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Comparison of the characteristics of homes for older people in Slovenia with Goffman's concept of the total institution
- Author:
- MALI Jana
- Journal article citation:
- European Journal of Social Work, 11(4), 2008, pp.431-443.
- Publisher:
- Taylor and Francis
The past concepts of life and work in homes for older people in Slovenia are no longer adequate to meet the needs, wishes and requirements of their current users. One of the basic premises, relying on Goffman's concept of the total institution, is that the first and foremost characteristic of homes for older people is that they are institutions. The theoretical starting point, namely that Goffman's concept of the total institution is ideal-typical, was corroborated by an investigation of the presence of elements of the total institution in Slovenian homes for older people, proving that not all features of the total institution can be found in any chosen empirical selection of institutions, with the data showing that those characteristics which are present do not exist in the ideal, that is in the most pronounced form. The homes' users are given consideration, their personnel are adapting to their needs and requirements, even though this occurs within the functioning of an institution whose aims, i.e. to care for a large number of people living in one place, make life in such an institution subordinated to rules, along with the bureaucratisation and routinisation of services.
How to keep residents active
- Author:
- SALE Anabel Unity
- Journal article citation:
- Community Care, 4.12.08, 2008, pp.30-31.
- Publisher:
- Reed Business Information
Ashley House care home in Borden, Hampshire provides a wide range of activities for residents - both formally structured events and spontaneous activities. This article reports on their practice and the benefits for residents.
What the resident meant to say: use of cognitive interviewing techniques to develop questionnaires for nursing home residents
- Authors:
- HOUSEN Patricia, et al
- Journal article citation:
- Gerontologist, 48(2), April 2008, pp.158-169.
- Publisher:
- Oxford University Press
Emphasis on consumer-centred care for frail and institutionalized older adults has increased the development and adaptation of surveys for this population. Conventional methods used to pretest survey items fail to investigate underlying sources of measurement error. However, the use of the cognitive interview (CI), a method for studying how respondents answer survey items, is not well established or documented in this population. This study demonstrates how CIs can be used to improve questionnaires intended for nursing home residents. CIs were conducted with 29 nursing home residents in order to identify potential problems with prospective survey items. Scripted probes were used to standardise the interviews and adapted the Question Appraisal System to enumerate and classify the problems discovered. Between one and five versions of each item were fielded in an iterative process that identified 61 item-specific problems. Additionally, residents' cognitive responses suggested that some screened their answers on the basis of perceived physical and environmental limitations, and some had difficulty answering items about preferences that fluctuate day to day. These findings led us to modify the items and response set to simplify the respondents' cognitive task. This study illustrates how CI techniques can be used to understand residents' comprehension of and response to survey items.
Combating elder abuse: the role of guardians for older people in residential care
- Author:
- COX Brian E.
- Journal article citation:
- Journal of Adult Protection, 10(2), May 2008, pp.33-38.
- Publisher:
- Emerald
This article presents a new way of combating neglect/abuse of individual residents, drawing also on preliminary findings from a long-term research project on guardianship.; The article focuses specifically on the need for guardians for people who reside in residential care homes.
Quality of nursing home care in Cyprus: are elder residents content with their treatment?
- Author:
- GEORGIADES Savvas
- Journal article citation:
- Journal of Gerontological Social Work, 50(3/4), 2008, pp.3-24.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
Residents (n=73) were interviewed in four different types of nursing home (governmental, community-run, faith-based and private) to ascertain their views on the quality of care they received. The results show that the majority are happy with the quality of primary care in terms of medical treatment, nutrition, cleanliness and staff professionalism. However, they also feel lonely and deprived of essential entertainment opportunities. The implications for both domestic and global service design, and for research, are discussed. (Copies of this article are available from: Haworth Document Delivery Centre, Haworth Press Inc., 10 Alice Street, Binghamton, NY 13904-1580).
BE-ACTIV: a staff-assisted behavioral intervention for depression in nursing homes
- Authors:
- MEEKS Suzanne, et al
- Journal article citation:
- Gerontologist, 48(1), February 2008, pp.105-114.
