scholarly journals Digital technologies to support people living with dementia in the care home setting to engage in meaningful occupations: protocol for a scoping review

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Nicholas Luscombe ◽  
Sarah Morgan-Trimmer ◽  
Sharon Savage ◽  
Louise Allan
Keyword(s):  
Scoping Review ◽  
Care Home ◽  
Digital Technologies ◽  
Mechanisms Of Action ◽  
Barriers And Facilitators ◽  
Care Staff ◽  
Care Homes ◽  
Intervention Design ◽  
Diverse Range ◽  
Home Setting

Abstract Background People living with all stages of dementia should have the opportunity to participate in meaningful occupations. For those living in care homes, this may not always occur and residents may spend significant parts of the day unengaged, especially those living with more advanced dementia. Digital technologies are increasingly being used in health care and could provide opportunities for people living with dementia (PLWD) in care homes to engage in meaningful occupations and support care staff to provide these activities. With technology advancing at a rapid rate, the objective of this scoping review is to provide an up-to-date systematic map of the research on the diverse range of digital technologies that support engagement in meaningful occupations. In particular, focus will be given to barriers and facilitators to inform future intervention design and implementation strategies, which have not yet been clearly mapped across the full range of these digital technologies. Method A scoping review will be conducted to systematically search for published research using a comprehensive search strategy on thirteen databases. Published, peer-reviewed studies that focused on PLWD in the care home setting and assessed any form of digital technology that supported a meaningful occupation will be included. All methodologies which meet the criteria will be included. Data will be extracted and charted to report the range of digital technologies, underlying mechanisms of action, facilitators and barriers to implementation. Discussion Mapping the range of technologies to support PLWD to engage in meaningful occupations will identify gaps in research. The systematic search will include a diverse range of technologies such as software to enhance care planning, tablets devices, smartphones, communication robots and social media platforms, rather than focussing on a specific design or interface. This will enable comparison between mechanisms of action, barriers and facilitators to implementation which will be useful for future research and intervention design. Trial registration Open Science Framework 10.17605/OSF.IO/7UDM2

scholarly journals Pain assessment and management in care homes: understanding the context through a scoping review

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jan Pringle ◽  
Ana Sofia Alvarado Vázquez Mellado ◽  
Erna Haraldsdottir ◽  
Fiona Kelly ◽  
Jo Hockley
Keyword(s):  
Cognitive Impairment ◽  
Scoping Review ◽  
Pain Assessment ◽  
Care Home ◽  
Nursing Home Residents ◽  
Assessment Tools ◽  
Care Staff ◽  
Care Homes ◽  
Cochrane Library ◽  
Assessment And Treatment

Abstract Background Internationally, 2–5% of people live in residential or nursing homes, many with multi-morbidities, including severe cognitive impairment. Pain is frequently considered an expected part of old age and morbidity, and may often be either under-reported by care home residents, or go unrecognized by care staff. We conducted a systematic scoping review to explore the complexity of pain recognition, assessment and treatment for residents living in care homes, and to understand the contexts that might influence its management. Methods Scoping review using the methodological framework of Levac and colleagues. Articles were included if they examined pain assessment and/or management, for care or nursing home residents. We searched Medline, CINAHL, ASSIA, PsycINFO, EMBASE, Cochrane Library, and Google Scholar; reference lists were also screened, and website searches carried out of key organisations. Conversations with 16 local care home managers were included to gain an understanding of their perspective. Results Inclusion criteria were met by 109 studies. Three overarching themes were identified: Staff factors and beliefs - in relation to pain assessment and management (e.g. experience, qualifications) and beliefs and perceptions relating to pain. Pain assessment – including use of pain assessment tools and assessment/management for residents with cognitive impairment. Interventions - including efficacy/effects (pharmaceutical/non pharmaceutical), and pain training interventions and their outcomes. Overall findings from the review indicated a lack of training and staff confidence in relation to pain assessment and management. This was particularly the case for residents with dementia. Conclusions Further training and detailed guidelines for the appropriate assessment and treatment of pain are required by care home staff. Professionals external to the care home environment need to be aware of the issues facing care homes staff and residents in order to target their input in the most appropriate way.

scholarly journals Pain Assessment and Management in Care Homes: Understanding the Internal and External Context Through a Scoping Review

2020 ◽  
Author(s):  
Jan Pringle ◽  
Jo Hockley ◽  
Sofia Alvarado ◽  
Erna Haraldsdottir ◽  
Fiona Kelly
Keyword(s):  
Scoping Review ◽  
Pain Assessment ◽  
Care Home ◽  
Grey Literature ◽  
Nursing Home Residents ◽  
Care Staff ◽  
Care Homes ◽  
Cochrane Library ◽  
Relevant Evidence ◽  
Assessment And Treatment

