Unit Manager's Role with Family Members of Clients in Complex Continuing Care Settings: An Untold Story

2005 ◽  
Vol 24 (2) ◽  
pp. 127-137
Author(s):  
Sepali Guruge ◽  
Katherine McGilton ◽  
Linda Yetman ◽  
Heather Campbell ◽  
Ruby Librado ◽  
...  
Keyword(s):  
Family Relationships ◽  
Family Members ◽  
Future Research ◽  
Continuing Care ◽  
Theory Approach ◽  
Term Care ◽  
Factors Affecting ◽  
Closing The Loop

ABSTRACTMost literature on staff-family relationships has come from studies of long-term care settings, has focused mainly on the families' perspectives on factors affecting their relationships with staff, and has included scant findings from the staff's perspective. No studies that examined staff-family relationships in complex continuing care (CCC) environments from the perspective of staff were found in the literature. A qualitative study that draws on a grounded theory approach was conducted to explore staff-family relationships in CCC, and the findings presented in this article illuminate the unit manager's role. Data were collected through in-depth interviews with nine unit managers and a follow-up focus group with five unit managers who work in three CCC facilities. Three categories reflecting the unit manager's role with family members of clients in CCC settings were derived: establishing supportive entry; building and preserving relationships; and closing the loop. Implications of the findings for practice and future research are presented.

scholarly journals Maybe She’ll Make Some Friends?: Family Members Cultivating Intimacy in Assisted Living

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 486-487
Author(s):  
Andrea Fitzroy ◽  
Candace Kemp ◽  
Elisabeth Burgess
Keyword(s):  
Older Adults ◽  
Assisted Living ◽  
Intimate Relationships ◽  
Long Term Care ◽  
Participant Observation ◽  
Family Members ◽  
Later Life ◽  
Theory Approach ◽  
Term Care

Abstract Intimacy continues to be important in later life, including for older adults in long-term care settings such as assisted living (AL). Our past work shows that intimacy is a multi-dimensional process and can involve a variety of partners. Drawing on data from the qualitative longitudinal “Convoys of Care” study (R01AG044368), we extend this research to examine the role family members play in cultivating intimacy and close relationships of AL residents. Using a grounded theory approach, we analyzed 2,224 hours of participant observation, and formal interviews with 28 assisted living residents (aged 58-96) and their formal and informal care partners (n=114) from four diverse AL communities. Findings show that family members can play integral roles in residents’ experiences with intimacy, directly as relationship partners, and by facilitating or impeding residents’ contacts with others. Family members cultivated residents’ intimacy opportunities and experiences by direct engagement, resident advocacy, to non-involvement and disengagement. Family members’ roles in cultivating intimacy fluctuated over time, increasing at times of health concerns and family change. Perceptive family members considered older adults’ intimacy preferences when cultivating their intimate relationships. Family members concerned for the safety of their loved one sometimes acted as “gatekeepers” to intimacy by interfering in intimate relationships. We conclude with a discussion of implications for policy and practice aimed at improving the intimacy process and opportunities for older adults receiving long-term care.

scholarly journals Decision-making factors affecting different family members regarding the placement of relatives in long-term care facilities

2014 ◽  
Vol 14 (1) ◽  
Author(s):  
Ying-Chia Huang ◽  
Chiao-Lee Chu ◽  
Ching-Sung Ho ◽  
Shou-Jen Lan ◽  
Chen-Hsi Hsieh ◽  
...  
Keyword(s):  
Decision Making ◽  
Long Term Care ◽  
Family Members ◽  
Term Care ◽  
Factors Affecting ◽  
Care Facilities ◽  
Decision Making Factors

scholarly journals Measuring Family Members’ Satisfaction with End-of-Life Care in Long-Term Care: Adaptation of the CANHELP Lite Questionnaire

2017 ◽  
Vol 2017 ◽  
pp. 1-17 ◽  
Author(s):  
Shevaun Nadin ◽  
Mohammed Ali Miandad ◽  
Mary Lou Kelley ◽  
Jill Marcella ◽  
Daren K. Heyland
Keyword(s):  
End Of Life ◽  
End Of Life Care ◽  
Long Term Care ◽  
Family Members ◽  
Face Validity ◽  
Future Research ◽  
Life Care ◽  
Term Care ◽  
New Instrument

Rationale. Improving end-of-life care (EOLC) in long-term care (LTC) homes requires quality measurement tools that assess families’ satisfaction with care. This research adapted and pilot-tested an EOLC satisfaction measure (Canadian Health Care Evaluation Project (CANHELP) Lite Questionnaire) for use in LTC to measure families’ perceptions of the EOLC experience and to be self-administered.Methods and Results.Phase 1. A literature review identified key domains of satisfaction with EOLC in LTC, and original survey items were assessed for inclusiveness and relevance. Items were modified, and one item was added.Phase 2. The revised questionnaire was administered to 118 LTC family members and cognitive interviews were conducted. Further modifications were made including reformatting to be self-administered.Phase 3. The new instrument was pilot-tested with 134 family members. Importance ratings indicated good content and face validity. Cronbach’s alpha coefficients (range: .88–.94) indicated internal consistency.Conclusion. This research adapted and pilot-tested the CANHELP for use in LTC. This paper introduces the new, valid, internally consistent, self-administered tool (CANHELP Lite Family Caregiver LTC) that can be used to measure families’ perceptions of and satisfaction with EOLC. Future research should further validate the instrument and test its usefulness for quality improvement and care planning.

