scholarly journals Effect of Patients’ Life Stories in Bringing Meaning to Nursing Home Care

PRiMER ◽  
2019 ◽  
Vol 3 ◽  
Author(s):  
Jane Qu ◽  
Laura N. Goldman ◽  
Joanne E. Wilkinson
Keyword(s):  
Nursing Home ◽  
Family Medicine ◽  
Home Care ◽  
Health Care Providers ◽  
Life Stories ◽  
Nursing Home Care ◽  
Semistructured Interview ◽  
Care Providers ◽  
Nursing Home Patients ◽  
Family Medicine Residents

Introduction: Although there is an increasing need for geriatricians, fewer physicians are entering the field. Family medicine residents find geriatrics, especially nursing home care, unsatisfying. Life stories of older adult patients may help providers cope with the challenges of nursing home care and increase provider satisfaction by offering a way to connect with patients. Methods: We conducted a qualitative study on life stories’ effects on attitudes towards nursing home care. Fourteen patient stories were created. Seven Boston University family medicine residents and one nurse practitioner participated in a semistructured interview both before and at least 2 months after learning about their patients’ stories. Data were analyzed using qualitative techniques from grounded theory. Results: Participants found nursing home care challenging, particularly for patients who were nonverbal due to advanced dementia, because they had difficulties forming meaningful relationships or discussing medical decisions with their patients. Life stories increased empathy, deepened relationships with patients, and led participants to feel more satisfied in their role as providers. The stories were considered useful for end-of-life discussions. Conclusion: Life stories incorporated into physician practice may help health care providers feel more connected to their patients and ultimately more satisfied in the care of nursing home patients.

The Herth Hope Index—A Psychometric Study Among Cognitively Intact Nursing Home Patients

2013 ◽  
Vol 21 (3) ◽  
pp. 378-400 ◽  
Author(s):  
Gørill Haugan ◽  
Britt Karin Støen Utvær ◽  
Unni Karin Moksnes
Keyword(s):  
Factor Analysis ◽  
Nursing Home ◽  
Home Care ◽  
Well Being ◽  
Nursing Home Care ◽  
Cross Sectional ◽  
Home Setting ◽  
Nursing Home Patients ◽  
Herth Hope Index ◽  
Cognitively Intact

Background and Purpose: Hope is seen as the act by which the temptation of despair is actively overcome and has thus been interpreted as an inner strength and an available resource for living in the present. An understanding of hope and its meaning in the lives of institutionalized older adults may aid in developing interventions to enhance hope and well-being in the nursing home setting. This study aimed to investigate the psychometric properties of the Norwegian version of the Herth Hope Index among cognitively intact nursing home patients. Methods: Cross-sectional data was obtained in 2008 and 2009 from 202 of 250 patients who met the inclusion criteria in 44 different nursing homes. Results: Exploratory factor analysis revealed 3 internal consistent dimensions of hope, explaining 51.2% of the variance. The 1-factor, 2-factor, and the originally 3-factor solutions of the Herth Hope Index were tested by means of confirmatory factor analysis. A 2-factor construct comprising 11 items came out with the best model fit. Conclusions: The Herth Hope Index was found to be a reliable and valid instrument for assessing hope in nursing home patients. The 2-factor structure was psychometrically superior the original 3-factor construct of hope in this particular sample. The Herth Hope Index might be used to assess hope and changes in the hope process during long-term nursing home care. An enhanced understanding of hope in this population might contribute to increased quality of nursing home care.

A Model of Risk Reduction for Older Adults Vulnerable to Nursing Home Placement

2014 ◽  
Vol 28 (2) ◽  
pp. 162-192 ◽  
Author(s):  
Janice L. Palmer ◽  
Joanne C. Langan ◽  
Jean Krampe ◽  
Mary Krieger ◽  
Rebecca A. Lorenz ◽  
...  
Keyword(s):  
Risk Factors ◽  
Older Adults ◽  
Nursing Home ◽  
Health Care Providers ◽  
Functional Disability ◽  
Nursing Home Placement ◽  
Nursing Home Care ◽  
Multiple Chronic Conditions ◽  
Care Providers ◽  
Home Placement

Because of the cost of nursing home care and desire of older adults to stay in their homes, it is important for health care providers to understand the factors that place older adults at risk for nursing home placement. This integrative review of 12 years of research, as published in 148 articles, explores the risk factors for nursing home placement of older adults. Using the framework of the vulnerable populations conceptual model developed by Flaskerud and Winslow (1998), we explored factors related to resource availability, relative risks, and health status. Important factors include socioeconomic status, having a caregiver, the availability and use of home- and community-based support services, race, acute illness particularly if hospitalization is required, medications, dementia, multiple chronic conditions, functional disability, and falls. Few intervention studies were identified. Development of evidence-based interventions and creation of policies to address modifiable risk factors are important next steps.

