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The provision of care for residents dying in UK nursing care homes
- Authors:
- KINLEY Julie, et al
- Journal article citation:
- Age and Ageing, 43(3), 2014, pp.375-379.
- Publisher:
- Oxford University Press
Objectives: To identify the care currently provided to residents dying in UK nursing care homes. Method: Study participants were residents who had died within 38 nursing care homes in southeast England over a 3-year period. The nursing care homes had been recruited to take part in a cluster randomised controlled trial looking at different models of facilitation while implementing the Gold Standards Framework in Care Homes (GSFCH) programme. Two researchers examined the notes and daily records of all residents who died in each of these homes between the 1 June 2008 and the 31 May 2011. Results: A total of 2,444 residents died during the 3-year period. Fifty-six percent of these residents died within a year of admission. The support from specialist healthcare services to residents during their last 6 months of life was variable. Conclusions: Nursing care homes have established links with some external healthcare providers. These links included the GP, palliative care nurses and physiotherapy. As dependency of resident increase with 56% residents dying within a year of admission these links need to be expanded. The provision of health care that meets the needs of future nursing care home residents needs to be ‘proactively’ obtained rather than left to chance.
Characteristics of nursing home residents and physical restraint: a systematic literature review
- Authors:
- HOFMANN Hedi, HAHN Sabine
- Journal article citation:
- Journal of Clinical Nursing, 23(21-22), 2014, pp.3012-3024.
- Publisher:
- John Wiley and Sons
Aims and objectives: Even though the application of physical restraint is highly controversial, prevalence rates show that it is a common intervention in nursing homes. This reviews aimed to analyse and to summarise factors associated with nursing home residents' characteristics which could lead to physical restraint, and to investigate the consequences of physical restraint use for this population. Methods:A systematic literature research involving the databases PubMed, Cumulative Index to Nursing and Allied Health Literature, ISI Web of Science and Cochrane Library was carried out for articles published from January 2005-November 2011. Nine Studies fulfilled the inclusion criteria and the quality assessment. Results: Restrained residents had low activities of daily living (ADL) scores and severe cognitive impairment. Residents with low cognitive status and serious mobility impairments were at high risk to be restrained, as well as residents with previous fall and/or fracture. Repeated verbal and physical agitation was found to be positively associated with restraint use. Possible consequences of physical restraint were as follows: lower cognitive and ADL performance, higher walking dependence, furthermore falls, pressure ulcers, urinary and faecal incontinence. Conclusions: This systematic literature review reveals notable resident-related factors for physical restraint use. The consequences of restraint seem to negatively influence residents' physical and psychological well-being. Physical restraint seems to be an important risk factor for residents' further health problems. Nurses need a high level of expertise and competence in evaluating the individual residents′ situation and deciding further steps, with respect for the autonomy and dignity of the person. (Edited publisher abstract)
The denial of NHS continuing healthcare in Northern Ireland
- Authors:
- CROSS Judith, KEARNS Brenda
- Publisher:
- Age NI
- Publication year:
- 2014
- Pagination:
- 70
- Place of publication:
- Belfast
This is a report of an investigation undertaken by Age NI to examine the provision of NHS Continuing Healthcare to older people in Northern Ireland. The report examines the principles that underpin the NHS, outlines the role of NHS Continuing Healthcare and discusses the contribution of the Health and Social Care Trust towards nursing care. It also discusses the demographic and public policy agenda in Northern Ireland. Finally, it details the actions that Age NI undertook to investigate the provision of NHS Continuing Healthcare in Northern Ireland and sets out a series of recommendations to clarify and ensure a consistent approach to NHS Continuing Healthcare across Northern Ireland. The report finds that while there is provision for NHS Continuing Healthcare in Northern Ireland its impact is modest as assessment for eligibility does not appear to be consistent across the HSC Trusts. The report calls for government guidance and for a formal investigation into the provision NHS Continuing Healthcare. (Edited publisher abstract)
Alternate housing models for older people with disabilities: their clientele, structures and resources in relation to the quality of and satisfaction with care delivery
- Authors:
- DUBUC Nicole, et al
- Journal article citation:
- Ageing and Society, 34(9), 2014, pp.1575-1600.
