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Identification of needs of older adults with intellectual disabilities
- Authors:
- ALBUQUERQUE Cristina P., CARVALHO Ana Cristina
- Journal article citation:
- Journal of Policy and Practice in Intellectual Disabilities, 17(2), 2020, pp.123-131.
- Publisher:
- Wiley
Information regarding individual needs of older adults with intellectual disabilities (IDs) is scarce although it is very important both from a person‐centered planning perspective and from a proactive service system perspective. This study has three main aims: (1) to identify and describe staff perceptions of the needs of a large group of adults aged 45 or over with IDs; (2) to analyze the perceived needs as function of age, gender, and level of disability; (3) to present information about the development and the psychometric properties of the assessment instrument used. The participants were 232 Portuguese older adults with IDs (mean age = 52), predominantly male (n = 129). There were 66 staff members who assessed the needs of the IDs participants through the Inventory of Identification of Needs (IIN). The IIN demonstrated satisfactory psychometric properties (e.g., internal consistency, interrater reliability, construct validity). The unmet needs were numerous and diverse, but those that were perceived as more prevalent were: literacy, handling of money, information on rights, self‐care, information on services, communication, occupation at holidays, occupation at weekends, general physical health, cognitive rehabilitation, and daytime activities. The needs were influenced by the disability level: regarding Literacy/Information and Occupation/Community, needs were significantly more common in persons with a moderate and/or severe disability. The influence of age was registered only in Mental Health. The needs identified should guide the planning and development of service provision. These should offer literacy learning experiences, information about the rights of persons with disabilities, information about the services available, self‐care assistance or training in self‐care skills; and meaningful activities during regular time periods, weekends and holidays. (Publisher abstract)
Using patient reported outcomes measures to promote integrated care
- Authors:
- RIKKERT Marcel G.M. Olde, et al
- Journal article citation:
- International Journal of Integrated Care, 18(2), 2018, p.8. Online only
- Publisher:
- International Foundation for Integrated Care
Introduction: Patient reported outcome measures (PROMs) have been introduced as standardised outcomes, but have not been implemented widely for disease targeted pathways of care, nor for geriatric patients who prefer functional performance and quality of life. Discussion: innovative multipurpose implementation of PROMs as evidenced by two best practices of PROMs application in geriatric and physiotherapy practice is described. The study shows that PROMs can show meaningful outcomes in older subjects’ patient journeys, which can at the same time serve individuals and groups of both patients and professionals. Key lesson: PROMs can deliver generic outcomes relevant for older patients, may improve patient-physician relationship, quality of care and prediction of future outcomes in geriatric care, if they are valid, reliable and responsive, but still short and simple. A precondition to make the hard tip from research to practice is that PROMs are carefully positioned in the clinical encounters and in electronic health records. (Edited publisher abstract)
Embracing touch in dementia care: a person-centred approach to touch and relationships
- Author:
- TANNER Luke
- Publisher:
- Jessica Kingsley
- Publication year:
- 2017
- Pagination:
- 256
- Place of publication:
- London
This practical guide instructs carers on how to re-evaluate their use of physical contact in dementia care to create a more effective, person-centred care system. It demonstrates the vital role touch plays in supporting relationships and wellbeing, and challenges the barriers preventing staff from using touch in meaningful ways. It demonstrates that touch and other forms of non-verbal communication are essential for 'being with' and not just 'doing to' people living with a dementia. It provides training exercises on consent and non-verbal communication, explaining how and when to use touch effectively in everyday interactions, and in all stages of dementia. (Edited publisher abstract)
Honoring the everyday preferences of nursing home residents: perceived choice and satisfaction with care
- Authors:
- BANGERTER Lauren R., et al
- Journal article citation:
- Gerontologist, 57(3), 2017, pp.479-486.
- Publisher:
- Oxford University Press
Purpose of the Study: The nursing home (NH) culture change movement advocates for residents to be able to make choices about important aspects of their care. This study seeks to understand NH residents’ perceptions of choice that they have in the care they receive while in the NH setting. The authors examine the association between residents’ perceived choice and satisfaction with care preferences being met using a mixed methods approach. Design and Methods: Using the Preferences of Everyday Living Inventory, cognitive interviews were completed with 39 NH residents which resulted in a total of 600 item-level ratings of residents’ perceived choice and satisfaction and corresponding open-ended comments on choice. Results: Quantitative findings revealed a significant Pearson correlation between residents’ perceived choice and satisfaction. Participants’ responses of free choice were linked to significantly higher ratings of satisfaction compared to no choice and some choice. Responses of some choice were associated with significantly higher ratings of satisfaction than the no choice group. Open-ended comments provided greater depth in understanding regarding how residents perceive the level of choice in fulfilling their preferences. Implications: This study establishes a positive association between NH residents’ perceived choice and feelings of satisfaction with their care preferences being met. Offering choices that are deemed favourable or solicited from NH residents is a fundamental step toward increasing resident satisfaction with NH care. (Edited publisher abstract)
Effects of multisensory and motor stimulation on the behavior of people with dementia
- Authors:
- SPOSITO Giovana, et al
- Journal article citation:
- Dementia: the International Journal of Social Research and Practice, 16(3), 2017, pp.344-359.
