scholarly journals Assessing Quality for People Living With Dementia in Residential Long-Term Care: Trends and Challenges

2019 ◽  
Vol 5 ◽  
pp. 233372141986119
Author(s):  
Eleanor S. McConnell ◽  
Julienne Meyer
Keyword(s):  
Performance Indicators ◽  
Long Term Care ◽  
Well Being ◽  
Subjective Assessment ◽  
Term Care ◽  
Centered Care ◽  
Care Health ◽  
Residential Long Term Care

The global prevalence of dementia is growing rapidly, driving an increased use of residential long-term care (LTC) services. Performance indicators for residential LTC should support targeting of limited resources to promote person-centered care, health, and well-being for both patients and caregivers (formal and informal), yet many performance indicators remain focused on structure, process, or outcome measures that are only assumed to support personally relevant outcomes for those with dementia, without direct evidence of meaningfulness for these individuals. In this article, two complementary approaches to assessing quality in residential LTC serve as a lens for examining a series of tensions related to assessment in this setting. These include measurement-focused approaches using generic psychometrically valid instruments, often used to monitor quality of services, and meaning-focused approaches using individual subjective assessment of personally relevant outcomes, often used to monitor care planning. Examples from the European and U.S. literature suggest an opportunity to strengthen an emphasis on personally meaning-focused outcomes in quality assessment.

scholarly journals FEDERAL POLICY SUPPORTS AND GAPS IN ADDRESSING RACIAL-ETHNIC HEALTH DISPARITIES IN U.S. LONG-TERM CARE FACILITIES

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S161-S161
Author(s):  
Rebecca L Mauldin ◽  
Kathy Lee ◽  
Antwan Williams
Keyword(s):  
Long Term Care ◽  
Federal Policy ◽  
Care Facility ◽  
Well Being ◽  
The United States ◽  
Term Care ◽  
Long Term Care Facility ◽  
Care Facilities

Abstract Older adults from racial and ethnic minority groups face health inequities in long-term care facilities such as nursing homes and assisted living facilities just as they do in the United States as a whole. In spite of federal policy to support minority health and ensure the well-being of long-term care facility residents, disparities persist in residents’ quality of care and quality of life. This poster presents current federal policy in the United States to reduce racial and ethnic health disparities and to support long-term care facility residents’ health and well-being. It includes legislation enacted by the Patient Protection and Affordable Care Act of 2010 (ACA), regulations of the U.S. Department of Health and Human Services (DHHS) for health care facilities receiving Medicare or Medicare funds, and policies of the Long-term Care Ombudsman Program. Recommendations to address threats to or gaps in these policies include monitoring congressional efforts to revise portions of the ACA, revising DHHS requirements for long-term care facilities staff training and oversight, and amending requirements for the Long-term Care Ombudsman Program to mandate collection, analysis, and reporting of resident complaint data by race and ethnicity.

scholarly journals END-OF-LIFE CARE PREFERENCES AND WELL-BEING IN LONG-TERM CARE RESIDENTS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S669-S669
Author(s):  
Kelly Shryock ◽  
Jacinta Dickens ◽  
Anisha Thomas ◽  
Suzanne Meeks
Keyword(s):  
Quality Of Life ◽  
Positive Affect ◽  
End Of Life ◽  
End Of Life Care ◽  
Long Term Care ◽  
Well Being ◽  
Life Care ◽  
Term Care

Abstract Research on end-of-life care in nursing homes comes largely from the viewpoint of staff or family members. We examined patient perspectives on end-of-life care, preferences for care, and quality of life in long-term care settings. We hypothesized that fulfillment of the Self Determination Theory (SDT) needs of autonomy, competence, and relatedness would be related to better well-being and that the degree to which end-of-life care preferences are seen as possible in the setting would be related to SDT need fulfillment and well-being. Preliminary data, collected from older individuals at the end of life (over 55, presence of significant chronic disease, in long term care setting) (n= 72), demonstrated that autonomy, competence, and relatedness measures were moderately and significantly correlated with well-being as measured by life satisfaction, higher positive affect, lower negative affect, and overall quality of life measures The degree to which residents believed that their end-of-life care preferences could be honored in the setting was also significantly correlated with autonomy, competence, relatedness, positive affect, and psychological quality of life. These results are consistent with SDT and suggest that if long term care settings can promote autonomy, connection, and competence in making end of life decisions, possibly by discovering and fulfilling preferences for end of life care, individuals who end their lives on those settings have potential for greater satisfaction and happiness. These results suggest that SDT is a useful framework for ongoing research on how to improve the end of life experiences of older adults in long term care.

