scholarly journals Depressive symptoms in long term care facilities in Western Canada: a cross sectional study

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Matthias Hoben ◽  
Abigail Heninger ◽  
Jayna Holroyd-Leduc ◽  
Jennifer Knopp-Sihota ◽  
Carole Estabrooks ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Depressive Symptoms ◽  
Long Term Care ◽  
Assessment Instrument ◽  
Western Canada ◽  
Cross Sectional ◽  
Term Care ◽  
Data Set ◽  
For Profit

Abstract Background The main objective is to better understand the prevalence of depressive symptoms, in long-term care (LTC) residents with or without cognitive impairment across Western Canada. Secondary objectives are to examine comorbidities and other factors associated with of depressive symptoms, and treatments used in LTC. Methods 11,445 residents across a random sample of 91 LTC facilities, from 09/2014 to 05/2015, were stratified by owner-operator model (private for-profit, public or voluntary not-for-profit), size (small: < 80 beds, medium: 80–120 beds, large > 120 beds), location (Calgary and Edmonton Health Zones, Alberta; Fraser and Interior Health Regions, British Columbia; Winnipeg Health Region, Manitoba). Random intercept generalized linear mixed models with depressive symptoms as the dependent variable, cognitive impairment as primary independent variable, and resident, care unit and facility characteristics as covariates were used. Resident variables came from the Resident Assessment Instrument – Minimum Data Set (RAI-MDS) 2.0 records (the RAI-MDS version routinely collected in Western Canadian LTC). Care unit and facility variables came from surveys completed with care unit or facility managers. Results Depressive symptoms affects 27.1% of all LTC residents and 23.3% of LTC resident have both, depressive symptoms and cognitive impairment. Hypertension, urinary and fecal incontinence were the most common comorbidities. Cognitive impairment increases the risk for depressive symptoms (adjusted odds ratio 1.65 [95% confidence interval 1.43; 1.90]). Pain, anxiety and pulmonary disorders were also significantly associated with depressive symptoms. Pharmacologic therapies were commonly used in those with depressive symptoms, however there was minimal use of non-pharmacologic management. Conclusions Depressive symptoms are common in LTC residents –particularly in those with cognitive impairment. Depressive symptoms are an important target for clinical intervention and further research to reduce the burden of these illnesses.

scholarly journals Relationship between environmental factors and responsive behaviours in long-term care homes: a secondary data analysis

BMJ Open ◽  
2021 ◽  
Vol 11 (10) ◽  
pp. e047364
Author(s):  
Kelsey Holt ◽  
Matthias Hoben ◽  
Lori Weeks ◽  
Carole Estabrooks
Keyword(s):  
Environmental Quality ◽  
Long Term Care ◽  
Care Delivery ◽  
Research Programme ◽  
Assessment Instrument ◽  
Cross Sectional ◽  
Term Care ◽  
Data Set

ObjectiveResponsive behaviours (eg, wandering, resisting care and verbal abuse) are a continuing issue for staff and individuals living in long-term care (LTC) homes. The LTC environment can influence responsive behaviours and is a factor in determining the quality of life for those living there. The ways in which the quality of the environment might influence responsive behaviours has not been investigated yet. We hypothesised that better quality environments would be associated with reduced rates of responsive behaviours. We used a tool that simultaneously encompasses human and structural elements of the environment, a novel approach in this field of research.DesignCross-sectional study, using data collected from September 2014 to May 2015 as part of the Translating Research in Elder Care research programme.SettingA representative, stratified (size, owner-operator model and health region) random sample of 76 LTC homes in British Columbia, Alberta, Manitoba.Participants13 224 individuals (67.3% females) living in participating LTC homes.Outcome measuresQuality of care unit work environment was assessed using the observable indicators of quality (OIQ) tool. Responsive behaviours were assessed using routinely collected Resident Assessment Instrument-Minimum Data Set V.2.0 data.ResultsAdjusted regression coefficients of overall Aggressive Behaviour Scale score and interpersonal communication were 0.02 (95% CI −0.011 to 0.045), grooming 0.06 (95% CI −0.032 to 0.157), environment-basics 0.067 (95% CI 0.024 to 0.110), odour −0.066 (95% CI −0.137 to −0.004), care delivery −0.007 (95% CI −0.033 to 0.019), environment-access −0.027 (95% CI −0.062 to 0.007), environment-homelike −0.034 (95% CI −0.065 to −0.002) and total OIQ score 0.003 (95% CI −0.004 to 0.010).ConclusionsWe found small associations between the environmental quality and responsive behaviours in Western Canadian LTC homes. Higher scores on homelikeness were associated with decreased responsive behaviours. Higher scores on basic environmental quality were associated with increased responsive behaviours.

