Search results for ‘Subject term:"older people"’ Sort:
Results 1 - 10 of 171
Calling the question of "possible dying" among nursing home residents: triggers, barriers, and facilitators
- Author:
- BERN-KLUG Mercedes
- Journal article citation:
- Journal of Social Work in End-of-Life and Palliative Care, 2(3), 2006, pp.61-85.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia
Glaser and Strauss reported decades ago that in order for a person to be treated as dying, he/she must be defined as dying. Defining nursing home residents as "dying" can be complicated because most residents are in advanced old age with multiple chronic conditions. Using a social construction theoretical framework, this study looks at the step before the declaration of dying, that is, the consideration of the possibility of dying. This qualitative study is a secondary analysis of prospective data collected during 16 months of fieldwork on behalf of 45 nursing home residents whose health was considered declining. The purpose of this paper is to build understanding about the social construction of "possible dying" by reporting triggers that can call the question of possible dying and stimulate a discussion about the nursing home resident's status, prognosis, care options, and preferences. These triggers include: Health status decline; non-compliance with diet or medications; available medical interventions not being well suited for the residents; and family consideration of an out-of-town trip. The paper also reports barriers (family, staff, and disease process) and facilitators to calling the question of possible dying, including families having a sense of treatments they would like to avoid and having the opportunity to talk through options. Findings are discussed in light of basic assumptions of social construction. Implications for social workers include helping residents, families, and staff anticipate and address the possibility of dying, and to reflect these discussion in care plans, as well as the need to be available to help residents and family members with psychosocial issues related to living and dying in the nursing home setting, including the profound issues that can be provoked or exacerbated by resident health status decline and possible dying. (Copies of this article are available from: Haworth Document Delivery Centre, Haworth Press Inc., 10 Alice Street, Binghamton, NY 13904-1580).
Measuring person-environment fit in nursing homes
- Author:
- BUFFUM William E.
- Journal article citation:
- Journal of Social Service Research, 11(2/3), 1988, pp.35-54.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
Presents the results of the development of an interviewing tool.
The social networks of nursing-home residents in Hong Kong
- Author:
- CHENG Sheung-Tak
- Journal article citation:
- Ageing and Society, 29(2), February 2009, pp.163-178.
- Publisher:
- Cambridge University Press
The degree of social support available to older persons who are institutionalised is under-researched. This study investigated the structural and functional support exchanges with their social network members of 72 nursing home residents in Hong Kong (58 women, 14 men). They were asked to identify their network members, to evaluate the degree to which each one was important in their lives, and to rate the support received from and provided to each individual. The participants reported few network members (average 2.6) and in many cases neither a spouse nor children were included. Only one-fifth of the participants reported a social network member in the nursing home, and most of those who did nominated a member of the staff. There were also few friends in their networks. On the whole, the participants were comparatively socially isolated. The findings were explained in terms of the shame associated by the Chinese with placement in an institutional home, cultural patterns of social support, changes in children's filial attitudes, home placement policies, and the management practices that accentuate the distance between the older person and family members around the time of institutionalisation. These inculcate a feeling of abandonment, and discourage family visits as well as social interactions within the home.
What the resident meant to say: use of cognitive interviewing techniques to develop questionnaires for nursing home residents
- Authors:
- HOUSEN Patricia, et al
- Journal article citation:
- Gerontologist, 48(2), April 2008, pp.158-169.
- Publisher:
- Oxford University Press
Emphasis on consumer-centred care for frail and institutionalized older adults has increased the development and adaptation of surveys for this population. Conventional methods used to pretest survey items fail to investigate underlying sources of measurement error. However, the use of the cognitive interview (CI), a method for studying how respondents answer survey items, is not well established or documented in this population. This study demonstrates how CIs can be used to improve questionnaires intended for nursing home residents. CIs were conducted with 29 nursing home residents in order to identify potential problems with prospective survey items. Scripted probes were used to standardise the interviews and adapted the Question Appraisal System to enumerate and classify the problems discovered. Between one and five versions of each item were fielded in an iterative process that identified 61 item-specific problems. Additionally, residents' cognitive responses suggested that some screened their answers on the basis of perceived physical and environmental limitations, and some had difficulty answering items about preferences that fluctuate day to day. These findings led us to modify the items and response set to simplify the respondents' cognitive task. This study illustrates how CI techniques can be used to understand residents' comprehension of and response to survey items.
Quality of nursing home care in Cyprus: are elder residents content with their treatment?
- Author:
- GEORGIADES Savvas
- Journal article citation:
- Journal of Gerontological Social Work, 50(3/4), 2008, pp.3-24.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
Residents (n=73) were interviewed in four different types of nursing home (governmental, community-run, faith-based and private) to ascertain their views on the quality of care they received. The results show that the majority are happy with the quality of primary care in terms of medical treatment, nutrition, cleanliness and staff professionalism. However, they also feel lonely and deprived of essential entertainment opportunities. The implications for both domestic and global service design, and for research, are discussed. (Copies of this article are available from: Haworth Document Delivery Centre, Haworth Press Inc., 10 Alice Street, Binghamton, NY 13904-1580).
BE-ACTIV: a staff-assisted behavioral intervention for depression in nursing homes
- Authors:
- MEEKS Suzanne, et al
- Journal article citation:
- Gerontologist, 48(1), February 2008, pp.105-114.
