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Preventing depression in homes for older adults: are effects sustained over 2 years?
- Authors:
- SCHAIK Dinga J.F. van, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 29(2), 2014, pp.191-197.
- Publisher:
- Wiley
Methods: A 2-year follow-up study of a pragmatic randomised controlled trial was conducted in 14 residential homes in the Netherlands to evaluate the 2-year effects of a stepped-care programme to prevent the onset of a major depressive disorder (MDD). A total of 185 residents (Center for Epidemiologic Studies Depression Scale score >7), who did not meet the diagnostic criteria for MDD, were randomised to a stepped-care programme (n = 93) or to usual care (n = 92). Stepped-care participants sequentially underwent watchful waiting, a self-help intervention, life review and a consultation with the general practitioner. The primary outcome measure was the incidence of MDD during a period of 2 years, according to the Mini International Neuropsychiatric Interview. Results: After 2 years, the incidence of MDD was not significantly reduced in the intervention group compared with the control group. However, in the completer analysis, on the basis of 79 residents who completed the 2-year measurements, there was a significant difference in favour of the intervention group. Dropout percentages were high (44%), mostly accounted for by illness and death (68%). Conclusion: A minority of residents had benefit from the intervention that sustained after 2 years in the completer group. Yet, these findings cannot be generalised as the majority of the residents did not opt for participation in the project and many dropped out. Ways should be sought to motivate residents with depressive symptoms to engage in preventive interventions. (Edited publisher abstract)
Avoiding unnecessary hospital admissions among older people: residential care
- Author:
- SOCIAL CARE INSTITUTE FOR EXCELLENCE
- Publisher:
- Social Care Institute for Excellence
- Publication year:
- 2012
- Place of publication:
- London
As care homes now support some of the most frail and ill older people in this country, they need to plan and deliver care carefully if they are to avoid adding to the numbers needing hospital admissions. This film presents the approach of Lime Court Care Home, who have introduced a number of new policies and practices with the specific aim of reducing hospital admissions amongst their residents. Lead by manager Mike Richardson, Lime Court have focussed on infection control, mental health support, reducing falls, better medication management, nutrition and planning for end of life care. The attention placed on each of these areas, combined with increased community health input and a stable team able to provide continuity and consistency of care, has enabled Lime Court to significantly reduce hospital admissions whilst improving outcomes for residents. The film will be useful for care home managers; care home staff; health and social care commissioners; GPs and community health professionals; people using services and carers.
Reducing hospital admissions from care homes
- Authors:
- BURNS Caroline, HURMAN Caroline
- Journal article citation:
- Nursing Times, 15.01.13, 2013, pp.23-25.
- Publisher:
- Nursing Times
A community matron for care homes was developed in an area of Surrey to help reduce inappropriate hospital admission of residents. The matrons used an advisory and supportive approach to assist care home staff in developing their competence and confidence in maintaing their residents' care. Issues contributing to avoidable emergency admission that were addressed included: lack of confidence and competence of staff; incidence of falls; lack of partnership working; advanced care planning; and the need for improved communication. A survey sent to 35 care home managers (79% response rate) recieved positive feedback on the service.
A review of cleanliness, hygiene and infection control in care homes for older people 2005
- Author:
- CARE COMMISSION
- Publisher:
- Care Commission
- Publication year:
- 2005
- Pagination:
- 25p.
- Place of publication:
- Dundee
Although the majority of Scotland's care homes have good procedures in place to prevent infection - but there is still much room for improvement. This review examined 916 inspection reports from 2003-04, and analysed compliance against a range of standards and regulations governing hygiene, cleanliness and infection control. The report shows that, at the time of inspection, 79% of homes appeared to be practising good infection control, by providing a clean environment and good hygiene practices. The remaining 21% were given requirements and recommendations for improvement. Most requirements were made about inadequate policies and procedures. Other reasons for putting requirements in place included the cleaning and maintenance of equipment, managing clinical waste, storing and serving food, and staff training.
Unexplained absence resulting in deaths of nursing home residents in Australia: a 13‐year retrospective study
- Authors:
- WOOLFORD Marta H., et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 33(8), 2018, pp.1082-1089.
