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Optimising quality sleep among older people in the community and care homes: Some key findings from a four-year collaborative research project
- Authors:
- VENN Susan, et al
- Journal article citation:
- Generations Review, 20(4), October 2010, Online only
- Publisher:
- British Society of Gerontology
The SomnIA (Sleep in Ageing) project aimed to undertake a range of studies relating to understanding poor sleep in later life. SomnIA is a four year NDA Collaborative Research Project which comprises eight workpackages aimed at (a) understanding poor sleep in later life in the community and in care homes, (b) devising interventions to help with poor sleep in the community and in care homes, and (c) dissemination through academic and practitioner conferences and workshops, briefing papers and journal articles, and through the creation of a module on ‘Sleep problems in Later Life’ for the Healthtalkonline website. Key findings are presented.
The experience of animal therapy in residential aged care in New Zealand: a narrative analysis
- Authors:
- WONG Gemma, BREHENY Mary
- Journal article citation:
- Ageing and Society, 41(11), 2021, pp.2641-2659.
- Publisher:
- Cambridge University Press
Animal therapy has been shown to have both physiological and psychological benefits for older people, including improvements in outlook and social interaction. Volunteer-led animal visitation programmes are common within residential aged care facilities in New Zealand. Visits by animals and handlers are intended to improve the quality of life of people in residential care. Very little research has been conducted on the informal animal visitation programmes typical in care facilities in New Zealand. This project examined the experience of animal therapy in two residential aged care homes that receive animal visits from an animal welfare organisation. In-depth interviews were conducted with seven older people about their experiences of the programme and analysed using narrative analysis. Three overarching narratives were identified: animal therapy as a fleeting pleasure, residential care as a sad environment, and identity outside residential care as highly valued. Older people in residential care do value animal therapy, but it is narrated as a fleeting pleasure, rather than having a long-lasting or far-reaching impact on the daily experience of residential care. In some ways, the structure of the animal therapy programme may underscore the challenges to everyday autonomy and identity experienced in residential aged care. These findings can be used to develop animal visiting programmes which recognise the importance of a valued social identity in later life. (Edited publisher abstract)
‘It gives you more to life, it's something new every day’: an Interpretative Phenomenological Analysis of wellbeing in older care home residents who keep a personal pet
- Authors:
- FREEDMAN Shoshanna, PARAMOVA Petia, SENIOR Victoria
- Journal article citation:
- Ageing and Society, 41(9), 2021, pp.1961-1983.
- Publisher:
- Cambridge University Press
There is a substantial amount of literature that suggests that animals, and specifically animals kept as pets, can have a positive effect on wellbeing. Research exploring the impact of animals on wellbeing in care homes mainly concerns visiting animals as well as shared communal pets. In light of the lack of research regarding personal pets in care homes, the aim of this study was to explore what the experience of keeping a personal pet in a care home means for residents’ sense of wellbeing. Semi-structured interviews were conducted with seven care home residents who were currently living with their pet in a care home. Interviews were analysed using Interpretative Phenomenological Analysis (IPA). Analysis revealed four master themes deemed to be relevant to participants’ wellbeing. these were: ‘sense of self and identity’, ‘responsibility and ownership’, ‘motivation and desire to live’ and ‘feeling content in the care home’. The analysis indicated that living with a personal pet in a care home has the potential to enhance residents’ wellbeing. At the same time, it also found that the benefits of keeping a personal pet may be dependent on specific circumstances, such as the attitudes of staff and fellow residents at the care home. This study indicates that it may be advisable for more care homes to accept personal pets. (Edited publisher abstract)
Care-home outbreaks of COVID-19 in Scotland March to May 2020: national linked data cohort analysis
- Authors:
- BURTON Jennifer Kirsty, et al
- Journal article citation:
- Age and Ageing, 50(5), 2021, pp.1482-1492.
