scholarly journals Is Long-Term Care Person Centred? A Case Study

2021 ◽  
Author(s):  
Katarina Young
Keyword(s):  
Long Term Care ◽  
Direct Care ◽  
Care Providers ◽  
Term Care ◽  
Study Approach ◽  
Key Stakeholders ◽  
Direct Care Providers ◽  
Government Legislation

In Ontario long-term care (LTC) settings, person-centred care (PCC) is promoted by government legislation, accreditation organizations and professional practice guidelines aiming to integrate this approach. However, there is currently no standardized approach to providing PCC in LTC. The purpose of this study was to examine public policies on PCC in Ontario and explore how they are interpreted and translated into practice in LTC. A qualitative case study approach was used to examine the perspectives of key stakeholders at one LTC facility in Ontario. Focus groups were conducted with residents, family members, direct care providers and managers. Through content analysis, findings were organized into four categories showcasing both overlapping and differential understandings of PCC in practice: 1) conceptualization, 2) barriers, 3) facilitators, and 4) evaluation. Identified tensions between policy and the delivery of PCC highlight systemic issues that must be addressed to enable equitable person-centred LTC rooted in resident-identified priorities.

scholarly journals Is Long-Term Care Person Centred? A Case Study

2021 ◽  
Author(s):  
Katarina Young
Keyword(s):  
Long Term Care ◽  
Direct Care ◽  
Care Providers ◽  
Term Care ◽  
Study Approach ◽  
Key Stakeholders ◽  
Direct Care Providers ◽  
Government Legislation

In Ontario long-term care (LTC) settings, person-centred care (PCC) is promoted by government legislation, accreditation organizations and professional practice guidelines aiming to integrate this approach. However, there is currently no standardized approach to providing PCC in LTC. The purpose of this study was to examine public policies on PCC in Ontario and explore how they are interpreted and translated into practice in LTC. A qualitative case study approach was used to examine the perspectives of key stakeholders at one LTC facility in Ontario. Focus groups were conducted with residents, family members, direct care providers and managers. Through content analysis, findings were organized into four categories showcasing both overlapping and differential understandings of PCC in practice: 1) conceptualization, 2) barriers, 3) facilitators, and 4) evaluation. Identified tensions between policy and the delivery of PCC highlight systemic issues that must be addressed to enable equitable person-centred LTC rooted in resident-identified priorities.

scholarly journals REDUCING ANTIPSYCHOTIC USE IN LONG-TERM CARE: CONSIDERING THE ROLE OF CULTURE OF CARE AND INFORMAL COMMUNICATION

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S434-S434
Author(s):  
Andre Smith ◽  
Sue Kurucz ◽  
Tara Erb ◽  
Ruth Kampen
Keyword(s):  
Health Care ◽  
Long Term Care ◽  
Direct Care ◽  
Care Providers ◽  
Informal Communication ◽  
Term Care ◽  
Culture Of Care ◽  
Direct Care Providers

Abstract Persons living with dementia-related disorders (PwD) can experience challenging behavioural and psychological symptoms (BPSD) as their illness progresses. There is a continued reliance on antipsychotic drugs (APD) in long-term care to manage this issue despite the well-documented risks of adverse events and increased morbidity and mortality. This study examines the role of culture of care in relation to efforts at reducing inappropriate APD use in managing BPSD within long-term care. Culture of care consists of shared norms, beliefs, and cognitive frames which guide clinical practice and inform the development and implementation of care strategies. Findings were obtained from three Canadian long-term care facilities working on reducing inappropriate use of APD. Data came from interviews with 6 nurses, 18 licenced practical nurses, 14 health care assistants, 4 activity leaders, 4 directors of care, 1 chaplain, and 10 physicians. We found that direct care providers initially varied in their perceived ability to develop and use alternate care strategies with health care assistants being most concerned about safety and exposure to violence. Change involved detective work and innovative thinking in assessing possible causes of BPSD beyond psychosis, including pain and feelings of confusion. Informal reciprocal patterns of communication emerged among health care assistants to identify effective non-pharmaceutical strategies to manage BPSD. Overall, the study shows how shared beliefs in the need for and value of alternate care practices among direct care providers along with the existence of effective informal communication can contribute to successful reduction in APD use when managing BPSD in PwD.

scholarly journals Why the Discretion Mix Matters: Understanding the Transformation of Long-term Care Services

2019 ◽  
Vol 56 ◽  
pp. 004695801987182
Author(s):  
Young Jun Choi ◽  
Hyejin Choi
Keyword(s):  
Long Term Care ◽  
Social Care ◽  
Implementation Process ◽  
Theoretical Concept ◽  
Care Provision ◽  
Term Care ◽  
Study Approach ◽  
Care Services

This study aims to extend the concept of discretion, ie, a certain degree of freedom in crucial decisions left to specific actors, to understand and examine the transformation of social care services in the era of aging and austerity. Although previous studies have reviewed and analyzed changes in care provision, they have been less concerned with who has the authority to make care decisions in the implementation process. We propose a new theoretical concept, the discretion mix, to understand the realignment of social care services beyond simply tracking institutional changes. Using a case study approach, this research investigates how the discretion mix of the Korean long-term care system has changed and the consequences of these changes; in addition, it discusses why the discretion mix can be a useful concept for analyzing the changing landscape of social care services.

scholarly journals Engaging Direct Care Providers in the Implementation of Montessori Programming for Dementia

