A Comparison of Wandering Behavior in Nursing Homes and Assisted Living Facilities

2005 ◽  
Vol 19 (2) ◽  
pp. 181-196 ◽  
Author(s):  
Elizabeth R. A. Beattie ◽  
JunAh Song ◽  
Shane LaGore

Wandering, a challenging behavior associated with dementia, affects many residents of long-term care facilities and can result in elopement, injury, and death. Most studies of wandering have taken place in nursing homes (NH). Expansion of the long-term care sector over the last 2 decades has resulted in a surge in options such as assisted living facilities (ALF). This study compared wandering behavior of residents (N = 108) in 21 long-term care facilities (15 NH, 6 ALF). Staff used the Revised Algase Wandering Scale-Nursing Home Version (RAWS-NH) to quantify wandering. While there were some differences in demographic variables (i.e., race, motor ability) between NH and ALF participants, no significant differences were found in either RAWS-NH overall or any of the 6 subscale scores. This suggests that the expression of wandering is similar in long-term care residents across all dimensions of the RAWS-NH regardless of facility type. Findings are of concern for those involved in the safe management and protection of residents at risk for wandering, particularly in long-term care facilities with underregulated staffing and training requirements.

2009 ◽  
Vol 14 (2) ◽  
pp. 37-41 ◽  
Author(s):  
Margaret P. Calkins ◽  
Jennifer Brush

Abstract The entire field of long-term care is under tremendous pressure to change. Traditional environmental approaches based on staff-centric or medical models are no longer considered appropriate in long-term care settings. The new emphasis is on person-centered or self-directed care. This is reflected in settings where people can live comfortably and feel at home, as opposed to feeling like they are in a hospital. Increasingly, nursing homes are working to be more like assisted living facilities, which emphasize privacy, dignity, and choice. These changes affect all aspects of care from structure of governance to staff training to management structure and facility design. This article will cover the issues and the possible solutions to ensuring that long-term care living is more like a home than a hospital.


2020 ◽  
Vol 68 (1) ◽  
pp. 114-122 ◽  
Author(s):  
Alison M. Trinkoff ◽  
Jung Min Yoon ◽  
Carla L. Storr ◽  
Nancy B. Lerner ◽  
Bo Kyum Yang ◽  
...  

2003 ◽  
Vol 43 (6) ◽  
pp. 883-896 ◽  
Author(s):  
T. J. Lowe ◽  
J. A. Lucas ◽  
N. G. Castle ◽  
J. P. Robinson ◽  
S. Crystal

2021 ◽  
Author(s):  
Kathy Lee ◽  
Rebecca L Mauldin ◽  
Weizhou Tang ◽  
John Connolly ◽  
Joseph Harwerth ◽  
...  

Abstract Background and Objectives The purpose of this project was to examine individual-level ethnic and racial differences and facility-level differences in types of complaints and rates of complaint resolution in a local long-term care ombudsman program. Research Design and Methods We employed a mixed-methods sequential explanatory design. First, we analyzed secondary complaint data based on residents’ race and ethnicity (n = 464) and facility characteristics (n = 101). We then conducted 2 focus groups with ombudsmen (n = 12) to provide context for our quantitative findings and to explore the ombudsmen’s views on disparities in long-term care facilities. Results Racial and ethnic minority residents were more likely to generate complaints related to residents’ rights than nonminority residents. Assisted living facilities were more likely to have complaints related to residents’ rights and outside agencies than nursing homes. The rate of complaint resolution increased among facilities with a higher proportion of minority residents, compared to facilities with a lower proportion of minority residents. However, an estimation of cross-level interaction revealed that non-Hispanic White residents in these facilities experienced faster complaint resolution than minority residents. Ombudsmen expressed concerns about communication barriers between minority residents and facility staff and discussed different complaint types and resolution rates according to facility types. Discussion and Implications Our findings highlight disparities across long-term care facilities as well as disparities in care minority residents experience. Long-term care ombudsman program complaint data should be disaggregated by race and ethnicity of the residents to advocate for policy change at facility, state, and federal levels.


