Search results for ‘Subject term:"older people"’ Sort:
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Process and preference: assessment of older people for institutional care
- Authors:
- SAMUEL Elaine, et al
- Publisher:
- Great Britain. Scottish Office. Central Research Unit
- Publication year:
- 1993
- Pagination:
- 127p.,bibliog.
- Place of publication:
- Edinburgh
Forward planning
- Author:
- GOFF Betty
- Journal article citation:
- Nursing Times, 30.12.92, 1992, pp.38-39.
- Publisher:
- Nursing Times
Describes a scheme to assess and place elderly hospital patients in community based private nursing homes.
Assessing early to late stage dementia: the TSI and BANS-S scales in the nursing-home
- Authors:
- APPOLLONIO Ildebrando, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 20(12), December 2005, pp.1138-1145.
- Publisher:
- Wiley
This study aimed to directly compare an observational scale to a performance-based instrument in moderate to severe dementia. The study compared a slightly modified version of the performance-based Test for Severe Impairment (mTSI) to the observer-based Bedford Alzheimer Nursing Severity Scale (BANS-S). Both scales were administered, together with the Mini-Mental State Examination (MMSE) and the Clinical Dementia Rating scale (CDR), to a nursing-home sample of 130 women suffering from different types of dementia. The BANS-S could be applied to all patients, the mTSI to 87 subjects. Results were similar for AD and non AD dementia. Both scales were independent from age and education and their test-retest and inter-rater reliabilities were satisfactory. The authors conclude that the mTSI looks promising in the moderate-to-severe range, whereas the BANS-S seems more useful in the very late stage of dementia. However, neither scale was optimal and additional instruments should be tested in future studies.
A systematic review of tools assessing the perspective of caregivers of residents with dementia
- Authors:
- HARPER Alexandra E., et al
- Journal article citation:
- Journal of Applied Gerontology, early cite July 2021,
- Publisher:
- Sage
In collaboration with stakeholders, we conducted a systematic review of psychometric evidence for self-report tools measuring the perspective of family caregivers of nursing home residents with dementia. Our rationale for this review was based on evidence that nonpharmacological interventions can ameliorate dementia symptoms in nursing home residents. Such interventions require caregiver participation, which is influenced by perspectives. Yet, no existing tool measures the multidomain caregiver perspective. Our review followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocol. The final sample included 42 articles describing 33 tools measuring domains of nursing home dementia care such as behavioral and psychological symptoms of dementia, resident quality of life, dementia-specific knowledge, communication, and medication use. We uncovered evidence gaps for tools measuring dementia-specific knowledge, communication, and medication use, all of which were important to our stakeholders. Future research should focus on development of psychometrically sound tools in alignment with the multidomain caregiver perspective. (Edited publisher abstract)
Instrumental swallowing assessment in adults in residential aged care homes: a scoping review
- Authors:
- BIRCHALL Olga, et al
- Journal article citation:
- Journal of the American Medical Directors Association, 22(2), 2021, pp.372-379.