- Publisher:
- Oxford University Press
Background: understanding care-home outbreaks of COVID-19 is a key public health priority in the ongoing pandemic to help protect vulnerable residents. Objective: to describe all outbreaks of COVID-19 infection in Scottish care-homes for older people between 01/03/2020 to 31/03/2020, with follow-up to 30/06/2020. Design and setting: national linked data cohort analysis of Scottish care-homes for older people. Methods: data linkage was used to identify outbreaks of COVID-19 in care-homes. Care-home characteristics associated with the presence of an outbreak were examined using logistic regression. Size of outbreaks was modelled using negative binomial regression. Results: 334 (41%) Scottish care-homes for older people experienced an outbreak, with heterogeneity in outbreak size (1–63 cases; median = 6) and duration (1–94 days; median = 31.5 days). Four distinct patterns of outbreak were identified: ‘Typical’ (38% of outbreaks, mean 11.2 cases and 48 days duration), Severe (11%, mean 29.7 cases and 60 days), Contained (37%, mean 3.5 cases and 13 days), and Late-onset (14%, mean 5.4 cases and 17 days). Risk of a COVID-19 outbreak increased with increasing care-home size (for ≥90 beds vs <20, adjusted OR = 55.4, 95%CI 15.0–251.7) and rising community prevalence (OR = 1.2 [1.0–1.4] per 100 cases/100,000 population increase). No routinely available care-home characteristic was associated with outbreak size. Conclusions: reducing community prevalence of COVID-19 infection is essential to protect those living in care-homes. More systematic national data collection to understand care-home residents and the homes in which they live is a priority in ensuring we can respond more effectively in future. (Edited publisher abstract)
Stories from the fourth age: autonomy and the lives of older care home residents
- Authors:
- POCOCK Lucy V., et al
- Journal article citation:
- Ageing and Society, 41(7), 2021, pp.1637-1650.
- Publisher:
- Cambridge University Press
Transition to a care home often follows a hospital admission and can be distressing. Care home settings play an important role in the care of many people at the end of life. This longitudinal study employed a narrative approach, aiming to explore the perspectives of older care home residents on transitions to, and life and death within, care homes. Five participants, aged 85 years and over, were recruited from two privately owned care homes in the South-West of England. All participants had a diagnosis of an advanced progressive condition (excluding advanced dementia), or were thought to be frail. Longitudinal interviews (19 in total) were conducted over a ten-month period. A structural narrative analysis was performed and participants’ narratives are presented under three headings, with one participant's story chosen to illustrate each narrative type: ‘becoming a care home resident’, ‘living in a care home’ and ‘death and dying’. Findings revealed that care home residents experience a loss of autonomy and a lack of agency; they are often excluded from decision-making. Older care home residents have few choices with regard to care at the end of life. Further work is required to improve transition into care homes, including support and advocacy during decision-making, which often takes place in hospitals at a time of crisis. (Edited publisher abstract)
COVID 19 and dementia: experience from six European countries
- Authors:
- BURNS Alistair, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, early cite 18 January 2021,
- Publisher:
- Wiley
The effects of Covid‐19 have been well documented across the world with an appreciation that older people and in particular those with dementia have been disproportionately and negatively affected by the pandemic. This is both in terms of their health outcomes (mortality and morbidity), care decisions made by health systems and the longer‐term effects such as neurological damage. The International Dementia Alliance (IDEAL) is a group of dementia specialists from six European countries and this paper is a summary of our experience of the effects of COVID‐19 on our populations. Experience from England, France, Germany, the Netherlands, Spain and Switzerland highlight the differential response from health and social care systems and the measures taken to maximise support for older people and those with dementia. The common themes include recognition of the atypical presentation of COVID‐19 in older people (and those with dementia) the need to pay particular attention to the care of people with dementia in care homes; the recognition of the toll that isolation can bring on older people and the complexity of the response by health and social services to minimise the negative impact of the pandemic. Potential new ways of working identified during the pandemic could serve as a positive legacy from the crisis. (Edited publisher abstract)
Care home residents on multiple medications have an increased risk of falling
- Author:
- NATIONAL INSTITUTE FOR HEALTH RESEARCH
- Publisher:
- National Institute for Health Research
- Publication year:
- 2020
- Place of publication:
- London
Falls among residents in UK care homes are commonplace. A new study examined whether multiple medications and drugs that act on the brain may contribute to the risk. The research, which included 84 UK care homes, found that residents taking multiple medicines had an increased risk of falling. Risk was also increased with a regular prescription for antidepressants or benzodiazepines (sedative drugs). Two-thirds of the residents in the study were living with dementia. Researchers suggest that care homes should emphasise non-drug approaches such as massage, music or art therapies. These interventions could help residents with depression and common symptoms of dementia such as agitation or sleep disturbance. Over a three-month period, the study found that: almost one in three residents (519 or 31%) had one or more falls; the risk was higher in those taking antidepressants and sedatives; older residents were more likely to fall than their younger counterparts; men had more falls than women; residents with dementia had 75% more falls than those without dementia. (Edited publisher abstract)
