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Pain in care home residents with dementia: an exploration of frequency, prescribing and relatives' perspectives
- Authors:
- BARRY Heather E., et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 30(1), 2015, pp.55-63.
- Publisher:
- Wiley
Objectives: This study aims to determine pain frequency amongst care home residents with dementia, to investigate variables associated with pain, to explore analgesic use among residents and to seek residents' relatives' views on provision of care and management of pain by the care home. Methods: Structured face-to-face interviews were conducted with residents, nursing staff and relatives from nine dementia care homes in Northern Ireland, between May 2010 and March 2012. Demographic information was collected from participants, neuropsychiatric tests were used to assess residents' cognitive functioning, medication use was determined from care home records and residents' pain was assessed using a verbal descriptor scale. Relatives' views were sought on care provision and management of pain. Results: Forty-two residents, 16 nurses/care assistants and 35 relatives participated; the participation rate of residents was low (27.6%). Most residents were suffering moderate–severe dementia, and some residents (26.2%) were unable to provide a self-report of pain. A significantly higher proportion of relatives (57.1%) deemed residents to be experiencing pain at the time of the interview, compared with residents (23.8%, p = 0.005) and nurses/care assistants (42.9%, p = 0.035). Most residents (88.1%) were prescribed with analgesia; non-opioid analgesics were most commonly prescribed. High proportions of residents were prescribed with psychoactive medications. Antipsychotic drug use was associated with presence of pain (p = 0.046). Conclusions: This study has reinforced the challenge of assessing and managing pain in this resident population and highlighted issues to be addressed by long-term care providers and clinicians. Participation of people with dementia, and their families, in healthcare research needs to be improved. (Publisher abstract)
Making choices: meeting the current and future accommodation needs of older people. Good practice guide: reconfiguration of statutory residential homes
- Author:
- NORTHERN IRELAND. Health and Social Care Board
- Publisher:
- Northern Ireland. Health and Social Care Board
- Publication year:
- 2013
- Pagination:
- 24
- Place of publication:
- Belfast
The relocation of older people from one care setting to another can be particularly stressful, and there is a perception that the closure of residential homes can have an adverse effect on residents' health and wellbeing. However, research carried out by AGE NI has found that the effects a home closure has on resident’s health and psychological well-being is influenced by the way in which a home is closed and how the relocation is managed. This document outlines how best practice should be adopted pre- relocation, during relocation and post relocation. For the purpose of this document, pre-relocation refers to the time period from when the resident begins to consider moving to another residence until the actual move. Relocation refers to the actual day of transition from one residence to another; and post relocation refers to the time after the individual has moved from one residence to a new residence. This document draws on previously published papers which outline lessons learnt in the reconfiguration of care homes in the past, both within the Health and Social Care system in Northern Ireland and in the wider UK. It also draws on examples of best practice for planned, phased or emergency reconfiguration; and on the experience of the community and voluntary sector (AGE NI and the Alzheimer’s Society) who have acted as advocates in the closure of care homes in the past. (Edited publisher abstract)
Jimmy: assessing and exploring unmet needs
- Authors:
- SCOTT Ann, HUTCHINSON Tania
- Journal article citation:
- Journal of Dementia Care, 16(5), September 2008, pp.30-33.
- Publisher:
- Hawker
A case study is used to demonstrate the support model used by the Newcastle Challenging Behaviour Service. The case study illustrates how an elderly man, whose agitated behaviour in the evenings caused problems for care staff and other residents, was helped using the model. The model conceptualises residents' behaviours as strategies employed by a person to meet an unfulfilled or 'unmet' need.
Low expectations: attitudes on choice, care and community for people with dementia in care homes
- Author:
- QUINCE Chris
- Publisher:
- Alzheimer's Society
- Publication year:
- 2013
- Pagination:
- 88p.
- Place of publication:
- London
This report looks at the key issues affecting people with dementia living in care homes. Evidence is drawn from surveys of family members of people with dementia, staff working in care homes, and people with dementia themselves. The surveys were distributed to Alzheimer’s Society members, care homes in England, Wales and Northern Ireland, and through some Alzheimer’s Society staff and online. The report also presents evidence from a YouGov poll carried out in December 2012, of 2,060 adults, into perceptions about care homes and draws on existing public policy evidence on care and performance of care homes. The report looks at four main areas of care: the context of the care home market; the availability of information and support to help families and individuals make choices about moving into care; the quality of care; and the access and quality of external services delivered from outside the home, as well as findings around how the home works with the wider community. The surveys found low expectations about the quality of life of people with dementia in care homes. Views on the quality of care for people living in care homes were more positive, but there were concerns about ongoing investment in training. People also found the process of finding information on care homes challenging. Experiences of support from health services and engagement with the community were mixed. The report makes six recommendations to raise awareness, inform policy and change practice. Tables presenting results from the surveys are included.