Dementia and sexuality in long-term care: Incompatible bedfellows?

Dementia ◽  
2021 ◽  
pp. 147130122110562
Author(s):  
Alisa Grigorovich ◽  
Pia Kontos ◽  
Ann Heesters ◽  
Lori Schindel Martin ◽  
Julia Gray ◽  
...  
Keyword(s):  
Family Members ◽  
Macro Level ◽  
Future Research ◽  
Sexual Expression ◽  
Negative Attitudes ◽  
Term Care ◽  
Dementia Research ◽  
Micro Level ◽  
Depth Interviews

Despite the recognized benefits of sexual expression and its importance in the lives of people living with dementia, research demonstrates that there are multiple barriers to its positive expression (e.g., expression that is pleasurable and free of coercion, discrimination, and violence) in RLTC homes. These barriers constitute a form of discrimination based on age and ability, and violate the rights of persons living with dementia to dignity, autonomy, and participation in everyday life and society. Drawing on a human rights approach to dementia and sexual expression, we explored the experiences of diverse professionals, family members, and persons living with dementia with explicit attention to the ways in which macro-level dynamics are influencing the support, or lack thereof, for sexual expression at the micro level. Focus groups and in-depth interviews were conducted with 27 participants, and the collected data were analyzed thematically. While all participants acknowledged that intimacy and sexual expression of persons living with dementia should be supported, rarely is such expression supported in practice. Micro-level factors included negative attitudes of professionals toward sexual expression by persons living with dementia, their discomfort with facilitating intimacy and sexual expression in the context of their professional roles, their anxieties regarding potential negative reactions from family members, and concerns about sanctions for failing to prevent abuse. In our analysis, we importantly trace these micro-level factors to macro-level factors. The latter include the cultural stigma associated with dementia, ageism, ableism, and erotophobia, all of which are reproduced in, and reinforced by, professionals’ education, as well as legal and professional standards that exclusively focus on managing and safeguarding residents from abuse. Our analysis demonstrates a complexity that has enormous potential to inform future research that is critically needed for the development of educational initiatives and to promote policy changes in this area.

Unit Manager's Role with Family Members of Clients in Complex Continuing Care Settings: An Untold Story

2005 ◽  
Vol 24 (2) ◽  
pp. 127-137
Author(s):  
Sepali Guruge ◽  
Katherine McGilton ◽  
Linda Yetman ◽  
Heather Campbell ◽  
Ruby Librado ◽  
...  
Keyword(s):  
Family Relationships ◽  
Family Members ◽  
Future Research ◽  
Continuing Care ◽  
Theory Approach ◽  
Term Care ◽  
Factors Affecting ◽  
Closing The Loop

ABSTRACTMost literature on staff-family relationships has come from studies of long-term care settings, has focused mainly on the families' perspectives on factors affecting their relationships with staff, and has included scant findings from the staff's perspective. No studies that examined staff-family relationships in complex continuing care (CCC) environments from the perspective of staff were found in the literature. A qualitative study that draws on a grounded theory approach was conducted to explore staff-family relationships in CCC, and the findings presented in this article illuminate the unit manager's role. Data were collected through in-depth interviews with nine unit managers and a follow-up focus group with five unit managers who work in three CCC facilities. Three categories reflecting the unit manager's role with family members of clients in CCC settings were derived: establishing supportive entry; building and preserving relationships; and closing the loop. Implications of the findings for practice and future research are presented.

scholarly journals Measuring Family Members’ Satisfaction with End-of-Life Care in Long-Term Care: Adaptation of the CANHELP Lite Questionnaire

2017 ◽  
Vol 2017 ◽  
pp. 1-17 ◽  
Author(s):  
Shevaun Nadin ◽  
Mohammed Ali Miandad ◽  
Mary Lou Kelley ◽  
Jill Marcella ◽  
Daren K. Heyland
Keyword(s):  
End Of Life ◽  
End Of Life Care ◽  
Long Term Care ◽  
Family Members ◽  
Face Validity ◽  
Future Research ◽  
Life Care ◽  
Term Care ◽  
New Instrument

Rationale. Improving end-of-life care (EOLC) in long-term care (LTC) homes requires quality measurement tools that assess families’ satisfaction with care. This research adapted and pilot-tested an EOLC satisfaction measure (Canadian Health Care Evaluation Project (CANHELP) Lite Questionnaire) for use in LTC to measure families’ perceptions of the EOLC experience and to be self-administered.Methods and Results.Phase 1. A literature review identified key domains of satisfaction with EOLC in LTC, and original survey items were assessed for inclusiveness and relevance. Items were modified, and one item was added.Phase 2. The revised questionnaire was administered to 118 LTC family members and cognitive interviews were conducted. Further modifications were made including reformatting to be self-administered.Phase 3. The new instrument was pilot-tested with 134 family members. Importance ratings indicated good content and face validity. Cronbach’s alpha coefficients (range: .88–.94) indicated internal consistency.Conclusion. This research adapted and pilot-tested the CANHELP for use in LTC. This paper introduces the new, valid, internally consistent, self-administered tool (CANHELP Lite Family Caregiver LTC) that can be used to measure families’ perceptions of and satisfaction with EOLC. Future research should further validate the instrument and test its usefulness for quality improvement and care planning.

