...a lack of support for independent living (through care at home and/or linked to sheltered housing), care and support for people with dementia, and carer support and respite. Other gaps included palliative care /end of life care at home, 24-hour care for younger people and having information about support when it is needed. There were concerns about a funding gap between the cost of the services needed
(Edited publisher abstract)
The National Development Team for Inclusion (NDTi) was commissioned by Scottish Borders Council and the Scottish Borders Health and Social Care Partnership (HSCP) to undertake some early engagement work with the Hawick community and key stakeholders regarding views about the development of a care village in the area and options for health and social care provision in the future. This report details the results of that engagement which will be used to inform the future plans for the area and the development of a more detailed business case. Scottish Borders recognise that this engagement is not a one off process and ongoing conversations will be take place using the principles of co-production to build on this work and inform future plans. We heard that people valued existing health and care services in Hawick including from the community hospital, Deanfield care home, supported housing and community groups. They missed some of the services that had closed, and a core message was not to close any further facilities until new services were opened. A number of gaps in services were highlighted, which reflected the demographics and focus of those engaging. Three of the main ones were a lack of support for independent living (through care at home and/or linked to sheltered housing), care and support for people with dementia, and carer support and respite. Other gaps included palliative care /end of life care at home, 24-hour care for younger people and having information about support when it is needed. There were concerns about a funding gap between the cost of the services needed and resources available, and a view that that services should be more joined up. Overall, it was clear that people want flexible care options to meet their needs in a way that preserves their dignity and independence at home and in residential settings through: better integration between housing, care and health services; a person-centred approach where staff understands what matters to an individual; future proofing when repurposing /designing care provision; training and development for all care staff.
(Edited publisher abstract)
Subject terms:
user views, retirement communities, residential care, adult social care;
Journal of Gerontological Nursing, 48(1), 2022, pp.35-41.
Publisher:
Healio
The purpose of the current pilot study was to determine the impact of an ambient activity technology, ABBY, on responsive behavior and family visiting in a long-term care (LTC) home. We were also interested in family and staff perceptions of the technology. A mixed methods research study was conducted over a 6-month period and data were collected using standardized measures and focus groups. Although no significant differences were noted in responsive resident behaviours, focus group data showed the ABBY enriched the care environment and provided additional opportunities for families and staff to engage residents. Although the introduction of a new technology can create challenges for staff, with time, these challenges can be overcome.
(Edited publisher abstract)
The purpose of the current pilot study was to determine the impact of an ambient activity technology, ABBY, on responsive behavior and family visiting in a long-term care (LTC) home. We were also interested in family and staff perceptions of the technology. A mixed methods research study was conducted over a 6-month period and data were collected using standardized measures and focus groups. Although no significant differences were noted in responsive resident behaviours, focus group data showed the ABBY enriched the care environment and provided additional opportunities for families and staff to engage residents. Although the introduction of a new technology can create challenges for staff, with time, these challenges can be overcome.
(Edited publisher abstract)
Subject terms:
residential care, family relations, carer views, staff views, digital technology, behaviour, participation, assistive technology, dementia, behaviour problems;
International Journal of Geriatric Psychiatry, 37(2), 2022,
Publisher:
Wiley
Objectives: The Covid-19 pandemic has taken a heavy toll on many people living with dementia and carers. Caring for a person living with dementia at home with limited avenues for support and a break challenged many carers. Care homes in England closed to visitors, with very few offering opportunities for a short-stay. The researchers investigated impact of Covid-19 on views and expectations...
(Edited publisher abstract)
Objectives: The Covid-19 pandemic has taken a heavy toll on many people living with dementia and carers. Caring for a person living with dementia at home with limited avenues for support and a break challenged many carers. Care homes in England closed to visitors, with very few offering opportunities for a short-stay. The researchers investigated impact of Covid-19 on views and expectations of carers of people living with dementia about residential respite. Methods/Design: Qualitative interviews with 35 carers were conducted March–December 2020: 30 women and 5 men, with ages ranging 30 to 83 years. Interviews explored experiences, views of residential respite, and expectations post-Covid. Data were thematically analysed and salient concepts were drawn out and discussed within the research team and study advisers. Results: Three themes were identified in transcripts, relating to impact of Covid-19 on views and expectations of respite: (1) Carers described regularly negotiating risks and stresses of Covid, weighing up how to prevent infection and changing family arrangements to facilitate caring; (2) Carers were balancing different needs, prioritising needs of their relatives while bearing the impact of cumulative caregiving responsibilities. (3) Uncertainty about future residential respite continued, in terms of availability, ongoing restrictions and trustworthy information sources. Conclusions: Residential respite is a positive, acceptable option for some carers to get a break from caring. Covid-19 may have heighted some of caregiving stressors and there may be an increased need for a break. Views of care homes developed during the pandemic suggest that individual confidence to use respite may need to be rebuilt.
