Using the Newcastle Model to Understand and Manage Behaviors That Challenge in Dementia: A Case Study

2021 ◽  
pp. 153465012110120
Author(s):  
Nils Rickardsson ◽  
Suzanne Crooks
Keyword(s):  
Unmet Needs ◽  
Care Home ◽  
Care Staff ◽  
Care Homes ◽  
Successful Implementation ◽  
Multiple Sources ◽  
Treatment Gains ◽  
Person With Dementia ◽  
The Impact

Behaviors that challenge (BC) are common in dementia and can have a significant impact on the wellbeing of the person with dementia, their family and staff in care homes. The Newcastle model is a biopsychosocial, person-centerd, approach that aims to support care staff and family members in order to manage BC within care homes by identifying and fulfilling unmet needs of the person with dementia. After outlining its theoretical basis and practical utility, we describe a case study where the Newcastle model has been implemented to manage sexualised behaviors and verbal aggression. The patient described is a lady with dementia residing in a care home where the staff felt unable to manage increasing incidence of these BC. Information from multiple sources was collated to conceptualise the behaviors and understand them in terms of unmet needs, which was followed by a process to develop corresponding practical strategies together with care staff and family. Following successful implementation of the Newcastle model, the care staff reported a reduction in BC on standardised instruments (Cohen-Mansfield Agitation Inventory, and the Neuropsychiatric Inventory). The staff group also described increasing confidence in managing sexualised vocalisations as they had a better understanding with regards to premorbid history and personality, and an increased awareness of the impact of dementia on behavior. Complicating factors relating to staff stress and physical health conditions in older adults are discussed, and adaptations to the model are suggested in order to maintain treatment gains in the long-term.

scholarly journals Living in a care home during COVID-19: a case study of one person living with dementia

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Ian Davies-Abbott ◽  
Catrin Hedd Jones ◽  
Gill Windle
Keyword(s):  
Study Design ◽  
Single Case ◽  
Care Home ◽  
Care Homes ◽  
Single Case Study ◽  
Content Type ◽  
Case Study Design ◽  
People With Dementia ◽  
The Impact

Purpose This paper aims to understand the lived experience of a person living with dementia in a care home during the COVID-19 pandemic. It responds to the absence in research of the voices of people with dementia living in care homes during the pandemic. Design/methodology/approach The paper adopts a single case study design applied thematic analysis to semi-structured interview data to discover the experiences of one person living with dementia in a care home during a period of lockdown. Findings Five themes reveal how the participant responded to the practical and emotional challenges of the pandemic: autonomy; fears; keeping connected; keeping safe and other people living with dementia. These themes highlight the participant’s ability to adapt, accept and dispute lockdown restrictions, revealing considerable insight into their situation. Research limitations/implications The pandemic has restricted access to care homes, which informed the single case study design. This approach to the research may restrict the generalisability of the findings. Other researchers are encouraged to include the voices of people with dementia living in care homes in further studies. Practical implications Implications for practice, presented in this paper, promote quality psychosocial approaches when health-care workers engage with people living with dementia during periods of restricted activity. Originality/value Unlike other studies about the impact of the pandemic on care homes, this paper explores the experience of the pandemic in care homes from the perspective of a person living with dementia.

scholarly journals Multifaceted intervention to Reduce Antimicrobial Prescribing in Care Homes: a process evaluation of a UK-based non-randomised feasibility study

BMJ Open ◽  
2019 ◽  
Vol 9 (11) ◽  
pp. e032185 ◽  
Author(s):  
Rachel Potter ◽  
Anne Campbell ◽  
David R Ellard ◽  
Catherine Shaw ◽  
Evie Gardner ◽  
...  
Keyword(s):  
Decision Making ◽  
Process Evaluation ◽  
Demographic Data ◽  
Care Home ◽  
Care Staff ◽  
Care Homes ◽  
Normalisation Process Theory ◽  
Successful Implementation ◽  
Care Home Staff ◽  
Antimicrobial Prescribing

