Age Related Visual Pathologies among Nursing Home Residents: An Evaluation of Light Conditions and Recording in Client Files

Objective: Reflection on visual problems in nursing homes. Data Sources: Eye examinations, documented visual problems and illuminance levels. Study design: The optometric examinations and recorded visual problems were combined with illuminance data. Data collection: In seven nursing homes, 259 residents underwent an optometric examination. Their client records were analyzed for information regarding visual functioning. The illuminance data were ranked to set the quality of the lighting conditions. Principal findings: 50% of the referred residents had problems with cataracts, retinal problems (21%), suspected glaucoma (13%), and other pathologies (16%). The information was not current in 56% of the records. The quality of lighting conditions was low or moderate. Conclusion: The finding of poor lighting conditions in nursing homes in combination with a high prevalence of visual problems (with cataract found to be the most common age related pathology), stretches the need of enhanced awareness of eye care by professional caregivers.

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A tablet-based intervention for activating nursing home residents with dementia: results from a cluster-randomized controlled trial

International Psychogeriatrics ◽

10.1017/s1041610221000818 ◽

2021 ◽

pp. 1-13

Author(s):

Julie L. O’Sullivan ◽

Sonia Lech ◽

Paul Gellert ◽

Ulrike Grittner ◽

Jan-Niklas Voigt-Antons ◽

...

Keyword(s):

Quality Of Life ◽

Randomized Controlled Trial ◽

Nursing Home ◽

Nursing Homes ◽

Psychotropic Medication ◽

Controlled Trial ◽

Nursing Home Residents ◽

Randomized Controlled ◽

Cluster Randomized

Abstract Objectives: To investigate global and momentary effects of a tablet-based non-pharmacological intervention for nursing home residents living with dementia. Design: Cluster-randomized controlled trial. Setting: Ten nursing homes in Germany were randomly allocated to the tablet-based intervention (TBI, 5 units) or conventional activity sessions (CAS, 5 units). Participants: N = 162 residents with dementia. Intervention: Participants received regular TBI (n = 80) with stimulating activities developed to engage people with dementia or CAS (n = 82) for 8 weeks. Measurements: Apathy Evaluation Scale (AES-I, primary outcome), Quality of Life in Alzheimer’s Disease scale, QUALIDEM scale, Neuropsychiatric Inventory, Geriatric Depression Scale, and psychotropic medication (secondary outcomes). Momentary quality of life was assessed before and after each activity session. Participants and staff were blinded until the collection of baseline data was completed. Data were analyzed with linear mixed-effects models. Results: Levels of apathy decreased slightly in both groups (mean decrease in AES-I of .61 points, 95% CI −3.54, 2.33 for TBI and .36 points, 95% CI −3.27, 2.55 for CAS). Group difference in change of apathy was not statistically significant (β = .25; 95% CI 3.89, 4.38, p = .91). This corresponds to a standardized effect size (Cohen’s d) of .02. A reduction of psychotropic medication was found for TBI compared to CAS. Further analyses revealed a post-intervention improvement in QUALIDEM scores across both groups and short-term improvements of momentary quality of life in the CAS group. Conclusions: Our findings suggest that interventions involving tailored activities have a beneficial impact on global and momentary quality of life in nursing home residents with dementia. Although we found no clear advantage of TBI compared to CAS, tablet computers can support delivery of non-pharmacological interventions in nursing homes and facilitate regular assessments of fluctuating momentary states.

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Improving Quality of Life in Nursing Homes: The Structured Resident Interview Approach

Journal of Aging Research ◽

10.1155/2014/892679 ◽

2014 ◽

Vol 2014 ◽

pp. 1-8 ◽

Cited By ~ 4

Author(s):

Howard B. Degenholtz ◽

Abby L. Resnick ◽

Natalie Bulger ◽

Lichun Chia

Keyword(s):

Quality Of Life ◽

Nursing Home ◽

Nursing Homes ◽

Planning Process ◽

Intervention Group ◽

Nursing Home Residents ◽

Care Plan ◽

Control Group ◽

Improvement Programs

The quality of life (QOL) of the approximately 1.5 million nursing facility (NF) residents in the US is undoubtedly lower than desired by residents, families, providers, and policy makers. Although there have been important advances in defining and measuring QOL for this population, there is a need for interventions that are tied to standardized measurement and quality improvement programs. This paper describes the development and testing of a structured, tailored assessment and care planning process for improving the QOL of nursing home residents. The Quality of Life Structured Resident Interview and Care Plan (QOL.SRI/CP) builds on a decade of research on measuring QOL and is designed to be easily implemented in any US nursing home. The approach was developed through extensive and iterative pilot testing and then tested in a randomized controlled trial in three nursing homes. Residents were randomly assigned to receive the assessment alone or both the assessment and an individualized QOL care plan task. The results show that residents assigned to the intervention group experienced improved QOL at 90- and 180-day follow-up, while QOL of residents in the control group was unchanged.