- Publisher:
- Elsevier (for the American Medical Directors Association)
Objectives: To systematically describe evidence on the use of instrumental swallowing assessment for residents of aged care homes. Design: Scoping review using the Joanna Briggs Institute methodology for scoping reviews. Setting and Participants: Published peer-reviewed and gray literature written in English between 2000 and 2020 about instrumental swallowing assessment (ISA) in adults in residential aged care homes (RACHs). Measures: A systematic, 3-tiered search of databases including Medline, CINAHL, Embase, Scopus, and Cochrane Database of Systematic Reviews, and gray literature databases was conducted. Content analysis identified common themes. Results: Forty-two sources, 30 from peer-reviewed journals, 12 gray literature publications, and 66 websites of mobile ISA providers that discussed videofluoroscopic swallowing studies (VFSS) and/or fiberoptic endoscopic evaluation of swallowing (FEES) use in RACHs were included. Most peer-reviewed sources were referenced narratives or surveys of speech pathology practice patterns (53.3%). Researchers in 3 studies used onsite mobile FEES and in 2 studies off-site VFSS, with adults living in RACHs, as part of their research design (16.7%). There were 66 mobile instrumental swallowing assessment provider websites, based within the United States. Three countries (Australia, United States, United Kingdom) had professional guidelines that stipulated minimal requirements for the safe and appropriate provision of ISA services across settings. Themes identified across sources included (1) the approach to swallowing management and clinical indicators for ISA, (2) the role of ISA, (3) service and consumer influences on ISA, and (4) mobile FEES. Conclusions and Implications: There is a paucity of quality research on instrumental swallowing assessment in adults living in RACHs. There are broad regional and international variances in the way that videofluoroscopy and FEES are accessed and used. A more robust evidence base is required to guide health professionals to design tailored ISA care pathways for residents of RACHs, to achieve high-quality health, social, and economic outcomes. (Edited publisher abstract)
Pain in older adults: development of a tool for measuring knowledge of residential aged care staff
- Authors:
- FETHERSTONHAUGH Deirdre, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 31(4), 2016, pp.428-434.
- Publisher:
- Wiley
Objective: To develop a psychometrically sound tool for measuring the knowledge of nursing and care staff about the experience, assessment and management of pain in older people (including people with dementia) for use in the residential aged care setting. Methods: The Pain in Older Adults Knowledge Survey (POAKS) was developed and tested in two phases. Phase 1 involved developing an initial item pool with good content validity based on a review of the research literature and a modified Delphi technique involving national and international experts. A pool of 24 items was developed for testing. Initial testing of the psychometric properties of the POAKS with 30 university employees led to refinement and final wording of items. Phase 2 involved testing of the psychometric properties of the POAKS with 279 respondents, including first year (n = 176) and third year (n = 70) nursing students and staff in a residential aged care service (n = 33). Results: Results established the content validity and internal consistency of the POAKS and supported its use as an instrument to measure nursing staff knowledge about the experience, assessment and management of pain in older people. Conclusions: The POAKS will enable residential aged care facilities to measure the level of knowledge among nursing and care staff about pain in older people (including people with dementia). The measure provides a basis for the development and implementation of educational interventions to address knowledge gaps that may impact on the quality of care provided. (Publisher abstract)
Factors associated with long-stay nursing home admissions among the U.S. elderly population: comparison of logistic regression and the Cox proportional hazards model with policy implications for social work
- Authors:
- CAI Qian, SALMON J. Warren, RODGERS Mark E.
- Journal article citation:
- Social Work in Health Care, 48(2), February 2009, pp.154-168.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
Demographic shifts and rising health care costs mean that care for the elderly will become a great societal challenge. This study investigated key factors associated with long-stay nursing home (LSNH) admission among the U.S. elderly population. Two statistical methods, multivariable logistic regression and Cox proportional hazards model, were performed and compared. Secondary data analyses using four waves (1995, 1998, 2000, and 2002) of the Health Retirement Study (HRS) coupled with the Assets and Health Dynamics among the Oldest Old (AHEAD) surveys were conducted. A total of 5980 respondents with a mean age of 78 were included, and during the study period 9.9% of these became a LSNH resident. Older age, lower self-perceived health, worse instrumental activities of daily living, psychiatric problems, and living alone were found significantly associated with increased risk of LSNH admission. In contrast, being female, African American, or Hispanic, owning a home, and having lower level of cognitive impairment reduced the admission risk. The Cox model generally provided more precise parameter estimates than logistic regression. Logistic regression can provide a good approximation to the Cox model in identifying factors of LSNH admission, however, the Cox model gives more information on how soon the LSNH admission may happen. These analyses, based on two models, dually identified the factors associated with LSNH admission, and therefore the results discussed confidently provide implications for both public and private long-term care policies.
Resident choice and the survey process: the need for standardized observation and transparency
- Authors:
- SCHNELLE John F., et al
- Journal article citation:
- Gerontologist, 49(4), August 2009, pp.517-524.