Sexuality, sexual expression in long-term care and the law

2021 ◽  
pp. 1-10
Author(s):  
Victor M. Aziz ◽  
Philip Slack
Keyword(s):  
Long Term Care ◽  
Family Members ◽  
Case Law ◽  
Sexual Expression ◽  
Staff Attitudes ◽  
Term Care ◽  
Factors Affecting ◽  
Legal Provisions ◽  
And Training

SUMMARY Balancing risk and safety in long-term care settings can be challenging while providing and respecting patients’/residents’ needs and rights in terms of sexual expression. We look at factors affecting the expression of sexuality, including staff attitudes and reactions, and the lack of policies governing sexuality. We review the various statute and case law, other legislative and quasi-legal provisions governing sexuality and sexual expression. Finally, we consider the need for clear policies and training for both staff and family members.

scholarly journals Information and Communication Technology Changes in Long-Term Care Due to COVID-19

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 219-219
Author(s):  
Amy Schuster ◽  
Shelia Cotten
Keyword(s):  
South Carolina ◽  
Nursing Homes ◽  
Assisted Living ◽  
Long Term Care ◽  
Family Members ◽  
Future Research ◽  
Assisted Living Facilities ◽  
Term Care ◽  
Ict Use

Abstract Residents of long-term care (LTC) facilities (e.g., nursing homes, assisted living facilities) have historically been vulnerable to feelings of loneliness and social isolation. Due to the COVID-19 pandemic, LTC facilities were required to restrict public access in March 2020. LTC communities were not prepared for the residents’ increased socioemotional needs which arose because of the mandated facility lockdown. This study investigated ICT use in LTC facilities and how ICTs are being used by residents since the onset of the COVID19 pandemic. Seventy LTC administrators in South Carolina (12 nursing homes and 58 assisted living facilities) completed an online survey exploring ICT access and use in LTC facilities and whether access and use changed as a result of COVID-19. Administrators from fifty-three percent of LTC facilities reported purchasing ICTs for their residents to use for communicating with family members and telehealth since the onset of COVID-19. LTC administrators reported that using the ICTs helped residents to socialize more frequently and feel more socially connected to their family members, friends and/or other residents. Barriers to ICT use included staff not having time to assist residents with technology, broken technology, and residents not wanting to share technology. LTC facilities were not adequately prepared to support the socioemotional needs of their residents in the event of a federally mandated facility lockdown. Future research should investigate the ICTs available for residents’ use in a national sample of LTC facilities and how LTC administrators adapted the ICTs available as a result of their experiences with COVID-19.

scholarly journals The Development and Testing of KNACC: Knowledgeable Nursing Assistants as Creative Caregivers

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 675-675
Author(s):  
Jacqueline Eaton ◽  
Kristin Cloyes ◽  
Brooke Paulsen ◽  
Connie Madden ◽  
Lee Ellington
Keyword(s):  
Focus Groups ◽  
Long Term Care ◽  
Family Members ◽  
Nursing Assistants ◽  
Direct Care ◽  
Term Care ◽  
Memory Care

Abstract Nursing assistants (NAs) provide 80% of direct care in long-term care settings, yet are seldom viewed as skilled professionals. Empowering NAs is linked to improved resident outcomes. In this study, we collaborate with NAs to adapt and test the feasibility and acceptability of arts-based creative caregiving techniques (CCG) for use in long-term care. We held a series of focus groups (n=14) to adapt, refine, and enhance usability. We then evaluated implementation in two waves of testing (n=8). Those working in memory care units were more likely to use all techniques, while those working in rehabilitation were more hesitant to implement. Participants reported using CCG to distract upset residents. Family members were excited about implementation, and NAs not participating wanted to learn CCG. Nursing assistants have the potential to become experts in creative caregiving but may require in-depth training to improve use.

scholarly journals Attitudes Toward Sexual Behaviors in Long-Term Care: Development of an Assessment Tool

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 602-603
Author(s):  
Rachael Spalding ◽  
Emma Katz ◽  
Barry Edelstein
Keyword(s):  
Sexual Behaviors ◽  
Long Term Care ◽  
Assessment Tool ◽  
Qualitative Interviews ◽  
Family Members ◽  
Community Dwelling ◽  
Term Care ◽  
Care Development

Abstract Most older adults living in long-term care settings (LTCs) indicate that expressing their sexuality is important to them (Doll, 2013). Little is known about the general public’s attitudes towards sexual behaviors in LTCs. Attitudes of LTC residents’ family members are particularly important, as family members are most likely to visit residents and to care about their quality of life. Family members’ attitudes could in turn inform facility policies and management. We will present preliminary data from a series of qualitative interviews with community-dwelling adults regarding their attitudes. We will discuss how these data are being used to inform current work on a measure of attitudes toward sexual behavior in LTCs.

