scholarly journals Adverse Events in Italian Nursing Homes During the COVID-19 Epidemic: A National Survey

2020 ◽  
Vol 11 ◽  
Author(s):  
Flavia L. Lombardo ◽  
Emanuela Salvi ◽  
Eleonora Lacorte ◽  
Paola Piscopo ◽  
Flavia Mayer ◽  
...  
Keyword(s):  
Nursing Homes ◽  
Adverse Events ◽  
Older People ◽  
National Survey ◽  
Physical Restraint ◽  
National Health System ◽  
Online Questionnaire ◽  
North West ◽  
North East ◽  
People With Dementia

Older people living in nursing homes (NHs) are particularly vulnerable in the ongoing COVID-19 pandemic, due to the high prevalence of chronic diseases and disabilities (e.g., dementia). The phenomenon of adverse events (AEs), intended as any harm or injury resulting from medical care or to the failure to provide care, has not yet been investigated in NHs during the pandemic. We performed a national survey on 3,292 NHs, either public or providing services both privately and within the national health system, out of the 3,417 NHs covering the whole Italian territory. An online questionnaire was addressed to the directors of each facility between March 24 and April 27, 2020. The list of NHs was provided by the Dementia Observatory, an online map of Italian services for people with dementia, which was one of the objectives of the implementation of the Italian National Dementia Plan. About 26% of residents in the Italian NHs for older people listed within the Dementia Observatory site had dementia. The objective of our study was to report the frequency of AEs that occurred during the months when SARS-CoV-2 spreading rate was at its highest in the Italian NHs and to identify which conditions and attributes were most associated with the occurrence of AEs by means of multivariate regression logistic analysis. Data are referred to 1,356 NHs that participated in the survey. The overall response rate was 41.2% over a time-period of six weeks (from March 24 to May 5). About one third of the facilities (444 out of 1,334) (33.3%) reported at least 1 adverse event, with a total of 2,000 events. Among the included NHs, having a bed capacity higher than the median of 60 beds (OR=1.57, CI95% 1.17–2.09; p=0.002), an observed increased in the use of psychiatric drugs (OR=1.80, CI95% 1.05–3.07; p=0.032), adopting physical restraint measures (OR=1.97, CI95% 1.47–2.64; p<0.001), residents hospitalized due to flu-like symptoms (OR =1.73, CI95% 1.28–2.32; p<0.001), and being located in specific geographic areas (OR=3.59, CI95% 1.81–7.08; OR = 2.90, CI95% 1.45–5.81 and OR = 4.02, CI05% 2.01–8.04 for, respectively, North-West, North-East and Centre vs South, p<0.001) were all factors positively associated to the occurrence of adverse events in the facility. Future recommendations for the management and care of residents in NHs during the COVID-19 pandemic should include specific statements for the most vulnerable populations, such as people with dementia.

scholarly journals Experiences of older people with dementia participating in a high-intensity functional exercise program in nursing homes: "While it's tough, it's useful"

PLoS ONE ◽  
2017 ◽  
Vol 12 (11) ◽  
pp. e0188225 ◽  
Author(s):  
Nina Lindelöf ◽  
Lillemor Lundin-Olsson ◽  
Dawn A. Skelton ◽  
Berit Lundman ◽  
Erik Rosendahl
Keyword(s):  
Nursing Homes ◽  
Older People ◽  
High Intensity ◽  
Exercise Program ◽  
People With Dementia ◽  
Functional Exercise

scholarly journals Cortisol levels among older people with and without depression and dementia

2018 ◽  
Vol 31 (04) ◽  
pp. 597-601 ◽  
Author(s):  
Maria Lage Barca ◽  
Rannveig S. Eldholm ◽  
Karin Persson ◽  
Guro Hanevold Bjørkløf ◽  
Tom Borza ◽  
...  
Keyword(s):  
Nursing Homes ◽  
Older People ◽  
Reference Group ◽  
Mmse Score ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
People With Dementia ◽  
Specialized Care ◽  
Cortisol Levels ◽  
Cortisol Ratio