- Publisher:
- Oxford University Press
This American study aims to describe a standardized observation protocol to determine if nursing home (NH) staff offer choice to residents during 3 morning activities of daily living (ADL) and compare the observational data with deficiency statements cited by state survey staff. Morning ADL care was observed in 20 NHs in 5 states by research staff using a standardized observation protocol. The number of observations in which choice was not offered was documented for 3 morning ADL care activities and compared with deficiency statements made by surveyors. Staff failed to offer choice during morning ADL care delivery for at least 1 of 3 ADL care activities in all 20 NHs. Observational data showed residents were not offered choice about when to get out of bed (11%), what to wear (25%), and breakfast dining location (39%). In comparison, survey staff issued only 2 deficiencies in all 20 NHs relevant to choice in the targeted ADL care activities, and neither deficiency was based on observational data. Survey interpretative guidelines instruct surveyors to observe if residents are offered choice during daily care provision, but standardized observation protocols are not provided to surveyors to make this determination. The use of a standardized observation protocol in the survey process similar to that used by research staff in this study would improve the accuracy and transparency of the survey process.
Validation of Fuld object memory evaluation for the detection of dementia in nursing home residents
- Authors:
- CHUNG Jenny C.C., HO Winnie S.K.
- Journal article citation:
- Aging and Mental Health, 13(2), March 2009, pp.274-279.
- Publisher:
- Taylor and Francis
This study aimed to examine the psychometric properties of the Fuld Object Memory Evaluation (FOME) as an instrument to detect dementia in nursing home residents in Hong Kong. Ninety-six elderly participants were recruited into a dementia group (n = 30) and a normal control group (n = 66). Forty participants (12 dementia, 28 normal controls) had visual impairment. The test-retest reliability and parallel-form reliability of FOME were excellent, with intraclass correlation coefficients of 0.92 and 0.96, respectively. Satisfactory convergent validity of FOME was established with the Cantonese version of Mini-Mental State Examination, and the Memory subscale and the Initiation/Perseveration subscale of the Chinese version of Dementia Rating Scale. The FOME total retrieval (TR) score and delayed recall (DR) score showed good discriminative power to screen for dementia. Optimal cutoff scores for TR and DR were suggested as 33 (93% sensitivity, 82% specificity) and 7 (87% sensitivity, 76% specificity) respectively. The performance of FOME was not influenced by age, educational level and visual impairment. The findings suggest that FOME is a valid assessment to screen for dementia in older nursing home residents and can be used with older individuals with limited education and those with visual impairments.
Quality of care in private sector and NHS facilities for people: cross sectional survey
- Authors:
- BALLARD Clive, et al
- Journal article citation:
- British Medical Journal, 25.8.01, 2001, pp.426-427.
- Publisher:
- British Medical Association
The authors used dementia care mapping to evaluate the quality of care in 10 private sector and seven NHS care facilities for people with dementia. Dementia care mapping is a direct, standardised assessment with good interrater reliability. Activities are coded according to category of behaviour, and they are recorded every five minutes. Wellbeing is measured using the dementia care index, which indicates the overall quality of care within a particular environment extrapolated from dementia care mapping of half the residents. The dementia care index rated all seven NHS facilities and five of the private sector facilities as needing radical improvement; the remaining five private sector facilities were rated as needing much improvement. Over the six hour daytime period of observation, people spent 61 minutes (17%) asleep and 108 minutes (30%) either socially withdrawn or not actively engaged in any form of basic or constructive activity. Only 50 minutes (14%) were spent communicating with staff or other residents, and less than 12 minutes(3%) were spent engaged in everyday constructive activities other than watching television (11 minutes(3%)). The remaining 33% of the observation period was spent engaged in basic activities such as eating, going to the toilet, etc. Quality of care was rated as needing radical improvement or much improvement in all homes, and no home showed even a fair standard of care. Recent reports have highlighted the need for review and improvement of the standards of care in nursing and residential and nursing homes. The data emphasises the need for urgency in this process.