Sustainable implementation of person-centred care in residential care facilities: hindering and supporting factors when improving incontinence care

2021 ◽  
Vol 23 (1) ◽  
pp. 1-14
Author(s):  
Eirini Alexiou ◽  
Irma Lindström Kjellberg ◽  
Helle Wijk
Keyword(s):  
Residential Care ◽  
Intervention Group ◽  
Control Group ◽  
Residential Care Facilities ◽  
Implementation Phase ◽  
Staff Members ◽  
Ward Atmosphere ◽  
Care Assessment ◽  
Care Facilities ◽  
The Impact

Purpose: The aim of the present study was to focus on the impact of the implementation of a person-centred approach on staff perception of the likelihood of being able to provide person-centred care and strain in the workplace. Design: The study was a controlled prospective cohort study performed at three residential care facilities in western Sweden involving all nursing staff members active from 2013 through 2015 at baseline and at three follow-ups during and after the implementation period. Two of the residential care facilities were assigned to the intervention group and one was assigned to the control group. Method: The study was designed to test the sustainability of a person-centred approach based on three aspects: partnership, narrative and documentation. A cross-section of 20 coworkers were purposively sampled from a total of 100 persons working at the two Intervention nursing homes to participate in the intervention group. The process outcome was measured as: perceived ward atmosphere, using the staff version of the validated Person-Centred Climate Questionnaire; person-centred care, measured using the validated Person-centred Care Assessment Tool; and experience of strain in work, using the Strain in Nursing Care Assessment Scale. Descriptive statistics were calculated for all variables using the SPSS Statistics software package. Findings: The results show that, at the control site, there were lower staff perceptions of the care atmosphere, higher level of strain experienced in their work and a lower likelihood of providing a person-centred care approach, whereas these factors remained rather stable over time at the intervention residential care facilities. Two contrasting results were observed—namely, that the higher the staff's perception of the likelihood of being able to provide individualised care and of a more person-centred ward atmosphere, the higher their stress levels experienced at work. In addition, older ages and long durations of work experience significantly negatively affected the staff's assessment of their ability to create an atmosphere of everydayness and to adopt a person-centred approach in care. Conclusions: The findings show that sustainability of a person-centred ward atmosphere is possible in the care of older people, despite staffing problems and other organisational challenges, according to the staff's assessment, after implementation of a person-centred programme. The more experienced staff members assessed their likelihood of being able to provide a person-centred care as lower after the implementation phase, indicating that despite the ambition of supporting person-centredness and quality of care, staffing and management difficulties that are present at the outset of the programme's implementation can later lead to stress and frustration relating to roles and routines.

Effectiveness of an innovative and comprehensive eye care model for individuals in residential care facilities: results of the residential ocular care (ROC) multicentred randomised controlled trial

2020 ◽  
pp. bjophthalmol-2019-315620
Author(s):  
Ryan Eyn Kidd Man ◽  
Alfred Tau Liang Gan ◽  
Marios Constantinou ◽  
Eva K Fenwick ◽  
Edith Holloway ◽  
...  
Keyword(s):  
Randomised Controlled Trial ◽  
Usual Care ◽  
Residential Care ◽  
Controlled Trial ◽  
Well Being ◽  
Vision Impairment ◽  
Residential Care Facilities ◽  
Care Facilities ◽  
Randomised Controlled ◽  
The Impact

BackgroundTo assess the clinical and patient-centred effectiveness of a novel residential ocular care (ROC) model in Australian individuals residing in residential care.MethodsIn this prospective, multicentred, randomised controlled trial conducted in 38 Australian aged-care facilities (2015–2017), 178 visually impaired individuals living in residential care facilities (mean age ±SD: 83.9±8.6 years; 65.7% women) were cluster randomised to ROC (n=95) or usual care (n=83) pathways. The ROC arm comprised a tailored and comprehensive within-site eye examination and care rehabilitation pathway, while usual care participants were given a referral to an external eyecare provider. Outcomes included presenting distance and near visual acuity (PNVA); Rasch-transformed Reading, Emotional and Mobility scores from the Impact of Vision Impairment questionnaire; quality of vision (QoV comprising Rasch-transformed Frequency, Severity and Bother domains) scores; Euroqol-5-Dimensions (raw scores); Cornell Scale for Depression (raw scores) and 6-month falls frequency, assessed at baseline and 6 months post intervention. Within-group and between-group comparisons were conducted using linear mixed models, adjusted for baseline differences in characteristics between the two arms.ResultsAt 6 months, intention-to-treat analyses showed significant between-group improvements in ROC residents compared with usual care for PNVA, Emotional and QoV scores (all p<0.05) These significant findings were retained in per-protocol analyses. No other between-group changes were observed.ConclusionOur ROC model was effective in improving near vision, emotional well-being and perceived burden of vision-related symptoms in residential care dwellers in Australia with vision impairment. Future studies to evaluate the cost effectiveness and implementation of ROC in Australia are warranted.

scholarly journals Effects of Horticultural Activities on Attitudes toward Aging, Sense of Hope and Hand–Eye Coordination in Older Adults in Residential Care Facilities

