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Assessing and comparing physical environments for nursing home residents: using new tools for greater research specificity
- Authors:
- CUTLER Lois D., et al
- Journal article citation:
- Gerontologist, 46(1), February 2006, pp.42-51.
- Publisher:
- Oxford University Press
The authors developed and tested theoretically derived procedures to observe physical environments experienced by nursing home residents at three nested levels: their rooms, the nursing unit, and the overall facility. Illustrating with selected descriptive results, in this article we discuss the development of the approach. On the basis of published literature, existing instruments, and expert opinion about environmental elements that might affect quality of life, the authors developed separate observational checklists for the room and bath environment, unit environment, and facility environment. The authors trained 40 interviewers without specialized design experience to high interrater reliability with the room-level assessment. The authors used the three checklists to assess 1,988 resident room and bath environments, 131 nursing units, and 40 facilities in five states. From the data elements, they developed quantitative indices to describe the facilities according to environmentally relevant constructs such as function-enhancing features, life-enriching features, resident environmental controls, and personalization. The authors reliably gathered data on a large number of environmental items at three environmental levels. Environments varied within and across facilities, and the authors noted many environmental deficits potentially relevant to resident quality of life. Implications: This research permits resident-specific data collection on physical environments and resident-level research using hierarchical analysis to examine the effects of specific environmental constellations.
Living in someone else's home: the concept of negotiation, the process of ownership and the role of relationships in homes for older people; the 1997 Graham Lecture, delivered at the Ismaili Centre, London, 4 November 1997
- Author:
- CLOUGH Roger
- Publisher:
- Counsel and Care
- Publication year:
- 1998
- Pagination:
- 36p.,bibliog.
- Place of publication:
- London
Paper focusing on the relationship of the people who live in residential care and nursing homes to the place where they live and to other people who live and work there.
Resident- and facility-level predictors of quality of life in long-term care
- Authors:
- SHIPPEE Tetyana P., et al
- Journal article citation:
- Gerontologist, 55(4), 2015, pp.643-655.
- Publisher:
- Oxford University Press
Purpose: This study assesses multiple domains of quality of life (QOL) for nursing home residents and examines facility- and resident-level correlates for different domains. Design and Methods: Data come from (a) self-reported resident interviews using a multidimensional measure of QOL; (b) resident clinical data from the Minimum Data Set; and (c) facility-level characteristics from Minnesota Department of Human Services. Factor analysis was used to confirm domains of QOL, and then employed cross-sectional hierarchical linear modelling to identify significant resident- and facility-level predictors of each domain. Results: Six unique domains of QOL were examined: environment, personal attention, food, engagement, negative mood, and positive mood. In multilevel models, resident-level characteristics were more reliable correlates of QOL than facility characteristics. Among resident characteristics, gender, age, marital status, activities of daily living, mood disorders, cognitive limitations, and length of stay consistently predicted QOL domains. Among facility characteristics, size, staff hours, quality of care, and percent of residents on Medicaid predicted multiple QOL domains. Implications: Examining separate domains rather than a single summary score makes associations with predictors more accurate. Resident characteristics account for the majority of variability in resident QOL. Helping residents maintain functional abilities, and providing an engaging social environment may be particularly important in improving QOL. (Edited publisher abstract)
Memories, identity and homeliness: the social construction of mealtimes in residential care homes in South Wales
- Authors:
- PHILPIN Susan, et al
- Journal article citation:
- Ageing and Society, 34(5), 2014, pp.753-789.
- Publisher:
- Cambridge University Press
Mealtimes in residential care homes are fundamentally social occasions, providing structure to the day and opportunities for conversation and companionship. This paper reports on particular findings from a qualitative study which investigated factors influencing nutritional care provided to residents in two different types of residential care settings in South Wales, UK. Data were generated through focus group interviews with relevant staff members (N = 15), individual interviews with managers (N = 4) and residents (N = 16) of the care homes and their informal carers (N = 10), observation of food preparation and mealtimes throughout the day, and analysis of appropriate documents. Data were analysed using thematic analysis. This paper's focus is on the ways in which care home residents' experiences and understandings of mealtimes were influenced by various environmental factors, such as the home's geographical location, physical lay-out and ambience. Moreover, the shared meaning of mealtimes for residents, informal carers and staff was constructed from each group's socio-cultural background, family experiences and memories, and was integral to residents' sense of normality, community and identity (Edited publisher abstract)
Lifting winter spirits: how to get through the dark months
- Author:
- NEWSON Pauline
- Journal article citation:
- Nursing and Residential Care, 12(12), December 2010, pp.595-599.
- Publisher:
- MA Healthcare Ltd.
- Place of publication:
- London
This article considers factors which have the potential to give greater meaning to life and promote the well-being of older people resident in care homes during the winter months. Getting to know each resident and improving upon staff-user relationships, through for example, life story work is important for staff when discussing how best they can spend the more limited hours of daytime in the winter. The authors explore how to create an enabling environment, through monitoring noise levels, use of mirrors to reflect more light into the environment, and the use of comforting smells such as baking and preserving. Strategies for physical and mental well-being; education; improving connections with family, friends; and entertainment are also advocated.
Social well-being in extra care housing
- Author:
- EVANS Simon
- Publisher:
- Care Services Improvement Partnership. Housing Learning and Improvement Network
- Publication year:
- 2008
- Pagination:
- 13p.
- Place of publication:
- London
The well-being of older people is an important issue for policy across health, housing and social care, and local authorities are increasingly considering extra care as a way of replacing older models of residential care provision and addressing low demand for traditional forms of sheltered housing. The researchers interviewed residents and managers from six extra care housing schemes in England to explore their experiences. They conclude that the social well-being of tenants should be a major consideration in the planning, designing and management of extra care housing and they identify a range of factors that need to be taken into account.
Quality of life and building design in residential and nursing homes for older people
- Authors:
- PARKER Chris, et al
- Journal article citation:
- Ageing and Society, 24(6), November 2004, pp.941-962.
- Publisher:
- Cambridge University Press
Older people living in residential and nursing care homes spend a large proportion of their time within the boundaries of the home, and may depend on the environment to compensate for their physical or cognitive frailties. Regulations and guidelines on the design of care buildings have accumulated over time with little knowledge of their impact on the quality of life of building users. The Design in Caring Environments Study (DICE) collected cross-sectional data on building design and quality of life in 38 care homes in and near Sheffield, Yorkshire. Quality of life was assessed using methods which included all residents regardless of their frailty, and staff morale was also assessed. The physical environment was measured on 11 user-related domains using a new tool, the Sheffield Care Environment Assessment Matrix (SCEAM). Significant positive associations were found between several aspects of the built environment and the residents' quality of life. There was evidence that a focus on safety and health requirements could be creating risk-averse environments which act against quality of life, particularly for the least frail residents. Staff morale was associated with attributes of a non-institutional environment for residents rather than with the facilities provided for the staff. The new tool for assessing building design has potential applications in further research and for care providers.