ABSTRACTCortisol dysregulation has been reported in dementia and depression. Cortisol levels and its associates were investigated among older people living at home and in nursing homes, in a cross-sectional study. A sample of 650 older people, from the community (home and nursing homes) and specialized care (memory clinics and old age psychiatry wards), mean age 76.8 (SD = 10.3) (dementia n = 319, depression, n = 154, dementia plus depression n = 53, and reference group n = 124), was included. Assessment included the Mini Mental State Examination (MMSE), Cornell scale for depression in dementia, activities of daily living scales, and salivary cortisol. Number of drugs was registered. The results showed that the cortisol ratio was highest among patients with dementia and co-morbid depression in comparison to those with either depression or dementia and the reference group. Characteristics significantly associated with cortisol levels were higher MMSE score (in patients with dementia and co-morbid depression), male gender (in people with dementia), and number of medications (in the reference group). We conclude that the cortisol ratio was highest among patients with dementia and co-morbid depression in comparison to those with either depression or dementia and the reference group. The association of cortisol level with MMSE score among patients with dementia and depression could further indicate that increased stress is related to cognitive function.

scholarly journals Motivation to participate in high-intensity functional exercise compared with a social activity in older people with dementia in nursing homes

PLoS ONE ◽  
2018 ◽  
Vol 13 (11) ◽  
pp. e0206899 ◽  
Author(s):  
Anna Sondell ◽  
Erik Rosendahl ◽  
Johan Nilsson Sommar ◽  
Håkan Littbrand ◽  
Lillemor Lundin-Olsson ◽  
...  
Keyword(s):  
Nursing Homes ◽  
Older People ◽  
High Intensity ◽  
Social Activity ◽  
People With Dementia ◽  
Functional Exercise ◽  
Motivation To Participate

scholarly journals The Effects of Exercise on Falls in Older People With Dementia Living in Nursing Homes: A Randomized Controlled Trial

2019 ◽  
Vol 20 (7) ◽  
pp. 835-842.e1 ◽  
Author(s):  
Annika Toots ◽  
Robert Wiklund ◽  
Håkan Littbrand ◽  
Ellinor Nordin ◽  
Peter Nordström ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Nursing Homes ◽  
Older People ◽  
Controlled Trial ◽  
Randomized Controlled ◽  
People With Dementia

scholarly journals Is the Effect of a High-Intensity Functional Exercise Program on Functional Balance Influenced by Applicability and Motivation among Older People with Dementia in Nursing Homes?

2019 ◽  
Vol 23 (10) ◽  
pp. 1011-1020
Author(s):  
Anna Sondell ◽  
H. Littbrand ◽  
H. Holmberg ◽  
N. Lindelöf ◽  
E. Rosendahl
Keyword(s):  
Nursing Homes ◽  
Older People ◽  
High Intensity ◽  
Exercise Program ◽  
Target Variable ◽  
Functional Balance ◽  
People With Dementia ◽  
Point Increase ◽  
Functional Exercise

Abstract Background and Objectives Exercise can be an important way of maintaining balance function in people with dementia, but further investigation is needed to determine the optimal way of exercising. The objective was to evaluate whether exercise applicability (i.e., attendance, exercise intensity, and adverse events) and motivation were associated with the effect on functional balance of a high-intensity functional exercise program for older people with dementia in nursing homes. Design, Setting and Participants Exercise intervention participants (n = 81; 60 women, 21 men) from a randomized controlled trial (UMDEX) were included. Their mean age was 84 and mean Mini-Mental State Examination score was 15. Intervention Groups of 3–8 participants participated in the High-Intensity Functional Exercise (HIFE) Program, with 5 sessions per 2-week period, for 4 months (total, 40 sessions). Measurements Outcome was the Berg Balance Scale (BBS), assessed at baseline and follow up, and the score difference, dichotomized to classify participants into two groups: responders (≥5-point increase) and non-responders (<5-point increase). Target variables were measures of applicability and motivation. Associations between each target variable and the outcome were analyzed using multivariable logistic regression. Baseline characteristics and new medical conditions developing during the intervention period were compared between responders and non-responders and included in the analyses when p < 0.10. Results The BBS score was 28.6 ± 14.3 at baseline and 31.2 ± 15.3 at follow up, with the difference between follow-up and baseline scores ranging from −35 to 24. Twenty-nine (35.8%) participants were responders. The multivariable models showed no significant association between responders vs. non-responders and any target variable. Conclusion Participation in a 4-month high-intensity functional exercise program can improve balance in many individuals with dementia in nursing homes, despite the progressiveness of dementia disorders and several co-existing medical conditions. Predicting balance exercise response based on applicability and motivation seem not to be possible, which lends no support for excluding this group from functional exercise, even when exercise intensity or motivation is not high.

