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Caregiver confidence: does it predict changes in disability among elderly home care recipients?
- Authors:
- LI Lydia W., MCLAUGHLIN Sara J.
- Journal article citation:
- Gerontologist, 52(1), February 2012, pp.79-88.
- Publisher:
- Oxford University Press
Caregivers who are confident in their care recipients’ functional capacity may be less likely to offer assistance and more likely to encourage the recipient to perform tasks independently. The aim of this study was to determine whether caregiver confidence in their care recipients’ functional capabilities predicts changes in the performance of activities of daily living (ADL) among elderly home care recipients over time. The sample included 5,138 elderly recipients of home and community-based long-term care in Michigan. ADL performance was assessed multiple times over a 2-year period. Caregiver confidence was measured at baseline with a single item. Multilevel modelling was used to estimate the effect of caregiver confidence on changes in ADL performance over time, controlling for baseline self-efficacy and ADL performance. The findings showed that elders whose caregivers were confident in their capacity for greater functional independence experienced greater improvement in ADL performance than those whose caregivers were not confident. Elders in dyads in which both members expressed confidence experienced more improvement in ADL performance than those in dyads in which either 1 or both members lacked confidence.
Physical performance characteristics of assisted living residents and risk for adverse health outcomes
- Authors:
- GIULIANI Carol A., et al
- Journal article citation:
- Gerontologist, 48(2), April 2008, pp.203-212.
- Publisher:
- Oxford University Press
This article aims to (a) describe the functional characteristics of residential care/assisted living (RC/AL) residents, (b) examine the relationships between resident- and facility-level characteristics and physical performance, and (c) determine the predictive value of physical performance for adverse outcomes. Data came from 1,791 residents in 189 RC/AL facilities participating in the Collaborative Studies of Long-Term Care in the US. At baseline, residents were tested on four performance measures (grip strength, chair rise, balance, and walking speed), and other resident- and facility-level information was collected. Adverse outcomes were measured over 1 year. Multivariable analyses showed that more cognitive and functional impairment, depressive symptoms and comorbid conditions, and for-profit ownership were associated with poorer physical performance. Controlling for individual characteristics, it was found that better performance on the four physical performance measures was associated with a reduced risk of nursing home placement, fracture, and decline in function over 1 year. Simple performance measures identify modifiable functional deficits and suggest targeted interventions to prolong independent mobility and aging in place in RC/AL facilities.
Bathing people with dementia: the bathroom and beyond
- Author:
- JENKINS Deirdre A.L.
- Publisher:
- University of Stirling. Dementia Services Development Centre
- Publication year:
- 1998
- Pagination:
- 40p.
- Place of publication:
- Stirling
This publication, written for front line staff in long term care settings, provides a insight about the issues which arise in helping people with dementia bathe. Easy to read, with humour, it can help caregivers to make bathing a positive experience for patients with dementia.
The association between quality of life and nursing home facility for the elderly population: a systematic review and meta-analysis
- Authors:
- LI Yang-Tzu, et al
- Journal article citation:
- International Journal of Gerontology, 15(1), 2021, pp.16-24.
- Publisher:
- Airiti Library
- Place of publication:
- Taiwan
Background: To investigate the association between quality of life and nursing home facility for the elderly population. Methods: The researchers searched the PubMed, Medline, and Cochrane Library for relevant perspective studies without language limitations from inception to 17^(th) June 2020 for relevant publications with a priori defined inclusion and exclusion criteria. Two authors independently selected studies, assessed risk of bias, and extracted data. The disagreement was resolved by discussion with a third author. Results: There are 18 articles involved in the final meta-analysis. The disparities were found of accessing the quality of life (World Health Organization Quality-of-Life, Quality of Life in Last-Stage Dementia, Nottingham Health Profile-Turkish Version, EUROPE Health Interview Survey-QoL , Visual analogue Scales, Flanagan Quality of Life Scale) and the level of independence (Barthel Index, Kahoku Aging Longitudinal Study Scale, Visual Analogue Scales, Activities of Daily Living Scales, Instrumental Activities of Daily Living Scales). Conclusion: The available limited, very low-quality evidence does not support a significant association between quality of life and nursing home facility for the elderly population. Further rigorous and long-term follow-up studies should be conducted with more objective measures. (Edited publisher abstract)
Activity involvement and quality of life of people at different stages of dementia in long term care facilities
- Authors:
- SMIT Dieneke, et al
- Journal article citation:
- Aging and Mental Health, 20(1), 2016, pp.100-109.