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How Important Are Choice, Autonomy, and Relationships in Predicting the Quality of Life of Nursing Home Residents?

Journal of Applied Gerontology ◽

10.1177/0733464820983972 ◽

2021 ◽

pp. 073346482098397

Author(s):

Marita McCabe ◽

Jessica Byers ◽

Lucy Busija ◽

David Mellor ◽

Michelle Bennett ◽

...

Keyword(s):

Quality Of Life ◽

Nursing Home ◽

Nursing Homes ◽

Social Relationships ◽

Daily Living ◽

Nursing Home Residents ◽

Predictor Variables ◽

Social Connections ◽

Hierarchical Regression

Older people face major challenges when they move into nursing homes, particularly in relation to independence and their ability to influence their activities of daily living (ADLs). This study evaluated the contribution of resident choice, as well as the staff–resident relationship, to promoting resident quality of life (QoL). A total of 604 residents from 33 nursing homes in Australia completed measures of QoL, perceived levels of choice in various ADLs, and the staff–resident relationship. A hierarchical regression demonstrated that the predictor variables accounted for 25% of the variance in QoL. Two of the four predictor variables (resident choice over socializing and the staff–resident relationship) significantly contributed to resident QoL. These findings reinforce the important contribution of autonomy and social relationships to resident QoL. Nursing home staff have a key role to play in supporting resident autonomy as a means of building residents’ chosen social connections, and thereby promoting QoL.

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Factors Influencing the Deterioration from Cognitive Decline of Normal Aging to Dementia among Nursing Home Residents

10.21203/rs.3.rs-42680/v2 ◽

2020 ◽

Author(s):

Audai A. Hayajneh ◽

Mohammad Rababa ◽

Alia A. Alghwiri ◽

Dina Masha'al

Keyword(s):

Quality Of Life ◽

Nursing Home ◽

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Nursing Homes ◽

Nursing Home Residents ◽

Bivariate Analysis ◽

Medical Factors ◽

Moderate Cognitive Impairment

Abstract Background: A dearth of differential research exists regarding the determinants of mild cognitive impairment (MCI) and moderate cognitive impairment or dementia among nursing home residents. This study aimed to identify and examine the association between medical factors (number of comorbidities, hospitalization, disability, depression, frailty and quality of life) and moderate cognitive impairment or dementia in nursing homes residents.Methods: A cross-sectional design was used in this study. Convenience sampling of 182 participants was conducted in nursing homes located in the central part of Jordan. Montreal cognitive assessment (MoCA) was used to screen both MCI and moderate cognitive impairment or dementia. Bivariate analysis, including t-test and ANOVA test, and logistic and linear regression models were used to examine and identify the medical factors associated with moderate cognitive impairment or dementia compared to mild cognitive impairment.Results: Most nursing home residents had MCI (87.4%) compared to a few with moderate cognitive impairment or dementia. Age (t = -2.773), number of comorbidities (t = -4.045), depression (t = -4.809), frailty (t = -4.038), and quality of life physical (t = 3.282) and mental component summaries (t = 2.469) were significantly different between the stages of cognitive impairment. Marital status (t = -4.050, p < 0.001), higher-income (t = 3.755, p < 0.001), recent hospitalization (t = 2.622,p = 0.01), depression (t = -2.737, p = 0.007), and frailty (t = 2.852, p = 0.005) were significantly associated with mental ability scores among nursing home residents.Conclusion: The coexistence of comorbidities and depression among nursing home residents with MCI necessitates prompt management by healthcare providers to combat depressive symptoms in order to delay the dementia trajectory among at-risk residents.Trail registration number: ClinicalTrials.gov Identifier: NCT04589637

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A Tablet ‐ Based Intervention for Activating Nursing Home Residents with Dementia: Results from a Cluster-Randomised Controlled Trial

10.21203/rs.3.rs-66724/v1 ◽

2020 ◽

Author(s):

Julie Lorraine O'Sullivan ◽

Sonia Lech ◽

Paul Gellert ◽

Ulrike Grittner ◽

Jan-Niklas Voigt-Antons ◽

...

