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The promise of assistive technology in institutionalized old age care: economic efficiency, improved working conditions, and better quality of care?
- Authors:
- SIREN Anu, et al
- Journal article citation:
- Disability and Rehabilitation: Assistive Technology, 16(5), 2021, pp.483-489.
- Publisher:
- Taylor and Francis
- Place of publication:
- London
Purpose: Assistive technologies in care work are expected to alleviate the challenges related to population aging, namely the pressure on public budgets and a shortage of care professionals. This study examines how various stakeholders view the potentials of assistive technology in an institutionalized care setting in Denmark. Method: Using ethnographic field observations, interviews, and document analysis, we explore the residents’, the staff’s, and the municipality’s perspectives on the technologies and analyze whether they live up to the stated expectations. Results: We identify three parallel narratives representing each of the stakeholder’s perspectives. The municipality’s triple-win narrative emphasizes expected gains in terms of efficiency, improved working conditions, and better quality of care. The staff’s ambiguity narrative contains both negative views regarding the motive for using technologies to save resources and positive accounts of how technologies have reduced work-related pain. The residents’ limited agency narrative reflects an internalization of the staff’s perspectives. Conclusions: We conclude that, despite both the staff and the municipality highlighting the residents’ well-being and comfort as important outcomes of assistive technologies, the residents’ wishes have limited influence on whether and, if so, how assistive technologies are used. (Edited publisher abstract)
Challenges faced by residential aged care staff in decision-making for residents with dementia
- Authors:
- CAMERON Nadine, FETHERSTONHAUGH Deirdre, BAUER Michael
- Journal article citation:
- Dementia: the International Journal of Social Research and Practice, 20(4), 2021, pp.1270-1283.
- Publisher:
- Sage
Care staff in residential aged care facilities (nursing homes) in Australia are obligated, under the Australian National Framework for Action on Dementia 2015–2019, to support residents to exercise choice and make decisions. Research indicates, however, that care staff are often given little guidance regarding which residents’ decisions should be supported or how to make decisions on their behalf. This lack of guidance can result in a denial of residents’ rights and inconsistent treatment by staff, placing residents’ wellbeing at risk. Through providing an analysis of the responses of staff at RACFs in Victoria and Queensland to two case scenarios, this study seeks to provide some understanding of the difficulties staff face in supporting residents’ self-determination and their own need for greater organisational support. (Edited publisher abstract)
Rosalie Kane: a career’s worth of “evergreen” insights
- Author:
- DOTY Pamela
- Journal article citation:
- Journal of Gerontological Social Work, 64(1), 2021, pp.78-87.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
The author reminisces about her collegial relationships and friendship with Rosalie Kane over a span of nearly 40 years. She also reflects on the main themes of Rosalie’s scholarly work as a social gerontologist, highlighting seminal publications and why Rosalie’s insights remain valuable and “evergreen” decades later. (Edited publisher abstract)
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.
Trajectories of at-homeness and health in usual care and small house nursing homes
- Authors:
- MOLONY Sheila, et al
- Journal article citation:
- Gerontologist, 51(4), August 2011, pp.504-515.
- Publisher:
- Oxford University Press
Long-term care providers across the United States are building new residential environments that weave humanistic person-centred philosophies into clinical care, organisational policies, and built environments. The small house model (SmH) relocates the resident from institutional care to a place that is believed to better emulate home. The aim of this study was to compare and contrast trajectories of at-homeness and health over time between residents remaining in a usual care nursing home and residents moving from that home to a SmH. The setting for the study was a 100-bed nursing home in a continuing care retirement community in the Midwest. Five new SmHs were built as part of this retirement community. Interviews were conducted with residents before the move to the SmHs and 1, 3, and 6 months after the move. The findings showed that prior to the move individuals who decided to relocate to the SmH had more depressive symptoms and lower levels of at-homeness. Their levels of at-homeness increased after the move, and, in addition, their levels of functional dependence decreased. Most participants who chose to stay in the nursing home reported high baseline levels of at-homeness and maintained this over the next 6 months. Qualitative findings highlight the variables that contributed to at-homeness in both groups. The study demonstrates that a ‘one size fits all’ approach may not be best because at-homeness is an individualised construct.