scholarly journals Social engagement and depressive symptoms of elderly residents with dementia: a cross-sectional study of 37 long-term care units

2010 ◽  
Vol 23 (4) ◽  
pp. 625-633 ◽  
Author(s):  
Adriana P. A. van Beek ◽  
Dinnus H. M. Frijters ◽  
Cordula Wagner ◽  
Peter P. Groenewegen ◽  
Miel W. Ribbe
Keyword(s):  
Depressive Symptoms ◽  
Social Engagement ◽  
Care Setting ◽  
Long Term Care ◽  
Individual Characteristics ◽  
Assessment Instrument ◽  
Term Care ◽  
Data Set ◽  
Residential Homes

ABSTRACTBackground: Social engagement and depression are important outcomes for residents with dementia in long-term care. However, it is still largely unclear which differences in social engagement and depression exist in residents of various long-term care settings and how these differences may be explained. This study investigated the relationship between social engagement and depressive symptoms in long-term care dementia units, and studied whether differences in social engagement and depressive symptoms between units can be ascribed to the composition of the resident population or to differences in type of care setting.Methods: Thirty-seven long-term care units for residents with dementia in nursing- and residential homes in the Netherlands participated in the study. Social engagement and depressive symptoms were measured for 502 residents with the Minimum Data Set of the Resident Assessment Instrument. Results were analyzed using multilevel analysis.Results: Residents of psychogeriatric units in nursing homes experienced low social engagement. Depressive symptoms were most often found in residents of psychogeriatric units in residential homes. Multilevel analyses showed that social engagement and depressive symptoms correlated moderately on the level of the units. This correlation disappeared when the characteristics of residents were taken into account.Conclusions: Social engagement and depressive symptoms are influenced not only by individual characteristics but also by the type of care setting in which residents live. However, in this study social engagement and depressive symptoms were not strongly related to each other, implying that separate interventions are needed to improve both outcomes.

scholarly journals Evidence for Publicly Reported Quality Indicators in Residential Long-Term Care: A Systematic Review

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 181-181
Author(s):  
Franziska Zúñiga ◽  
Magdalena Osinska ◽  
Franziska Zuniga
Keyword(s):  
New Zealand ◽  
Quality Indicators ◽  
Long Term Care ◽  
Grey Literature ◽  
Public Reporting ◽  
Assessment Instrument ◽  
Term Care ◽  
Data Set ◽  
Residential Long Term Care

Abstract Quality indicators (QIs) are used internationally to measure, compare and improve quality in residential long-term care. Public reporting of such indicators allows transparency and motivates local quality improvement initiatives. However, little is known about the quality of QIs. In a systematic literature review, we assessed which countries publicly report health-related QIs, whether stakeholders were involved in their development and the evidence concerning their validity and reliability. Most information was found in grey literature, with nine countries (USA, Canada, Australia, New Zealand and five countries in Europe) publicly reporting a total of 66 QIs in areas like mobility, falls, pressure ulcers, continence, pain, weight loss, and physical restraint. While USA, Canada and New Zealand work with QIs from the Resident Assessment Instrument – Minimal Data Set (RAI-MDS), the other countries developed their own QIs. All countries involved stakeholders in some phase of the QI development. However, we only found reports from Canada and Australia on both, the criteria judged (e.g. relevance, influenceability), and the results of structured stakeholder surveys. Interrater reliability was measured for some RAI QIs and for those used in Germany, showing overall good Kappa values (&gt;0.6) except for QIs concerning mobility, falls and urinary tract infection. Validity measures were only found for RAI QIs and were mostly moderate. Although a number of QIs are publicly reported and used for comparison and policy decisions, available evidence is still limited. We need broader and accessible evidence for a responsible use of QIs in public reporting.

scholarly journals Incapacitated and Alone: Prevalence of Unbefriended Residents in Alberta Long-Term Care Homes

SAGE Open ◽  
2019 ◽  
Vol 9 (4) ◽  
pp. 215824401988512 ◽  
Author(s):  
Stephanie A. Chamberlain ◽  
Wendy Duggleby ◽  
Janet Fast ◽  
Pamela B. Teaster ◽  
Carole A. Estabrooks
Keyword(s):  
Online Survey ◽  
Long Term Care ◽  
Survey Methods ◽  
Population Level ◽  
Urban Centers ◽  
Cross Sectional ◽  
Term Care ◽  
For Profit ◽  
Not For Profit