ObjectivesTo explore the facilitators and obstacles to the development and implementation of the Reduce Antimicrobial Prescribing in Care Homes intervention.DesignWe used a mixed-methods approach. We conducted focus groups with care home staff and relatives of residents, and interviews with general practitioners (GPs) and home managers, completed observational visits and collected demographic data, training attendance records and data on the use of a decision-making algorithm. We used normalisation process theory to inform topic guides and interpretation of the data.SettingSix care homes, three in Northern Ireland and three in the West Midlands, England.InterventionA decision-making algorithm for urinary tract, respiratory tract and skin and soft-tissue infections, plus small group interactive training for care home staff.ResultsWe ran 21 training sessions across the six homes and trained 35/42 (83%) of nurses and 101/219 (46%) of all care staff. Care home staff reported using the decision-making algorithm 81 times. Postimplementation, staff reported being more knowledgeable about antimicrobial resistance but were unsure if the intervention would change how GPs prescribed antimicrobials. The pressures of everyday work in some homes meant that engagement was challenging at times. Staff felt that some of the symptoms included in decision-making algorithm, despite being evidence based, were not easy to detect in residents with dementia or urinary incontinence. Some staff did not use the decision-making algorithm, noting that their own knowledge of the resident was more important.ConclusionWe delivered a training package to a substantial number of key staff in care homes. A decision-making algorithm for common infections in care homes empowered staff but was challenging to operationalise at times. A future study should consider the findings from the process evaluation to help ensure the successful implementation on a larger scale.

Making things personal: a project promoting the wellbeing of older residents and staff in sheltered housing and care homes

2020 ◽  
Vol 19 (3) ◽  
pp. 251-257
Author(s):  
Heather Edwards
Keyword(s):  
Personal Information ◽  
Care Home ◽  
Care Staff ◽  
Care Homes ◽  
Sheltered Housing ◽  
Successful Implementation ◽  
Content Type ◽  
Care Home Staff ◽  
Experience Of Care ◽  
Personal A

Purpose This paper aims to present findings of a project implementing training to enable care staff to create simple audio-biographical resources with older tenants and residents in sheltered housing and care homes. Design/methodology/approach This paper draws on written evaluations by participants of training workshops delivered to 136 care home staff within 28 care homes of the NorseCare group in Norfolk, UK and of their experience after three months in the workplace. Findings The evaluations showed a high degree of satisfaction with training and impact of the intervention. Successful implementation of training in the workplace depended on factors of time and leadership within individual homes and housing schemes. Originality/value Making innovative personal information documents valued carers’ unique understanding of residents and tenants. This creative co-production may have benefits in personalising and enriching the experience of care for both staff and residents.

scholarly journals Recognition of the complexity facing residential care homes: a practitioner inquiry

2018 ◽  
Vol 19 (6) ◽  
pp. 584-590 ◽  
Author(s):  
Jenny Dudman ◽  
Julienne Meyer ◽  
Cheryl Holman ◽  
Wendy Moyle
Keyword(s):  
Residential Care ◽  
Care Home ◽  
Assessment Tools ◽  
Care Staff ◽  
Care Homes ◽  
Structured Interviews ◽  
Care Home Staff ◽  
Healthcare Needs ◽  
Health And Social Care

AbstractAimTo explore the experiences and challenges for residential care home staff when managing the healthcare needs of their residents, in particular those living with dementia.BackgroundIncreasing number of older people, with complex health and social care needs are living in residential care homes. Yet there is limited appreciation of why staff sometimes struggle to manage residents’ healthcare needs, or understanding of their working relationship with district nurses (DNs), whose responsibility it is to provide nursing support.MethodsThis PhD study, in a metropolitan area in the United Kingdom, was conducted by an experienced DN and involved three phases. This paper focuses on the first two phases. Phase 1 data included: semi-structured interviews (n=8), reflective field notes based on non-participant observation, documentary analysis of policies, procedures and assessment tools and other contextual data from one care home (case study site). The practitioner researcher reflected on the findings from the case study, in relation to her own knowledge and experience as a DN, focusing in particular on findings that were familiar, or which surprised. In Phase 2 she fed these findings back to other care homes (n=11) to check whether the findings from the single case study were unique or resonated with others. She gathered their feedback through semi-structured interviews with senior care staff (n=14). Data were analysed using thematic data analysis.FindingsFindings highlight the complexity facing residential care homes: high levels of healthcare needs amongst residents, the demands of caring for residents living with dementia, variations in the knowledge and skill set of care staff, inequity in the level of healthcare support, the challenges of building a good relationship with DNs, and funding pressures facing care homes.ImplicationsAny, or all of these factors can prevent care home staff from managing the healthcare needs of their residents.

scholarly journals Feasibility Study of a Digital Screen-Based Calming Device for Managing BPSD During Care