- Publisher:
- Taylor and Francis
Objectives: Involvement in activities is assumed to positively influence the quality of life of people with dementia, yet activity provision in long-term care remains limited. This study aims to provide more insight into the value of activity involvement for domains of the quality of life of long-term dementia care residents, taking resident characteristics and cognitive status into account. Method: Data were derived from 144 long-term care facilities participating in the second measurement (2010/2011) of the living arrangements for dementia study. Amongst 1144 residents, the relationship between time involved in activities (activity pursuit patterns; RAI-MDS) and quality of life (Qualidem) was studied using multilevel linear regression analyses. Analyses were adjusted for residents’ age, gender, neuropsychiatric symptoms, ADL dependency and cognition. To check for effect modification of cognition, interactions terms of the variables activity involvement and cognitive status were added to the analyses. Results: Despite resident's cognitive status, their activity involvement was significantly related to better scores on care relationship, positive affect, restless tense behaviour, social relations, and having something to do. A negative relationship existed between the activity involvement and positive self-image. The explained variance in the quality of life between residents caused by the activity involvement was small. Conclusion: Activity involvement seems to be a small yet important contributor to higher well-being in long-term care resident at all stages of dementia. Adjusting activities to individual preferences and capabilities might enlarge this relationship. Further research is needed to confirm this hypothesis, using measurement instruments less sensitive to recall bias and differentiating between the active and passive activity involvement. (Publisher abstract)
Rehabilitation for older people in long-term care (review)
- Authors:
- FORSTER A., et al
- Publisher:
- John Wiley and Sons
- Publication year:
- 2009
- Pagination:
- 110p., bibliog.
- Place of publication:
- Chichester
Physical rehabilitation (interventions based on the exercising the body) may have a role in improving the physical condition of older people in long-term care and this review examines the evidence available. Forty-nine trials are included in this review, 30 of which were conducted in the USA. In total, 3611 participants with an average age of 82 years were involved, more than two-thirds of whom were female. Most interventions in some way addressed disability in routine daily life, for example walking, eating and dressing. The trial outcomes addressed by this review are disability in daily life, strength, flexibility, balance, general physical condition, mood, cognitive status, participant drop out, session attendance, death, illness, and unwanted effects associated with the intervention, such as injuries. Due to the wide variety of outcome measures used, the studies could not be summarised statistically, therefore a narrative review is provided. While variations between the trials means specific recommendations cannot be made, they were overwhelmingly successful, demonstrating that many different types of physical rehabilitation have benefits to physical health with few reports of unwanted events relating to the intervention.
Enriching opportunities for people living with dementia: the development of a blueprint for a sustainable activity-based model
- Authors:
- BROOKER Dawn J., WOOLEY Rosemary J.
- Journal article citation:
- Aging and Mental Health, 11(4), July 2007, pp.371-383.
- Publisher:
- Taylor and Francis
The aim of this paper is to describe the process of building a multi-level intervention called the Enriched Opportunities Programme, the objective of which is to provide a sustainable activity-based model for people with dementia living in long-term care. It is hypothesised that five key elements need to work together to bring about a sustainable activity-based model of care. These elements are specialist expertise-the staff role of Locksmith was developed as part of this programme; individualised assessment and case work; an activity and occupation programme; staff training; and management and leadership. These elements working together are known as the Enriched Opportunities Programme. This paper reports on the processes undertaken to develop Enriched Opportunities from its inception to the present, and focuses on lessons learnt from the literature, an expert working group and action research in four UK study sites. A blueprint for evaluation in other long-term care facilities is described.
Projected use of long-term-care services by enrolled veterans
- Authors:
- KINOSIAN Bruce, STALLARD Eric, WIELAND Darryl
- Journal article citation:
- Gerontologist, 47(3), June 2007, pp.356-364.
