scholarly journals Community Visioning for Innovation in Integrated Dementia Care: Stakeholder Focus Group Outcomes

2021 ◽  
Vol 12 ◽  
pp. 215013272110427
Author(s):  
Emily Roberts ◽  
Anas Shehadeh
Keyword(s):  
Focus Group ◽  
Community Education ◽  
Spatial Configuration ◽  
Dementia Care ◽  
Term Care ◽  
Existing Structures ◽  
Group Outcomes ◽  
Midwestern University ◽  
Memory Care ◽  
Cross Case Analysis

It is estimated that 5.4 million Americans have some form of dementia and these numbers are expected to rise in the coming decades, leading to an unprecedented demand for memory care housing and services. In searching for innovative options to create more autonomy and better quality of life in dementia care settings, repurposing existing structures, in particular vacant urban malls, may be 1 option for the large sites needed for the European model of dementia villages. These settings may become sustainable Dementia Friendly City Centers (DFCC), because in the case of enclosed mall construction, the internal infrastructure is in place for lighting, HVAC, with varied spatial configuration of public spaces. This paper describes the community engagement research being conducted by a research team at a Midwestern university, laying groundwork for the DFCC model for centralized dementia programs, services, and attached housing. Using graphics and plans for the DFCC model using an 800 000 ft2 closed mall site, focus groups were conducted with family caregivers of individuals with dementia and long-term care residents to gather their input and response to the model. The participants identified both opportunities and barriers in using an adaptive reuse of a large site for an innovative integrated dementia care model and through the cross-case analysis of the focus group findings, 5 themes were identified which include: community education and acceptance; amenities and activities; maintaining family connections; resident adaptation and staffing.

scholarly journals Adaptive Reuse of Distressed Malls for Dementia-Friendly City Centers: Outcomes From Community Focus Groups

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 61-61
Author(s):  
Emily Roberts
Keyword(s):  
Spatial Configuration ◽  
Public Spaces ◽  
Dementia Care ◽  
Model Of Care ◽  
Community Revitalization ◽  
Existing Structures ◽  
Group Outcomes ◽  
Midwestern University ◽  
Memory Care

Abstract It is estimated that 5.4 million Americans have some form of dementia and these numbers are expected to rise in the coming decades, leading to an unprecedented demand for memory care housing and services. In searching for innovative options to create more autonomy and better quality of life in dementia care settings, repurposing existing structures, in particular vacant urban malls, may be one option for the large sites needed for the European model of dementia villages. These settings may become sustainable Dementia Friendly City Centers (DFCC), because in the case of enclosed mall construction, the internal infrastructure is in place for lighting, HVAC, with varied spatial configuration of public spaces. This presentation describes the community engagement research being conducted by a research team at a Midwestern university, laying groundwork for the DFCC model for centralized dementia programs, services and attached housing. Focus group outcomes from four disciplines (caregiver, physician, designer, community development) detailed four principle themes including : community revitalization, building sustainability, urban regreening and the nurturing of innovation to further a culture of dementia care which is inclusive, progressive and convergent with the needs of an aging. The DFCC model can be seen as one opportunity to make life better not only for those with needs associated with dementia now, but also for ourselves in the future, therefore educating and updating future stakeholders about the value of this model of care will be critical in transforming current hurdles into future opportunities.

scholarly journals Making the Case for Centralized Dementia Care Through Adaptive Reuse in the Time of COVID-19

2020 ◽  
Vol 57 ◽  
pp. 004695802096930
Author(s):  
Emily Roberts ◽  
Heather Carlile Carter
Keyword(s):  
Infectious Disease ◽  
Disease Control ◽  
Disease Outbreaks ◽  
Dementia Care ◽  
Infectious Disease Control ◽  
Community Revitalization ◽  
Existing Structures ◽  
Infectious Disease Outbreaks ◽  
Memory Care

