Search results for ‘Author:"reinhardt joann p."’ Sort:
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What predicts hospice use in the nursing home?
- Author:
- REINHARDT Joann P.
- Journal article citation:
- Journal of Social Work in End-of-Life and Palliative Care, 16(3), 2020, pp.286-293.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia
The choice to utilize hospice care in the nursing home when residents are experiencing progressive decline can promote positive quality of care and comfort for residents at the end of life. Concurrent hospice and nursing home care can be less aggressive, and improve symptom management and perceived quality by family members. Using a secondary analysis of retrospective data from the electronic medical record, this study identified predictors of hospice use among 300 nursing home decedents using a six-month look back period. Findings showed that having poorer physical status (weight loss), cognitive status, and having had a “goals of care” conversation were significantly associated with greater likelihood of using hospice in the nursing home in the last six months of life. Interdisciplinary team members who provide care on a daily basis and are in a position to detect worsening medical condition of residents and can facilitate advance planning. Care planning that includes examining goals of care and communication with hospice providers when multiple care providers are involved is essential. (Publisher abstract)
End-of-life conversations and hospice placement: association with less aggressive care desired in the nursing home
- Authors:
- REINHARDT Joann P., et al
- Journal article citation:
- Journal of Social Work in End-of-Life and Palliative Care, 13(1), 2017, pp.61-81.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia
Education about end-of-life care and treatment options, communication between family and health care providers, and having advance directives and medical orders in place are important for older adults with chronic, progressive decline and end-stage disease who spend their last days in the nursing home. This study used retrospective data (6 months before death) of long-stay nursing home decedents (N = 300) taken from electronic health records to capture the end-of-life experience. Findings showed for almost all decedents, Do Not Resuscitate and Do Not Intubate orders were in place, and just over one-half had Do Not Hospitalize and No Artificial Feeding orders in place. A small proportion had No Artificial Hydration or No Antibiotic orders in place. Overall, there was congruence between documented medical orders and treatment received. Findings showed that use of hospice and discussions about particular life-sustaining treatments each had significant associations with having less aggressive medical orders in place. These results can inform best practice development to promote high quality, person-directed, end-of-life care for nursing home residents. (Publisher abstract)
Vital conversations with family in the nursing home: preparation for end-stage dementia care
- Authors:
- REINHARDT Joanne P., et al
- Journal article citation:
- Journal of Social Work in End-of-Life and Palliative Care, 10(2), 2014, pp.112-126.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia
Family members of persons with advanced dementia may be asked to make complex treatment decisions without having adequate knowledge regarding the risks and benefits. This 6-month, prospective, randomised trial tested the effect of an intervention consisting of a face-to-face, structured conversation about end-of-life care options with family members of nursing home residents with advanced dementia. A comparison group received only social contact via telephone. Structured conversations between a palliative care team and intervention group family members included goals of care and how best to achieve those goals, and provision of psychosocial support. Psychosocial support was also provided via telephone at three 2-month intervals. Family members participated in three telephone interviews: baseline, 3, and 6 months. Specific advance directives for persons with dementia were extracted from medical records. Results showed that intervention families had higher satisfaction with care than comparison families at the 6-month time point, and they were more likely to have decided on medical options listed in residents' advance directives (Do Not Resuscitate, Intubate, Hospitalize) over time. Study findings reinforce the need for increased education and support for families around issues of end-of-life care decisions for advanced dementia. (Edited publisher abstract)
The positive association of end-of-life treatment discussions and care satisfaction in the nursing home
- Authors:
- REINHARDT Joann P., BOERNER Kathrin, DOWNES Deirdre
- Journal article citation:
- Journal of Social Work in End-of-Life and Palliative Care, 11(3-4), 2015, pp.307-322.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia
With the progression of dementia, the need for families and health care providers to have discussions about end-of-life (EOL) treatments arises. EOL treatment decisions often involve whether or not medical interventions intended to prolong life—such as resuscitation, artificial nutrition and hydration, and use of antibiotics—are desired. It is unclear if family satisfaction with care in the nursing home may be associated with involvement in EOL treatment discussions. The frequency of discussions that family members reported having with health care team members regarding multiple life-sustaining treatments and symptom management for their relatives with advanced dementia were examined over a 6-month period along with the association of these particular discussions with care satisfaction over time. Results showed that greater frequency of discussion of EOL treatment wishes was positively associated with higher care satisfaction scores among family members of nursing home residents with dementia. When considered together, greater frequency of discussion of artificial hydration was uniquely associated with greater care satisfaction and increased care satisfaction over time. Social workers must ensure that EOL treatment discussions with older adults in the nursing home and their family members take place and that preferences are communicated among the various interdisciplinary health team members. (Publisher abstract)
Personal and social resources and adaptation to chronic vision impairment over time
- Authors:
- REINHARDT Joann P., BOERNER Kathrin, HOROWITZ Amy
- Journal article citation:
- Aging and Mental Health, 13(3), May 2009, pp.367-375.