The objective of this study was to assess the prevalence of residents who are incapacitated and have no surrogate decision maker, known as the “unbefriended” in Alberta long-term care (LTC) homes. Using cross-sectional online survey methods, data were collected from 123 staff (i.e., directors of care/nursing, administrators) from Alberta LTC homes. Information was collected on survey respondents’ demographic characteristics, number of unbefriended residents, and on organizational characteristics. The overall prevalence of unbefriended residents in LTC homes was 4.14% in Alberta ( SD = 6.28%, range: 0%-34.6%). Homes with the highest prevalence (nearly 15%) of unbefriended residents had >135 beds and were public not-for-profit and located in large urban centers. Fifty-three percent of unbefriended residents were male. The highest prevalence of unbefriended residents lived in homes located in large urban centers and public not-for-profit operators. Population level and LTC home level prevalence data are needed to assess the scope of unmet needs.

scholarly journals DNR Linked to Reduced Depressive Symptoms in Nursing Home Residents During COVID-19 Illness

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 720-721
Author(s):  
Wingyun Mak ◽  
Orah Burack ◽  
Joann Reinhardt ◽  
Himali Weerahandi ◽  
Benjamin Canter ◽  
...  
Keyword(s):  
Nursing Home ◽  
Depressive Symptoms ◽  
Functional Status ◽  
Long Term Care ◽  
Nursing Home Residents ◽  
Do Not Resuscitate ◽  
Term Care ◽  
Data Set ◽  
Care Plans

Abstract Prior work shows that older adults who establish future care plans have a lower risk of depression. Residents in long-term care may benefit from establishing a do-not-resuscitate (DNR) order when cardiopulmonary resuscitation is unlikely to provide medical benefit. The current study examines whether having a DNR order in place prior to COVID-19 diagnosis was associated with fewer depressive symptoms during the illness course. Residents at a NYC skilled nursing facility with a positive COVID-19 PCR test between 3/1/2020 – 6/1/2020 were included (N=338). The Minimum Data Set (3.0) was used to examine residents’ Patient Health Questionnaire-9 (PHQ-9) scores 1-30 days after diagnosis, functional status, cognition, age, and sex. A retrospective chart review was conducted to determine whether participants had an established DNR, DNI, and/or DNH order before developing COVID-19. Forty-eight percent, 46%, and 12% of participants had a DNR, DNI, or DNH order prior to COVID-19 illness, respectively. Average PHQ-9 score was 1.65 (SD=2.37). A hierarchical regression showed that after controlling for age (β=-.13, p=.06), sex (β=-.08, p=.28), cognition (β=.14, p=.04), and functional status (β=.23, p=.001; R2=.10, p=.001), having a DNR (β=-.22, p=.006) order in place prior to COVID illness was associated with lower endorsement of depressive symptoms during illness (ΔR2=.04, p=.01). Results suggest that establishing a DNR in long-term care residents when appropriate may potentially buffer depressive symptoms during illness in nursing home residents regardless of their age, sex, cognitive abilities, and functional status. Future examination of the underlying mechanism is warranted.

An estimate of the prevalence of dementia among residents of long-term care geriatric institutions in the Jerusalem area

2006 ◽  
Vol 18 (4) ◽  
pp. 643-652 ◽  
Author(s):  
Helena Feldman ◽  
A. Mark Clarfield ◽  
Jenny Brodsky ◽  
Yaron King ◽  
Tzvi Dwolatzky
Keyword(s):  
Cognitive Impairment ◽  
Medical Records ◽  
Long Term Care ◽  
The Elderly ◽  
Care Providers ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Term Care ◽  
Prevalence Of Dementia

Background: To determine the prevalence of dementia among the residents of geriatric institutions in the greater Jerusalem area.Methods: A population-based, cross-sectional survey of a representative sample, weighted according to the level of care, of 11 of the 88 long-term care (LTC) wards in 34 LTC institutions providing care for the elderly residents in the greater Jerusalem area in 1999. A single physician interviewed 311 residents. The presence of dementia was determined from medical records and by performance on the Modified Mini-mental State Examination (3MS) instrument (with a score less than 78/100 indicating significant cognitive impairment or suspected dementia), and professional care providers were interviewed for their opinion regarding the presence of dementia in each subject.Results: The mean age of the patients was 83.9 years and 75% were women. Overall, 180 residents, representing 49.9% of the weighted sample in Jerusalem LTC facilities, were determined to have dementia according to medical records, ranging from 22.9% in independent and frail care units to 97.7% in skilled nursing care wards. However, based on their performance on the 3MS, the prevalence of cognitive impairment with suspected dementia among the subjects was substantially greater, with the staff being unaware of this diagnosis in about one-quarter of the subjects.Conclusions: There is a high prevalence of dementia in geriatric institutions in the Jerusalem area, particularly in those providing greater care. Moreover, significant cognitive impairment is probably under-reported in the medical records.