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 151-151
Author(s):  
Natalie Douglas
Keyword(s):  
Nursing Assistants ◽  
Direct Care ◽  
Certified Nursing Assistants ◽  
Care Providers ◽  
Severe Dementia ◽  
Term Care ◽  
Engagement Strategies ◽  
Direct Care Providers ◽  
New Ideas

Abstract There is a need to engage direct care providers such as certified nursing assistants (CNAs) explicitly in efforts to implement innovative programming in long-term care environments. This presentation will outline engagement strategies that supported the implementation of Montessori programming in a community of 20 individuals living with severe dementia. Examples about positioning the CNA at the center of decision making, negotiating and building trust, cultivating opportunities for mutual consultation, creating spaces for new ideas to emerge, and synthesizing diverse perspectives will be highlighted. Although the program achieved positive outcomes on a number of measures including decreased responsive behaviors from people living with dementia, decreased negative qualities of relationships between CNAs and persons with dementia, and increased positive qualities of relationships between CNAs and persons with dementia, this presentation will focus on the “how” of engagement between the project team and the CNAs by highlighting qualitative data.

A Self-Monitoring Method of Resident Care Quality Assurance in Long Term Care Facilities

1983 ◽  
Vol 2 (3) ◽  
pp. 137-151 ◽  
Author(s):  
Larry W. Chambers ◽  
Pat Caulfield ◽  
Mark Magenheim ◽  
E. Ann Mohide ◽  
Vince Rudnick ◽  
...  
Keyword(s):  
Quality Assurance ◽  
Long Term Care ◽  
Care Quality ◽  
Direct Care ◽  
Care Providers ◽  
Monitoring Method ◽  
Term Care ◽  
Resident Care ◽  
Care Facilities

ABSTRACTQuality assurance packages for common health problems are being developed for use in long term care settings. Each package includes a criteria map outlining explicit process and outcome criteria, a reviewer's manual and data summary forms. The packages were developed for use by direct care providers in long term care facilities. Established criteria are applied to records on resident care in order to identify areas which require remedial actions. A feasibility study to assess the use of the packages in eleven nursing homes is reported.

scholarly journals COVID-19 in Assisted Living: Evidence on Policies, Provider Experiences, and Resident Mortality

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 57-57
Author(s):  
Kali Thomas ◽  
Lindsay Schwartz
Keyword(s):  
Health Care Providers ◽  
Assisted Living ◽  
Long Term Care ◽  
Healthcare Providers ◽  
Care Providers ◽  
Term Care ◽  
Key Stakeholders ◽  
National Organizations ◽  
Poor Outcomes

Abstract The devastating effects of Coronavirus disease 2019 (COVID-19) among older adults residing in long-term care settings has been well documented. Assisted living settings in the U.S. have 811,000 residents; most are 80 years or older, and many have one or more chronic illnesses, making them highly susceptible to poor outcomes if exposed to COVID-19. This symposium highlights five studies that focus on various levels of COVID-19 response in assisted living: national organizations, states, assisted living operators and healthcare providers, and residents. The first study compares the sometimes conflicting guidance provided by national long-term care industry-related organizations and recommends assisted living-specific actions for the future. The second study describes the state regulatory response to COVID-19 in assisted living, identifying the themes and implications for the function of the care networks of assisted living residents. The third study presents findings from interviews with key stakeholders, including policymakers and industry leaders, that reflect on the challenges responding to changing recommendations and policies. The fourth study reports results from a survey with administrators and medical and mental health care providers who treat their residents that illustrates the care practices that were implemented in response to COVID-19 in assisted living. The fifth presentation documents the national excess assisted living resident mortality that was attributable to COVID-19. This symposium culminates with a leading assisted living industry expert reflecting on providers’ experiences and posing areas to consider when preparing for and responding to future pandemic events in assisted living settings.

Informal Caregivers As Long-Term Care Providers: Differential Experiences By Gender

2002 ◽  
Author(s):  
Maryam Navaie-Waliser ◽  
Aubrey L. Spriggs ◽  
Penny H. Feldman
Keyword(s):  
Long Term Care ◽  
Informal Caregivers ◽  
Care Providers ◽  
Term Care

scholarly journals The Development and Testing of KNACC: Knowledgeable Nursing Assistants as Creative Caregivers

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 675-675
Author(s):  
Jacqueline Eaton ◽  
Kristin Cloyes ◽  
Brooke Paulsen ◽  
Connie Madden ◽  
Lee Ellington
Keyword(s):  
Focus Groups ◽  
Long Term Care ◽  
Family Members ◽  
Nursing Assistants ◽  
Direct Care ◽  
Term Care ◽  
Memory Care

Abstract Nursing assistants (NAs) provide 80% of direct care in long-term care settings, yet are seldom viewed as skilled professionals. Empowering NAs is linked to improved resident outcomes. In this study, we collaborate with NAs to adapt and test the feasibility and acceptability of arts-based creative caregiving techniques (CCG) for use in long-term care. We held a series of focus groups (n=14) to adapt, refine, and enhance usability. We then evaluated implementation in two waves of testing (n=8). Those working in memory care units were more likely to use all techniques, while those working in rehabilitation were more hesitant to implement. Participants reported using CCG to distract upset residents. Family members were excited about implementation, and NAs not participating wanted to learn CCG. Nursing assistants have the potential to become experts in creative caregiving but may require in-depth training to improve use.

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