It is estimated that 5.4 million Americans have some form of dementia and these numbers are expected to rise in the coming decades, leading to an unprecedented demand for memory care housing and services. At the same time, infectious disease outbreaks like the COVID-19 pandemic have raised great concerns for the future of care settings for people living with dementia. In searching for innovative options to create more autonomy and better quality of life in dementia care settings, while at the same time improving infectious disease control, repurposing existing structures, in particular vacant urban malls, may be one option for the large sites needed for the European model of dementia villages. This editorial paper makes the case for the Dementia Friendly City Center model for centralized dementia programs, medical services and housing. By working across multiple disciplines, this research team has simultaneously addressed numerous issues, including community revitalization, building sustainability, and the strengthening of infectious disease control in care sites which are inclusive, progressive and convergent with the needs of an aging population.

scholarly journals Unveiling the Unspeakable: Integrating Video Elicitation Focus Group Interviews and Participatory Video in an Action Research Project on Dementia Care Development

2019 ◽  
Vol 18 ◽  
pp. 160940691983056 ◽  
Author(s):  
Bing Yu Li ◽  
Rainbow Tin Hung Ho
Keyword(s):  
Action Research ◽  
Focus Group ◽  
Community Education ◽  
Care Home ◽  
Dementia Care ◽  
Community Dwelling ◽  
Action Research Project ◽  
Research Project ◽  
Participatory Video ◽  
Participatory Health Research

With the intention to comprehensively reflect the reality, foster interactions between researchers and participants, and empower the marginalized groups to be heard, videos are increasingly used in health studies. The findings of an action research project that integrates video-based methods into the development of dementia care in an aged care home in Hong Kong are reported. A working alliance consisted of practitioners, community-dwelling volunteers, service managers, university educators, and researchers was formed to develop a sustainable, need-based play program for the institutionalized elderly with dementia (EWD). Two innovative methods, namely, video elicitation focus group interview (VEFI) and participatory video (PV), were applied. Data analyses were collaboratively conducted by all practitioner-researchers during eight reflexive sessions. Several short films were made through PV for institutional training and community education. VEFI effectively enhanced the practitioners’ understanding of the embodied expressions of the EWD and provided a reflexive, democratic environment to generate knowledge among practitioner-researchers. Counter-narratives of the EWD and educational materials on dementia care were generated through PV. The study demonstrates how innovative video-based methods may enable participatory health research to be more inclusive, engaging, and empowering, and how these methods may provide new perspectives on the ethics of researching vulnerable populations.

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 Facilitators and barriers to implement nurse-led interventions in long-term dementia care: a qualitative interview study with Swiss nursing experts and managers

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Julian Hirt ◽  
Melanie Karrer ◽  
Laura Adlbrecht ◽  
Susi Saxer ◽  
Adelheid Zeller
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Public Perception ◽  
Dementia Care ◽  
Term Care ◽  
Face To Face ◽  
People With Dementia ◽  
Qualitative Interview Study ◽  
Facilitators And Barriers