Keyword(s):

Quality Of Life ◽

Nursing Home ◽

Nursing Homes ◽

Primary Outcome ◽

Controlled Trial ◽

Nursing Home Residents ◽

Cluster Randomised Controlled Trial ◽

Post Intervention ◽

Randomised Controlled

Abstract Background: Non-pharmacological interventions (NPI) can improve cognitive and non-cognitive symptoms in nursing home residents living with dementia. However, delivery of suitable NPI can be challenging in everyday nursing home settings. Internet and communication technologies (ICT) may be promising tools for supporting NPI delivery in nursing homes. Methods: A two-arm cluster-randomised controlled trial was conducted to investigate global and momentary effects of a novel ICT-based NPI for nursing home residents with dementia. Ten nursing homes were randomly allocated to the tablet-based intervention (TBI) or conventional activity sessions (CAS) group (each with five nursing homes) between April 2016 and May 2017. A total of N = 162 participants received either regular TBI (n = 80) or CAS (n = 82) over a period of eight weeks. Linear mixed models were used to analyse group differences regarding the primary outcome apathy (AES-I), and secondary outcomes quality of life (QOL-AD, QUALIDEM), neuropsychiatric (NPI-NH, psychotropic medication) and depressive symptoms (GDS). Ecological Momentary Assessments (EMA) of quality of life were also conducted in both groups before and after each activity session.Results: No significant group difference in the change of apathy (AES-I score, primary outcome) was found post intervention (mean group difference: B = .19; 95% CI: -3.90 to 4.28, p = .93). Regarding secondary outcomes, a reduction of psychotropic medication was found for TBI compared to CAS (B = .42; 95% CI: .15 to .69, p < .01). Further analyses revealed a post-intervention improvement of informant-rated quality of life across both groups (B = 3.69; 95% CI: .68 to 6.69, p = .02). Analysis of EMA also rendered short-term post-session improvements of quality of life in the CAS group (B = .43; 95% CI: .30 to .57, p < .001). Conclusions: These findings suggest that NPI involving individually tailored activities have a beneficial impact on quality of life in nursing home residents with dementia. Although we found no clear advantage of TBI compared to CAS, ICT have the potential to support NPI delivery and facilitate regular assessments of fluctuating momentary states in nursing home residents with dementia. Trial registration: The trial was retrospectively registered with the ISRCTN registry (Trial registration number: ISRCTN98947160) on 01/09/2016 http://www.isrctn.com/ISRCTN98947160.

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The relationship of nursing home price and quality of life

BMC Health Services Research ◽

10.1186/s12913-020-05833-y ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Sarah Raes ◽

Sophie Vandepitte ◽

Delphine De Smedt ◽

Herlinde Wynendaele ◽

Yannai DeJonghe ◽

...

Keyword(s):

Quality Of Life ◽

Nursing Home ◽

Nursing Homes ◽

Research Question ◽

Nursing Home Residents ◽

Cross Sectional Study ◽

Ownership Type ◽

Cross Sectional ◽

The Relationship

Abstract Background Knowledge about the relationship between the residents’ Quality of Life (QOL) and the nursing home price is currently lacking. Therefore, this study investigates the relationship between 11 dimensions of QOL and nursing homes price in Flemish nursing homes. Methods The data used in this cross-sectional study were collected by the Flemish government from years 2014 to 2017 and originates from 659 Flemish nursing homes. From 2014 to 2016, data on the QOL of 21,756 residents was assessed with the InterRAI instrument. This instrument contains 11 QOL dimensions. Multiple linear regression analyses were conducted to examine the research question. Results The multiple linear regressions indicated that a 10 euro increase in the daily nursing home price is associated with a significant decrease (P < 0.001) of 0.1 in 5 dimensions of QOL (access to services, comfort and environment, food and meals, respect, and safety and security). Hence, our results indicate that the association between price and QOL is very small. When conducting a subgroup analysis based on ownership type, the earlier found results remained only statistically significant for private nursing homes. Conclusion Our findings show that nursing home price is of limited importance with respect to resident QOL. Contrary to popular belief, our study demonstrates a limited negative effect of price on QOL. Further research that includes other indicators of QOL is needed to allow policymakers and nursing home managers to improve nursing home residents’ QOL.