- Publisher:
- Sage
A quasi-experimental study using a pre–posttest design was conducted in four aged care facilities to assess the effects of a person-centred care (PCC) multisensory stimulation (MSS) and motor stimulation (MS) programme, implemented by direct care workers, on the behaviours of residents with dementia. Data were collected at baseline and after the intervention through video recordings of morning care routines. Forty-five residents with moderate and severe dementia participated in the study. A total of 266 morning care routines were recorded. The frequency and duration of a list of behaviours were analysed. The frequency of engagement in task decreased significantly (p = .002) however, its duration increased (p = .039). The duration of gaze directed at direct care workers improved significantly (p = .014) and the frequency of closed eyes decreased (p = .046). There was a significant decrease in the frequency of the expression of sadness. These results support the implementation of PCC–MSS and MS programmes as they may stimulate residents' behaviours. (Edited publisher abstract)
Focusing on personal outcomes in care homes
- Authors:
- BARRY K., et al
- Publisher:
- My Home Life
- Publication year:
- 2016
- Pagination:
- 2
- Place of publication:
- Hamilton
This briefing describes steps taken by the My Home Life project to explore the opportunities and challenges of implementing a focus on personal outcomes in care homes. It summarises key elements of a personal outcomes approach, highlights some unique features of outcomes focused practice in the care home sector, and considers the ways in which My Home Life principles might support this. (Edited publisher abstract)
Taking control: putting older people at the centre of elder abuse response strategies
- Author:
- CHESTERMAN John
- Journal article citation:
- Australian Social Work, 69(1), 2016, pp.115-124.
- Publisher:
- Taylor and Francis
Elder abuse is acknowledged to be a significant social problem in Australia, but Australia's elder abuse responses have significant limitations. These responses, as evidenced by state and territory elder abuse strategies, voice important principles and typically seek to improve the knowledge of service providers, potential victims, and the general public about elder abuse. But they tend only to identify and draw upon existing service and community care responses in their attempts to address elder abuse. This article provides a policy analysis of existing elder abuse response strategies and argues that reforms are needed to ensure that the strategies: prioritise the wishes and wellbeing of the person in question; identify and empower lead agencies; and drive collaborative responses. (Publisher abstract)
Crossing the bridge – connecting with people in the later stages of dementia
- Author:
- BRADLEY Andy
- Journal article citation:
- Working with Older People, 19(4), 2015, pp.177-181.
- Publisher:
- Emerald
Purpose: The purpose of this paper is to provoke reflection on the risks of people in the later stages of dementia being marginalised in care settings and to set out some key principles and approaches which enable ongoing connection. The paper provides practice examples to illuminate ways in which connected relationships can be maintained. Design/methodology/approach: This is a view point paper based on both a personal perspective (the writer grew up in a care home) and professional experience in the field of care work and culture change. Findings: Connecting with people who are in the later stages of dementia is of central importance in offering person-centred relational care. Originality/value: The PACE principles described are original and are published here for the first time. (Publisher abstract)
User-oriented elderly care: a validation study in two different settings using observational data
- Authors:
- KAZEMI Ali, KAJONIUS Petri J.
- Journal article citation:
- Quality in Ageing and Older Adults, 16(3), 2015, pp.140-152.
- Publisher:
- Emerald
Purpose: User-oriented care, defined as individualised assisting behaviours, is the dominant approach within elderly care today. Yet, there is little known about its conceptual structure. This paper proposes that user-oriented care has a bi-partite structure which may be decomposed into the two dimensions of task and relation. Design/methodology/approach: Care workers were “shadowed” (i.e. observed) at their work (n=391 rated interactions). User-oriented care was assessed along ten process quality indicators targeting the acts of caregiving (i.e. task focus, relation focus, involvement, time-use, body language, autonomy, respect, warmth, encouragement, and information) in two elderly care settings, i.e. home care and nursing home. Observations added up to 45 hours. Findings: Principal component analyses confirmed the proposed two-factor structure of user-oriented care. Specifically, the user-oriented care indicators loaded on two distinct factors, i.e. task and relation. The underlying structure of user-oriented care revealed to be invariant across the two settings. However, the results revealed interesting structural differences in terms of explained variance and the magnitude of factor loadings in the home care and nursing home settings. Differences also emerged specifically pertaining to the indicators of autonomy and time-use. These findings suggest that user-oriented behaviour may to some extent denote different acts of caregiving and what may be called task- and relation-orientation may be loaded with different meanings in these two care settings. Originality/value: This is the first study investigating user-oriented behaviour in the context of elderly care using a quantitative observational approach. The authors propose that the observed differences between the two care settings are primarily not due to better elderly care work in home care, but due to some inherent differences between these two contexts of care (e.g. better health and living at home). (Edited publisher abstract)
Computer activities for persons with dementia
- Authors:
- TAK Sunghee H., et al
- Journal article citation:
- Gerontologist, 55, Supplement 1 2015, pp.S40-S49.
- Publisher:
- Oxford University Press
Purpose of the study: The study examined participant’s experience and individual characteristics during a 7-week computer activity programme for persons with dementia. Design and Methods: The descriptive study with mixed methods design collected 612 observational logs of computer sessions from 27 study participants, including individual interviews before and after the programme. Quantitative data analysis included descriptive statistics, correlational coefficients, t-test, and chi-square. Content analysis was used to analyse qualitative data. Results: Each participant averaged 23 sessions and 591min for 7 weeks. Computer activities included slide shows with music, games, internet use, and emailing. On average, they had a high score of intensity in engagement per session. Women attended significantly more sessions than men. Higher education level was associated with a higher number of different activities used per session and more time spent on online games. Older participants felt more tired. Feeling tired was significantly correlated with a higher number of weeks with only one session attendance per week. More anticholinergic medications taken by participants were significantly associated with a higher percentage of sessions with disengagement. The findings were significant at p < .05. Qualitative content analysis indicated tailoring computer activities appropriate to individual’s needs and functioning is critical. All participants needed technical assistance. Implications: A framework for tailoring computer activities may provide guidance on developing and maintaining treatment fidelity of tailored computer activity interventions among persons with dementia. Practice guidelines and education protocols may assist caregivers and service providers to integrate computer activities into homes and ageing services settings. (Edited publisher abstract)