Abstract Background To support the implementation of nurse-led interventions in long-term dementia care, in-depth knowledge of specific supporting factors and barriers is required. Conditions and structures of caring for people with dementia differ widely, depending on the country and the care context. Our study aimed to describe the experiences and opinions of nursing experts and managers with regard to facilitators and barriers to the implementation of nurse-led interventions in long-term dementia care. Methods We conducted a qualitative descriptive study using individual interviews based on qualitative vignettes as a useful stimulus to generate narrations allowing to study peoples’ perceptions and beliefs. The study took place in nursing homes in the German-speaking part of Switzerland and in the Principality of Liechtenstein using purposive sampling. We intended to conduct the interviews face-to-face in a quiet room according to the participant’s choice. However, due to the lockdown of nursing homes during the COVID-19 pandemic in spring 2020, we performed interviews face-to-face and by video. We analysed data thematically following Braun and Clarke to achieve a detailed, nuanced description. To verify our interpretation and to ensure congruence with participants’ perspectives, we conducted member checks. The Standards for Reporting Qualitative Research (SRQR) served to structure our manuscript. Results Six dyads of nursing home managers and nursing experts from six nursing homes took part in our study (n = 12). Our thematic analysis yielded seven themes reflecting facilitators and barriers to implementing nurse-led interventions in long-term dementia care: «A common attitude and cohesion within the organization», «Commitment on several levels», «A needs-oriented implementation», «The effect and the public perception of the intervention», «A structured and guided implementation process», «Supporting knowledge and competencies», as well as «Resources for implementing the intervention». Conclusions To support the implementation of nurse-led interventions in long-term dementia care, active commitment-building seems essential. It is necessary that the value of the intervention is perceptible.Commitment-building is the precondition to reach the persons involved, such as nursing home managers, nursing staff, residents and relatives. Furthermore, nurses should precisely inform about the intervention. It is necessary that the value of the intervention is perceptible. In addition, nurses should adjust the interventions to the situational needs of people with dementia, thus. Therefore, it is important to support dementia-specific competencies in long-term care. Findings indicate that the barrier is determined by the intervention and its implementation – and not by the behaviour of the person with dementia.

scholarly journals 2051. Frequency of Inappropriate Antibiotic Prescribing in Nursing Homes

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S691-S691
Author(s):  
Chitra Kanchagar ◽  
Brie N Noble ◽  
Christopher Crnich ◽  
Jessina C McGregor ◽  
David T Bearden ◽  
...  
Keyword(s):  
Nursing Homes ◽  
Tract Infection ◽  
Multidrug Resistant ◽  
Antibiotic Prescribing ◽  
Prescribing Practices ◽  
Term Care ◽  
Antibiotic Overuse ◽  
For Profit ◽  
Memory Care ◽  
Minimum Criteria

Abstract Background Antibiotics are among the most prescribed medications in nursing homes (NHs). The increasing incidence of multidrug-resistant and C. Difficile infections due to antibiotic overuse has driven the requirement for NHs to establish antibiotic stewardship programs (ASPs). However, estimates of the frequency of inappropriate antibiotic prescribing in NHs have varied considerably between studies. We evaluated the frequency of inappropriate antibiotic prescribing in a multi-state sample of NHs. Methods We utilized a retrospective, (20%) random sample of residents of 17 for-profit NHs in Oregon, California, and Nevada who received antibiotics between January 1, 2017 and May 31, 2018. Study NHs ranged in size from 50 to 188 beds and offered services including subacute care, long-term care, ventilator care, and Alzheimer’s/memory care. Data were collected from residents’ electronic medical records. Antibiotic appropriateness was defined using Loeb Minimum Criteria for initiation of antibiotics for residents with indications for lower respiratory tract infection (LRTI), urinary tract infection (UTI) and skin and soft-tissue infection (SSTI). Residents with other types of infections were excluded from the study. Results Among 232 antibiotic prescriptions reviewed, 61% (141/232) were initiated in the NH. Of these, 65% were for female residents and 81% were for residents above the age of 65. Nearly 70% (98/141) of antibiotic prescriptions were for an indication of an LRTI, UTI, or SSTI of which 51% (57% of LRTIs, 52% of UTIs, and 35% of SSTIs) did not meet the Loeb Minimum Criteria and were determined to be inappropriate. Among antibiotics that did not meet the Loeb Minimum Criteria, more than half were cephalosporins (40%) or fluoroquinolones (14%) and the median (interquartile range) duration of therapy was 7 (5–10) days. Conclusion These data from a multi-state sample of NHs suggest the continued need for improvement in antibiotic prescribing practices and the importance of ASPs in NHs. Disclosures All authors: No reported disclosures.