Physical Health and Cognitive Ability Among Married Long-Term-Care Patients and Among Their Spouses—A Comparison Between Home Care and Nursing Home Care

1993 ◽  
Vol 5 (2) ◽  
pp. 157-168 ◽  
Author(s):  
Ann-Christine Löfgren ◽  
Gösta Bucht ◽  
Sture Eriksson ◽  
Tage Lundström
Keyword(s):  
Nursing Home ◽  
Cognitive Function ◽  
Nursing Homes ◽  
Home Care ◽  
Physical Health ◽  
Long Term Care ◽  
Nursing Home Care ◽  
Term Care ◽  
Nursing Home Patients

The purpose of this study was to establish whether physical health and cognitive function in married long-term patients or in their spouses determines why some patients are cared for in home care while others reside in nursing homes. Out of 38 married couples with a sick spouse cared for in a nursing home, 23 couples were studied; out of 34 couples with a sick spouse cared for in home care, 22 patients and 25 spouses were studied. The results showed no significant differences in physical health score either between the two groups of patients, or between the two groups of spouses. Both home-care patients and nursing home patients had low cognitive function scores, but nursing home patients had significantly lower scores. A multivariate analysis showed that physical health and cognitive function explained only 20% of patients' residence. Between the two groups of spouses there was no difference in cognitive function score. The conclusion is that physical health status and cognitive function explain only to a small extent why married long-term care patients are cared for in nursing homes or in home care.

The Need to Educate Nursing Home Administrators about Variations in State Legislation Affecting Patients' Rights to Refuse Treatment

2003 ◽  
Vol 11 (2) ◽  
pp. 148-161 ◽  
Author(s):  
Cynthia K. Hosay
Keyword(s):  
Nursing Home ◽  
Advance Directives ◽  
Health Care Providers ◽  
The United States ◽  
Direct Care ◽  
Care Providers ◽  
State Laws ◽  
Nursing Home Administrators ◽  
Nursing Home Patients ◽  
Right To Refuse Treatment

Nursing home patients in the United States have a constitutional right to refuse treatment. The federal Patient Self-Determination Act confirms that right. State laws address the obligations of health care providers and facilities to honor those rights. But state laws vary, and nursing home administrators may not know the laws of their states. In this article, areas of significant variation in state laws are identified so that educators of nursing home administrators and direct care providers can address providers' statutory obligations concerning end-of-life issues. The advance directives statutes of the fifty states and the District of Columbia were reviewed and analyzed to determine the principal areas of variation in state requirements. Three key areas with high levels of variation were identified. Recommendations for teaching about state requirements on advance directives were developed. Education of nursing home administrators is needed to alert them to their states' requirements, benefiting them and the patients they serve.

scholarly journals Training Family Medicine Residents in Effective Communication Skills While Utilizing Promotoras as Standardized Patients in OSCEs: A Health Literacy Curriculum

2015 ◽  
Vol 2015 ◽  
pp. 1-9 ◽  
Author(s):  
Patti Pagels ◽  
Tiffany Kindratt ◽  
Danielle Arnold ◽  
Jeffrey Brandt ◽  
Grant Woodfin ◽  
...  
Keyword(s):  
Health Literacy ◽  
Family Medicine ◽  
Communication Skills ◽  
Health Care Providers ◽  
Standardized Patients ◽  
Care Providers ◽  
Future Health ◽  
Limited Health Literacy ◽  
Literacy Knowledge ◽  
Family Medicine Residents

Introduction. Future health care providers need to be trained in the knowledge and skills to effectively communicate with their patients with limited health literacy. The purpose of this study is to develop and evaluate a curriculum designed to increase residents’ health literacy knowledge, improve communication skills, and work with an interpreter. Materials and Methods. Family Medicine residents N=25 participated in a health literacy training which included didactic lectures and an objective structured clinical examination (OSCE). Community promotoras acted as standardized patients and evaluated the residents’ ability to measure their patients’ health literacy, communicate effectively using the teach-back and Ask Me 3 methods, and appropriately use an interpreter. Pre- and postknowledge, attitudes, and postdidactic feedback were obtained. We compared OSCE scores from the group that received training (didactic group) and previous graduates. Residents reported the skills they used in practice three months later. Results. Family Medicine residents showed an increase in health literacy knowledge p=0.001 and scored in the adequately to expertly performed range in the OSCE. Residents reported using the teach-back method (77.8%) and a translator more effectively (77.8%) three months later. Conclusions. Our innovative health literacy OSCE can be replicated for medical learners at all levels of training.

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