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Assessing the Registered Nursing Care Contribution for older people in care homes: issues of reliability and validity
- Authors:
- REED Jan, WATSON Bill, COOK Margaret
- Journal article citation:
- Health and Social Care in the Community, 15(2), March 2007, pp.136-145.
- Publisher:
- Wiley
The present paper reports on a study designed to investigate the validity and reliability of the Registered Nursing Care Contribution (RNCC) tool for assessing the level of nursing care required by care home residents. Care plan data from 186 residents in participating care homes were assessed by multiple assessors using the RNCC tool (i.e. care home registered nurses, a nurse researcher, an external care home expert and a nurses consultant). The Minimum Data Set (MDS) rating was used as a validated comparison. The findings from the study indicated that there were disparities between the RNCC and MDS bandings, and between different raters, with the external care home expert achieving the closest agreement with the MDS. This suggests that the use of the RNCC tool varies considerably according to the assessor, which also suggests that training of users is needed to ensure consistency and reliability. However, the difference between the outcomes of using the RNCC tool and the MDS suggests that assessment of nursing need may need to be re-examined to ensure validity.
Making a move: care-home residents' experiences of relocation
- Authors:
- REED Jan, et al
- Journal article citation:
- Ageing and Society, 23(2), March 2003, pp.225-241.
- Publisher:
- Cambridge University Press
Reports on a research study to identify patterns of relocation across care-homes, describe the strategies used by care-home staff to manage moves, and to explore older peoples experiences of relocations. A questionnaire was distributed to care homes in two English local authorities to determine the incidence of relocation. 10 homes were also approached to take party in further studies which included case-not audits and interviews with staff and 12 older people who had relocated. This article focuses on the experiences and narratives of older people involved in relocation. The study found that the pattern of moves was complex and that some residents were active in deciding to relocate and in the selection of the relocation home. However, for residents to have an active role, they must be given support to access the information required for decision-making and to implement their decisions.
Settling in and moving on: transience and older people in care homes
- Authors:
- REED Jan, PAYTON Valerie Roskell, BOND Senga
- Journal article citation:
- Social Policy and Administration, 32(2), June 1998, pp.151-165.
- Publisher:
- Wiley
Examines the experiences of older people who moved into nursing and residential care homes, interviewing them at four points, from before the move to up to six months afterwards. A key finding was that older people were actively involved in the process of settling into homes and forming new friendships. Participant data also indicated that these older people had often experienced many moves in recent years, as their need for care had changed, and following them through after their inclusion in the study indicated that, for some, there were more moves to come. These data place the debates about assessment, and the identified problem of 'misplacement' in a different light.
Understanding the dynamics of life in care homes for older people: implications for de-institutionalising practice
- Authors:
- REED Jan, PAYTON Valerie Roskell
- Journal article citation:
- Health and Social Care in the Community, 5(4), July 1997, pp.261-268.
- Publisher:
- Wiley
Describes findings of a study undertaken to examine the processes of adaptation that older people engage in when moving into nursing and residential homes. Presents data from resident interviews which indicate the importance of the relationships that they develop with each other, and also data from staff focus groups which indicates that staff have a limited awareness of this. Argues that attempts to develop practice in care homes to overcome the effects of institutionalisation, frequently promoted through the concept could benefit from a parallel recognition of the importance of resident groups in enhancing the experience of life in care homes.
Constructing familiarity and managing the self: ways of adapting to life in nursing and residential homes for older people
- Authors:
- REED Jan, PAYTON Valerie Roskell
- Journal article citation:
- Ageing and Society, 16(5), September 1996, pp.543-560.
- Publisher:
- Cambridge University Press
Reports on the analysis of data collected in a study looking at older people moving into nursing and residential homes. The discussion focuses on two themes which have been identified from the data: constructing familiarity whereby participants use sometimes tenuous knowledge of people and places to make the home seem less strange, and managing the self, whereby familiarity is used as a means of permitting social conversation to take place without leaving residents open to the dangers of being intrusive. These two themes have relevance for the way in which new residents can be introduced to homes, and the way in which the social skills of older people are viewed.
Re-conceptualising the status of residents in a care home: older people wanting to ‘live with care’
- Authors:
- COOK Glenda, THOMPSON Juliana, REED Jan
- Journal article citation:
- Ageing and Society, 35(8), 2015, pp.1587-1613.
- Publisher:
- Cambridge University Press
The construction of a meaningful life depends upon satisfying ‘fundamental human needs’. These are broadly categorised as: physical, social and self-actualisation needs that every human experiences. Some fundamental human needs satisfiers, such as ‘home’, are synergic, addressing more than one need. For an older person, the move to a care home compromises their ontological security (through disruption of identification with place and control over environment) that one's own ‘home’ provides. This paper explores the complex issues surrounding the residential status of care home residents in terms of fundamental human needs. The methodology utilised was hermeneutic phenomenology. Eight older residents participated in the study, and each resident was interviewed up to eight times over a period of six months. Narrative analysis was used to interpret how participants viewed their experiences and environment. Five themes emerged from the narratives that collectively demonstrate that residents wanted their residential status to involve ‘living with care’ rather than ‘existing in care’. The five themes were: ‘caring for oneself/being cared for’; ‘being in control/losing control’; ‘relating to others/putting up with others’; ‘active choosers and users of space/occupying space’ and ‘engaging in meaningful activity/lacking meaningful activity’. This study indicates that if care homes are to achieve synergic qualities so residents are able to regard care homes as ‘home’, then care home staff may need to be more focused on recognising, acknowledging and supporting residents' aspirations regarding their future lives, and their status as residents. (Publisher abstract)
Transitions to a care home - the importance of choice and control
- Authors:
- REED Jan, STANLEY David
- Journal article citation:
- Quality in Ageing, 7(4), December 2006, pp.12-17.
- Publisher:
- Pier Professional
- Place of publication:
- Brighton
This article reports on a seminar organised as part of an ESRC-funded series on older people and care homes that focused on the period of transition into a care home and the experiences of older people immediately before and after they made the move. The papers presented suggest that there were ways in which older people could exercise choice and control over the process, but that problems existed, ranging from the ways in which assessment and referral systems were crisis or service led, to how people were supported after their move. This article outlines these arguments, and concludes that such processes need to be addressed if the quality of care at this difficult period is to be improved.