scholarly journals Feasibility of a Geriatric Assessment to Detect and Quantify Sarcopenia and Physical Functioning in German Nursing Home Residents—A Pilot Study

Geriatrics ◽  
2021 ◽  
Vol 6 (3) ◽  
pp. 69
Author(s):  
Daniel Haigis ◽  
Rebekka Pomiersky ◽  
Dorotheé Altmeier ◽  
Annika Frahsa ◽  
Gorden Sudeck ◽  
...  
Keyword(s):  
Nursing Home ◽  
Pilot Study ◽  
Physical Functioning ◽  
Mini Mental State Examination ◽  
Nursing Home Residents ◽  
Anthropometric Data ◽  
Timed Up And Go ◽  
Home Setting ◽  
Nursing Home Setting ◽  
State Examination

Background: Entering into a nursing home leads to increased immobility and further reductions in physical and cognitive functioning. As a result, there is a risk of sarcopenia, which is characterized by loss of muscle strength, muscle mass and physical functioning. To our knowledge, the feasibility of sarcopenia screening has not yet been performed in the German nursing home setting. Methods: For sarcopenia screening, the specifications of EWGSOP2 were applied. The quantification of sarcopenia was performed according to the corresponding cut-off values. The collection of anthropometric data and the morbidity status were recorded. SARC-F, mini-mental state examination, Barthel Index, Short Physical Performance Battery and Timed Up and Go tests were implemented. Results: In one participant, severe sarcopenia could be identified. The quantification was not possible for four participants. A suspicion of sarcopenia was not confirmed in five participants. Only one person was able to perform all assessments. Conclusions: Sarcopenia screening according to EWGSOP2 presented satisfactory feasibility by nursing home residents. However, further tests to assess the physical functioning of the participants often could not be performed. Moreover, inconsistencies in individual assessments became apparent, leading to inconclusive analyses. The recording of sarcopenia prevalence in German nursing homes should be the goal of further research.

scholarly journals A PILOT STUDY TO TEST METHODS FOR DATA COLLECTION ON NURSES CARING FOR RESIDENTS WITH DEMENTIA IN THE NURSING HOME

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S451-S451
Author(s):  
Rebekah Perkins ◽  
Elizabeth Cashdan ◽  
Katherine Supiano
Keyword(s):  
Nursing Home ◽  
Pilot Study ◽  
Psychological Symptoms ◽  
Nursing Home Residents ◽  
Test Methods ◽  
Structured Interviews ◽  
Home Setting ◽  
Interview Method ◽  
Expert Nurses ◽  
Nursing Home Setting

Abstract Nurses draw from their experiences and intuition to detect changes in patient condition, patterns of patient behaviors, and evidence of distress. In the nursing home setting, nurses care for residents with dementia and manage challenging behavioral and psychological symptoms of dementia (BPSD), and may rely on informed intuition to assess and capably respond to such behaviors. To date, no observational method has been developed to discern nurse-resident interactions that identify expert nurses who effectively address BPSD. It is not known if or how nurses in this setting use intuition to make clinical judgments and decisions to manage BPSD events. Using an ethogram approach, we developed an observational tool and spot interview method to discern BPSD events, background and proximal factors and nurse responses to BPSD. Pilot observations took place over three nursing shifts to identify nurse-resident interactions during BPSD events using the observation tool. Nurse-resident interactions were followed by spot interviews with each nurse to clarify their responses to BPSD. Semi-structured interviews were conducted with nurse participants to further develop an interview guide and identify elements of nurse intuition. The pilot study affirmed the feasibility of gaining access to facilities with residents with BPSD, of nurse comfort with field observation and interviews, and established preliminary construct validity of the “expert nurse.” Verification of the utility of this observation and interview method permit further examination of effective nurse engagement with nursing home residents with BPSD, informs our understanding of nurse intuition and permits further exploration of the broader context of BPSD.

scholarly journals Between Social Inclusion and Exclusion: Integration of Daycare Guests in the Nursing Home Setting

2020 ◽  
Author(s):  
Kerstin Hämel ◽  
Gundula Röhnsch
Keyword(s):  
Nursing Home ◽  
Social Inclusion ◽  
Nursing Home Residents ◽  
Community Dwelling ◽  
Cognitive Capacity ◽  
Home Setting ◽  
Residential Care Facilities ◽  
Care Approach ◽  
Nursing Home Setting ◽  
Close Relatives

Abstract Background and Objectives In integrated daycare, community-dwelling older people in need of care join existing groups in residential care facilities during the day. This study focuses on how nursing home residents experience the integrative care approach, exploring opportunities for social inclusion and mechanisms of exclusion. Research Design and Methods A purposive sample of residents differing in cognitive capacity and level of (non)conflictual interaction with daycare guests was selected. Episodic interviews with residents (N = 10) and close relatives (N = 2) were conducted in 3 pilot facilities in Germany and analyzed using thematic coding. Results The analysis revealed different orientation patterns towards the presence of daycare guests: respondents (a) demonstrated indifference to the daycare guests, (b) saw bonding with guests as a means to connect to the outside world, and (c) perceived incompatibility between in-group and out-group. Criticisms included disruption of daily routines and loss of privacy. Most interviewees came to terms with the care situation using rational and moral arguments. Discussion and Implications The study reveals the importance of residents’ participation when integrating daycare guests. Institutional procedures are required to prevent exclusion of daycare guests and avoid overtaxing residents.