(Edited publisher abstract)
Subject terms:
Covid-19, carers, carer views, short break care, dementia, access to services, residential care, qualitative research;
Dementia: the International Journal of Social Research and Practice, 21(1), 2022, pp.136-152.
Publisher:
Sage
Background and objectives: Residential care facilities (RCFs) strive to enhance autonomy for people with dementia and to enhance informal care provision, although this is difficult. This study explored how RCF staff can enhance autonomy and improve informal care by looking at the influence of interactions (contact and approachability between residents, staff members and informal caregivers...
(Edited publisher abstract)
Background and objectives: Residential care facilities (RCFs) strive to enhance autonomy for people with dementia and to enhance informal care provision, although this is difficult. This study explored how RCF staff can enhance autonomy and improve informal care by looking at the influence of interactions (contact and approachability between residents, staff members and informal caregivers) and the physical environment, including the use of technologies. Research design and methods: A realist evaluation multiple-case study was conducted using document analyses, eight semi-structured interviews with staff members and relatives and 56 hours of observations of residents across two RCFs aiming to provide person-centred care. Realist logic of analysis was performed, involving Context-Mechanism-Outcome configurations. Findings: The behaviour, attitudes and interactions of staff members with residents and informal caregivers appeared to contribute to the autonomy of people with dementia and enhance informal care provision. The physical environment of the RCFs and the use of technologies were less relevant to enhancing autonomy and informal care provision, although they can support staff members in providing person-centred care in daily practice. Discussion and implications: The findings add to those of other studies regarding the importance of interaction between residents, staff members and informal caregivers. The findings provide insight for other RCFs on how successfully to enhance autonomy for their residents and to improve informal care provision, as well as, more broadly, how to implement person-centred care.
(Edited publisher abstract)
Subject terms:
independence, residential care, informal care, staff-user relationships, person-centred care, environmental factors;
HERNANDEZ Gabrielle B. Rosa, MURRAY Carolyn M., STANLEY Mandy
Journal article citation:
Health and Social Care in the Community, 30(2), 2022, pp.488-497.
Publisher:
Wiley
...staff were invited to participate. Consent from any older adults with known cognitive impairment was sought from next of kin. Consent for children was provided by caregivers. A total of 12 clients (n = 8 diagnosis of dementia, 4 without dementia; 11 females, 1 male), three staff members, and 10 caregivers and their children (0–5 years) provided consent to be observed. Of these, five older adults (all
(Edited publisher abstract)
Intergenerational programs are emerging within the aged-care context as they provide a unique opportunity for older adults living with or without cognitive impairments to connect with children. One type of intergenerational program is an ‘intergenerational playgroup’ which creates opportunities for children to develop their skills, parents to create a local peer support network and provides older adults at risk of isolation with vital community interaction. The objective of this research was to evaluate an intergenerational playgroup taking place weekly within a residential aged-care setting. A qualitative case study research design was used to perform five observation sessions and semi-structured in-depth interviews. All members of the group (older adults and caregivers) as well as involved staff were invited to participate. Consent from any older adults with known cognitive impairment was sought from next of kin. Consent for children was provided by caregivers. A total of 12 clients (n = 8 diagnosis of dementia, 4 without dementia; 11 females, 1 male), three staff members, and 10 caregivers and their children (0–5 years) provided consent to be observed. Of these, five older adults (all female, 1 with diagnosis of dementia), three staff and five caregivers participated in interviews. Data were analysed thematically. Four key themes: Learning from each other; Appreciating experience in the moment; Connecting through play; and A sense of home and belonging were identified. These themes suggest that older adults play an active role in the dynamics of the playgroup, often being ‘in the moment’ during play, but also actively reminiscing on their past experiences of childhood. The sense of an inclusive and supportive community with a culture of being open to learning and to different perspectives was strong. The findings support the role of intergenerational playgroups for promoting community engagement with benefits of building relationships and connectivity for all stakeholders.
