The Influence of Spiritual Well-being, Attitude Toward Death and Hospice Perception in Nurse Working in Long-term Care Hospitals

Abstract A consequence of the strict visitor restrictions implemented by many Long-term Care Facilities (LTCFs), during the COVID-19 pandemic, was the exacerbation of loneliness and social isolation felt by older adult residents. While there had been a shift by some persons to utilize digital solutions to mitigate the effects of the imposed social isolation, many facilities did not have sufficient information regarding available solutions to implement institutional strategies to support social connectedness through digital solutions. To support our partners in evidence-based policy-making we conducted a scoping review to identify existing virtual technology solutions, apps, and platforms feasible to promote social connectedness among persons residing in a long-term care facility context during times of lockdown such as experienced during the COVID-19 pandemic. Initial identification of relevant literature involved a combination of keywords and subject headings searches within 5 databases (PubMed, CINAHL EBSCO, PsychINFO EBSCO, Embase OVIDSP, and Web of Science ISI). DistillerSR was used to screen, chart and summarize the data. There is growth in the availability of technologies focused on promoting health and well-being in later life for persons in long-term care facilities however a gap remains in widespread uptake. We will describe the breadth of technologies identified in this review and discuss how they vary in utility in smaller scale facilities common in rural areas. Of the technologies that can be used to mitigate the impacts of social isolation felt by long-term care residents, many “solutions” depend on stable highspeed internet, which remains a challenge in rural and northern areas.

Download Full-text

Informal carer in Portugal: moving towards political recognition in Portugal

European Journal of Public Health ◽

10.1093/eurpub/ckz187.178 ◽

2019 ◽

Vol 29 (Supplement_4) ◽

Author(s):

I Fronteira ◽

J Simoes ◽

G Augusto

Keyword(s):

Informal Care ◽

Long Term Care ◽

Well Being ◽

Oecd Countries ◽

Low Fertility ◽

Informal Carer ◽

Term Care ◽

System Perspective ◽

Informal Carers

Abstract Informal care represents around 80% of all long term care provided in EU countries. Nevertheless, the needs for this type of care are expected to increase in the coming years in all OECD countries. Portugal is among the OECD countries with the highest ageing index (21.5% of the population was older than 65 years in 2017) due to high life expectancy and low fertility rates. As this demographic trend establishes, Portugal is expected to have more than 40% of the population over 65 years in 2037, and the expected prevalence of dementia is 3%, in 2050. In 2015 there were 2.1% of people over 65 receiving long-term care, representing 52% of all long-term care users. Around 38% were receiving care at home. It is estimated that 287,000 people in Portugal depend on informal carers. The agenda towards the official recognition of informal cares has been push forward in the country. Since 2015, several recommendations have been issued by the Parliament as well as legislative initiatives and a proposal for a Status of the Informal Carer is currently under discussion. We analyse the process of formulation of this policy in terms of sectors and stakeholders involved, definition and scope of informal carer, rights and obligations, role of the person being cared for, formal protection (e.g., labor, social, financial, training) and implementation. Recognition of the informal carer is a sector wide approach. One of the main features is the economic, social and labor protection mainly through reconciliation between work life and caring activities and promotion of the carer’s well being. Notwithstanding, and from a health system perspective, community health teams are to be the focal point for informal carers, supporting and providing specific training whenever needed. Despite its relevance, informal care should not be professionalized and responsibility of care should not be shifted from health services to informal carers. Key messages Needs for informal care are expected to increase in the coming years in OECD countries. Recognition of the informal carer is a sector wide approach.

Download Full-text

#MoreThanAVisitor: Families as “Essential” Care Partners During COVID-19

The Gerontologist ◽

10.1093/geront/gnaa161 ◽

2020 ◽

Author(s):

Candace L Kemp

Keyword(s):

Family Involvement ◽

Long Term Care ◽

Research Policy ◽

Well Being ◽

Direct Care ◽

Negative Consequences ◽

Public Health Response ◽

Term Care ◽

Care Partners

Abstract The public health response to the current Coronavirus pandemic in long-term care communities, including assisted living, encompasses prohibiting visitors. This ban, which includes family members, has been criticized for being unfair, unhealthy, and unsafe. Against this backdrop, I examine the roles family play in residents’ daily lives and care routines. I argue that classifying family as “visitors” rather than essential care partners overlooks their critical contributions and stems from taken-for-granted assumption about gender, families, and care work, and I demonstrate why families are more than visitors. Policies that ban family visits also reflect a narrow understanding of health that focuses on mitigating infection risk, but neglects overall health and well-being. This policy further stems from a limited comprehension of care relations. Research shows that banning family visits has negative consequences for residents, but also families themselves, and direct care workers. I argue that identifying ways to better understand and support family involvement is essential and demonstrate the utility of the Convoys of Care model for guiding the reconceptualization of family in long-term care research, policy, and practice during and beyond the pandemic.