- Publisher:
- Cambridge University Press
This paper reports on the study of a subsidy programme that was established in Quebec for alternate housing models (AHMs), which allows private and community organisations to offer housing services within the framework of a partnership with public health-care services. The research objectives were: (a) to compare how facility characteristics and services provided by AHMs and nursing homes (NHs) differ; (b) to examine the personal characteristics of residents living in AHMs; and (c) to compare residents with similar characteristics within AHMs and NHs in terms of unmet needs, quality of care, satisfaction with care and services, and psycho-social adaptation to the residence. A cross-sectional study was undertaken with individually matched groups to assess whether AHMs meet the needs of elders in a way similar to NHs. Overall, residents in both groups had moderate to severe levels of disability and about 60 per cent had mild to severe cognitive problems. While their general features were heterogeneous, the AHMs were more comfortable and homelike than the NHs. The quality of and satisfaction with care was appropriate in both settings, although AHMs performed better. Only one-quarter of residents in both settings, however, evidenced a good level of psycho-social adaptation to their residence. This partnership approach is a good strategy to provide a useful range of housing types in communities that can respond to the needs of elders with moderate to severe disabilities. (Publisher abstract)
Review of minimum standards in nursing homes: engagement with residents in nursing homes: report
- Author:
- AGE NI
- Publisher:
- Age NI
- Publication year:
- 2014
- Pagination:
- 42
- Place of publication:
- Belfast
This report sets out the findings from an engagement exercise with nursing home residents (and their carers where appropriate), designed to ascertain their views on their care and the home, and their positive and negative experiences in the setting. Findings and emerging themes from the engagement are intended to inform the review of the minimum standards in care homes. The draft revised standards set out the requirements for registration and inspection of nursing homes providers by the Regulation and Quality Improvement Authority to ensure a consistency of approach throughout Northern Ireland and ensure that residents and their families and carers, service providers and commissioners have a clear understanding of the minimum standards of care they can expect to receive and provide. (Edited publisher abstract)
Review of minimum care standards for nursing homes; report of stakeholder engagement exercises
- Author:
- NORTHERN IRELAND. Department of Health, Social Services and Public Safety
- Publisher:
- Northern Ireland. Department of Health, Social Services and Public Safety
- Publication year:
- 2014
- Pagination:
- 18
- Place of publication:
- Belfast
This report outlines the results of a series of stakeholder engagement exercises designed to canvass views on Minimum Care Standards for Nursing Homes and the proposed amendments. Nursing home providers, managers of registered nursing home and trust care managers took part in the exercises. Delegates were asked to discuss the positive and challenging aspects of the current standards; examine the format, style, language and tone of the standards and indicate their preferences for how a revised version might look; and identify the positive and challenging aspects of the new standards and whether they felt the standards would be achievable and effective. The draft revised standards set out the requirements for registration and inspection of nursing homes providers by the Regulation and Quality Improvement Authority to ensure a consistency of approach throughout Northern Ireland and ensure that residents and their families and carers, service providers and commissioners have a clear understanding of the minimum standards of care they can expect to receive and provide. (Edited publisher abstract)
Sense of coherence among cognitively intact nursing home residents – a five-year longitudinal study
- Authors:
- DRAGESET Jorunn, et al
- Journal article citation:
- Aging and Mental Health, 18(7), 2014, pp.889-896.