Hearing Loss and Cognitive-Communication Test Performance of Long-Term Care Residents With Dementia: Effects of Amplification

2016 ◽  
Vol 59 (6) ◽  
pp. 1533-1542 ◽  
Author(s):  
Tammy Hopper ◽  
Susan E. Slaughter ◽  
Bill Hodgetts ◽  
Amberley Ostevik ◽  
Carla Ickert
Keyword(s):  
Hearing Loss ◽  
Test Performance ◽  
Speech Intelligibility ◽  
Long Term Care ◽  
Assessment Instrument ◽  
Term Care ◽  
Data Set ◽  
Hearing Ability ◽  
The Relationship

Purpose The study aims were (a) to explore the relationship between hearing loss and cognitive-communication performance of individuals with dementia, and (b) to determine if hearing loss is accurately identified by long-term care (LTC) staff. The research questions were (a) What is the effect of amplification on cognitive-communication test performance of LTC residents with early- to middle-stage dementia and mild-to-moderate hearing loss? and (b) What is the relationship between measured hearing ability and hearing ability recorded by staff using the Resident Assessment Instrument–Minimum Data Set 2.0 (RAI-MDS; Hirdes et al., 1999)? Method Thirty-one residents from 5 long-term care facilities participated in this quasiexperimental crossover study. Residents participated in cognitive-communication testing with and without amplification. RAI-MDS ratings of participants' hearing were compared to audiological assessment results. Results Participants' speech intelligibility index scores significantly improved with amplification; however, participants did not demonstrate significant improvement in cognitive-communication test scores with amplification. A significant correlation was found between participants' average pure-tone thresholds and RAI-MDS ratings of hearing, yet misclassification of hearing loss occurred for 44% of participants. Conclusions Measuring short-term improvement of performance-based cognitive communication may not be the most effective means of assessing amplification for individuals with dementia. Hearing screenings and staff education remain necessary to promote hearing health for LTC residents.

scholarly journals Depressive symptoms and cognitive impairment predict all-cause mortality in long-term care residents.

2010 ◽  
Vol 25 (2) ◽  
pp. 446-452 ◽  
Author(s):  
Katherine D. Kane ◽  
Brian P. Yochim ◽  
Peter A. Lichtenberg
Keyword(s):  
Cognitive Impairment ◽  
Depressive Symptoms ◽  
Long Term Care ◽  
Term Care ◽  
All Cause Mortality

scholarly journals Characteristics of Socially Isolated Residents in Long-Term Care: A Retrospective Cohort Study

2020 ◽  
Vol 6 ◽  
pp. 233372142097532
Author(s):  
Stephanie A. Chamberlain ◽  
Wendy Duggleby ◽  
Pamela B. Teaster ◽  
Carole A. Estabrooks
Keyword(s):  
Cohort Study ◽  
Functional Status ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Long Term Care ◽  
Assessment Instrument ◽  
Term Care ◽  
Data Set ◽  
Socially Isolated

Objectives: To identify socially isolated long-term care residents and to compare their demographic characteristics, functional status, and health conditions to residents who are not isolated. Methods: We conducted a retrospective cohort study using the Resident Assessment Instrument, Minimum Data Set, 2.0 (RAI-MDS) data, from residents in 34 long-term care homes in Alberta, Canada (2008–2018). Using logistic regression, we compared the characteristics, conditions, and functional status of residents who were socially isolated (no contact with family/friends) and non-socially isolated residents. Results: Socially isolated residents were male, younger, and had a longer length of stay in the home, than non-socially isolated residents. Socially isolated residents lacked social engagement and exhibited signs of depression. Discussion: Socially isolated residents had unique care concerns, including psychiatric disorders, and co-morbid conditions. Our approach, using a single item in an existing data source, has the potential to assist clinicians in screening for socially isolated long-term care residents.

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