- Publisher:
- Oxford University Press
This article aims to describe the projected use for long-term-care services through 2012. The study used a static-component projection model using age, function, and other covariates. The authors obtained enrolee projections from the Veterans Health Administration (VHA) and combined these with nursing home and community long-term-care service use rates from the 1999 National Long-Term Care Survey and the 2000 National Health Interview Survey. Over the next decade, the number of oldest veterans (aged 85+) will double, and VHA-enrolled veterans aged 85 and older will increase sevenfold. This will result in a 20–25% increase in use for both nursing home and home- and community-based services. VHA currently concentrates 90% of its long-term-care resources on nursing home care. However, among those who receive long-term care from all formal sources, 56% receive care in the community. Age and marital status are significant predictors of use of either type of formal long-term-care service for any given level of disability. VHA's experience with the mandatory nursing home benefit suggests that even when the cost to the veteran is near zero, only 60–65% of eligibles will choose VHA-provided care. Assisted living represents nearly 15% of care provided during the past decade to individuals in nursing homes, and approximately 19% of veterans using nursing homes have disability levels comparable to those of men supported in assisted living. Implications: As most of the increased projected use for long-term care will be for home- and community-based services, VHA will need to expand those resources. Use of VHA resources to leverage community services may offer new opportunities to enhance community-based long-term care.
In search for the "humane": staffs' perspectives on everyday activities in a nursing home
- Authors:
- MONDACA Margarita, et al
- Journal article citation:
- Aging and Mental Health, 24(4), 2020, pp.679-688.
- Publisher:
- Taylor and Francis
Objectives: To better understand how a dialogue about the influence of nursing home residents on their everyday activities evolve among diverse practitioners and to identify the consequences of such an understanding in practice. Methods: Inspired by a collaborative approach, five workshops, one focus group and follow up interviews were conducted. The participants were 19 diverse practitioners. Analysis followed a dialogical approach. Findings: Tensions, opportunities and challenges were articulated and discussed during the workshops and are developed in: a) Bypassing the “humane”? The dilemma between using shields preventing engagement or acting in a clandestine manner b)“What is our stance?” Seeking common ground on which to stand regarding everyday activities and c) Recognising expertise and seeking connections. Discussion: For the staff, acting in a clandestine manner seems to create ways of enabling “humane” practices towards nursing home residents. The “clandestine manners” seem to be grounded in an effort on the part of the staff to make sense of the everyday activities for the nursing home residents. These “clandestine manners” could be seen as responses to institutional routines and a lack of common ground on the understanding of everyday activities in the context of nursing homes. (Edited publisher abstract)
Enabling meaningful activities and quality of life in long-term care facilities: the stepwise development of a participatory client-centred approach in Flanders
- Authors:
- DE VRIENDT Patricia, et al
- Journal article citation:
- British Journal of Occupational Therapy, 82(1), 2019, pp.15-26.
- Publisher:
- Sage
Introduction: Meaningful activities of daily living promote the quality of life of residents of long-term care facilities. This project aimed to develop an approach to enable meaningful activities of daily living and to guide long-term care facilities in a creative and innovative attitude towards residents' meaningful activities of daily living. Method: The approach was developed in six steps: (1) in-depth-interviews with 14 residents; (2) a survey with 171 residents; (3) a systematic map and synthesis review on interventions enriching meaningful activities of daily living; (4) qualitative analysis of 24 ‘good examples’ and, to support future implementation, (5) focus groups with staff (n = 69). Results determined the components of the new approach which was (6) pilot-tested in one long-term care facility. Quantitative and qualitative data were gathered concerning benefits for the residents and feasibility for the staff. Results: A client- and activity-oriented approach was developed, characterised by an active participatory attitude of residents and staff and a systematic iterative process. Significant positive effects were found for the number of activities, the satisfaction with the leisure offered, the social network, medication use, but not for quality of life. The approach appeared to be feasible. Conclusion: This approach stimulates residents' meaningful activities of daily living and social life. Further investigation is needed to evaluate its outcome and implementation potentials.