Download Full-text

FEDERAL POLICY SUPPORTS AND GAPS IN ADDRESSING RACIAL-ETHNIC HEALTH DISPARITIES IN U.S. LONG-TERM CARE FACILITIES

Innovation in Aging ◽

10.1093/geroni/igz038.576 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S161-S161

Author(s):

Rebecca L Mauldin ◽

Kathy Lee ◽

Antwan Williams

Keyword(s):

Long Term Care ◽

Federal Policy ◽

Care Facility ◽

Well Being ◽

The United States ◽

Term Care ◽

Long Term Care Facility ◽

Care Facilities

Abstract Older adults from racial and ethnic minority groups face health inequities in long-term care facilities such as nursing homes and assisted living facilities just as they do in the United States as a whole. In spite of federal policy to support minority health and ensure the well-being of long-term care facility residents, disparities persist in residents’ quality of care and quality of life. This poster presents current federal policy in the United States to reduce racial and ethnic health disparities and to support long-term care facility residents’ health and well-being. It includes legislation enacted by the Patient Protection and Affordable Care Act of 2010 (ACA), regulations of the U.S. Department of Health and Human Services (DHHS) for health care facilities receiving Medicare or Medicare funds, and policies of the Long-term Care Ombudsman Program. Recommendations to address threats to or gaps in these policies include monitoring congressional efforts to revise portions of the ACA, revising DHHS requirements for long-term care facilities staff training and oversight, and amending requirements for the Long-term Care Ombudsman Program to mandate collection, analysis, and reporting of resident complaint data by race and ethnicity.

Download Full-text

TRAINING STAFF IN LONG-TERM CARE FACILITIES – EFFECTS ON RESIDENTS’ SYMPTOMS, PSYCHOLOGICAL WELL-BEING, AND PROXY SATISFACTION

Journal of Pain and Symptom Management ◽

10.1016/j.jpainsymman.2021.03.020 ◽

2021 ◽

Author(s):

Pauli J Lamppu ◽

Marja-Liisa Laakkonen ◽

Harriet Finne-Soveri ◽

Hannu Kautiainen ◽

Jouko V Laurila ◽

...

Keyword(s):

Long Term Care ◽

Well Being ◽

Term Care ◽

Psychological Well Being ◽

Care Facilities

Download Full-text

END-OF-LIFE CARE PREFERENCES AND WELL-BEING IN LONG-TERM CARE RESIDENTS

Innovation in Aging ◽

10.1093/geroni/igz038.2474 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S669-S669

Author(s):

Kelly Shryock ◽

Jacinta Dickens ◽

Anisha Thomas ◽

Suzanne Meeks

Keyword(s):

Quality Of Life ◽

Positive Affect ◽

End Of Life ◽

End Of Life Care ◽

Long Term Care ◽

Well Being ◽

Life Care ◽

Term Care

Abstract Research on end-of-life care in nursing homes comes largely from the viewpoint of staff or family members. We examined patient perspectives on end-of-life care, preferences for care, and quality of life in long-term care settings. We hypothesized that fulfillment of the Self Determination Theory (SDT) needs of autonomy, competence, and relatedness would be related to better well-being and that the degree to which end-of-life care preferences are seen as possible in the setting would be related to SDT need fulfillment and well-being. Preliminary data, collected from older individuals at the end of life (over 55, presence of significant chronic disease, in long term care setting) (n= 72), demonstrated that autonomy, competence, and relatedness measures were moderately and significantly correlated with well-being as measured by life satisfaction, higher positive affect, lower negative affect, and overall quality of life measures The degree to which residents believed that their end-of-life care preferences could be honored in the setting was also significantly correlated with autonomy, competence, relatedness, positive affect, and psychological quality of life. These results are consistent with SDT and suggest that if long term care settings can promote autonomy, connection, and competence in making end of life decisions, possibly by discovering and fulfilling preferences for end of life care, individuals who end their lives on those settings have potential for greater satisfaction and happiness. These results suggest that SDT is a useful framework for ongoing research on how to improve the end of life experiences of older adults in long term care.

