A Study on Environment-related Factors that Promote Wayfinding for People with Dementia - Focused on the Context of Long-term Care Facilities for People with Dementia

ABSTRACTBackground:Research showed that long-term care facilities differ widely in the use of psychotropic drugs and physical restraints. The aim of this study is to investigate whether characteristics of an unhealthy work environment in facilities for people with dementia are associated with more prescription of psychotropic drugs and physical restraints.Methods:Data were derived from the first wave (2008–2009) of a national monitoring study in the Netherlands. This paper used data on prescription of psychotropic drugs and physical restraints from 111 long-term care facilities, residing 4,796 residents. Survey data of a sample of 996 staff and 1,138 residents were considered. The number of residents with prescribed benzodiazepines and anti-psychotic drugs, and physical restraints were registered. Work environment was assessed using the Leiden Quality of Work Questionnaire (LQWQ).Results:Logistic regression analyses showed that more supervisor support was associated with less prescription of benzodiazepines. Coworker support was found to be related to less prescription of deep chairs. Job demands and decision authority were not found to be predictors of psychotropic drugs and physical restraints.Conclusions:Staff's job characteristics were scarcely related to the prescription of psychotropic drugs and physical restraints. This finding indicates that in facilities with an unhealthy work environment for nursing staff, one is not more likely to prescribe drugs or restraints. Further longitudinal research is needed with special attention for multidisciplinary decision making – especially role of physician, staff's knowledge, philosophy of care and institutional policy to gain further insight into factors influencing the use of psychotropic drugs and restraints.

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Decision letter for "Longitudinal changes in frailty prevalence and related factors in older adults living in long-term care facilities"

10.1111/jan.14388/v1/decision1 ◽

2019 ◽

Keyword(s):

Older Adults ◽

Long Term Care ◽

Related Factors ◽

Term Care ◽

Longitudinal Changes ◽

Care Facilities

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Mealtimes as Active Processes in Long-term Care Facilities

Canadian Journal of Dietetic Practice and Research ◽

10.3148/66.1.2005.5 ◽

2005 ◽

Vol 66 (1) ◽

pp. 5-11 ◽

Cited By ~ 31

Author(s):

Amie J. Gibbs-Ward ◽

Heather H. Keller

Keyword(s):

Long Term Care ◽

Comparison Method ◽

Theory Approach ◽

Care Providers ◽

Term Care ◽

Individualized Care ◽

People With Dementia ◽

Care Facilities ◽

Active Processes

Mealtimes are central to the nutritional care of residents in long-term care facilities. There has been little Canadian research to guide interdisciplinary practice around mealtimes. This study included a grounded theory approach to explore mealtime experiences of 20 people with dementia living in two long-term care facilities, and the meal-related care they received from registered nurses, health care aides, and dietitians. Theoretical sampling directed the collection and analysis of data from mealtime observations in special care units and key informant interviews with care providers. The constant comparison method was used to analyze and conceptualize the data. A substantive theory emerged with three key themes: Each mealtime is a unique process embedded within a long-term care facility's environment. Residents are central to the process through their actions (i.e., arriving, eating, waiting, socializing, leaving, and miscellaneous distracted activities). Internal (i.e., residents’ characteristics) and external (i.e., co-resident, direct caregiving, indirect caregiving, administrative, and government activities) influences affect residents’ actions at mealtimes. The theory suggests that optimal mealtime experiences for residents require individualized care that reflects interdisciplinary, multi-level interventions.

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