Disruptive Vocalization and Depression in Older Nursing Home Residents

2000 ◽  
Vol 12 (4) ◽  
pp. 463-471 ◽  
Author(s):  
Michael Dwyer ◽  
Gerard J. A. Byrne
Keyword(s):  
Nursing Home ◽  
Cognitive Impairment ◽  
Depressive Symptoms ◽  
Mini Mental State Examination ◽  
Mmse Score ◽  
Nursing Home Residents ◽  
Confounding Variables ◽  
The Relationship ◽  
State Examination ◽  
Age And Sex

Screaming and other types of disruptive vocalization are commonly observed among nursing home residents. Depressive symptoms are also frequently seen in this group, although the relationship between disruptive vocalization and depressive symptoms is unclear. Accordingly, we sought to examine this relationship in older nursing home residents. We undertook a controlled comparison of 41 vocally disruptive nursing home residents and 43 non-vocally-disruptive nursing home residents. All participants were selected to have Mini-Mental State Examination (MMSE) scores of at least 10. Participants had a mean age of 81.0 years (range 63-97 years) and had a mean MMSE score of 17.8 (range 10-29). Nurse ratings of disruptive vocalization according to a semioperationalized definition were validated against the noisy behavior subscale of the Cohen-Mansfield Agitation Inventory. Subjects were independently rated for depressive symptoms by a psychiatrist using the Dementia Mood Assessment Scale, the Cornell Scale for Depression in Dementia, and the Depressive Signs Scale. Vocally disruptive nursing home residents scored significantly higher than controls on each of these three depresion-in-dementia scales. These differences remained significant when the effects of possible confounding variables of cognitive impairment, age, and sex were removed. We conclude that depressive symptoms are associated with disruptive vocalization and may have an etiological role in the generation of disruptive vocalization behaviors in elderly nursing home residents.

The Grief Experiences of Certified Nursing Assistants: Personal Growth and Complicated Grief

2007 ◽  
Vol 54 (4) ◽  
pp. 301-318 ◽  
Author(s):  
Keith A. Anderson ◽  
Joseph E. Gaugler
Keyword(s):  
Nursing Home ◽  
Personal Growth ◽  
Complicated Grief ◽  
Nursing Home Residents ◽  
Past Research ◽  
Nursing Assistants ◽  
Certified Nursing Assistants ◽  
Disenfranchised Grief ◽  
Home Setting ◽  
Nursing Home Setting

The grief that certified nursing assistants (CNAs) experience following the deaths of nursing home residents has received scant attention in past research, particularly from an empirical standpoint. The purpose of this quantitative study was to investigate the grief experiences of CNAs in the nursing home setting and to identify and evaluate factors that may mediate or exacerbate grief. Participants ( N = 136) from 12 nursing homes completed self-administered surveys. Regression analyses revealed that CNAs with lower levels of perceived disenfranchised grief reported higher levels of personal growth, while CNAs with greater fear of death and those who experienced fewer deaths on the job reported higher levels of complicated grief. Practitioners and future researchers may benefit from these findings through the construction and implementation of interventions aimed at effectively enfranchising the grief experiences of this important group of healthcare workers.

Managing the Secrets of Dying Backstage: The Voices of Nursing Home Staff

2006 ◽  
Vol 53 (3) ◽  
pp. 193-207 ◽  
Author(s):  
Debra Parker Oliver ◽  
Davina Porock ◽  
David B. Oliver
Keyword(s):  
Nursing Home ◽  
End Of Life Care ◽  
Interaction Analysis ◽  
Nursing Home Residents ◽  
Home Setting ◽  
Licensed Practical Nurses ◽  
Practical Nurses ◽  
Interview Guide ◽  
Nursing Home Setting ◽  
Staff Experiences

The project analyzed staff descriptions of undocumented care given to dying nursing home residents. Registered nurses, licensed practical nurses, certified nurse aids, and social service designees were interviewed using an unstructured interview guide. Transcripts were coded by two members of the team and a thematic analysis was guided with the theoretical framework of Erving Goffman's dramaturgical model of social interaction. Analysis of interview transcripts revealed practices related to end of life care that went undocumented. Viewed through the lens of Goffman's theoretical model, this undocumented care revealed “secrets” related to socialization processes, communication, tension, superstitions, and interactions between staff and dying residents. Findings show that while dying is not formally acknowledged in the nursing home setting, staff experiences the reality of death and informally responds to the special needs of residents.