Sexuality, sexual expression in long-term care and the law

2021 ◽  
pp. 1-10
Author(s):  
Victor M. Aziz ◽  
Philip Slack
Keyword(s):  
Long Term Care ◽  
Family Members ◽  
Case Law ◽  
Sexual Expression ◽  
Staff Attitudes ◽  
Term Care ◽  
Factors Affecting ◽  
Legal Provisions ◽  
And Training

SUMMARY Balancing risk and safety in long-term care settings can be challenging while providing and respecting patients’/residents’ needs and rights in terms of sexual expression. We look at factors affecting the expression of sexuality, including staff attitudes and reactions, and the lack of policies governing sexuality. We review the various statute and case law, other legislative and quasi-legal provisions governing sexuality and sexual expression. Finally, we consider the need for clear policies and training for both staff and family members.

Dementia and sexuality in long-term care: Incompatible bedfellows?

Dementia ◽  
2021 ◽  
pp. 147130122110562
Author(s):  
Alisa Grigorovich ◽  
Pia Kontos ◽  
Ann Heesters ◽  
Lori Schindel Martin ◽  
Julia Gray ◽  
...  
Keyword(s):  
Family Members ◽  
Macro Level ◽  
Future Research ◽  
Sexual Expression ◽  
Negative Attitudes ◽  
Term Care ◽  
Dementia Research ◽  
Micro Level ◽  
Depth Interviews

Despite the recognized benefits of sexual expression and its importance in the lives of people living with dementia, research demonstrates that there are multiple barriers to its positive expression (e.g., expression that is pleasurable and free of coercion, discrimination, and violence) in RLTC homes. These barriers constitute a form of discrimination based on age and ability, and violate the rights of persons living with dementia to dignity, autonomy, and participation in everyday life and society. Drawing on a human rights approach to dementia and sexual expression, we explored the experiences of diverse professionals, family members, and persons living with dementia with explicit attention to the ways in which macro-level dynamics are influencing the support, or lack thereof, for sexual expression at the micro level. Focus groups and in-depth interviews were conducted with 27 participants, and the collected data were analyzed thematically. While all participants acknowledged that intimacy and sexual expression of persons living with dementia should be supported, rarely is such expression supported in practice. Micro-level factors included negative attitudes of professionals toward sexual expression by persons living with dementia, their discomfort with facilitating intimacy and sexual expression in the context of their professional roles, their anxieties regarding potential negative reactions from family members, and concerns about sanctions for failing to prevent abuse. In our analysis, we importantly trace these micro-level factors to macro-level factors. The latter include the cultural stigma associated with dementia, ageism, ableism, and erotophobia, all of which are reproduced in, and reinforced by, professionals’ education, as well as legal and professional standards that exclusively focus on managing and safeguarding residents from abuse. Our analysis demonstrates a complexity that has enormous potential to inform future research that is critically needed for the development of educational initiatives and to promote policy changes in this area.

scholarly journals Information and Communication Technology Changes in Long-Term Care Due to COVID-19

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 219-219
Author(s):  
Amy Schuster ◽  
Shelia Cotten
Keyword(s):  
South Carolina ◽  
Nursing Homes ◽  
Assisted Living ◽  
Long Term Care ◽  
Family Members ◽  
Future Research ◽  
Assisted Living Facilities ◽  
Term Care ◽  
Ict Use

Abstract Residents of long-term care (LTC) facilities (e.g., nursing homes, assisted living facilities) have historically been vulnerable to feelings of loneliness and social isolation. Due to the COVID-19 pandemic, LTC facilities were required to restrict public access in March 2020. LTC communities were not prepared for the residents’ increased socioemotional needs which arose because of the mandated facility lockdown. This study investigated ICT use in LTC facilities and how ICTs are being used by residents since the onset of the COVID19 pandemic. Seventy LTC administrators in South Carolina (12 nursing homes and 58 assisted living facilities) completed an online survey exploring ICT access and use in LTC facilities and whether access and use changed as a result of COVID-19. Administrators from fifty-three percent of LTC facilities reported purchasing ICTs for their residents to use for communicating with family members and telehealth since the onset of COVID-19. LTC administrators reported that using the ICTs helped residents to socialize more frequently and feel more socially connected to their family members, friends and/or other residents. Barriers to ICT use included staff not having time to assist residents with technology, broken technology, and residents not wanting to share technology. LTC facilities were not adequately prepared to support the socioemotional needs of their residents in the event of a federally mandated facility lockdown. Future research should investigate the ICTs available for residents’ use in a national sample of LTC facilities and how LTC administrators adapted the ICTs available as a result of their experiences with COVID-19.