“They don't just disappear”: Acknowledging death in the long-term care setting

2012 ◽  
Vol 10 (4) ◽  
pp. 241-247 ◽  
Author(s):  
Janine Maitland ◽  
Kevin Brazil ◽  
Bill James-Abra
Keyword(s):  
Long Term Care ◽  
Emotional Health ◽  
Family Members ◽  
Care Facility ◽  
Term Care ◽  
Long Term Care Facility ◽  
Qualitative Research Study ◽  
Staff Members

AbstractObjective:The purpose of this study was to describe the value of a formal room blessing ritual held within a long-term care facility, from the perspectives of staff, residents, and family members.Method:A qualitative research study involving interviews with staff, residents, and family members was conducted to examine the perceived value of a room blessing ritual.Results:Twenty-four room blessing attendees participated in the study (nine staff, eight residents, and seven family members). Attendees felt that the room blessing provided an opportunity to formally acknowledge the death of the resident and their grief; the majority felt that this was a positive experience and that it provided an element of closure. Staff members and residents expressed their appreciation for the opportunity to connect with family members of the deceased to express their condolences during the ritual. Participants also identified the inclusivity of the ritual (i.e., an open invitation to all staff, residents, and family members) as a positive aspect that served as a reminder that others shared in their grief. Staff members felt that blessing the room for the new resident was an important component of the ritual, helping to bridge the gap between mourning and welcoming a new person. Staff, residents, and family members felt that the room blessing positively reflected the mission and values of the facility. The most highly valued aspect of the ritual for all attendees was the sharing of stories about the deceased to celebrate that person's life.Significance of results:Long-term care facilities need to recognize that formal supports to manage the bereavement needs of staff and residents, such as a room blessing ritual, should be incorporated into their model for managing end-of-life care, given the relationship between the emotional health of staff and the quality of care provided for residents.

scholarly journals PERCEPTIONS OF LONG-TERM CARE RESIDENTS AND THEIR FAMILY MEMBERS ABOUT USING THE CONVERSATION STARTER KIT

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S157-S157
Author(s):  
Sharon Kaasalainen ◽  
Tamara Sussman
Keyword(s):  
Long Term Care ◽  
Family Members ◽  
Term Care ◽  
Disease Trajectory ◽  
Lack Of Information ◽  
Difficult Conversations ◽  
Advance Care ◽  
Future Work ◽  
To Receive

Abstract The need for a palliative approach in long term care (LTC) is widely recognized. However, advance care planning (ACP) is still rare. The purpose of this study was to explore the perceptions of LTC residents and their families about using an ACP tool called The Conversation Starter Kit (CSK). This study utilized a mixed methods approach. Data was collected in four LTC homes in Ontario, Canada from 31 residents and family members during an interview after they had completed the CSK. Data was analyzed using thematic analysis and descriptive statistics. All participants read all sections but only 73% completed all sections of the toolkit. Participants spent an average of 36 minutes discussing it with their family members and/or LTC staff. Participants reported: a better understanding of ACP after using the tool (80%), that the tool helped clarify the available resources and/or choices (53%), and that they felt less apprehensive about ACP after using the tool (60%). Qualitative findings revealed many strengths (e.g., usefulness, ability to start difficult conversations, content and clarification), and weaknesses of the tool (e.g., redundant information, difficulty understanding the content and lack of information regarding medically assisted dying). Family members noted that the toolkit would have been helpful to receive earlier on in their family members’ disease trajectory, perhaps before being admitted into LTC. These study findings support the CSK for residents and family members to have ACP discussions in LTC. Future work is needed to evaluate the effectiveness of the tool with a larger sample.

Anatomy of a Stalled Revolution: Processes of Reproduction and Change in Russian Women’s Gender Ideologies

2018 ◽  
Vol 32 (4) ◽  
pp. 441-468 ◽  
Author(s):  
Sarah Ashwin ◽  
Olga Isupova
Keyword(s):  
Gender Ideology ◽  
Important Variable ◽  
Domestic Labor ◽  
Macro Level ◽  
Gender Ideologies ◽  
Theoretical Contribution ◽  
Continuity And Change ◽  
Male Breadwinner ◽  
Micro Level ◽  
Depth Interviews

Russia’s gender revolution notoriously produced women’s economic empowerment without domestic equality. Although the Soviet state vastly expanded women’s employment, this had little impact on a starkly unequal gender division of domestic labor. Such “stalling” is common, but in Russia its extent and persistence presents a puzzle, requiring us to investigate linkages between macro-level factors and micro-level interactions regarding the gender division of domestic labor. We do this by focusing on gender ideology, an important variable explaining the gender division of domestic labor that bridges the macro level of the gender order and the micro-interactional level. We use longitudinal qualitative data to examine continuity and change in young Russian women’s gender ideologies between 1999 and 2010. Based on an analysis of 115 in-depth interviews from 23 respondents, we identify traditional and egalitarian trajectories and the processes underlying them, showing how the male breadwinner schema and an ideology of women’s independence support traditionalism, while non-traditional breadwinning and interactional support from men facilitate egalitarianism. Our analysis enables us to explain the Soviet gender paradox and distinguish sources of change in the post-Soviet era. Our theoretical contribution is to situate gender ideology in a multilevel framework, the efficacy of which we demonstrate in our empirical analysis.

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