2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 219-219
Author(s):  
Amy Schuster ◽  
Shelia Cotten

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.


Long-term care for older adults is highly affect by the COVID-19 outbreak. The objective of this rapid review is to understand what we can learn from previous crises or disasters worldwide to optimize the care for older adults in long term care facilities during the outbreak of COVID-19. We searched five electronic databases to identify potentially relevant articles. In total, 23 articles were included in this study. Based on the articles, it appeared that nursing homes benefit from preparing for the situation as best as they can. For instance, by having proper protocols and clear division of tasks and collaboration within the organization. In addition, it is helpful for nursing homes to collaborate closely with other healthcare organizations, general practitioners, informal caregivers and local authorities. It is recommended that nursing homes pay attention to capacity and employability of staff and that they support or relieve staff where possible. With regard to care for the older adults, it is important that staff tries to find a new daily routine in the care for residents as soon as possible. Some practical tips were found on how to communicate with people who have dementia. Furthermore, behavior of people with dementia may change during a crisis. We found tips for staff how to respond and act upon behavior change. After the COVID-19 outbreak, aftercare for staff, residents, and informal caregivers is essential to timely detect psychosocial problems. The consideration between, on the one hand, acute safety and risk reduction (e.g. by closing residential care facilities and isolating residents), and on the other hand, the psychosocial consequences for residents and staff, were discussed in case of other disasters. Furthermore, the search of how to provide good (palliative) care and to maintain quality of life for older adults who suffer from COVID-19 is also of concern to nursing home organizations. In the included articles, the perspective of older adults, informal caregivers and staff is often lacking. Especially the experiences of older adults, informal caregivers, and nursing home staff with the care for older adults in the current situation, are important in formulating lessons about how to act before, during and after the coronacrisis. This may further enhance person-centered care, even in times of crisis. Therefore, we recommend to study these experiences in future research.


1997 ◽  
Vol 36 (1) ◽  
pp. 77-87 ◽  
Author(s):  
Nicholas G. Castle

Long-term care institutions have emerged as dominant sites of death for the elderly. However, studies of this trend have primarily examined nursing homes. The purpose of this research is to determine demographic, functional, disease, and facility predictors and/or correlates of death for the elderly residing in board and care facilities. Twelve factors are found to be significant: proportion of residents older than sixty-five years of age, proportion of residents who are chair- or bed-fast, proportion of residents with HIV, bed size, ownership, chain membership, affiliation with a nursing home, number of health services provided other than by the facility, the number of social services provided other than by the facility, the number of social services provided by the facility, and visits by Ombudsmen. These are discussed and comparisons with similar studies in nursing homes are made.


Geriatrics ◽  
2021 ◽  
Vol 6 (2) ◽  
pp. 48
Author(s):  
Roger E. Thomas

The COVID-19 pandemic identifies the problems of preventing respiratory illnesses in seniors, especially frail multimorbidity seniors in nursing homes and Long-Term Care Facilities (LCTFs). Medline and Embase were searched for nursing homes, long-term care facilities, respiratory tract infections, disease transmission, infection control, mortality, systematic reviews and meta-analyses. For seniors, there is strong evidence to vaccinate against influenza, SARS-CoV-2 and pneumococcal disease, and evidence is awaited for effectiveness against COVID-19 variants and when to revaccinate. There is strong evidence to promptly introduce comprehensive infection control interventions in LCFTs: no admissions from inpatient wards with COVID-19 patients; quarantine and monitor new admissions in single-patient rooms; screen residents, staff and visitors daily for temperature and symptoms; and staff work in only one home. Depending on the vaccination situation and the current risk situation, visiting restrictions and meals in the residents’ own rooms may be necessary, and reduce crowding with individual patient rooms. Regional LTCF administrators should closely monitor and provide staff and PPE resources. The CDC COVID-19 tool measures 33 infection control indicators. Hand washing, social distancing, PPE (gowns, gloves, masks, eye protection), enhanced cleaning of rooms and high-touch surfaces need comprehensive implementation while awaiting more studies at low risk of bias. Individual ventilation with HEPA filters for all patient and common rooms and hallways is needed.


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