(Edited publisher abstract)
Subject terms:
user views, older people, intergenerational relationships, case studies, residential care, children, play, evaluation, intervention, staff views;
International Journal of Geriatric Psychiatry, 37(3), 2022,
Publisher:
Wiley
...was decreased in those who were on antidepressants (aSHR 0.64, 95% confidence interval 0.42–0.97), even after the exclusion of residents who had healthcare contacts for dementia or were on anti-dementia drugs. The aSHR for suicide was more than two-fold higher in those who were on hypnotics (2.20, 1.46–3.31). Suicide risk was particularly elevated in those with an episode of self-harm prior to LTCF admittance
(Edited publisher abstract)
Objectives: To investigate psychoactive medication use and risk of suicide in long-term care facility (LTCF) residents aged 75 and above. A second aim was to investigate the role of psychiatric and medical conditions in the occurrence of suicide in LTCF residents. Methods: A Swedish national register-based cohort study of LTFC residents aged ≥75 years between 1 January 2008 and 31 December 2015, and followed until 31 December 2016 (N = 288,305). Fine and Gray regression models were used to analyse associations with suicide. Results: The study identified 110 suicides (15.8 per 100,000 person-years). Half of these occurred during the first year of residence. Overall, 54% of those who died by suicide were on hypnotics and 45% were on antidepressants. Adjusted sub-hazard ratio (aSHR) for suicide was decreased in those who were on antidepressants (aSHR 0.64, 95% confidence interval 0.42–0.97), even after the exclusion of residents who had healthcare contacts for dementia or were on anti-dementia drugs. The aSHR for suicide was more than two-fold higher in those who were on hypnotics (2.20, 1.46–3.31). Suicide risk was particularly elevated in those with an episode of self-harm prior to LTCF admittance (15.78, 10.01–24.87). Specialized care for depression was associated with increased risk, while medical morbidity was not. Conclusions: A lower risk of suicide in LTCF residents was found in users of antidepressants, while elevated risk was observed in those on hypnotics. Our findings suggest that more can be done to prevent suicide in this setting.
(Edited publisher abstract)
Subject terms:
care homes, residential care, suicide, self-harm, medication, long term care;
...median age 80.3). POIs were predominantly male (67.0%) and were younger than the victims (median age 57.0). While low rates of mental illnesses were recorded (29.1% in victims; 17.4% in POIs), "dementia" was the most common condition among POIs (55.7%) and victims (73.0%). "Physical abuse" was the most common abuse type (80.2%) with "bruising" the most common injury (36.8%). The most common
(Edited publisher abstract)
Background and Objectives: The police are often the first to attend domestic violence events in New South Wales (NSW), Australia, recording related details as structured information (e.g., date of the event, type of incident, premises type) and text narratives which contain important information (e.g., mental health status, abuse types) for victims and perpetrators. This study examined the characteristics of victims and persons of interest (POIs) suspected and/or charged with perpetrating a domestic violence-related crime in residential care facilities. Research Design and Methods: The study employed a text mining method that extracted key information from 700 police-recorded domestic violence events in NSW residential care facilities. Results: Victims were mostly female (65.4%) and older adults (median age 80.3). POIs were predominantly male (67.0%) and were younger than the victims (median age 57.0). While low rates of mental illnesses were recorded (29.1% in victims; 17.4% in POIs), "dementia" was the most common condition among POIs (55.7%) and victims (73.0%). "Physical abuse" was the most common abuse type (80.2%) with "bruising" the most common injury (36.8%). The most common relationship between perpetrator and victim was "carer" (76.6%). Discussion and Implications: These findings highlight the opportunity provided by police text-based data to offer insights into elder abuse within residential care facilities.
(Edited publisher abstract)
Subject terms:
care homes, domestic violence, residential care, nursing homes, crime victims, offenders, data analysis, elder abuse;
International Journal of Geriatric Psychiatry, 37(1), 2022, pp.1-13.
Publisher:
Wiley
Objectives: Research has found that music-based interventions can decrease behavioral and psychological symptoms of dementia or behaviors that challenge (BPSD/BtC). However, how to effectively implement these interventions is unclear. This study synthesizes available evidence regarding implementation strategies and outcomes of music-based interventions for people with dementia at residential long...
(Edited publisher abstract)
Objectives: Research has found that music-based interventions can decrease behavioral and psychological symptoms of dementia or behaviors that challenge (BPSD/BtC). However, how to effectively implement these interventions is unclear. This study synthesizes available evidence regarding implementation strategies and outcomes of music-based interventions for people with dementia at residential long-term care facilities. Methods: Study registered with PROSPERO (registration number: CRD42020194354). The researchers searched the following databases: PsychInfo, PubMed, MEDLINE, CINAHL, and The Cochrane Library. Inclusion criteria included articles targeting music-based interventions conducted for people with dementia, studies conducted in residential long-term care facilities, and articles that reported implementation strategies and outcomes of the intervention. Results: Of the included eight studies, half were studies of music therapy and the other half were on individualized music. 49 implementation strategies were reported. The most frequently reported category of strategies was planning (34.7%), followed by education (24.5%), quality management (24.5%), restructuring (12.2%), and finance (4.1%). No strategies under the category of attending to the policy context were reported. The most frequently reported implementation outcomes were appropriateness (27.3%), followed by adoption (22.7%), fidelity (22.7%), acceptability (9.1%), sustainability (9.1%), and cost (9.1%). No studies measured feasibility or penetration. Conclusions: Although various effective implementation strategies were identified, this study was unable to examine the effectiveness of individual implementation strategies due to the designs of the selected studies. Less attention has been paid to strategies that aim at structural changes of intervention delivery systems. Future studies should investigate facilitators and barriers of implementing music-based interventions especially focusing on structural aspects.