Abstract Background: Internationally, 2-5% of people live in residential or nursing homes, many with multi-morbidities, including severe cognitive impairment. Pain is frequently considered an expected part of old age and morbidity, and may often be either under-reported by care home residents, or go unrecognized by care staff. We conducted a systematic scoping review to explore the complexity of pain recognition, assessment and treatment for residents living in care homes, and to understand the internal and external contexts that might influence its management.Methods: We conducted a scoping review using the methodological framework of Levac and colleagues. Articles were included if they examined pain assessment or management for care or nursing home residents. We searched Medline, CINAHL, ASSIA, PsycINFO, EMBASE, Cochrane Library, and Google Scholar; reference lists were screened, and website searches carried out of key organisations, to ensure relevant evidence was retrieved, including grey literature. As per the methodolocal framework, stakeholder evidence from 16 local care home managers was also accessed, to undertand their current perspectives.Results: Inclusion criteria were met by 109 studies. Three overarching themes were identified: staff variables and beliefs, pain assessment, and interventions. Evidence from the review indicated a lack of training and staff confidence in relation to pain assessment and management in care homes. This was particularly the case for residents with dementia, who cannot always verbalize their pain, and may resort to behavioral manifestations to try and communicate their distress.Conclusions: This review has highlighted that training and detailed guidelines for the appropriate assessment and treatment of pain are required by care home staff. Professionals external to the care home environment need to be aware of the issues facing care homes staff and residents in order to target their input in the most appropriate way. Internal and external contexts need further examination in order to integrate recognition and assessment of pain, and its management, to the benefit of residents.

Managing health changes for people with a learning disability in a residential care home setting

2019 ◽  
Vol 25 (11) ◽  
pp. 531-540 ◽  
Author(s):  
Sharon Scott ◽  
Lilette Denton ◽  
Frances Conway ◽  
Julie Kinley
Keyword(s):  
Learning Disability ◽  
Care Home ◽  
Signs And Symptoms ◽  
Health Needs ◽  
Care Staff ◽  
Care Homes ◽  
Home Setting ◽  
Health Changes ◽  
Combined Use ◽  
Residential Care Home

Background: People with learning disability (LD) have complex comorbidities that develop at an earlier age than the general population and with which they are now living longer. Identification, assessment and management of these conditions is important but challenging. Aim: To develop resources with care staff to enable them to recognise and manage changes and decline in the health of a person with a LD. Methods: Two resources (PIP-LD and CIRC) were developed through undertaking a literature review; networking with experts; and collaborating with staff in the care homes for people with a LD. Care staff then used these resourcesto review their residents. Findings: The PIP-LD and CIRC were used in 39 care homes. The PIP-LD empowered staff to meet people's immediate health needs, and the CIRC helped them to recognise changes or a decline. Conclusions: The combined use of the PIP-LD and the CIRC enabled care staff to recognise the signs and symptoms of each person's comorbidities early, and to identify and manage changes when their health declined.

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.

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.

scholarly journals Reducing urinary tract infections in care homes by improving hydration

2019 ◽  
Vol 8 (3) ◽  
pp. e000563 ◽  
Author(s):  
Katie Lean ◽  
Rasanat Fatima Nawaz ◽  
Sundus Jawad ◽  
Charles Vincent
Keyword(s):  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Hospital Admissions ◽  
Low Cost ◽  
Care Home ◽  
Kidney Injury ◽  
Care Staff ◽  
Care Homes ◽  
Raising Awareness ◽  
Tract Infections

Dehydration may increase the risk of urinary tract infections (UTIs), which can lead to confusion, falls, acute kidney injury and hospital admission. We aimed to reduce the number of UTIs in care home residents which require admission to hospital. The principal intervention was the introduction of seven structured drink rounds every day accompanied by staff training and raising awareness. UTIs requiring antibiotics reduced by 58% and UTIs requiring hospital admissions reduced by 36%, when averaged across the four care homes. Care home residents benefited from greater fluid intake, which in turn may have reduced infection. Structured drink rounds were a low-cost intervention for preventing UTIs and implemented easily by care staff.

