Search results for ‘Subject term:"older people"’ Sort:
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Sleep patterns in older people
- Author:
- HUMM Christopher
- Journal article citation:
- Nursing Times, 6.9.01, 2001, pp.40-41.
- Publisher:
- Nursing Times
Highlights the importance of assessing the sleep needs of older people and the impact this can have on quality of care.
Measurement features of a long-term care quality of life (LTC-QoL) assessment scale
- Author:
- McDONALD Tracey
- Journal article citation:
- Journal of Care Services Management, 7(3), 2013, pp.76-86.
- Publisher:
- Taylor and Francis
The issue of life quality for older people admitted for long-term care is of concern to those keen to provide services that support an acceptable quality of life. This study investigates measurement characteristics of the long-term care quality of life (LTC-QoL) assessment scale developed to address a gap in quality in life assessment in such contexts, i.e. an easy to use single scale generating summary information on the life quality experienced by all older adults in care, indicating aspects requiring attention from direct care personnel and providing management information on individual and care unit outcomes in supporting residents' experiences of life quality. Analysis of repeated LTC-QoL data for 62 long-term residents in an Australian aged care facility establishes the instrument as having good reliability and validity. Exploratory factor analysis of nine items revealed high internal consistency, good test–retest reliability, and validity across age, gender, and cognitive capacity of participants. Findings establish that the LTC-QoL has adequate reliability and dimensionality. Content validity and management utility were verified by experts using and refining the scale over 7 years in long-term care contexts, resulting in an easy to use and reliable assessment tool for long-term care recipients. (Publisher abstract)
Resident-directed long-term care: staff provision of choice during morning care
- Authors:
- SIMMONS Sandra F., et al
- Journal article citation:
- Gerontologist, 51(6), December 2011, pp.867-875.
- Publisher:
- Oxford University Press
This study aimed to develop a protocol to assess the quality of staff-resident communication relevant to choice, and describe staff-resident interactions to assess current nursing home practices related to offering choice during morning care provision. The study included 73 long-stay residents in 2 facilities in the United States who were observed for four consecutive morning hours during targeted care activities, for twelve weeks. Interactions were observed of staff offers of choice and residents’ responses. Findings revealed that staff offered residents choice during only 18% of the morning care activities. The authors concluded that nursing home staff could use a simplified version of the tool to measure staff-resident interactions related to choice as a first step toward improving care practice.
Evaluation of Qualidem: a dementia-specific quality of life instrument for persons with dementia in residential settings; scalability and reliability of subscales in four Dutch field surveys
- Authors:
- BOUMAN A.I.E., et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 26(7), July 2011, pp.711-722.
- Publisher:
- Wiley
Data from four field surveys in the Netherlands were used to evaluate the scalability and reliability of the Qualidem quality of life instrument; an observation instrument rated by professional caregivers of persons with dementia living in residential settings. Qualidem consists of nine subscales for mild to severe dementia, of which six can be used in very severe dementia. The Mokken scaling model was used to compute scalability by subscale and dementia group. A total of 759 people with mild to severe dementia and 214 with very severe dementia residing in 36 nursing homes and 4 homes for the elderly were included. In general, the subscales for the mild to severely demented group were scalable and sufficiently reliable; confirming the results of previous research. For the very severe group, four of the six subscales were scalable (care relationship, positive affect, restless tense behaviour, and social isolation) they were also sufficiently reliable to measure quality of life. Of the other two subscales, social relations was not scalable and negative affect was scalable but insufficiently reliable. The authors conclude that Qualidem is an easy to administer and overall moderately (sufficiently) reliable rating scale that provides a quality of life profile of persons with mild to even very severe dementia living in residential settings.
Conceptualizing quality of life among older adults in guardianship: guardians and elder law attorneys talk about QOL and spirituality
- Authors:
- SVARE Gloria Messick, ANNGELA-COLE Linda
- Journal article citation:
- Journal of Religion and Spirituality in Social Work, 29(3), July 2010, pp.237-255.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
To explore definitions and assessments of Quality of Life (QOL) and spirituality as a component of QOL for older people four focus groups were conducted with elder law attorneys and guardians. All 21 participants were professionals working with incapacitated adults; 13 were guardians or case managers from a public guardian agency, 6 were guardians or case mangers from two private guardian agencies, and 2 were senior law attorneys. Seven key themes about QOL and spirituality were identified: QOL is impossible without choice; choice can be identified only by knowing the incapacitated adult as an individual; for this population, QOL is primarily subjective; quality of life versus quality of care; QOL is not static; finances limit choices; spirituality as broadly defined is related to QOL. Choice was identified as central to QOL. Choice allowed incapacitated older adults to engage in relationships and activities that are important to them and thereby increase hope, purpose,, and meaning in life. As individuals lose the ability to communicate, spiritual aspects of life continue to be as, or even more, prominent although taking different forms. Participant feedback supported the use of a general QOL measure, rather than a health-related QOL measure, which includes a measure of spiritual wellbeing in this population.