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 755-755
Author(s):  
Gloria Gutman ◽  
Avantika Vashisht ◽  
Taranjot Kaur ◽  
Ryan Churchill ◽  
Amir Moztarzadeh ◽  
...  
Keyword(s):  
Usual Care ◽  
Psychological Symptoms ◽  
Care Home ◽  
Routine Care ◽  
Care Staff ◽  
Successful Implementation ◽  
Term Care ◽  
Item Checklist ◽  
And Control

Abstract MindfulGarden (MG) is a digital device resembling a flat screen TV, with touchless sensors that react to voice and motion. In this study 13 long-term care home residents aged 74-100 exhibiting Behavioural and Psychological Symptoms of Dementia (BPSD) were randomized to treatment and control groups. On days 1-3 the treatment group received usual care plus exposure to MG during morning and evening care - events well documented to be problematic for residents and care staff; controls received usual care only. On day 4 both groups were exposed to MG with verbal cueing. A 26-item checklist was used to record frequency and types of disruptive BPSD exhibited; care duration was recorded in minutes. There was a trend toward reduction of BPSD and duration of care during morning care. Findings suggest that verbal cueing may be important for successful implementation of MG in calming residents with dementia during routine care.

Supporting creative ageing through the arts: the impacts and implementation of a creative arts programme for older people

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Simon Chester Evans ◽  
Jennifer Bray ◽  
Claire Garabedian
Keyword(s):  
Social Interaction ◽  
Older People ◽  
Well Being ◽  
Care Staff ◽  
Successful Implementation ◽  
Creative Arts ◽  
Standard Format ◽  
Content Type ◽  
The Impact

Purpose The purpose of this paper is to report on an independent evaluation of a three-year “Creative Ageing” programme, focussing on the impacts for participants and factors promoting successful delivery of sessions. Design/methodology/approach Artists provided feedback through reflective journals and questionnaires, while the views of care staff and participants were also captured in a standard format at the end of each arts session. Thematic analysis of the qualitative data identified common themes. Findings Twenty-three arts projects were delivered across a range of settings and through diverse art forms including dance, drama, music, visual arts and poetry. They reached nearly 2,200 participants who recorded over 8,100 session attendances in total. Participation in high quality creative experiences improved well-being for older people, as well as increasing social interaction and reducing isolation. Several factors facilitated successful implementation and delivery of the activities, particularly the need to hold planning meetings with staff to provide guidance around participant numbers and suitability, minimising disruption of the sessions and the supportive role of staff during the sessions. Opportunities for reflection enabled artists to address potential challenges and adapt their practice to meet the needs and preferences of participants and to the complexities of diverse settings. Originality/value Previous research has largely focussed on the impact of activities in a single setting. This study supports the role of creative arts in increasing social interaction as an attempt to tackle isolation and loneliness, both for older people living in the community and for those living in a communal setting such as care homes and supported living schemes.

scholarly journals A qualitative study exploring therapists’ experiences of implementing a complex intervention promoting meaningful activity for residents in care homes

2018 ◽  
Vol 33 (3) ◽  
pp. 575-583 ◽  
Author(s):  
Raymond Smith ◽  
Julia Wood ◽  
Fiona Jones ◽  
Sue Turner ◽  
Michael Hurley
Keyword(s):  
Care Home ◽  
Complex Interventions ◽  
Occupational Therapists ◽  
Care Staff ◽  
Care Homes ◽  
Complex Care ◽  
Meaningful Activity ◽  
Qualitative Interview Study ◽  
Home Intervention ◽  
Trusting Relationships

Objectives: To explore the experiences of occupational therapists and physiotherapists and to reveal any factors that can facilitate delivering a complex care home intervention promoting meaningful activity. Design: Qualitative interview study using data from three focus groups conducted longitudinally post intervention implementation. Data were analysed thematically. Setting: Three residential care homes in South London, UK. Subjects: All therapists involved in the implementation of the intervention: three occupational therapists and three physiotherapists. Results: Three interconnected themes emerged from the analysis: (1) developing trusting relationships, (2) empowering staff and (3) remaining flexible. Therapists described how successfully implementing a complex care home intervention was dependant on developing trusting relationships with care staff. This enabled the therapists to empower care staff to take ownership of the intervention and help embed it in care home culture, facilitating long-term change. The therapists described how remaining flexible in their approach helped keep care staff engaged for the duration of implementation. Conclusion: This study has revealed several important factors that can help facilitate therapists delivering complex interventions in care homes.

