scholarly journals Staff Perspectives of Barriers to Access and Delivery of Palliative Care for Persons With Dementia in Long-Term Care

2018 ◽  
Vol 33 (5) ◽  
pp. 284-291 ◽  
Author(s):  
Emily Hill ◽  
Marie Y. Savundranayagam ◽  
Aleksandra Zecevic ◽  
Marita Kloseck
Keyword(s):  
Palliative Care ◽  
Long Term Care ◽  
Care Staff ◽  
Term Care ◽  
Palliative Care Education ◽  
Barriers To Access ◽  
Communication Difficulties ◽  
Phenomenological Methodology

Dementia is a syndrome that is progressive, degenerative, and terminal. The palliative care philosophy aims to maximize quality of life for the dying individual and is both beneficial for and underused with persons dying with dementia. Objectives: The purpose of this study was to investigate the experiences of long-term care staff delivering palliative care to individuals with dementia to determine how care was delivered, to learn which guidelines were used, and whether policies affected the delivery of palliative care. Methods: Twenty-two staff participants were interviewed. Their experiences were interpreted using phenomenological methodology. Results: Findings yielded 3 key themes: confusion, resource shortages, and communication difficulties. Conclusion: Implications for practice include clarification of terminology surrounding palliative care, education of families about dementia and palliative care, better resource management, and the need to address when palliative care best fits within the dementia process.

Communication Disordered: Program Implementation in Long-Term Care

2016 ◽  
Vol 1 (15) ◽  
pp. 64-67
Author(s):  
George Barnes ◽  
Joseph Salemi
Keyword(s):  
Program Implementation ◽  
Long Term Care ◽  
Family Satisfaction ◽  
Regulatory Compliance ◽  
Care Staff ◽  
Term Care ◽  
Staff Members ◽  
Change Policy

The organizational structure of long-term care (LTC) facilities often removes the rehab department from the interdisciplinary work culture, inhibiting the speech-language pathologist's (SLP's) communication with the facility administration and limiting the SLP's influence when implementing clinical programs. The SLP then is unable to change policy or monitor the actions of the care staff. When the SLP asks staff members to follow protocols not yet accepted by facility policy, staff may be unable to respond due to confusing or conflicting protocol. The SLP needs to involve members of the facility administration in the policy-making process in order to create successful clinical programs. The SLP must overcome communication barriers by understanding the needs of the administration to explain how staff compliance with clinical goals improves quality of care, regulatory compliance, and patient-family satisfaction, and has the potential to enhance revenue for the facility. By taking this approach, the SLP has a greater opportunity to increase safety, independence, and quality of life for patients who otherwise may not receive access to the appropriate services.

scholarly journals Understanding contributors to quality of care in long-term care and changes under COVID-19

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 960-960
Author(s):  
Sara Luck ◽  
Katie Aubrecht
Keyword(s):  
Quality Of Care ◽  
Long Term Care ◽  
The United States ◽  
Control Measures ◽  
Qualitative Description ◽  
Care Staff ◽  
Term Care ◽  
The Impact

Abstract Nursing home facilities are responsible for providing care for some of the most vulnerable groups in society, including the elderly and those with chronic medical conditions. In times of crisis, such as COVID-19 or other pandemics, the delivery of ‘regular’ care can be significantly impacted. In relation to COVID-19, there is an insufficient supply of personal protective equipment (PPE) to care for residents, as PPE not only protects care staff but also residents. Nursing homes across the United States and Canada have also taken protective measures to maximize the safety of residents by banning visitors, stopping all group activities, and increasing infection control measures. This presentation shares a research protocol and early findings from a study investigating the impact of COVID-19 on quality of care in residential long-term care (LTC) in the Canadian province of New Brunswick. This study used a qualitative description design to explore what contributes to quality of care for residents living in long-term care, and how this could change in times of crisis from the perspective of long-term care staff. Interviews were conducted with a broad range of staff at one LTC home. A semi-structured interview guide and approach to thematic analysis was framed by a social ecological perspective, making it possible to include the individual and proximal social influences as well as community, organizations, and policy influencers. Insights gained will improve the understanding of quality of care, as well as potential barriers and facilitators to care during times of crisis.

Verbal and nonverbal indicators of quality of communication between care staff and residents in ethnoculturally and linguistically diverse long-term care settings

2015 ◽  
Vol 30 (3) ◽  
pp. 285-304 ◽  
Author(s):  
Jeff Small ◽  
Sing Mei Chan ◽  
Elisabeth Drance ◽  
Judith Globerman ◽  
Wendy Hulko ◽  
...  
Keyword(s):  
Long Term Care ◽  
Linguistically Diverse ◽  
Care Staff ◽  
Term Care

scholarly journals CLINICAL AUDIT: QUALITY OF PALLIATIVE CARE IN LONG TERM-CARE FACILITIES IN WESTERN FRANCE, 2015

2017 ◽  
Vol 1 (suppl_1) ◽  
pp. 547-547
Author(s):  
J. Prudhomm ◽  
V. Morin-Chouarbi ◽  
M. Bechac ◽  
E. Menand ◽  
A. Corvol ◽  
...  
Keyword(s):  
Palliative Care ◽  
Audit Quality ◽  
Long Term Care ◽  
Clinical Audit ◽  
Term Care ◽  
Care Facilities

Development of a Palliative Care Education Program in Rural Long-Term Care Facilities

