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Covert elder abuse in the nursing home
- Author:
- MEDDAUGH Dorothy I.
- Journal article citation:
- Journal of Elder Abuse and Neglect, 5(3), 1993, pp.21-37.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
Reports on a study which used ethnographic field techniques to assess certain interactions that took place between staff members and nursing home residents. Some subtle forms of psychological elder abuse that involved personal choice issues, isolation, labelling, and other thoughtless practices were evident. The data shows that those least able to affect the outcome of their care were particularly affected.
Living in a nursing home: outcome standards for Australian nursing homes
- Author:
- AUSTRALIA. Department of Community Services and Health. Commonwealth/State Working Party on Nursing Home Standards
- Publisher:
- Australian Government Publishing Service
- Publication year:
- 1987
- Pagination:
- 69p.
- Place of publication:
- Canberra, ACT
The adverse effects of the COVID-19 pandemic on nursing home resident well-being
- Authors:
- LEVERE Michael, ROWAN Patricia, WYSOCKI Andrea
- Journal article citation:
- Journal of the American Medical Directors Association, 22(5), 2021, pp.948-954.e2.
- Publisher:
- Elsevier (for the American Medical Directors Association)
Objective: Quantify the effects of the COVID-19 pandemic on nursing home resident well-being. Design: Quantitative analysis of resident-level assessment data. Setting and participants: Long-stay residents living in Connecticut nursing homes. Methods: this study used Minimum Data Set assessments to measure nursing home resident outcomes observed in each week between March and July 2020 for long-stay residents (eg, those in the nursing home for at least 100 days) who lived in a nursing home at the beginning of the pandemic. This study compared outcomes to those observed at the beginning of the pandemic, controlling for both resident characteristics and patterns for outcomes observed in 2017-2019. Results: This study found that nursing home resident outcomes worsened on a broad array of measures. The prevalence of depressive symptoms increased by 6 percentage points relative to before the pandemic in the beginning of March - representing a 15% increase. The share of residents with unplanned substantial weight loss also increased by 6 percentage points relative to the beginning of March—representing a 150% increase. This study also found significant increases in episodes of incontinence (4 percentage points) and significant reductions in cognitive functioning. The findings suggest that loneliness and isolation play an important role. Though unplanned substantial weight loss was greatest for those who contracted COVID-19 (about 10% of residents observed in each week), residents who did not contract COVID-19 also physically deteriorated (about 7.5% of residents in each week). Conclusions and Implications: These analyses show that the pandemic had substantial impacts on nursing home residents beyond what can be quantified by cases and deaths, adversely affecting the physical and emotional well-being of residents. Future policy changes to limit the spread of COVID-19 or other infectious disease outbreaks should consider any additional costs beyond the direct effects of morbidity and mortality due to COVID-19. (Edited publisher abstract)
The adverse effects of the COVID-19 pandemic on nursing home resident well-being
- Authors:
- LEVERE Michael, ROWAN Patricia, WYSOCKI Andrea
- Journal article citation:
- Journal of the American Medical Directors Association, early cite March 2021,
- Publisher:
- Elsevier (for the American Medical Directors Association)
Objective: Quantify the effects of the COVID-19 pandemic on nursing home resident well-being. Design: Quantitative analysis of resident-level assessment data Setting and participants: Long-stay residents living in Connecticut nursing homes Methods: This study used Minimum Data Set assessments to measure nursing home resident outcomes observed in each week between March and July 2020 for long-stay residents (e.g., those in the nursing home for at least 100 days) who lived in a nursing home at the beginning of the pandemic. This study compared outcomes to those observed at the beginning of the pandemic, controlling for both resident characteristics and patterns for outcomes observed in 2017 to 2019. Results: this study found that nursing home resident outcomes worsened on a broad array of measures. The prevalence of depressive symptoms increased by 6 percentage points relative to before the pandemic in the beginning of March - representing a 15 percent increase. The share of residents with unplanned substantial weight loss also increased by 6 percentage points relative to the beginning of March - representing a 150 percent increase. This study also found significant increases in episodes of incontinence (4 percentage points) and significant reductions in cognitive functioning. Our findings suggest that loneliness and isolation play an important role. Though unplanned substantial weight loss was greatest for those who contracted COVID-19 (about 10 percent of residents observed in each week), residents who did not contract COVID-19 also physically deteriorated (about 7.5 percent of residents in each week). Conclusions and implications: These analyses show that the pandemic had substantial impacts on nursing home residents beyond what can be quantified by cases and deaths, adversely affecting the physical and emotional well-being of residents. Future policy changes to limit the spread of COVID-19 or other infectious disease outbreaks should consider any additional costs beyond the direct effects of morbidity and mortality due to COVID-19. (Edited publisher abstract)
Pushing the boundaries: a physical activity intervention extends sensor-assessed life-space in nursing home residents
- Authors:
- JANSEN Carl-Philipp, et al
- Journal article citation:
- Gerontologist, 58(5), 2018, pp.979-988.