scholarly journals THE IMPACT OF A PARO INTERVENTION ON DEPRESSION AND WELL-BEING IN OLDER ADULTS WITH DEPRESSION

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S341-S341
Author(s):  
Shu-Chuan Chen ◽  
Wendy Moyle ◽  
Cindy Jones
Keyword(s):  
Quality Of Life ◽  
Older Adults ◽  
Older People ◽  
Long Term Care ◽  
Well Being ◽  
World Health ◽  
Term Care ◽  
Care Facilities

Abstract Aim: This study aimed to explore the effect of a social robot Paro intervention on depression and well-being in older adults with depression living in long-term care facilities in Taiwan. Methods: This study was adopted a single group and quasi-experimental with repeated measures design. Each participant participated in two stages: observation and Paro intervention stages. Stage 1 was an 8-week observation stage in long-term care facilities where the purpose was to observe the normal mood, behaviour and activities of older adults with depression. In stage 2, each participant was given a Paro by the researcher to keep for 24 hours for 7 days in for 8 weeks. Outcome measurements were obtained 4 times: a week before the intervention (T1), immediately the end of 8-week observation (T2), mid-point of Paro intervention (T3), and immediately the end of 8-week Paro intervention (T4). Instruments included the Geriatric Depression Scale, the UCLA Loneliness Scale version 3, and the World Health Organization Quality of Life Questionnaire-OLD. Results: There were 20 participants completed the study. The mean age of participants was 81.1years (SD = 8.2). After 8-week Paro intervention, statistically significant differences in changes were found on depression, loneliness, and quality of life from pre-intervention to post-intervention. Conclusion: This study was found that Paro intervention has beneficial effects on depression and mental well-being for older people with depression in long-term care facilities. Paro Intervention might be a suitable psychosocial intervention for older people with depression and should be considered as a useful tool in clinical practice.

Perceptions of family and staff on the role of the environment in long-term care homes for people with dementia

2012 ◽  
Vol 24 (5) ◽  
pp. 753-765 ◽  
Author(s):  
Linda J. Garcia ◽  
Michèle Hébert ◽  
Jean Kozak ◽  
Isabelle Sénécal ◽  
Susan E. Slaughter ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Focus Groups ◽  
Long Term Care ◽  
Disruptive Behaviors ◽  
Well Being ◽  
Care Homes ◽  
Term Care ◽  
Staff Members

ABSTRACTBackground: Disruptive behaviors are frequent and often the first predictor of institutionalization. The goal of this multi-center study was to explore the perceptions of family and staff members on the potential contribution of environmental factors that influence disruptive behaviors and quality of life of residents with dementia living in long-term care homes.Methods: Data were collected using 15 nominal focus groups with 45 family and 59 staff members from eight care units. Groups discussed and created lists of factors that could either reduce disruptive behaviors and facilitate quality of life or encourage disruptive behaviors and impede the quality of life of residents. Then each participant individually selected the nine most important facilitators and obstacles. Themes were identified from the lists of data and operational categories and definitions were developed for independent coding by four researchers.Results: Participants from both family and staff nominal focus groups highlighted facility, staffing, and resident factors to consider when creating optimal environments. Human environments were perceived to be more important than physical environments and flexibility was judged to be essential. Noise was identified as one of the most important factors influencing behavior and quality of life of residents.Conclusion: Specialized physical design features can be useful for maintaining quality of life and reducing disruptive behaviors, but they are not sufficient. Although they can ease some of the anxieties and set the stage for social interactions, individuals who make up the human environment are just as important in promoting well-being among residents.

scholarly journals 519 - PET@home: Research protocol for a toolkit to improve care for non-residential long term care clients owning pets

2021 ◽  
Vol 33 (S1) ◽  
pp. 68-68
Author(s):  
Ruslan Leontjevas ◽  
Marie-José Enders-Slegers ◽  
Peter Reniers ◽  
Ine Declerq ◽  
Debby Gerritsen ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Long Term Care ◽  
Support Network ◽  
Social Support Network ◽  
Term Care ◽  
Care Workers ◽  
Residential Long Term Care