- Publisher:
- Oxford University Press
This article (a) describes a 10-week, behavioural, activities-based intervention for depression that can be implemented in nursing homes collaboratively with nursing home activities staff and (b) presents data related to its development, feasibility, and preliminary outcomes. BE-ACTIV, which stands for Behavioral Activities Intervention, was developed in two pilot study phases: a treatment development phase and a feasibility–outcome phase with a small, randomized trial. The intervention was piloted with five depressed residents in a single nursing home in collaboration with the social services and activities staff. In the second phase randomized 20 residents from six nursing homes to receive either the intervention or treatment as usual. The intervention was well received by residents, family, and staff members. Experience with the intervention and input from staff members resulted in modifications to streamline the intervention and improve implementation. Results suggest that BE-ACTIV reduced institutional barriers to participation in pleasant activities, increased resident control over activity participation, increased overall activity participation, and improved depressive symptoms. Despite low power, statistical and graphical comparisons suggest superiority of the intervention over treatment as usual. Because depression among nursing home residents is prevalent, heterogeneous, and often treatment resistant, there is a need for effective, low-cost interventions that are ecologically acceptable and efficient. BE-ACTIV is a promising intervention; it is brief, addresses institutional barriers, involves facility staff in treatment, and is acceptable to residents. As such, BE-ACTIV merits further evaluation to establish efficacy and effectiveness.
The MDS Challenging Behavior Profile for long-term care
- Authors:
- GERRITSEN D. L., et al
- Journal article citation:
- Aging and Mental Health, 12(1), January 2008, pp.116-123.
- Publisher:
- Taylor and Francis
The objective was to construct a reliable and valid challenging behaviour scale with items from the Minimum Data Set (MDS). Exploratory factor analyses of a sample of 656 nursing home residents in the Netherlands yielded a 16-item Behavior Profile containing four internally consistent and valid subscales measuring conflict behaviour, withdrawn behaviour, agitation and attention seeking behaviour. On a second dataset of 227 nursing home residents, internal consistency, inter-rater reliability and validity against the Behavior Rating Scale for Psychogeriatric Inpatients (GIP) were established. Internal consistency of the subscales ranged between 0.54 and 0.78. The overall inter-rater reliability of the items was 0.53 (kappa); of the scale it was 0.75 (ICC). The MDS Challenging Behavior Profile could potentially be an important contribution to existing clinical MDS-scales but additional studies on reliability, validity and usefulness are needed.
Dementia and depression among nursing home residents in Lebanon: a pilot study
- Authors:
- CHAHINE L.M., et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 22(4), April 2007, pp.283-285.
- Publisher:
- Wiley
The aim of this study was to investigate the prevalence of dementia and depression among a portion of nursing home residents (NHR) in Lebanon and describe the characteristics of NHR afflicted with dementia and depression. Of 200 NHR from three NH in Lebanon, 117 were selected by random sampling. Data on demographics and medical history were collected. An Arabic version of the Mini-Mental Status Examination and Geriatric Depression Scale (GDS) were administered. The final sample consisted of 102 NHR. Sixty-one (59.8%) had dementia of some kind. Seventeen (27.9%) had mild dementia, 14 (22.9%) had moderate dementia, and 30 (49.2%) had severe dementia. Forty-five (57.7%) of the NHR tested had depression as measured by a GDS score of more than 10. Dementia and depression were present in more than half of the NHR in our sample. The results highlight the importance of screening NHR for dementia and depression on admission and at regular time intervals.
Unfolding the culture change map and locating ourselves together
- Authors:
- ANGELELLI Joseph, HIGBIE Imogene
- Journal article citation:
- Journal of Social Work in Long-Term Care, 3(3/4), 2005, pp.121-135.
- Publisher:
- Taylor and Francis
- Place of publication:
- London
One promising aspect of the culture change movement in long-term care is the collective effort to “junk the jargon”-to do away with institutional language and instead speak plainly in a way that makes it possible for the voices of elders to be heard. This article was written with that spirit of listening in mind. It was co-authored by a 35-year-old gerontologist and an 87-year-old retired professor of social work and sociology with direct experience as a “patient” in the old long-term care culture. The introduction was written by the elder, and her wisdom and perspective guided the body of the text. (Copies of this article are available from: Haworth Document Delivery Centre, Haworth Press Inc., 10 Alice Street, Binghamton, NY 13904-1580).
Assessing and comparing physical environments for nursing home residents: using new tools for greater research specificity
- Authors:
- CUTLER Lois D., et al
- Journal article citation:
- Gerontologist, 46(1), February 2006, pp.42-51.
- Publisher:
- Oxford University Press
The authors developed and tested theoretically derived procedures to observe physical environments experienced by nursing home residents at three nested levels: their rooms, the nursing unit, and the overall facility. Illustrating with selected descriptive results, in this article we discuss the development of the approach. On the basis of published literature, existing instruments, and expert opinion about environmental elements that might affect quality of life, the authors developed separate observational checklists for the room and bath environment, unit environment, and facility environment. The authors trained 40 interviewers without specialized design experience to high interrater reliability with the room-level assessment. The authors used the three checklists to assess 1,988 resident room and bath environments, 131 nursing units, and 40 facilities in five states. From the data elements, they developed quantitative indices to describe the facilities according to environmentally relevant constructs such as function-enhancing features, life-enriching features, resident environmental controls, and personalization. The authors reliably gathered data on a large number of environmental items at three environmental levels. Environments varied within and across facilities, and the authors noted many environmental deficits potentially relevant to resident quality of life. Implications: This research permits resident-specific data collection on physical environments and resident-level research using hierarchical analysis to examine the effects of specific environmental constellations.