2021 ◽  
Vol 18 (12) ◽  
pp. 6555
Author(s):  
Hui-Ying Chu ◽  
Hui-Shan Chan ◽  
Mei-Fang Chen
Keyword(s):  
Older Adults ◽  
Standard Deviation ◽  
Residential Care ◽  
Control Group ◽  
Residential Care Facilities ◽  
Care Facilities ◽  
Attitudes Toward Aging ◽  
Hand Eye Coordination ◽  
The Mean ◽  
Experimental Group

This study investigated the effects of an 8-week horticultural activity intervention on attitudes toward aging, sense of hope, and hand–eye coordination in 88 older adults in residential care facilities. In the experimental group, the mean score for “attitudes toward aging” increased from 3.81 before the intervention to 4.74 points after the intervention (standard deviation SD = 0.24 and 0.27, respectively), and the control group dropped from 3.75 to 3.70 (standard deviations, respectively SD = 0.27 and 0.28). The mean score for “sense of hope” increased from 3.28 before the intervention to 3.81 points after the intervention (SD = 0.49 and 0.26, respectively). In contrast to the control group, the mean score gradually declined from 3.26 to 3.16 points (standard deviation SD = 0.54 and 0.48, respectively). In the test of hand–eye coordination, the time required to complete the cup stacking test significantly decreased from 33.56 to 25.38 s in the experimental group but did not significantly change in the control group. Generalized estimating equation analysis revealed a significant interaction between group and time (p < 0.001). The data trends revealed significant differences in outcomes between the experimental group and the control group. At 3 months after the end of the study, the effect size in the experimental group remained higher than that in the control group.

scholarly journals Exploring how residential care facilities can enhance the autonomy of people with dementia and improve informal care

Dementia ◽  
2021 ◽  
pp. 147130122110305
Author(s):  
Jogé Boumans ◽  
Leonieke C van Boekel ◽  
Marjolein EA Verbiest ◽  
Caroline A Baan ◽  
Katrien G Luijkx
Keyword(s):  
Residential Care ◽  
Informal Care ◽  
Physical Environment ◽  
Informal Caregivers ◽  
Realist Evaluation ◽  
Care Provision ◽  
Residential Care Facilities ◽  
Staff Members ◽  
People With Dementia ◽  
Care Facilities

Background and objectives Residential care facilities (RCFs) strive to enhance autonomy for people with dementia and to enhance informal care provision, although this is difficult. This study explored how RCF staff can enhance autonomy and improve informal care by looking at the influence of interactions (contact and approachability between residents, staff members and informal caregivers) and the physical environment, including the use of technologies. Research design and methods A realist evaluation multiple-case study was conducted using document analyses, eight semi-structured interviews with staff members and relatives and 56 hours of observations of residents across two RCFs aiming to provide person-centred care. Realist logic of analysis was performed, involving Context-Mechanism-Outcome configurations. Findings The behaviour, attitudes and interactions of staff members with residents and informal caregivers appeared to contribute to the autonomy of people with dementia and enhance informal care provision. The physical environment of the RCFs and the use of technologies were less relevant to enhancing autonomy and informal care provision, although they can support staff members in providing person-centred care in daily practice. Discussion and implications The findings add to those of other studies regarding the importance of interaction between residents, staff members and informal caregivers. The findings provide insight for other RCFs on how successfully to enhance autonomy for their residents and to improve informal care provision, as well as, more broadly, how to implement person-centred care.

scholarly journals Children’s participation and agency in Italian residential care for children: Adult-child interactions at dinnertime

2021 ◽  
Author(s):  
Marzia Saglietti ◽  
Cristina Zucchermaglio
Keyword(s):  
Residential Care ◽  
Adult Child ◽  
Routine Activity ◽  
Alternative Care ◽  
Residential Care Facilities ◽  
Vulnerable Families ◽  
Care Facilities ◽  
Children’S Participation ◽  
Children's Participation ◽  
The Impact

AbstractThis paper analyzes the impact of adults’ interactive moves and strategies on children’s participation and agency at dinnertime in two Italian residential care facilities, one of the most widely used alternative care life-context for children and youth coming from vulnerable families. Participants are 14 children and 11 educators living in two residential care facilities in Rome (Italy). Adopting an interactional and multimodal analytic approach, this paper focuses on two dinnertime activities: the routine activity of praying before eating and the very frequent one of talking about rules and transgressions. The comparative analysis of the two facilities shows how, in stable patterns of adult-child interactions recurring across different activities in the same facility, adults’ strategies and interactive maneuvers differently impact on children’s participation and agency and consequent socialization practices. In the conclusion, we emphasize the relevance and implications of this study for either research in educational sciences and for professionals operating in alternative care and related fields.