(Edited publisher abstract)
Subject terms:
systematic reviews, music therapy, music, dementia, long term care, policy implementation, challenging behaviour, residential care, outcomes;
Background: People working in long-term care homes (LTCH) face difficult decisions balancing the risk of infection spread with the hardship imposed on residents by infection control and prevention (ICP) measures. The Dementia Isolation Toolkit (DIT) was developed to address the gap in ethical guidance on how to safely and effectively isolate people living with dementia while supporting...
(Edited publisher abstract)
Background: People working in long-term care homes (LTCH) face difficult decisions balancing the risk of infection spread with the hardship imposed on residents by infection control and prevention (ICP) measures. The Dementia Isolation Toolkit (DIT) was developed to address the gap in ethical guidance on how to safely and effectively isolate people living with dementia while supporting their personhood. In this observational study, we report the results of a survey of LTCH staff on barriers and facilitators regarding isolating residents, and the impact of the DIT on staff moral distress. Methods: We completed an online cross-sectional survey. Participants (n = 207) were staff working on-site in LTCH in Ontario, Canada since March 1, 2020, with direct or indirect experience with the isolation of residents. LTCH staff were recruited through provincial LTCH organizations, social media, and the DIT website. Survey results were summarized, and three groups compared, those: (1) unfamiliar with, (2) familiar with, and (3) users of the DIT. Results:61% of respondents identified distress of LTCH staff about the harmful effects of isolation on residents as a major barrier to effective isolation. Facilitators for isolation included delivery of 1:1 activity in the resident’s room (81%) and designating essential caregivers to provide support (67%). Almost all respondents (84%) reported an increase in moral distress. DIT users were less likely to report an impact of moral distress on job satisfaction (odds ratio (OR) 0.41, 95% CI 0.19-0.87) with 48% of users reporting the DIT was helpful in reducing their level of moral distress. Conclusions: Isolation as an ICP measure in LTCH environments creates moral distress among staff which is a barrier to its effectiveness. ICP guidance to LTCH would be strengthened by the inclusion of a dementia-specific ethical framework that addresses how to minimize the harms of isolation on both residents and staff.
(Edited publisher abstract)
Subject terms:
infection control, ethics, person-centred care, dementia, prevention, residential care, care homes, staff views, social isolation, stress;
International Journal of Nursing Studies, early cite January 2022,
Publisher:
Elsevier
Background: Prevalence of neuropsychiatric symptoms amongst people living with dementia in residential aged care is high. Their presence is associated with poorer quality of life for residents and higher burden of care for staff. Existing reviews have not focused on the evaluation of efficacy of non-pharmacological interventions in specific population settings (community vs. residential aged care...
(Edited publisher abstract)
Background: Prevalence of neuropsychiatric symptoms amongst people living with dementia in residential aged care is high. Their presence is associated with poorer quality of life for residents and higher burden of care for staff. Existing reviews have not focused on the evaluation of efficacy of non-pharmacological interventions in specific population settings (community vs. residential aged care). Objectives: To determine the efficacy of non-pharmacological interventions to manage neuropsychiatric symptoms of dementia in residential aged care settings. Design: An umbrella review was conducted. Data sources: PubMed/Medline, Embase, Cochrane Library and Web of Science were searched for eligible reviews in December 2019, February 2020 and June 2021. Methods: Two authors independently screened titles and abstracts, and assessed full-text reviews for eligibility. The quality of reviews was appraised with ‘AMSTAR-2: A Measurement tool to assess systematic reviews’. Narrative summaries grouped findings by intervention domains. Results: From 1362 systematic reviews identified, 26 met the inclusion criteria. Of these, 10 focused on person tailored interventions, six on sensory stimulation interventions, three on environmental interventions, three on exercise interventions, and four on multiple intervention types. Quality ratings identified reviews to be of mostly moderate quality (73%). The majority or reviews reported positive results but not all were statistically significant. Tailored interventions that included music and social elements appeared to be most beneficial for depressive symptoms and mood. Furthermore, outcome measures and intervention protocols were highly heterogeneous across interventions. Conclusions: The findings of this umbrella review suggest that combining different types of interventions and tailoring them to the personal experiences of the resident is recommended. A more standardised approach for outcome measures used is vital to assess efficacy and allow comparison of future non-pharmacological interventions.
(Edited publisher abstract)
Subject terms:
systematic reviews, literature reviews, intervention, dementia, residential care, nursing homes, care homes, environmental factors, physical exercise, outcomes;