- Publisher:
- Oxford University Press
Background and Objectives: To determine whether a multicomponent, individually tailored intervention to promote physical activity (PA) enhances life-space (LS) utilization in nursing home (NH) residents and whether intervention effects can be sustained at follow-up after continuation of the program as part of institutional daily routines. Research Design and Methods: Pre-post-assessed controlled trial in two highly similar NHs with a 3month follow-up in 143 NH residents (intervention group: n = 78; control group: n = 65) and LS as primary outcome. The PA promoting intervention consisted of several components (group sessions; individual exercise; serious games training; competence training for staff) tailored to residents’ individual functional capacity. LS was innovatively assessed via an indoor wireless sensor network including three assessment-specific LS parameters: overall LS score (LSSc), time spent away from the private room (TAFR), and the maximally distal zone from private room visited (MaxZ). To exploit the available intervention-control comparative data in the best way possible, a generalized linear mixed model approach was applied. Results: At post-test, intervention participants had a significantly higher overall LSSc, spent more TAFR, and had extended their MaxZ as compared to controls. At follow-up, a significant group difference remained for MaxZ. Discussion and Implications: A PA intervention in the NH setting impacts on LS utilization as measured using sensor-based assessment. The program has proven its practical sustainability when being handed over to NH personnel for continuation in daily practice. Further research is needed to determine whether an increase in LS utilization also impacts on social participation and quality of life. (Edited publisher abstract)
Specialist mental health consultation for depression in Australian aged care residents with dementia: a cluster randomized trial
- Authors:
- MCSWEENEY Kate, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 27(11), November 2012, pp.1163-1171.
- Publisher:
- Wiley
There is a high prevalence of depression in nursing home residents with dementia, and data has indicated an inadequate approach to the management of depression in this setting. This randomised controlled trial examined whether multidisciplinary specialist mental health consultation was more effective than care as usual in treating the depression of aged care residents with dementia. Three hundred and eighty nine older care residents were screened for dementia and major depression. Forty four were ultimately included in the intervention sample, selected from care facilities in Melbourne, Australia. Consultations involved individually tailored medical and psychosocial recommendations provided to care staff and general practitioners. All residents participated in a comprehensive pre-intervention diagnostic assessment. Findings revealed that multidisciplinary specialist mental health consultation was significantly more effective than care as usual in treating the clinical depression of aged care residents with dementia. At follow-up, 77% of the intervention group no longer met criteria for major depression. The authors concluded that the management of depressed older care residents could be improved by increasing access to specialist mental health consultation.
Associations of special care units and outcomes of residents with dementia: 2004 national nursing home survey
- Authors:
- LUO Huabin, et al
- Journal article citation:
- Gerontologist, 50(4), August 2010, pp.509-518.
- Publisher:
- Oxford University Press
This study examined the rates of specialised care for residents with Alzheimer's disease or dementia in special care units (SCUs) and other nursing home (NH) units and explored the associations of SCU residence with process of care and resident outcomes. The indicators of process of care included physical restraints, continence management, feeding tubes, and influenza and pneumococcal vaccinations. Resident outcomes included pressure ulcers, hospitalisation, emergency room visits, weight loss, and falls. Findings revealed that SCU residents were more likely to have received specialised dementia care and specialised behavioural problem management. They were less likely to have bed rails, use catheters, and yet more likely to have toilet plans/bladder training for incontinence control than those in regular units and those in NHs without an SCU. Also, SCU residents were less likely to have: pressure ulcers; hospitalisation; experienced weight loss. However, they were more likely to have falls than those in regular units and those in NHs without an SCU. The results showed that SCU residents had, in general, better process of care than those in regular units and in NHs without an SCU.
