation tool and (3) an ACP document to record outcomes of conversations. These nursing home-specific ACP tools aim to avoid a purely document-driven or ‘tick-box’ approach to the ACP process and to involve residents, including those living with dementia according to their capacity, their families and healthcare professionals.

scholarly journals Implementing Changing Talk Online Training: A Pragmatic Trial to Improve Dementia Care Communication in NHs

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 495-495
Author(s):  
Carissa Coleman ◽  
Kristine Williams ◽  
Yelena Perkhounkova ◽  
Maria Hein ◽  
Tim Beachy ◽  
...  
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Culture Change ◽  
Pragmatic Trial ◽  
Implementation Strategies ◽  
Direct Care ◽  
Care Staff ◽  
Knowledge Gain ◽  
Staff Members ◽  
Post Test

Abstract The Changing Talk (CHAT) training effectively reduces elderspeak and subsequent behavioral challenges in residents with dementia in nursing homes. The Changing Talk: Online (CHATO) training was developed to increase staff access to education using a new online format. A pilot test was conducted to confirm the feasibility and effects of CHATO on training outcomes. In the initial nursing home, twenty-three direct care staff members in a small Midwestern nursing home enrolled in the course including 12 CNAs, 4 RNs, 2 LPNs, 2 CMAs, 1 Dietary Aide, 1 Social Worker, and 1 in Transportation. Two forms of a 13-item scenario-based test to measure knowledge gain were developed and tested. Of the 23 staff, 18 (78%) completed the post-test and 83% of completers achieved a post-test score of 70% or greater. Scores on the test improved from M=69% correct (SD=11.7) at pretest to 86% correct (SD=10.6) on posttest demonstrating knowledge gain (p=.024). Participants improved their recognition of elderspeak (21%) and person-centered communication (24%) in a video vignette and 86% self-reported improvement in their abilities to recognize ineffective communication and to apply more effective communication strategies in practice. A randomized control trial enrolled staff (N=187) in eight additional nursing homes. Preliminary results confirm improvements in test scores from M=70.6% correct (SD=15.8) at pretest to 77.2% correct (SD=14.1) on posttest and increased elderspeak recognition (p=.004). Relationships between nursing home characteristics, implementation strategies, and culture change measured by the Artifacts of Culture Change Tool and their relationship to communication outcomes will be presented.

scholarly journals 468 - Can a Robotic Seal Called PARO Manage Chronic Pain in People with Dementia Living in Nursing Homes?

2020 ◽  
Vol 32 (S1) ◽  
pp. 190-190
Author(s):  
Lihui Pu ◽  
Wendy Moyle ◽  
Cindy Jones ◽  
Michael Todorovic
Keyword(s):  
Chronic Pain ◽  
Nursing Home ◽  
Nursing Homes ◽  
Usual Care ◽  
Rating Scale ◽  
Nursing Home Residents ◽  
Care Staff ◽  
Term Care ◽  
Randomized Controlled ◽  
People With Dementia

AbstractObjective: To evaluate the effect of interaction with a robotic seal (PARO) for pain management in nursing home residents living with dementia.Methods: Registered with the Australian New Zealand Clinical Trials Registry (ACTRN 12618000082202), a pilot randomized controlled trial followed by semi-structured interviews were conducted between January 2018 and January 2019. Forty-three residents aged ?65 years living with dementia and chronic pain were recruited from three nursing homes in Australia. Participants were randomized to either a PARO group (individual, non-facilitated, 30-minute sessions, five days per week for six weeks) or a usual care group using a computer-generated random number. Observational pain behaviors were rated by researchers using the Pain Assessment in Advanced Dementia (PAINAD) scale and staff-rated pain levels were measured by the numeric rating scale. Medications regularly prescribed and as needed were quantified by the Medication Quantification Scale-III (MQS-III). Generalized estimating equation model and thematic analysis were used to analyze the data.Results: Participants in the PARO group had significantly lowered level of observed pain (-0.514, 95% confidence interval [CI] -0.774 to -0.254, p<0.001) and used fewer PRN medications (-1.175, 95% CI - 2.205 to -0.145, p=0.025) than those in usual care after controlling for age, gender, cognitive function and medications at baseline. There were no significant differences in staff-rated pain levels and regularly scheduled medications between the two groups. Interviews also indicated that the PARO intervention may reduce the pain experience through distraction and reminiscence of previous positive memories. Limitations of weight, voice and characteristics of PARO were identified.Conclusions and Implications: PARO shows promise in reducing pain and medications for nursing home residents living with dementia and chronic pain. This intervention might be incorporated into daily practice as an alternative to manage pain in people with dementia. Care staff need to balance the benefits and limitations of incorporating social robots into their clinical practice and residents’ individualized preferences need to be considered. Larger randomized controlled trials with longer time frames are warranted to further test the use of PARO in long-term care settings.

scholarly journals “Teleswallowing”: a case study of remote swallowing assessment

2015 ◽  
Vol 20 (3) ◽  
pp. 155-168 ◽  
Author(s):  
Elaine Bidmead ◽  
Tilly Reid ◽  
Alison Marshall ◽  
Veronica Southern
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Nursing Home Residents ◽  
Cost Savings ◽  
Lessons Learned ◽  
Teaching Hospitals ◽  
Speech And Language ◽  
Structured Interviews ◽  
Content Type ◽  
Adoption Study

Purpose – Telemedicine has enabled speech and language therapists (SLTs) to remotely assess swallowing difficulties (dysphagia) experienced by nursing home residents. The new technique, “teleswallowing”, was designed by the Speech and Language Therapy Service at Blackpool Teaching Hospitals NHS Foundation Trust. It allows prompt assessment, avoiding potential risks of aspiration pneumonia, malnutrition, poor rehabilitation, increased hospital stays and reduced quality of life (Hinchey et al., 2005; Langmore et al., 1998). The purpose of this paper is to report on a second pilot of teleswallowing and the concomitant adoption study. Design/methodology/approach – The adoption study employed qualitative methods, including consultations with senior managers, semi-structured interviews with nursing home matrons/managers and nurses, two focus groups and semi-structured interviews with SLTs. The project clinical lead kept an activity log, which was used to estimate resource savings. Findings – Over a three-month period, six SLTs and 17 patients in five nursing homes participated in teleswallowing assessments. Teleswallowing benefited both patients and participating nursing homes. Better use of therapist time and cost savings were demonstrated and evidence showed that the service could be successfully scaled up. Despite this, a number of barriers to service transformation were identified. Originality/value – This is the first implementation of teleswallowing in the UK, but it has been used in Australia (Ward et al., 2012). The approach to engaging stakeholders to understand and address barriers to adoption is novel. The value lies in the lessons learned for future innovations.

Sign in / Sign up

Export Citation Format

Share Document