- Publisher:
- Taylor and Francis
This study aimed to examine the effect of personal (coping strategies and locus of control) and social resources (family and friendship support) on adjustment to chronic vision impairment in older adults at baseline (rehabilitation service application), 6 months, and 18 months later. Three hundred and thirteen community dwelling, English speaking older adult applicants to a vision rehabilitation agency in the northeast of America were interviewed in their homes following informed consent. A larger portion of variability was accounted for in positive compared to negative outcomes. Greater use of acceptance coping, less use of wishfulness coping, lower endorsement of chance locus of control, and higher family support were associated with better baseline adaptation, yet these predictors had little effect on short- or long-term change in adaptation. Higher friendship support predicted increased adaptation to vision loss at both follow-up points. Friendship support was also associated with decreased depression at Time 3, and lower use of wishfulness was related to decreased depression at Time 2. Results showed differential effects for positive versus negative outcome variables, short- versus long-term adaptation, personal and social resources, and within social resources, for family versus friendship support.
Understanding older Americans' attitudes, knowledge and fears about vision loss and aging
- Authors:
- BRENNAN Mark, HOROWITZ Amy, REINHARDT Joann P.
- Journal article citation:
- Journal of Social Work in Disability and Rehabilitation, 3(3), 2004, pp.17-37.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
The purpose of the present study was to identify factors associated with attitudes, knowledge, and fear of age-related vision impairment in a representative sample of US adults age 55 and older. Data were obtained from a national telephone survey. Attitudes toward vision impairment and aging were positive, but fears were extensive and knowledge was lacking. Higher socioeconomic status and experience with nonrelated persons who were visually impaired predicted better attitudes and greater knowledge. Being a women and having experience with persons who were visually impaired predicted lower fear. Findings emphasize the importance of accurate knowledge and training about visual impairment for practitioners working with this population. (Copies of this article are available from: Haworth Document Delivery Centre, Haworth Press Inc., 10 Alice Street, Binghamton, NY 13904-1580)
Congruence between disabled elders and their primary caregivers
- Authors:
- HOROWITZ Amy, GOODMAN Caryn R., REINHARDT Joann P.
- Journal article citation:
- Gerontologist, 44(4), August 2004, pp.532-542.
- Publisher:
- Oxford University Press
This study examines the extent and independent correlates of congruence between disabled elders and their caregivers on several aspects of the caregiving experience. Participants were 117 visually impaired elders and their caregivers. Correlational analyses, kappa statistics, and paired t tests were used to examine the extent of congruence. Hierarchical multiple regression analyses identified significant correlates of congruence on four target issues: elder's functional disability, elder's adaptation to vision impairment, caregiver's overprotectiveness, and caregiver's understanding of the vision problem. Caregivers assessed elders as more disabled and rated themselves as more overprotective than did the elders. Although independent correlates varied by target issue, two domains most consistently influenced congruence across measures: the caregiver's assessment of the elder's status and quality of the relationship. Findings underscore the importance of addressing congruence by target issue, rather than as a global characteristic of the caregiving relationship.