Involving institutionalized people with dementia in their care-planning meetings: Impact on their quality of life measured by a proxy method: Innovative Practice

Dementia ◽  
2017 ◽  
Vol 18 (5) ◽  
pp. 1936-1941 ◽  
Author(s):  
Feliciano Villar ◽  
Montserrat Celdrán ◽  
Josep Vila-Miravent ◽  
Elena Fernández
Keyword(s):  
Quality Of Life ◽  
Nursing Homes ◽  
Older People ◽  
The Other ◽  
Care Planning ◽  
Staff Members ◽  
Care Plans ◽  
People With Dementia ◽  
The Impact

The objective of the study was to assess the impact of an intervention in which people with dementia attended meetings to discuss their individual care plans on their quality of life. Fifty-two older people ( M = 86.7 years, SD = 7.3) diagnosed with moderate-to-severe dementia living in four nursing homes in Spain participated in the study. The intervention was implemented with 27 residents at two of the nursing homes; the other 25 cases at the other two homes acted as controls. A proxy measure of quality of life was used. Improvements were found in quality of life as assessed by staff members, in both within and between-group comparisons, which suggests that including older people with dementia in care-planning meetings may improve their quality of life. However, further controlled studies are needed to confirm these preliminary results.

scholarly journals The ideals of group living homes for people with dementia: do they practice what they preach?

2011 ◽  
Vol 23 (9) ◽  
pp. 1526-1527 ◽  
Author(s):  
Selma te Boekhorst ◽  
Marja F.I.A. Depla ◽  
Anne Margriet Pot ◽  
Jacomine de Lange ◽  
Jan A. Eefsting
Keyword(s):  
Twentieth Century ◽  
Nursing Home ◽  
Nursing Homes ◽  
The Netherlands ◽  
Home Care ◽  
Older People ◽  
Hospital Care ◽  
Group Living ◽  
Nursing Home Care ◽  
People With Dementia

In the Netherlands, as well as in other countries, nursing home care has been traditionally modeled on hospital care. However, in the last decades of the twentieth century, realization grew that, unlike hospitals, nursing homes needed to serve as literal homes to people. As a consequence, the concept of group living homes for older people with dementia has taken root.

Discussing advance care planning: insights from older people living in nursing homes and from family members

2017 ◽  
Vol 30 (4) ◽  
pp. 569-579 ◽  
Author(s):  
Francesca Ingravallo ◽  
Veronica Mignani ◽  
Elena Mariani ◽  
Giovanni Ottoboni ◽  
Marie Christine Melon ◽  
...  
Keyword(s):  
Nursing Homes ◽  
Older People ◽  
Advance Care Planning ◽  
Family Members ◽  
Nursing Home Residents ◽  
Care Planning ◽  
People With Dementia ◽  
Advance Care ◽  
The Right ◽  
Age Range

ABSTRACTBackground:Evidence concerning when and in which manner older people living in nursing homes (NHs) would prefer to discuss advance care planning (ACP) is still scarce. This study explored the attitudes of NH residents and family members toward ACP and their opinions as to the right time to broach the subject, the manner in which it should be approached, and the content of ACP.Methods:This was a qualitative study using face-to-face interviews with 30 residents (age range 66–94), and 10 family members from 4 Italian NHs. The interviews were analyzed using content analysis.Results:Three main themes were identified: (1) life in the NH, including thoughts about life in a nursing home, residents’ concerns, wishes and fears, and communication barriers; (2) future plans and attitudes toward ACP, including attitudes toward planning for the future and plans already made, and attitudes toward and barriers against ACP; (3) contents and manner of ACP, including contents of ACP discussions, the right moment to introduce ACP, with whom it is better to discuss ACP, and attitudes toward advance directives.Conclusions:ACP was a welcome intervention for the majority of participants, but an individualized assessment of the person's readiness to be involved in ACP is needed. For people with dementia, it is essential to identify the right time to introduce ACP before NH admission. Participants in our study suggested that ACP should include palliative care and practical issues, and that in the NH setting all staff and family members may have a valuable role in ACP.

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