A feasibility study af a blended learning dementia care: elective course for nursing students

2020 ◽  
Vol 1 ◽  
pp. 125-131
Author(s):  
Azam David Saifullah ◽  
Sri Mulyani ◽  
Eria Riski Artanti
Keyword(s):  
Nursing Students ◽  
Blended Learning ◽  
Learning Strategy ◽  
Attitude Scale ◽  
Dementia Care ◽  
P Value ◽  
Term Care ◽  
People With Dementia ◽  
Elective Course ◽  
Care Course

As there is a limited long-term care options in Indonesia, people with dementia are cared for by their family. They often hospitalized as the condition progresses. Nurses are the profession with most contact. Therefore, preparing nursing students to care for people living with dementia is needed. Blended learning as e new learning strategy in dementia care for nursing student need to be evaluated to comprehend its feasibility in the future dementia care course.  This study aimed to evaluate the feasibility of a blended learning course for nursing students about dementia. A blended learning course was developed as a three-credits elective course that voluntarily joined by 42 fourth year nursing students. This course integrates the schedule, modules, and assignments in a learning management system called eLOK (Moodle based). One group pre-post test was conducted to evaluate this course using DKAS (Dementia Knowledge Assessment Scale) and DAS (Dementia Attitude Scale) as instruments. Google form was integrated to evaluate the course and the use of eLOK. Data were analysed using a paired t-test. 37 students (88.1%) completed the questionnaires. There is a significant improvement in knowledge towards dementia (t = 5.96, p value < .00) but not the attitude (t = 2.50, p value = .17) right after completing the course. Students also well appreciated the quizzes and project as the evaluation of learning outcomes of the course. Moreover, the audio-visual material in eLOK made them feel helpful in learning new topics and made new constructive experience of learning. In conclusion, this blended learning is feasible to be used as a learning method for delivering dementia care course.

scholarly journals The Effect of Long Term Care Resources on Burdens for Caregiving People Living with Dementia in Taiwan

2021 ◽  
Author(s):  
Yang-Hao Ou ◽  
Ming-Che Chang ◽  
Wen-Fu Wang ◽  
Kai-Ming Jhang
Keyword(s):  
Caregiver Burden ◽  
Long Term Care ◽  
Dementia Care ◽  
Care Team ◽  
Control Group ◽  
Term Care ◽  
People With Dementia ◽  
Home Based ◽  
Caregiver Group

Abstract Background: There is an increasing awareness of caregiver's burden, especially in those caring for people with dementia. The caregiver burden has been studied extensively in Western countries; however, the interpretation of the results and replication of the intervention may deem unfit in the Chinese culture. Therefore, this study identifies the change in caregiver burden by interventional methods under current Taiwan's long-term care Act 2.0.Method: A total of 2,598 newly diagnosed dementia outpatients was evaluated by the Changhua Christian Hospital dementia care team. Eighty patients utilize one of the three care resources, including community-based services (n = 33), home-based services (n = 19), or taking care by foreign caregivers (n = 28). Participants in the control group were selected by matching their global CDR score, gender, age, and caregivers' age with a 1:4 ratio. All caregivers completed the Zarit Burden Interview (ZBI) questionnaires before and six months after utilizing the care resources. Results: The home-based and the foreign caregiver groups have the highest baseline ZBI scores with 37.63±16.14 and 36.57±17.14, respectively. The second ZBI score was assessed about six months after the baseline showing that the home-based group remained the highest caregiver burden (ZBI = 31.74±12.23) and the foreign caregiver group showed the lowest burden (ZBI = 25.68±12.09). The mean difference in the ZBI score confirmed that the foreign caregiver group had the most improvement, averaging a decrease of 17.99±31.08 points (adjust observation time). A linear regression model showed that home-based care and foreign caregiver contributes the most reduction in caregiver burden (-11.83 and -19,07 ZBI scores, respectively).Conclusion: Caring for people with dementia includes caring for their caregivers. Dementia care team should provide proper social resources, which are crucial in the alleviation of caregiver burden.

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