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.
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.
Self report on quality of life in dementia with modified COOP/WONCA charts
- Authors:
- ETTEMA T. P., et al
- Journal article citation:
- Aging and Mental Health, 11(6), November 2007, pp.934-742.
- Publisher:
- Taylor and Francis
This study investigates whether a modified version of the COOP/WONCA charts is suitable to assess quality of life (QOL) in persons with dementia in nursing homes. A group of 112 institutionalized persons in Dutch nursing homes with moderate to severe dementia were approached for an interview. Twenty-two were observed not to be communicative, leaving 90. Sixty-seven persons were able to answer four out of six questions adequately (interviewable). Inter-observer reliability (n=38) was excellent. Test-retest reliability (n=34; one week interval) ranged from poor for Daily and Social Activities and for the QOL charts, to moderate for Feelings and Pain, and satisfactory for Physical Functioning. Interviewability was associated with severity of the dementia and communication ability. Support for convergent validity was found in medium-sized Spearman correlations between the COOP/WONCA charts and related variables. Support for discriminant validity was found in the absence of association between the COOP/WONCA charts and non-related variables. The modified COOP/WONCA charts can be used to assess QOL in 60% of people with dementia in nursing homes but further modification is needed. Severe cognitive impairment and communication disabilities proved limiting factors for the use of the instrument. Although the illustrations on the charts appeared not to be helpful, the written response options in addition to verbal presentation proved useful during the administration of the charts.
Development of a nursing home vision-targeted health-related quality of life questionnaire for older adults
- Authors:
- DREER L. E., et al
- Journal article citation:
- Aging and Mental Health, 11(6), November 2007, pp.722-733.
- Publisher:
- Taylor and Francis
To develop a questionnaire assessing vision-targeted health-related quality of life in older adults residing in nursing homes. Using content previously identified through structured interviews with nursing home residents, the 57-item Nursing Home Vision-Targeted Health-Related Quality of Life questionnaire (NHVQoL) was drafted with nine subscales - general vision, reading, ocular symptoms, mobility, psychological distress, activities of daily living, activities/hobbies, adaptation/coping and social interaction. Construct validity and internal consistency and test-retest reliability of subscales were evaluated in a sample of adults 60 years old residing in nursing homes in Birmingham, Alabama, who had Mini Mental State Exam (MMSE) scores of 13. Results: Participants (n=189) had a mean age of 82 years (SD=7.7), were 84% women and 16% men, 24% African-American and 76% Caucasian and had resided in a nursing home for two years on average. All NHVQoL subscales were correlated with subscales from other vision-targeted and generic health-related quality of life instruments. Lower scores were associated with increased depressive symptomatology by the Geriatric Depression Scale, increased mobility problems, worse distance and near acuity and worse contrast sensitivity. All subscales had Cronbach >0.95. Test-retest reliability (two-week period) for subscales ranged from 0.57 to 0.84. Subscale scores did not differ as a function of MMSE scores. The NHVQoL has subscales with good internal consistency reliability and validity. Test-retest reliability is comparable to other questionnaires designed for the nursing home population. This questionnaire may ultimately be useful in understanding the personal burden of visual impairment and eye disease on quality of life and mental health in older nursing home residents and for evaluating the impact of psychosocial and eye care interventions on health-related quality of life in this population.
The single assessment process in primary care: older people's accounts of the process
- Authors:
- POWELL Jackie, et al
- Journal article citation:
- British Journal of Social Work, 37(6), September 2007, pp.1043-1058.
- Publisher:
- Oxford University Press
Recent government policies have been active in addressing social inclusion and active participation of older people in many aspects of societal life. Drawing on a feasibility study of the Single Assessment Process as a ‘case-finding’ approach, this paper presents findings drawn from older people’s accounts of this experience. These accounts indicate the potential of the process for identifying ‘low-level’ need, whilst raising issues of access to formal services and resource constraint; also they underline the importance of understanding how older people seek ways of managing their own health and well-being, whilst continuing to contribute to the social cohesion of society by providing support to their peers and to younger generations. Interdependence, it is suggested, rather than dependence should underlie any approach to assessing older people’s needs, if we are to appreciate and build upon the complexity of older people’s strategies for actively managing their lives.