- Publisher:
- Wiley
Objectives: To examine deaths of Australian nursing home (NH) residents following an unexplained absence. Methods: Population based cross‐sectional study was conducted using coronial data from the National Coronial Information System. Participants are residents of accredited NHs if death followed an unexplained absence and was reported to the Coroner between July 1, 2000 and June 30, 2013. Individual, organisational, environmental, and unexplained absence event factors were extracted from coronial records. Data were analysed using descriptive statistics. Results: Of 21 672 NH deaths, 24 (0.1%) followed an unexplained absence. This comprised 17 unintentional external (injury‐related) causes and 7 natural cause deaths. Drowning was the most frequent external cause of death (59%, n = 10). Deaths occurred more frequently in males (83.3%, n = 20), and in the age group 85‐94 years (37.5%, n = 9). The majority of NH residents, for whom data were available (n = 15), had a diagnosis of dementia (86.7%, n = 13). Most residents were found in waterways (41.7%, n = 10). Median distance travelled was 0.5 km (IQR: 0.25‐2.4 km), with almost 70% of residents found within 1.0 km of their NH. Most residents left the NH by foot (88.2%, n = 15). Half of the residents were found within 6 hours of time last seen (median: 6 hours, 40 minutes; IQR: 6.0‐11.45 hours). Conclusion: Unexplained absences in elderly NH residents are a relatively common event. This study provides valuable information for aged care providers, governments, and search and rescue teams, and should contribute to debates about balancing issues of safety with independence. (Edited publisher abstract)
Staying on my feet: a practice guide for care homes
- Author:
- MY HOME LIFE CYMRU
- Publisher:
- My Home Life Cymru
- Publication year:
- 2018
- Pagination:
- 16
- Place of publication:
- Swansea
This practice guide, funded by the Welsh Government, explores what works well in supporting care home residents to remain mobile and to reduce their risk of falling. It draws on the experiences of care home staff attending events in Wales to share their expertise and stories of good practice. The guide includes examples on how care home practitioners can support residents to navigate safely around the home; how they can help residents feel motivated to get out of their chair and engage in physical activity, and how they can encourage residents to drink or eat properly. It also shows how staff have to consider how they help get the balance between reducing the risks of falling with the rights of these individuals to make choices. The guide highlights a number of creative individual strategies. It also includes a Care Home Falls Prevention Wheel which identifies 8 key areas that together can support best practice. (Edited publisher abstract)
Staff-reported strategies for prevention and management of resident-to-resident elder mistreatment in long-term care facilities
- Authors:
- ROSEN Tony, et al
- Journal article citation:
- Journal of Elder Abuse and Neglect, 28(1), 2016, pp.1-13.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
Resident-to-resident elder mistreatment (R-REM) in nursing homes is frequent and leads to adverse outcomes. Nursing home staff responses may significantly mitigate R-REM’s impact, but little is known about current practices. The objective was to identify common staff responses to R-REM. The authors interviewed 282 certified nursing assistants (CNAs) in five urban nursing homes on their responses during the previous 2 weeks to R-REM behaviours of residents under their care. Ninety-seven CNAs (34.4%) reported actions responding to R-REM incidents involving 182 residents (10.8%), describing 22 different responses. Most common were physically intervening/separating residents (51), talking calmly to settle residents down (50), no intervention (39), and verbally intervening to defuse the situation (38). Less common were notifying a nurse (13) or documenting in behaviour log (4). Nursing home staff report many varied responses to R-REM, a common and dangerous occurrence. CNAs seldom documented behaviours or reported them to nurses. (Edited publisher abstract)
Reducing the incidence of falls and hip fractures in care homes
- Authors:
- JOHNSON Tracy, BINNEY Samantha
- Journal article citation:
- Nursing Times, 17.6.03, 2003, pp.38-40.
- Publisher:
- Nursing Times
Reports on a project, hosted by a primary care trust to, provide older residents in nursing and residential care homes in Sheffield with hip protectors if they were at risk of falling. During the project it became apparent that care home staff had little knowledge of hip protectors, and felt unable to take steps to prevent falls. The project then extended its scope to raise the awareness of falls-risk assessment and prevention strategies, and develop structures through which best practice could be shared between homes.
Educating health and social service professionals in the detection and management of mistreated nursing home residents
- Authors:
- CAPEZUTI Elizabeth, SIEGLER Eugenia
- Journal article citation:
- Journal of Elder Abuse and Neglect, 8(3), 1996, pp.73-86.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
After serving as expert witnesses in the successful criminal prosecution of a nursing home corporation in the USA charged with involuntary manslaughter of two nursing home residents, the authors saw the need to improve recognition and prevention of institutional mistreatment. This article describes their involvement in post-trial advocacy efforts to improve the quality of care of nursing home residents through community education efforts.
Safeguarding adults: looking out for each other to prevent abuse
- Author:
- SOCIAL CARE INSTITUTE FOR EXCELLENCE
- Publisher:
- Social Care Institute for Excellence
- Publication year:
- 2014
- Pagination:
- 11 minutes 16 seconds
- Place of publication:
- London
The film shows how good communication with older people can improve safeguarding. In residential care it is important that staff take the time to talk to residents and to listen to their concerns. Two community projects demonstrate how people are encouraged to look out for each other and to report any concerns about the safety of individuals. The Elders Forum based at the Malcolm X Community Centre in Bristol and the Ivybank House Residential Home in Bath both demonstrate how an open learning environment can encourage older people to speak out if they have seen or experienced abuse. This film was previously available under the title: Safeguarding adults: preventing abuse through community cohesion, communication and good practice.' (Publisher abstract)