- Publisher:
- Taylor and Francis
Aim and objectives: To examine how stable the sense of coherence (SOC) is over a five-year period among residents of nursing homes (NH) who are not cognitively impaired and whether components of social support influence SOC.Background: Many studies have investigated the stability of SOC, and the findings have been inconsistent. Social support is a crucial resource in developing SOC. Few researchers have studied the stability of SOC and how various social support dimensions influence changes in SOC among older NH residents who are cognitively intact.Design: The study was prospective and included baseline assessment and five-year follow-up.Methods: The sample comprised 52 cognitively intact NH residents (Clinical Dementia Rating score ≤0.5). The authors obtained data through direct interviews using the Social Provisions Scale and Sense of Coherence Scale.Results: SOC increased statistically significantly from baseline to follow-up. The social support subdimension reassurance of worth predicted change in SOC after adjustment for sociodemographic factors. When controlled for baseline SOC, attachment was associated with change in SOC, but reassurance of worth was not.Conclusions: The study indicates that the change in SOC over time during the 5 years of follow-up and the social support dimension attachment appear to be important components of change in SOC. Nursing personnel should be aware of the residents’ individual needs for attachment and the importance of emotional support for personal strength and ability to cope. (Edited publisher abstract)
Supporting residents moving into long-term care: multiple layers shape residents’ experiencei
- Authors:
- SUSSMAN Tamara, DUPUIS Sherry L.
- Journal article citation:
- Journal of Gerontological Social Work, 57(5), 2014, pp.438-459.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
This interpretive grounded theory study explores 10 residents’ retrospective accounts of the relocation process, including the decision to move into a long-term care home, the pre-move preparations, the moving day circumstances, and the initial adjustment period following the move. Analysis of the data revealed a complex intersection of conditions at multiple layers that shaped residents’ experiences of the transitional process. Recommendations to enhance circumstances at individual, interpersonal, and systemic layers, for each temporal stage of the relocation process are proposed. Implications for social work practice across the continuum of care are also discussed. (Publisher abstract)
Reducing antipschotic drugs in care homes
- Authors:
- PRENTICE Aileen, WRIGHT David
- Journal article citation:
- Nursing Times, 110(23), 2014, pp.12-15.
- Publisher:
- Nursing Times
Anti-psychotic medication should be used in people with dementia only when there is an identified need ad the benefits outweigh the risks. An audit-based service provided by pharmacists, working with nursing and care staff in residential home, resulted in antipsychotic doses reductions of 20% and drug discontinuation in 17% of residents with dementia. (Publisher abstract)
The dark side of Norwegian nursing homes: factors influencing inadequate care
- Authors:
- MALMEDAL Wenche, HAMMERVOLD Randi, SAVERMAN Britt-Inger
- Journal article citation:
- Journal of Adult Protection, 16(3), 2014, pp.133-151.
- Publisher:
- Emerald
Purpose: The purpose of this paper is to investigate factors that influence the probability that staff will commit acts of inadequate care, abuse, and neglect. Design/methodology/approach: A cross-sectional survey study was carried out in one county in the middle of Norway (Sør-Trøndelag). Random sampling, stratified by size of nursing homes, and location (rural or urban areas), was used to select a variety of nursing homes from a total population of 55 nursing homes. All staff working in 16 nursing homes working were asked to participate in the study. A response rate of 79 per cent was achieved (n=616). Findings: Findings reveal that location and size of the nursing home, age of the staff, education level, job satisfaction, resident aggression, and conflicts between residents and staff predict inadequate care, abuse, and neglect. The most consistent findings are that resident aggression increases the risk for all three types of inadequate care, and that conflicts predict different types of inadequate care depending on whether the conflicts are related to direct care-giving activities or not. Practical implications: Nursing home care is an important part of care for the elderly, and should be characterized by good-quality services. The relation between inadequate care and resident aggression, conflicts, and other factors shown in this study points to the relevance of further improvements in nursing home practices to minimize the occurrence of episodes of inadequate care, abuse, and neglect. Originality/value: This study investigated the relationships between 11 specific factors and different types of inadequate care in a nursing home context. (Publisher abstract)