Learning from the impacts of COVID-19 on care homes: a pilot survey
- Authors:
- RAJAN Selina, MCKEE Martin
- Publisher:
- International Long Term Care Policy Network
- Publication year:
- 2020
- Pagination:
- 19
- Place of publication:
- London
Findings of an anonymous online pilot survey of care home managers and directors across England, surveyed between May 15th and June 1st to understand the challenges care homes faced during the COVID-19 pandemic, what strategies they used to mitigate them and what they would need in future to strengthen their response. The survey covered four key themes, including partnership working, infection control, workforce and wellbeing of residents. Care home providers described marked differences in the support offered to them by local government and NHS organisations. While many had received supportive offers from local authorities, NHS Clinical CCGs and the CQC, this was not universal, and many received conflicting advice from different organisations, often sensing that their NHS colleagues were sometimes unable to identify with the daily challenges in care homes. Three quarters of managers and directors expressed concerns about staff wellbeing and reported how staff shortages had increased pressures on care staff, leading at times to an unavoidable reliance on agency staff. Residents had been impacted adversely by the prolonged absence of their loved ones, with reports of residents experiencing resulting deterioration in mood from 84% of managers and of reduced oral intake from 30%. Despite these challenges, it was clear that some providers had gone to great lengths to implement stringent infection control measures such as enhanced cleaning and restructuring or rearranging their homes to facilitate appropriate segregation of residents. Others closed to visitors and required facemasks in all communal areas before these were formally advised. Measures were also taken in many homes to support staff, while local communities and relatives also helped by providing food and Personal Protective Equipment (PPE) and letters of support. Yet the pandemic has revealed clearly a deep divide between health and social care that must urgently be addressed. (Edited publisher abstract)
The prioritisation of choice in eldercare: the case of Ireland
- Author:
- LOLICH Luciana
- Journal article citation:
- International Journal of Care and Caring, 3(4), 2019, pp.517-530.
- Publisher:
- Policy Press
In recent decades, there has been a prioritisation of choice in eldercare in many Western countries. In many policy documents, choice is framed as giving older adults the choice to be cared for at home. The article draws on secondary sources to trace the impact of a logic of choice in eldercare in Ireland. It situates the analysis within the re-conceptualisation of care as a commodity and the home-care worker as the most ‘efficient’ option. The article examines the limitations of choice and questions whether choice should be the most important aspect of care in old age. (Publisher abstract)
Quality of life in older adult care homes: comparing office hours with out-of-office hours
- Authors:
- SMITH N., et al
- Journal article citation:
- Journal of Long-Term Care, November 2019, pp.153-163. Online only
- Publisher:
- King's College London
- Place of publication:
- London
Context: Poorer mortality rates and quality of care in hospitals outside of office hours is well documented. The literature on adult social (long-term) care, and in particular, care homes, is much less developed. There are, however, a few studies that suggest that outside of Monday to Friday between 9.00am and 16.30pm, quality of care in care homes might be lower. Objective(s): The objective of this study was to compare the social care-related quality of life (SCRQoL) of residents in older adult care homes during office hours (0900 to 16.30) with outside of office hours (evenings and weekends). Method(s): Researchers conducted a nested, cross-sectional study, collecting SCRQoL data using the Adult Social Care Outcomes Toolkit at two time points, office hours (Monday-Friday between 9.00 and 16.30) and outside of office hours. We did not examine nigh times in the homes. Data were collected for 99 older adult care home residents in 13 care homes (5 residential and 8 nursing) and analysed using a combination of non-parametric and parametric techniques. Findings: SCRQoL ratings were lower during the weekends and early evenings than during office hours. The differences were most pronounced in the higher order domains of social participation, occupation and control over daily life. Limitations: The study struggled to explain this variation. This work was both exploratory and small in size. The study also did not collect data on levels of staffing. Implications: Further work is required to both confirm the findings and explore the reasons for the difference. Nonetheless, this study challenges the traditional model of care, in which social activities and meaningful pastimes are mostly organised during ‘office hours’. Researchers observed evenings that were very short, as residents tended to return to their room shortly after dinner, and quiet weekends, and this was reflected in residents’ quality of life. This is contrary to the rhetoric of care homes being people’s own homes, where they would be able to choose to remain active and engaged into the evening and on the weekends, as they may have done throughout their lives. (Edited publisher abstract)