BackgroundOver half of the households in The Netherlands have one or more pets. In elderly people, owning a pet is associated with a better quality of life and less loneliness, anxiety, depression and agitation. Many non-residential long term care (LTC) clients rely on support of others to take care of their pets. However, that may place a significant burden on the social support network of the LTC client. Issues relevant to keeping pets are not explicitly incorporated in the Dutch Long-term Care Act. Many LTC organizations have no instruments for care workers, clients and their family (1) to consolidate the positive role of pets for clients’ quality of life and (2) to address whether it is possible to keep the pets and to organize care accordingly.Research ObjectivesTo help care workers, clients and their family to gain insight into the role of the pets in the clients’ life and their social support network; to develop practical instruments that help making decisions about owning and caring for pets.MethodPLAN: In months 0-16, a narrative systematic review will be conducted (STUDY 1.1) on the meaning of pets for elderly people in general. A qualitative STUDY 1.2 with LTC clients, their informal carers and care professionals will validate and further explore the topic. STUDY 1.3 and 1.4 develop and (cognitively) validate work cards for interviews of clients and relatives by care providers. In months 17-29, an Experience based co-design method (STUDIES 2.1-2.3) will be used to develop the PET@home toolkit. The method includes (1) discovery interviews (10 clients and their family), (2) focus groups with healthcare providers (N = 2x6); (3) focus groups with 6-8 clients and informal and professional carers. In STUDY 3.1, potential users will pre-test the Toolkit. In months 30-34, a process evaluation (STUDY 3.2) is performed in 10-15 clients. A dissemination and an implementation plan will be developed.ConclusionsThe project will result in an innovative PET@home toolkit that will help to assess the pets role in the clients’ quality of life and support network, and will help making decisions about owning and caring for pets.

scholarly journals Perspectives Toward Long-Term Care Measurement From Frontline Workers in Brazil

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 161-161
Author(s):  
Patrick Wachholz ◽  
Paulo José Fortes Villas Boas ◽  
Vivian Schutz ◽  
Michael Lepore ◽  
Deanna Myer ◽  
...  
Keyword(s):  
Organizational Context ◽  
Long Term Care ◽  
Term Care ◽  
Frontline Staff ◽  
Frontline Workers ◽  
Care Facilities ◽  
Centered Care ◽  
Care Outcomes

Abstract The Brazilian long-term care (LTC) sector remains poorly structured and underdeveloped. COVID-19 did not bring unprecedented focus to the sector just because of the high mortality; it also affected the quality of care. In this pilot study, we evaluated the perspectives toward WE-THRIVE LTC measurements from Brazilian frontline workers in five long-term care facilities. For the four WE-THRIVE domains of LTC measurement (workforce and staffing, person-centered care, organizational context, and care outcomes), respondents used a 4-point Likert scale to rate their importance and answered open-ended questions about how these aspects of care changed since COVID-19. With few exceptions, respondents rated these aspects of LTC as extremely important or very important. Qualitative results highlighted concerns about and impacts of COVID-19, such as challenges related to the isolation of residents. The assessed measurement domains are confirmed to be important by frontline staff in Brazil. Measurement adoption must account for current issues.

How Context Shapes the Experience of Staff and Residents in Residential Long-Term Care Settings

2019 ◽  
pp. 232-249
Author(s):  
Carole A. Estabrooks ◽  
Stephanie A. Chamberlain
Keyword(s):  
Quality Of Life ◽  
Organizational Context ◽  
Long Term Care ◽  
Local Context ◽  
Term Care ◽  
Context Shapes ◽  
Study Context ◽  
Residential Long Term Care

This chapter describes 10 years of research into organizational context in residential long-term care (LTC) settings. It focuses on this book’s first and third questions: What constitutes context for an event, situation, or phenomenon? And how do contexts change, and what is the role of actors in such processes? Although with respect to change, it does not focus as much on secular trends as it does on strategies to improve local context. We explore how context influences use of research by staff, quality-of-life indicators for staff, and ability to improve quality of care and quality of life for LTC residents. First, it describes the development and ongoing use of the Alberta Context Tool. Second, it describes the Translating Research in Elder Care (TREC) program of research, and the LTC setting in which the authors study context to bring about quality improvements. Third, it presents selected empirical findings as evidence that context matters in LTC. Finally, it proposes future directions to understand and modify context for improved quality in LTC.

Long-term Care Residents' Preferences for Health States on the Quality of Well-Being Scale

1996 ◽  
Vol 16 (3) ◽  
pp. 254-261 ◽  
Author(s):  
Ron D. Hays ◽  
Albert L. Siu ◽  
Emmett Keeler ◽  
Grant N. Marshall ◽  
Robert M. Kaplan ◽  
...  
Keyword(s):  
Long Term Care ◽  
Well Being ◽  
Health States ◽  
Term Care
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