Staff training using STAR: a pilot study in UK care homes

2012 ◽  
Vol 24 (6) ◽  
pp. 911-920 ◽  
Author(s):  
Judith Goyder ◽  
Martin Orrell ◽  
Jennifer Wenborn ◽  
Aimee Spector
Keyword(s):  
Pilot Study ◽  
Behavioral Problems ◽  
Staff Training ◽  
Large Scale ◽  
Controlled Trial ◽  
Care Home ◽  
Care Staff ◽  
Care Homes ◽  
People With Dementia ◽  
Star Program

ABSTRACTBackground: Symptoms such as depression, anxiety, and behavioral problems are very common in people with dementia living in care homes. Staff training has been identifed as a promising psychosocial intervention. This pilot study investigated the feasibility of implementing the Staff Training in Assisted Living Residences (STAR) program in UK care homes.Methods: The eight-week STAR program was delivered in two care homes. Twenty-five care staff attended the training. Thirty-two residents, with dementia and clinically significant anxiety, depression, or behavioral problems, were included in the study. Residents and staff were assessed at baseline and eight-week follow-up.Results: Residents demonstrated significantly reduced symptoms of depression and behavioral problems following the implementation of the program, although resident-rated quality of life and anxiety symptoms did not improve significantly. Staff sense of hopefulness towards people with dementia also improved significantly and staff rated themselves as significantly more competent at forming relationships with residents.Conclusion: Delivering the STAR program to care staff can have an impact on the behavioral and psychological symptoms of dementia displayed by care home residents. The program was feasible to implement and was rated highly by care staff. A large-scale randomized controlled trial is now required to evaluate the effectiveness of this training intervention.

What’s in a word? The importance of the concept of “values” in the prevention of abuse of older people in care homes

2017 ◽  
Vol 19 (3) ◽  
pp. 130-145 ◽  
Author(s):  
Steve Moore
Keyword(s):  
Older People ◽  
Mixed Methods Research ◽  
Care Home ◽  
Care Staff ◽  
Care Homes ◽  
Contributory Factor ◽  
Structured Interviews ◽  
Content Type ◽  
Personal Value ◽  
Provision Of Care

Purpose The purpose of this paper is to present some of the findings from an empirical, mixed methods research project that reveal the importance of the personal value frameworks held by individual staff in the prevention of abuse of older people in private sector care homes. Design/methodology/approach Semi-structured interviews were undertaken with a sample of 36 care home personnel, including proprietors, care managers and care staff. Findings A significant number of respondents identified the importance of personal value frameworks among staff providing care as a potential contributory factor in the prevention of abuse of older people. Research limitations/implications Though the research draws upon the experiences of only 36 care home personnel through interviews, data suggest that the personal evaluations of staff towards those in their care is a significant contributory factor to the occurrence of abuse. Originality/value The research has identified individual staff value frameworks as a causal factor in the occurrence of abuse. The research also confirms that the perceptions of “values” among respondents directly involved in the provision of care are at odds with common understanding of “values” often cited elsewhere in connection with staff recruitment and training as a means of preventing the occurrence of abuse.

scholarly journals Restraints and Restrictive Interventions during Essential Personal Care in Elderly People Living with Dementia in Care Homes

2021 ◽  
pp. 26-38
Author(s):  
Matthew Crooks ◽  
Katherine Wakenshaw ◽  
Julie Young ◽  
Kayleigh Purvis ◽  
Karin Smith ◽  
...  
Keyword(s):  
Care Home ◽  
Legal Framework ◽  
Care Staff ◽  
Care Homes ◽  
Personal Care ◽  
Personal Assistance ◽  
Care Home Staff ◽  
People With Dementia ◽  
Training Materials ◽  
Materials Used

Care home staff are frequently required to provide invasive personal care for their residents, and on occasions need to use restraint and restrictive practices with people with dementia. This often occurs in situations where the residents no longer have the insight that they require help and may misperceive the personal assistance as an assault. On a practical level, a significant number of people with dementia are currently being admitted to inpatient units due to their level of resistance around essential personal care. Often these same people are settled at all other times. This paper provides practical advice on how to support residents and their caregivers, and gives clinical, legal and ethical guidance. Previous work undertaken by the present authors have shown that care staff require supervision and coaching on this topic. The paper includes training materials used by the authors.  This includes a composite, fictitious case example that illustrates approaches that are compliant with UK guidelines.  It addresses the training of staff working in care homes. As such this paper provides a review and practical example of the appropriate use of restraint for residents unable to consent to the ‘intimate’ care they are receiving. It describes a method delivered in a person-centred manner and within a legal framework.  Having read this paper, care home staff should feel more confident, competent and secure in the assistance they are providing in this contentious area.

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