Counselling the Relatives of the Long-Term Adult Mentally Ill

1989 ◽  
Vol 154 (6) ◽  
pp. 775-782 ◽  
Author(s):  
Liz Kuipers ◽  
Brigid MacCarthy ◽  
Jane Hurry ◽  
Rod Harper ◽  
Alain LeSage
Keyword(s):  
Family Relationships ◽  
Mentally Ill ◽  
Expressed Emotion ◽  
Realistic Model ◽  
Education Session ◽  
Term Care ◽  
Interactive Education ◽  
Severely Mentally Ill ◽  
Group Facilitators

A psychosocial intervention is described geared to the needs of carers of the long-term mentally ill, which is feasible for a busy clinical team to implement: relatives were not selected for the group by patient diagnosis or motivation and little extra staff input was required. An interactive education session at home was followed by a monthly relatives group which aimed to reduce components of expressed emotion (EE) and to alleviate burden. The group facilitators adopted a directive but non-judgemental style, and constructive coping efforts were encouraged. The intervention was effective at reducing EE and improving family relationships. The study offers a realistic model of how to offer support to people providing long-term care for the severely mentally ill.

scholarly journals Public reporting of performance measures in long-term care in Canada: does it make a difference?

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
M Poldrugovac ◽  
J E Amuah ◽  
H Wei-Randall ◽  
P Sidhom ◽  
K Morris ◽  
...  
Keyword(s):  
Performance Measures ◽  
Performance Indicators ◽  
Long Term Care ◽  
Public Reporting ◽  
Policy Implications ◽  
Term Care ◽  
Factors Affecting ◽  
Care Facilities ◽  
The Impact

Abstract Background Evidence of the impact of public reporting of healthcare performance on quality improvement is not yet sufficient to draw conclusions with certainty, despite the important policy implications. This study explored the impact of implementing public reporting of performance indicators of long-term care facilities in Canada. The objective was to analyse whether improvements can be observed in performance measures after publication. Methods We considered 16 performance indicators in long-term care in Canada, 8 of which are publicly reported at a facility level, while the other 8 are privately reported. We analysed data from the Continuing Care Reporting System managed by the Canadian Institute for Health Information and based on information collection with RAI-MDS 2.0 © between the fiscal years 2011 and 2018. A multilevel model was developed to analyse time trends, before and after publication, which started in 2015. The analysis was also stratified by key sample characteristics, such as the facilities' jurisdiction, size, urban or rural location and performance prior to publication. Results Data from 1087 long-term care facilities were included. Among the 8 publicly reported indicators, the trend in the period after publication did not change significantly in 5 cases, improved in 2 cases and worsened in 1 case. Among the 8 privately reported indicators, no change was observed in 7, and worsening in 1 indicator. The stratification of the data suggests that for those indicators that were already improving prior to public reporting, there was either no change in trend or there was a decrease in the rate of improvement after publication. For those indicators that showed a worsening trend prior to public reporting, the contrary was observed. Conclusions Our findings suggest public reporting of performance data can support change. The trends of performance indicators prior to publication appear to have an impact on whether further change will occur after publication. Key messages Public reporting is likely one of the factors affecting change in performance in long-term care facilities. Public reporting of performance measures in long-term care facilities may support improvements in particular in cases where improvement was not observed before publication.

scholarly journals Impact of Frailty on Medical and Long-Term Care Expenditures for the Elderly Age 75 or Over in Japan

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 176-176
Author(s):  
Hiroto Yoshida ◽  
Yuriko Kihara
Keyword(s):  
Long Term Care ◽  
The Elderly ◽  
Elderly Age ◽  
Term Care ◽  
Intentional Weight Loss ◽  
Long Term Care Insurance ◽  
And Gender ◽  
The Impact

Abstract This study examined the impact of frailty on medical and long-term care expenditures in an older Japanese population. The subjects were those aged 75 years and over who responded to the survey (March 2018) in Bibai, Hokkaido, Japan (n=1,203) and have never received certification of long-term care insurance at the survey. We followed up 867 individuals (72.1%) until the end of December 2018 (10 month-period). We defined frailty as a state in performing 4 items and over of 15 items which were composed of un-intentional weight loss, history of falls, etc. Among 867 subjects, 233 subjects (26.9%) were judged to be frailty group, and 634 subjects (73.1%) non-frailty group. We compared period to the new certification of long-term care insurance (LTCI), accumulated medical and long-term care expenditures adjusted for age and gender between the two groups during the follow-up period. Cox proportional hazard models were used to examine the association between baseline frailty and the new certification of LTCI. The relative hazard ratio (HR) was higher in frailty group than non-frailty group (HR=3.51, 95% CI：1.30-9.45, P=.013). The adjusted mean accumulated medical and long-term care expenditures per capita during the follow-up were significantly (P=.002) larger for those in the frailty group (629,699 yen), while those in the non-frailty group were 450,995 yen. We confirmed strong economic impact of frailty in the elderly aged 75 or over in Japan.

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.

Sign in / Sign up

Export Citation Format

Share Document