- Publisher:
- Oxford University Press
This article (a) describes a 10-week, behavioural, activities-based intervention for depression that can be implemented in nursing homes collaboratively with nursing home activities staff and (b) presents data related to its development, feasibility, and preliminary outcomes. BE-ACTIV, which stands for Behavioral Activities Intervention, was developed in two pilot study phases: a treatment development phase and a feasibility–outcome phase with a small, randomized trial. The intervention was piloted with five depressed residents in a single nursing home in collaboration with the social services and activities staff. In the second phase randomized 20 residents from six nursing homes to receive either the intervention or treatment as usual. The intervention was well received by residents, family, and staff members. Experience with the intervention and input from staff members resulted in modifications to streamline the intervention and improve implementation. Results suggest that BE-ACTIV reduced institutional barriers to participation in pleasant activities, increased resident control over activity participation, increased overall activity participation, and improved depressive symptoms. Despite low power, statistical and graphical comparisons suggest superiority of the intervention over treatment as usual. Because depression among nursing home residents is prevalent, heterogeneous, and often treatment resistant, there is a need for effective, low-cost interventions that are ecologically acceptable and efficient. BE-ACTIV is a promising intervention; it is brief, addresses institutional barriers, involves facility staff in treatment, and is acceptable to residents. As such, BE-ACTIV merits further evaluation to establish efficacy and effectiveness.
The MDS Challenging Behavior Profile for long-term care
- Authors:
- GERRITSEN D. L., et al
- Journal article citation:
- Aging and Mental Health, 12(1), January 2008, pp.116-123.
- Publisher:
- Taylor and Francis
The objective was to construct a reliable and valid challenging behaviour scale with items from the Minimum Data Set (MDS). Exploratory factor analyses of a sample of 656 nursing home residents in the Netherlands yielded a 16-item Behavior Profile containing four internally consistent and valid subscales measuring conflict behaviour, withdrawn behaviour, agitation and attention seeking behaviour. On a second dataset of 227 nursing home residents, internal consistency, inter-rater reliability and validity against the Behavior Rating Scale for Psychogeriatric Inpatients (GIP) were established. Internal consistency of the subscales ranged between 0.54 and 0.78. The overall inter-rater reliability of the items was 0.53 (kappa); of the scale it was 0.75 (ICC). The MDS Challenging Behavior Profile could potentially be an important contribution to existing clinical MDS-scales but additional studies on reliability, validity and usefulness are needed.
'The Last Refuge' revisited: a case study
- Authors:
- JOHNSON Julia, ROLPH Sheena, SMITH Randall
- Journal article citation:
- Generations Review, 18(1), January 2008, Online only
- Publisher:
- British Society of Gerontology
The authors were awarded a grant by the ESRC to revisit Peter Townsend's study of residential care for older people, published in 1962 as 'The Last Refuge'. In this article the authors look at one of the 39 voluntary homes they revisited, comparing the home then with what it is now. Whereas most of the homes revisited were still in the same building, in the mid-1980s this home was replaced by a new purpose built one.
The association between changes in health status and nursing home resident quality of life
- Authors:
- DEGENHOLTZ Howard B., et al
- Journal article citation:
- Gerontologist, 48(5), October 2008, pp.584-592.
- Publisher:
- Oxford University Press
Previous research on nursing home resident quality of life (QOL) has mainly been cross-sectional. This study examined the association between changes in QOL and changes in resident clinical factors. A longitudinal study of resident QOL was conducted in two nursing homes in the US. Self-report interviews using a multidimensional measure of QOL were linked with clinical data from the Minimum Data Set. Five waves of interviews were conducted at 6-month intervals. Residents with one or more Stage II or higher pressure ulcers for two consecutive 6-month periods reported declines in autonomy, security, and spiritual well-being QOL domains; those with declines in physical disability reported declines in the dignity domain. Increases in depressive symptoms were associated with decreases in comfort, meaningful activities, and food enjoyment domains, and increases in pain were associated with decreases in functional competence and dignity domains. There is evidence of an association between physical health and self-reported QOL. However, not every dimension of QOL exhibited the same pattern. Further research is needed on the link between specific clinical factors and aspects of QOL.
Factors associated with non-use of antipsychotics among older residents with schizophrenia in long-term institutional care
- Authors:
- ALANEN Hanna-Mari, FINNE-SOVERI Harriet, LEINONEN Esa
- Journal article citation:
- International Journal of Geriatric Psychiatry, 23(12), December 2008, pp.1261-1265.
- Publisher:
- Wiley
This study aimed to investigate factors associated with non-use of antipsychotics among older schizophrenia residents in long-term institutional care. A retrospective study was designed using cross-sectional data gathered between 1 January and 30 June 2006 in Finland. Data were extracted from the Resident Assessment Instrument (RAI) database, based on Minimum Data Set for long-term care facilities (MDS-LC) assessments. Residents with schizophrenia 65 years or older were included, giving a total of 356 patient assessments. The prevalence of older schizophrenia residents not receiving any antipsychotic medication was 18.5%. Factors independently associated with non-use of antipsychotics in the logistic regression model were: severe degree of functional impairment, severely impaired vision, any diagnosis of dementia and severe underweight. There was a negative association between non-use of antipsychotics and a factor had arrived from a psychiatric hospital. Severe degree of functional impairment and dementia were the main findings associated with non-use of antipsychotics in this resident group.