Neglect of older adults in Michigan nursing homes
- Authors:
- ZHANG Zhenmei, et al
- Journal article citation:
- Journal of Elder Abuse and Neglect, 23(1), January 2011, pp.58-74.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
Although research on domestic elder abuse and neglect is a rapidly growing area, it is relatively poorly understood in the nursing home environment. The purpose of this study was to estimate the incidence of elder neglect in nursing homes and to identify the individual and contextual risks associated with elder neglect. Data came from a 2005 random digit dial survey of individuals in Michigan who had relatives in long term care. The sample included 414 family members who had a relative aged 65 or older in a nursing home. The collated responses suggest that about 21% of nursing home residents were neglected on one or more occasion in the last 12 months. Two nursing home residents' characteristics reported by family members appear to significantly increase the odds of neglect: functional impairments in activities of daily living and previous resident-to-resident victimisation. Behaviour problems were also associated with higher odds of neglect. However there was no strong evidence that social support reduced the risk of abuse except perhaps a suggestion of a link with frequency of visits. The authors emphasise that estimates of neglect were based solely on family reports and this may be a limitation of the study. Policy implications of these results are discussed.
Self-injurious behavior in the nursing home setting
- Authors:
- MAHGOUB Nahla, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 26(1), January 2011, pp.27-30.
- Publisher:
- Wiley
Self-injurious behaviour in older adults is defined as harm inflicted on oneself without conscious suicidal intent. In this literature search aiming to determine the scope of the literature, online database searches identified 10 publications concerning self-injurious behaviour in older adults, 4 of which included studies investigating this in nursing homes. The results showed that there are few clinical studies of self-injurious behaviour in older adult nursing home residents, but that the limited literature suggests that it is a prevalent phenomenon, reported to be strongly associated with dementia and a risk of accidental death. The authors conclude that there is little evidence-based treatment guidance for self-injurious behaviour in older populations, and that clinical studies are urgently needed to help clarify causes and treatment approaches.
Bettercaring
- Publisher:
- Pavilion Interactive
Bettercaring offers a searchable database of all registered care homes in the UK with more than four beds. The database contains information on more than 20,000 care homes, in all regions of the UK. It is possible to search by location, size, cost and special support services offered. The resource also provides a frequently-asked questions page, and a number of articles on topics related to residential care.
Use of physical restraints and antipsychotic medication is in nursing homes: a cross-national study
- Authors:
- FENG Zhanlian, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 24(10), October 2009, pp.1110-1118.
- Publisher:
- Wiley
This study compared inter- and intra-country differences in the prevalence of physical restraints and antipsychotic medications in nursing homes, looking at aggregated residence conditions and organisational characteristics correlated with these treatments. Data were collected from long-term care facilities providing nursing home services in five countries. The findings were that the prevalence of physical restraint use varied more than five-fold across the study countries with an average 6% in Switzerland, 9% in the United States (US), 20% in Hong Kong (China), 28% in Finland, and over 31% in Canada. Prevalence of antipsychotic use ranged from 11% in Hong Kong, between 26-27% in Canada and the US, 34% in Switzerland, and nearly 38% in Finland. Within each country, substantial variations existed, but neither facility case mix nor organisational characteristics were particularly predictive of the prevalence of either treatment. The study concluded that there is large, unexplained variability in the prevalence of physical restraint and antipsychotic use in nursing home facilities both between and within countries, and that since restraints and antipsychotics are associated with adverse outcomes, it is important to understand the factors specific to each country that contribute to variation in use rates.
Family members’ reports of abuse in Michigan nursing homes
- Authors:
- GRIFFORE Robert J., et al
- Journal article citation:
- Journal of Elder Abuse and Neglect, 21(2), April 2009, pp.105-114.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
Data on the abuse and neglect of people aged 65 and over in Michigan nursing homes over a 12-month period were collected using list-assisted random-digit dialling of relatives. Most of the residents represented in the study were female, widowed and Caucasian. Neglect and caretaking mistreatment were the most frequent types of abuse reported. Comparison of the data with information from the National Ombudsman Reporting System suggests that the incidence of abuse is substantially higher than reflected in official data and warrants further research to investigate reasons for this discrepancy to provide accurate and validated data on abuse in nursing homes.