Hazards of hospitalization: residence prior to admission predicts outcomes
- Authors:
- FRIEDMAN Susan M., et al
- Journal article citation:
- Gerontologist, 48(4), August 2008, pp.537-541.
- Publisher:
- Oxford University Press
This is a prospective, observational study of 212 sequential patients admitted during a 1-month period in 2006 to a 38-bed Acute Care for Elders unit in Rochester, New York and followed until discharge. Patients were categorised by residence prior to admission (i.e., community, assisted living, and nursing home). Outcome categories were: worsening function, delirium, depression, falls, pressure sores, and nursing home admission. After adjusting for multiple characteristics, results found that patients admitted from assisted living facilities were at substantially higher risk than those admitted from the community for functional decline and falls. Patients from nursing homes had a trend toward increased risk for these outcomes, but the trend did not reach statistical significance. More than three fourths of assisted living facility residents were discharged to a nursing home after hospitalization, with a relative risk of 9.41 (p <.001) versus community-dwellers for this outcome. People who are admitted to the hospital from assisted living facilities are at high risk for falls and functional decline during hospitalization. Assisted living residents are at a particularly high risk of nursing home admission following hospitalization. Targeted preventive programs should be developed with a goal of reducing risk in this vulnerable population.
Motivational style, length of residence, voluntariness, and gender as influences on adjustment to long term care: a pilot study
- Authors:
- CURTISS Karin, HAYSLIP Bert, DOLAN Diana C.
- Journal article citation:
- Journal of Human Behavior in the Social Environment, 15(4), 2007, pp.13-34.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
A range of measurement instrument was administered to 75 nursing home residents (mean age 79.08 years; 25 men, 50 women) who varied by length of residence, gender and motivational style. The aim was to examine the impact of these variables on indicators of adjustment such as health, life satisfaction, desired and expected control, self-esteem, activities of daily living and positive/negative affect. MANCOVAs (controlling for social desirability) showed that a self-determined motivational style had a positive impact on adjustment, and interacted with gender in this respect. Length of residence and gender influenced activities of daily living, and motivational style also affected desired/expected control and self-esteem, where those with higher self-determined motivational styles had expectations for, and desirability of, control. Voluntariness of the decision to move into a nursing home generally had a positive impact on adjustment but was moderated by motivational style. The implications for nursing homes are discussed. (Copies of this article are available from: Haworth Document Delivery Centre, Haworth Press Inc., 10 Alice Street, Binghamton, NY 13904-1580).
Positive affect among nursing home residents with Alzheimer's dementia: the effect of recreational activity
- Authors:
- SCHREINER A. S., YAMANOTO E., SHOTANI H.
- Journal article citation:
- Aging and Mental Health, 9(2), March 2005, pp.129-134.
- Publisher:
- Taylor and Francis
The experience of positive emotions is an integral component of quality of life. Research suggests that cognitive deficits in persons with dementia may impede their ability to generate pleasurable moments and hence decrease their positive affect. Therefore, structured recreation activities may have the potential to significantly improve resident affect. However, differences in affect between ordinary time and recreation time are not well known. The present study used previously published structured-observation instruments to measure affect and behaviour among 35 dementia residents at two nursing homes in Japan during ordinary time and during recreation time. A total of 3,854 one-minute observations were coded. Dementia residents expressed happiness over seven times more often during recreation time than during ordinary time. Over 60% of ordinary time was solitary, with 65.72% of all observed affect being ‘Null Affect'. A total of 43.75% of residents expressed happiness only during recreation time. In addition 48.9% of all behaviour during ‘Ordinary Time' was coded as ‘Null Behaviour', which indicated that the resident was sitting and doing nothing. Findings indicate that recreation time is significantly higher in positive affect than ordinary time and that virtually all residents benefited from recreation.