The ambulance service advanced practitioner's role in supporting care homes: a qualitative study of care staff experiences

2021 ◽  
Vol 27 (8) ◽  
pp. 1-8
Author(s):  
Chris Harvey ◽  
Simon Froggatt ◽  
Bryan Lightowler ◽  
Andrew Hodge
Keyword(s):  
Qualitative Study ◽  
Care Home ◽  
Community Services ◽  
Ambulance Service ◽  
Care Staff ◽  
Care Homes ◽  
Service Demand ◽  
Staff Members ◽  
Care Home Staff ◽  
Advanced Practitioner

Background/Aims The demand from care homes on NHS services continues to rise, with little evidence of ambulance service contribution in this area. The Yorkshire Ambulance Service provides an advanced practitioner model to support care homes in Sheffield, as an alternative to calling 999. This study investigated the experiences and needs of the care home staff who use the ambulance service advanced practitioner model. Methods This qualitative study conducted semi-structured, face-to-face interviews with 19 staff members from 10 different care home settings. Thematic analysis using a combination of NVivo and manual coding was undertaken. Results The three key themes from the interviews were variations in service demand, the service user's expectations and experience, and benefits to residents. Participants reported that good community services reduced the need to call 999, empowering carers to support residents to remain in the community. Conclusions Care homes require comprehensive services that meet their needs. The advanced practitioner model provided by the ambulance service supports this, preventing unnecessary 999 calls and fitting with other community service provision.

Enhancing RCIES Model

2016 ◽  
pp. 624-643
Author(s):  
Arwa Mukhtar Makki ◽  
Tarig Mohamed Ahmed
Keyword(s):  
Risk Factors ◽  
Risk Identification ◽  
Successful Implementation ◽  
Management Process ◽  
Erp Implementation ◽  
Erp System ◽  
Strategic Risk ◽  
Risk Management Process ◽  
The Impact

Risk identification and prioritization is very essential activity in any successful strategic risk management process. Developing a plan for dealing with such problems reduces the impact of unexpected risks and failures while prioritizing risks draws attention, efforts and resources to the risks with great impact on projects success. The aim of this paper, is to identify the critical risk factors in an ERP project through a case study of a successful implementation of an ERP system in a Sudanese organization and to understand how the organization implemented the appropriate controls to minimize its business risks impact. To achieve this objective, a number of key articles were reviewed and analyzed to understand the different critical risk factors influence ERP implementation. New risk factors and controls influence ERP implementation have been identified. A new model of ERP implementation critical risk factors was developed. Furthermore, the risk factors were classified into categories, probability, impact and proximity, then using a prioritizing tool, the results of this study contributes to risks identification and prioritization by pointing to the less priority and the most critical risk factors.

scholarly journals A Novel Approach to Reduce Sedentary Behaviour in Care Home Residents: The GET READY Study Utilising Service-Learning and Co-Creation

2019 ◽  
Vol 16 (3) ◽  
pp. 418 ◽  
Author(s):  
Maria Giné-Garriga ◽  
Marlene Sandlund ◽  
Philippa Dall ◽  
Sebastien Chastin ◽  
Susana Pérez ◽  
...  
Keyword(s):  
Service Learning ◽  
Sedentary Behaviour ◽  
Undergraduate Students ◽  
Care Home ◽  
End Users ◽  
Care Staff ◽  
Care Homes ◽  
Novel Approach ◽  
Inductive Thematic Analysis ◽  
Individual Service

The GET READY study aimed to integrate service-learning methodology into University degrees by offering students individual service opportunities with residential care homes, to co-create the best suited intervention to reduce the sedentary behaviour (SB) of residents throughout the day, with researchers, end-users, care staff, family members and policymakers. Eight workshops with care home residents and four workshops with care staff, relatives and policymakers, led by undergraduate students, were audiotaped, transcribed verbatim and analysed with inductive thematic analysis to understand views and preferences for sustainable strategies to reduce SB and increase movement of residents. Perspectives about SB and movement in care homes highlighted four subthemes. Assets for decreasing SB included three subthemes, and suggestions and strategies encapsulated four subthemes. There is a need to include end-users in decision making, and involve care staff and relatives in enhancing strategies to reduce SB among residents if we want sustainable changes in behaviour. A change in the culture at a policymaker and care staff’s level could provide opportunities to open care homes to the community with regular activities outside the care home premises, and offer household chores and opportunities to give residents a role in maintaining their home environment.

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