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Quality of Service in Nursing Homes

Health Services Management Research ◽

10.1177/095148480001300401 ◽

2000 ◽

Vol 13 (4) ◽

pp. 205-215 ◽

Cited By ~ 24

Author(s):

A. Curry ◽

S. Stark

Keyword(s):

Quality Of Service ◽

Nursing Home ◽

Nursing Homes ◽

Frail Elderly ◽

Best Practice ◽

Nursing Home Residents ◽

Quality Measurement ◽

Measurement Tool ◽

Future Improvement

This paper illustrates the relevance of using the Servqual instrument as a service quality measurement tool in the healthcare context. The expectations and perceptions of nursing home residents and their relatives are compared and contrasted to determine the priorities and satisfaction levels of both groups with respect to the services provided. Some interesting differences emerged between the two respondent groups, which gave more accurate and relevant pointers as to potential areas of future improvement. Because a number of nursing homes were surveyed, it was also possible to ascertain which homes might serve as useful examples of the best practice and which were in need of improvement action. In frail, elderly respondent groups it is not especially easy to elicit views as to quality of service. Servqual, carefully and sympathetically designed and applied, proved appropriate for this task.

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Factors influencing the deterioration from cognitive decline of normal aging to dementia among nursing home residents

BMC Geriatrics ◽

10.1186/s12877-020-01875-3 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Audai A. Hayajneh ◽

Mohammad Rababa ◽

Alia A. Alghwiri ◽

Dina Masha’al

Keyword(s):

Quality Of Life ◽

Nursing Home ◽

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Nursing Homes ◽

Nursing Home Residents ◽

Bivariate Analysis ◽

Medical Factors ◽

Moderate Cognitive Impairment

Abstract Background A dearth of differential research exists regarding the determinants of mild cognitive impairment (MCI) and moderate cognitive impairment or dementia among nursing home residents. This study aimed to identify and examine the association between medical factors (number of comorbidities, hospitalization, disability, depression, frailty and quality of life) and moderate cognitive impairment or dementia in nursing homes residents. Methods A cross-sectional design was used in this study. Convenience sampling of 182 participants was conducted in nursing homes located in the central part of Jordan. Montreal cognitive assessment (MoCA) was used to screen both MCI and moderate cognitive impairment or dementia. Bivariate analysis, including t-test and ANOVA test, and logistic and linear regression models were used to examine and identify the medical factors associated with moderate cognitive impairment or dementia compared to mild cognitive impairment. Results Most nursing home residents had MCI (87.4%) compared to a few with moderate cognitive impairment or dementia. Age (t = − 2.773), number of comorbidities (t = − 4.045), depression (t = − 4.809), frailty (t = − 4.038), and quality of life physical (t = 3.282) and mental component summaries (t = 2.469) were significantly different between the stages of cognitive impairment. Marital status (t = − 4.050, p < 0.001), higher-income (t = 3.755, p < 0.001), recent hospitalization (t = 2.622,p = 0.01), depression (t = − 2.737, p = 0.007), and frailty (t = 2.852, p = 0.005) were significantly associated with mental ability scores among nursing home residents. Conclusion The coexistence of comorbidities and depression among nursing home residents with MCI necessitates prompt management by healthcare providers to combat depressive symptoms in order to delay the dementia trajectory among at-risk residents. Trail registration ClinicalTrials.gov NCT04589637, October 15,2020, Retrospectively registered.

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Quality of Life in People With Severe Dementia and Its Association With the Environment in Nursing Homes: An Observational Study

The Gerontologist ◽

10.1093/geront/gny017 ◽

2018 ◽

Vol 59 (4) ◽

pp. 665-674 ◽

Cited By ~ 3

Author(s):

Rebecca Palm ◽

Diana Trutschel ◽

Christian G G Sorg ◽

Martin N Dichter ◽

Burkhard Haastert ◽

...

Keyword(s):

Quality Of Life ◽

Nursing Homes ◽

Observational Study ◽

Nursing Home Residents ◽

Theoretical Models ◽

Annual Data ◽

Significant Interaction Effect ◽

Significant Difference ◽

Diagnosis Of Dementia

Abstract Background and Objectives Theoretical models propose the environment as a factor influencing the quality of life (QoL) of nursing home residents with dementia. This study investigates whether the observed QoL differs depending on the type of care unit. Research Design and Methods DemenzMonitor is an exploratory, observational study involving annual data collection in German nursing homes (2012–2014). For this analysis, we selected residents with a recorded diagnosis of dementia and severe cognitive impairment. QoL was measured with the proxy assessment QUALIDEM. Four care unit types were investigated: large integrated, large segregated, small integrated, and small segregated. Results We did not find a significant difference between the care units. During the 2 years, the observed QoL was not affected by any of the care unit types in a statistically significant or clinically relevant manner. However, a significant interaction effect between time and care unit types was found. Discussion and Implications Structural and organizational characteristics of care units, which in turn have implications for residents characteristics and the quality of care, may influence the QoL of residents. This may explain the interaction we observed.

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