2007 ◽  
Vol 23 (3) ◽  
pp. 154-162 ◽  
Author(s):  
Kathy Kortes-Miller ◽  
Sonja Habjan ◽  
Mary Lou Kelley ◽  
Marilyn Fortier
Keyword(s):  
Palliative Care ◽  
Rural Communities ◽  
Rural Areas ◽  
Long Term Care ◽  
Care Homes ◽  
Term Care ◽  
Care Education ◽  
Palliative Care Education ◽  
Age Cohort

In North America, people 85 years and older are the fastest growing age cohort and long-term care homes are increasingly becoming the place of end-of-life care. This is especially true in rural communities where services are lacking. Staff in long-term care homes lack education about palliative care, but in rural areas, accessing education and the lack of relevant curricula are barriers. The focus of this paper is to describe an approach to developing and delivering a research-based palliative care education curriculum in rural long-term care homes. The approach included conducting a detailed assessment of staffs’ educational needs and preferred educational formats; developing a 15-hour interprofessional curriculum tailored to the identified needs; and delivering the curriculum on site in rural long-term care homes. Staff confidence and participation in delivering palliative care increased. Based on work in northwestern Ontario, Canada, this approach can serve as a model for palliative care education in other rural areas.

Palliative care for advanced dementia: Knowledge and attitudes of long‐term care staff

2017 ◽  
Vol 27 (3-4) ◽  
pp. 848-858 ◽  
Author(s):  
I‐Hui Chen ◽  
Kuan‐Yu Lin ◽  
Sophia H Hu ◽  
Yeu‐Hui Chuang ◽  
Carol O Long ◽  
...  
Keyword(s):  
Palliative Care ◽  
Long Term Care ◽  
Care Staff ◽  
Advanced Dementia ◽  
Term Care ◽  
Knowledge And Attitudes

scholarly journals Challenges in Caring for Unbefriended Residents in Long-term Care Homes: A Qualitative Study

2020 ◽  
Vol 75 (9) ◽  
pp. 2050-2061
Author(s):  
Stephanie A Chamberlain ◽  
Wendy Duggleby ◽  
Pamela B Teaster ◽  
Janet Fast ◽  
Carole A Estabrooks
Keyword(s):  
Complex Adaptive Systems ◽  
Adaptive Systems ◽  
Long Term Care ◽  
Care Staff ◽  
Care Homes ◽  
Term Care ◽  
Complex Adaptive ◽  
Care Aides

Abstract Objectives This study examined challenges experienced by long-term care staff in caring for unbefriended residents who are incapacitated and alone. These residents often are estranged from or have no living family or live geographically distant from them and require a public guardian as their surrogate decision-maker. To date, research on unbefriended older adults has focused on those living in acute care and community settings. Little is known about those living in long-term care homes. Method We conducted semi-structured interviews with 39 long-term care staff (e.g., registered nurses, care aides, social workers) and 3 public guardians. Staff were sampled from seven long-term care homes in Alberta, Canada. We analyzed interview transcripts using content analysis and then using the theoretical framework of complex adaptive systems. Results Long-term care staff experience challenges unique to unbefriended residents. Guardians’ responsibilities did not fulfill unbefriended residents’ needs, such as shopping for personal items or accompanying residents to appointments. Consequently, the guardians rely on long-term care staff, particularly care aides, to provide increased levels of care and support. These additional responsibilities, and organizational messages dissuading staff from providing preferential care, diminish quality of work life for staff. Discussion Long-term care homes are complex adaptive systems. Within these systems, we found organizational barriers for long-term care staff providing care to unbefriended residents. These barriers may be modifiable and could improve the quality of care for unbefriended residents and quality of life of staff. Implications for practice include adjusting public guardian scope of work, improving team communication, and compensating staff for additional care.

scholarly journals INTEREST GROUP SESSION—RESEARCH IN QUALITY OF CARE: LIVING IN AND LEAVING NURSING HOMES: THE FACTORS THAT CONTRIBUTE TO QUALITY OF LIFE, HEALTH, AND SAFETY OUTCOMES

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S359-S359
Author(s):  
Nancy Kusmaul ◽  
Mercedes Bern-Klug
Keyword(s):  
Quality Of Life ◽  
Nursing Home ◽  
Nursing Homes ◽  
Long Term Care ◽  
Community Dwelling ◽  
Care Staff ◽  
Term Care ◽  
The Impact

Abstract Nursing homes house some of the most vulnerable older adults. They often have complex medical conditions and/or cognitive impairments that put them at risk for negative outcomes and poor quality of life. These outcomes can be altered through incorporating evidence-based practices aimed to improve care and residents’ life experiences. In this symposium we will explore factors that are shown to influence outcomes and quality of life for people that live in and are discharged from, long term care settings. Amy Roberts and colleagues will explore the influences of nursing home social service staff qualifications on residents’ discharge outcomes. Colleen Galambos and colleagues will present findings on advance directives and their impact on reducing potentially avoidable hospitalizations. Kelsey Simons and colleagues will discuss the potential for unmet needs for mental health services as part of nursing home care transitions, and will discuss a model of quality improvement that addresses this gap in care. Vivian Miller will present findings on the impact transportation access has on the ability of community-dwelling family members to visit and provide social support to their family member residents in long-term care. Finally, Nancy Kusmaul and Gretchen Tucker report the findings of their study comparing perceptions of nursing home residents, direct care staff, management, and families on the care practices that influence resident health and quality of life while they live in a long term care setting.

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