A randomized trial of early psychiatric intervention in residential care: impact on health outcomes

2005 ◽  
Vol 17 (3) ◽  
pp. 475-485 ◽  
Author(s):  
Ria Kotynia-English ◽  
Helen McGowan ◽  
Osvaldo P. Almeida
Keyword(s):  
Mental Health ◽  
Older Adults ◽  
Health Outcomes ◽  
Residential Care ◽  
Physical Restraint ◽  
Intervention Group ◽  
Behavioral Disturbances ◽  
Residential Care Facilities ◽  
Care Facilities ◽  
Psychiatric Intervention

Background: The prevalence of psychological and behavioral disturbances among older adults living in residential care facilities is high, and it has been shown previously that people with such symptoms have poorer health outcomes. This study was designed to assess the efficacy of an early psychiatric intervention on the 12-month health outcomes of older adults admitted to residential care facilities in Perth, Western Australia. We hypothesized that subjects in the intervention group would have better mental and physical health outcomes than controls.Methods: The study was designed as a randomized, single-blinded, controlled trial. All subjects aged 65 years or over admitted to one of the 22/26 participating residential care facilities of the Inner City area of Perth were approached to join the study and were allocated randomly to the intervention or usual care group. Demographic and clinical information (including medications and use of physical restraint) was gathered systematically from all participants at baseline, and at 6 and 12 months. At each assessment, the Geriatric Depression Scale (GDS), the Health of the Nation Outcome Scales for older adults (HoNOS 65+), the Mini-mental State Examination (MMSE) and the Neuropsychiatric Inventory (NPI) were administered. Subjects in the intervention group who screened positive at the baseline assessment for psychiatric morbidity were reviewed within a 2-week period by the Inner City Mental Health Service of Older Adults (ICMHSOA). If clinically appropriate, mental health services were introduced without the involvement of the research team.Results: One hundred and six subjects and their next of kin consented to participate in the study (53 in each group). Mental health screening and early referral to a psychogeriatric service did not significantly change the average number of medical contacts, self-rated health, use of psychotropic or PRN medication, use of physical restraint, 12-month mortality, or mental health outcomes, as measured by the GDS-15, HoNOS 65+ and NPI (p>0.05 for all relevant outcomes).Conclusion: Systematic mental health screening of older adults admitted to residential care facilities and early clinical intervention does not change 12-month health outcomes. More effective interventions to improve the health outcomes of older adults with psychological and behavioral disturbances admitted to residential care facilities are needed.

scholarly journals COVID-19 and residential care facilities: issues and concerns identified by the international network prevention of elder abuse (INPEA)

2020 ◽  
Vol 22 (6) ◽  
pp. 385-389
Author(s):  
Marie Beaulieu ◽  
Julien Cadieux Genesse ◽  
Kevin St-Martin
Keyword(s):  
Residential Care ◽  
Older Persons ◽  
Elder Abuse ◽  
Global Perspective ◽  
Protective Measures ◽  
International Network ◽  
Content Type ◽  
Residential Care Facilities ◽  
Care Facilities ◽  
The Impact

Purpose The COVID-19 pandemic has affected the physical, psychological, social and financial health of older persons. On this subject, the United Nations published a policy brief on the impact of COVID-19 on older persons in May 2020. In line with this, the purpose of this general review is to address three issues affecting older persons living in residential care facilities: protective measures implemented to block the virus’ entry, the types of mistreatment most frequently experienced and the necessity to promote and defend the rights of these persons. Design/methodology/approach The design of this study is based on input gathered since the end of April during meetings of the International Network for the Prevention of Elder Abuse (INPEA) and the results of a July survey of its members. Findings The survey results indicate variability in the implementation of protective measures in different countries and the significant presence of mistreatment and violation of the rights of older persons. Three major issues demand attention: ageism, systemic and managerial problems and the effects of implemented measures. All these prompt the INPEA to once again plea for the adoption of an international convention of human rights of older persons. Originality/value To our knowledge, this is the first article sharing the views of the INPEA from a global perspective in the context of COVID-19.

scholarly journals Volunteer Tourism in Cambodian Residential Care Facilities—A Child Rights-based Approach

2018 ◽  
Vol 26 (4) ◽  
pp. 808-836
Author(s):  
Marit Ursin ◽  
Mona Lock Skålevik
Keyword(s):  
Residential Care ◽  
Volunteer Tourism ◽  
Child Rights ◽  
Residential Care Facilities ◽  
Rights Of The Child ◽  
Residential Care Institutions ◽  
Children’S Wellbeing ◽  
Care Facilities ◽  
Competence Training ◽  
The Impact

Cambodia has experienced a rapid and uncontrolled increase in the institutionalisation of children in the last decade. In this article, we analyse the impact of volunteer tourism on children’s wellbeing in residential care facilities in Cambodia by employing a child rights-based approach. Four articles of the United Nations Convention of the Rights of the Child are chosen as framework to analyse two bodies of documents. We engage in critical reflections on the impact of volunteer tourism on children’s wellbeing in residential care institutions in Cambodia as it is regulated, described and reported. We provide a critical stance on current debates about the reasons behind institutionalisation; the various linkages between institutionalisation and volunteer tourism to care facilities; the (lack of) competence, training and stability of volunteer tourists in care facilities; the interface between volunteer tourism and corruption; and the ways in which institutionalisation and volunteer tourism reinforce and are reinforced by predominant Western ideas and ideals about childhood.

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