Correlates of agitation and depression in nursing home residents with dementia

2012 ◽  
Vol 24 (11) ◽  
pp. 1779-1789 ◽  
Author(s):  
Tomislav Majić ◽  
Jan P. Pluta ◽  
Thomas Mell ◽  
Yvonne Treusch ◽  
Hans Gutzmann ◽  
...  
Keyword(s):  
Nursing Home ◽  
Mini Mental State Examination ◽  
Nursing Home Residents ◽  
Regression Analyses ◽  
Dementia Severity ◽  
Advanced Stages ◽  
Severity Of Depression ◽  
And Gender ◽  
The Relationship ◽  
State Examination

ABSTRACTBackground:The purpose of this study was to investigate the relationship between dementia severity, age, gender, and prescription of psychotropics, and syndromes of agitation and depression in a sample of nursing home residents with dementia.Methods:The Cohen-Mansfield Agitation Inventory (CMAI) was administered to residents with dementia (N= 304) of 18 nursing homes. Agitation symptoms were clustered using factorial analysis. Depression was estimated using the Dementia Mood Assessment Scale (DMAS). Dementia severity was assessed categorically using predefined cut-off scores derived from the Mini-Mental State Examination (MMSE). The relationship between agitation and its sub-syndromes, depression, and dementia severity was calculated usingχ2-statistics. Linear regression analyses were used to calculate the effect of dementia severity and psychotropic prescriptions on agitation and depression, controlling for age and gender.Results:Increasing stages of dementia severity were associated with higher risk for physically aggressive (p< 0.001) and non-aggressive (p< 0.01) behaviors, verbally agitated behavior (p< 0.05), and depression (p< 0.001). Depressive symptoms were associated with physically aggressive (p< 0.001) and verbally agitated (p< 0.05) behaviors, beyond the effects of dementia severity. Prescription of antipsychotics was correlated with depression and all agitation sub-syndromes except hiding and hoarding.Conclusions:Dementia severity is a predictor for agitation and depression. Beyond that, depression increased with dementia severity, and the severity of depression was associated with both physically and verbally aggressive behaviors, indicating that, in advanced stages of dementia, depression in some patients might underlie aggressive behavior.

Vocally disruptive behaviour in nursing home residents in Ireland: a descriptive study

2020 ◽  
pp. 1-11
Author(s):  
C. Nwogbunyama ◽  
B. D. Kelly ◽  
C. Cooney
Keyword(s):  
Nursing Home ◽  
Mini Mental State Examination ◽  
Nursing Home Residents ◽  
Target Population ◽  
Care Plan ◽  
Disruptive Behaviour ◽  
Two Factors ◽  
Randomised Controlled ◽  
State Examination ◽  
Study Inclusion

Background: Vocally disruptive behaviour (VDB) is relatively common in nursing home residents but difficult to treat. There is limited study on prevalence and treatment of VDB. We hypothesise that VDB is a result of complex interaction between patient factors and environmental contributors. Methods: Residents of nursing homes in south Dublin were the target population for this study. Inclusion criteria were that the residents were 65 years or over and exhibited VDB significant enough for consideration in the resident’s care plan. Information on typology and frequency of VDB, Interventions employed and their efficacy, diagnoses, Cohen-Mansfield Agitation Inventory scores, Mini-Mental State Examination scores, and Barthel Index scores were obtained. Results: Eight percent of nursing home residents were reported to display VDB, most commonly screaming (in 39.4% of vocally disruptive residents). VDB was associated with physical agitation and dementia; together, these two factors accounted for almost two-thirds of the variation in VDB between residents. One-to-one attention, engaging in conversation, redirecting behaviour, and use of psychotropic medication were reported by nurses as the most useful interventions. Analgesics were the medications most commonly used (65.7%) followed by quetiapine (62.9%), and these were reportedly effective in 82.6% and 77.2% of residents respectively. Conclusions: VDB is common, challenging, and difficult to manage. The study of VDB is limited by a variety of factors that both contribute to this behaviour and make its treatment challenging. Issues relating to capacity and ethics make it difficult to conduct randomised controlled trials of treatments for VDB in the population affected.

Long-term care

2017 ◽  
pp. 273-280
Author(s):  
Jos M. G. A. Schols ◽  
Adam Gordon
Keyword(s):  
Nursing Home ◽  
Long Term Care ◽  
Institutional Care ◽  
Nursing Home Residents ◽  
Term Care ◽  
Home Setting ◽  
Nursing Home Setting ◽  
Care For Older People

In this chapter, institutional long-term care for older people is addressed from a European perspective. A short historical overview is followed by some thoughts on how long-term institutional care may develop in the future, including a consideration of the role of informal care as a competing and complementary sector. It then describes the clinical profile of nursing home residents including reason(s) for admission, access issues, and length of stay. Thereafter, the types of care offered to nursing home residents will be described, with particular attention given to staffing and financing issues. Special consideration is given to the medical care of nursing home residents. Finally, we consider quality assurance in long-term care and how this is approached in different legislations before closing with a description of relevant themes and issues for research in the nursing home setting.

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