Download Full-text

Economic Well-Being of the Chronically Disabled Elderly: Practice and Policy Implications

Families in Society The Journal of Contemporary Social Services ◽

10.1177/104438949307400802 ◽

1993 ◽

Vol 74 (8) ◽

pp. 460-467 ◽

Cited By ~ 1

Author(s):

Jean W. Bauer ◽

Marlene S. Stum ◽

Paula J. Delaney

Keyword(s):

Stepwise Regression ◽

Long Term Care ◽

Well Being ◽

Policy Implications ◽

Term Care ◽

Disabled Elderly ◽

The Disabled ◽

Care Survey ◽

Economic Well Being

The 1982 Long-Term Care Survey (N = 5,670) was used to gain an understanding of predisposing, need, and enabling variables that influence the economic well-being of disabled elderly. Stepwise regression results suggest that a combination of enabling and predisposing factors best explained differences in economic well-being. Implications of the findings for practitioners are discussed within the context of practice and policy for the disabled elderly.

Download Full-text

Implementation of Assistive Technologies and Robotics in Long-Term Care Facilities: A Three-Stage Assessment Based on Acceptance, Ethics, and Emotions

Frontiers in Psychology ◽

10.3389/fpsyg.2021.694297 ◽

2021 ◽

Vol 12 ◽

Author(s):

Annette Franke ◽

Elmar Nass ◽

Anna-Kathleen Piereth ◽

Annabel Zettl ◽

Christian Heidl

Keyword(s):

Transformational Leadership ◽

Long Term Care ◽

Implementation Process ◽

Well Being ◽

Emotion Management ◽

Assistive Technologies ◽

Care Staff ◽

Term Care ◽

Care Facilities

Assistive technologies including assistive robots (AT/AR) appear to be a promising response to the increasing prevalence of older adults in need of care. An increasing number of long-term care facilities (LTCFs) try to implement AT/AR in order to create a stimulating environment for aging well and to reduce workload for professional care staff. The implementation of new technologies in an organization may lead to noticeable cultural changes in terms of social interactions and care practices associated with positive or negative emotions for the employees. This applies especially for LTCFs with high rates of vulnerable residents affected by increasing care needs and specific ethics in nursing and cultural rules within the setting. Thus, systematic consideration in leadership management of emotions and ethical aspects is essential for stakeholders involved in the implementation process. In this article, we explicitly focus on the emotions of the employees and leaders within LTCFs. We relate to direct consequences for the organizational well-being and culture, which is of course (indirectly) affecting patients and residents. While aspects of technology acceptance such as safety and usefulness are frequently discussed in academic literature, the topic of emotion-management and ethical questions during the organizational implementation process in LTCFs received little attention. Emotional culture entails affective values, ethical norms and perceptions of employees and further investigation is needed to address the importance of transformational leadership during implementation process. For this purpose, we developed a three-staged assessment tool for implementation of AT/AR in long-term care institutions. Acceptance (A), ethical acceptability (A) and emotional consequences (E) are considered as comprehensive assessment, in which emotional consequences comprise management aspects of transformational leadership (T), emotion-management (E) and organizational culture (O). Based on AAE and TEO, this paper presents an integrated framework illustrated with a illustrative example and aims to combine established approaches with ethical insights in order to unfold potentials of AT/AR in LTCSs.

Download Full-text

A comparison of caregiver burden between long-term care and developmental disability family caregivers

Journal of Research in Nursing ◽

10.1177/17449871211024325 ◽

2021 ◽

Vol 26 (8) ◽

pp. 781-793

Author(s):

Alison Pattison ◽

Elissa Torres ◽

Lori Wieters ◽

Jennifer G. Waldschmidt

Keyword(s):

Family Caregivers ◽

Caregiver Burden ◽

Developmental Disability ◽

Long Term Care ◽

Role Strain ◽

Well Being ◽

The United States ◽

Term Care ◽

Personal Strain

Background As the United States’ population ages and health concerns rise, the family caregiver occupation will continue to be an integral part of the health care system. Aims It is important to examine the burden that family caregivers experience so they can seek out additional training and services to maintain their own well-being. The researchers examined caregiver burden from a perspective of developmentally disabled and long-term care. Methods The researchers examined difference in Zarit scores, guilt, burden and personal strain for 72 caregivers of people with developmental disability (DD) or people with long-term care (LTC) needs. The researchers also examined differences in these based on whether the individual was caregiving for family or “others”. Results For DD, there were significant differences in Zarit, role strain and personal strain; caring for others has significantly lower scores on these. Role strain was significantly higher than personal strain, which was significantly higher than guilt for both LTC and DD groups. Conclusions Given these findings, it is important to support family caregivers first and foremost with role strain, especially for those caring for family members with DD. This support could be given through personal counselling, caregiver training, non-profit social service resources, and support groups for family caregivers.

Download Full-text