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Hoarding in the community: a code enforcement and social service perspective
- Authors:
- McGUIRE Joseph F., et al
- Journal article citation:
- Journal of Social Service Research, 39(3), 2013, pp.335-344.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
Hoarding behaviours endanger individuals and their communities. Although there is a growing literature on clinically referred and elderly hoarders, there is limited information about hoarding behaviours beyond these contexts. This study examines the frequency, characteristics, and outcomes of cases involving hoarding encountered by code enforcement officials and social service staff. Prior to an in-service training, 236 social service staff members completed a 43-item survey about their experiences with cases involving hoarding. Respondents reported encountering between two and three cases per year. Although these hoarding cases were estimated to cost more than $3,700 in cleaning fees, 83% of respondents reported having received no prior training on dealing with hoarding. Survey responses suggested that hoarding situations were difficult to resolve and involved multiple community agencies. Collectively, hoarding behaviors appear to be a problem regularly encountered by social service members, who often serve as the initial point of contact. Along with increased training, future research is needed to develop and evaluate collaborative interagency protocols to manage this multifaceted problem. Empirically informed interagency protocols may facilitate the timely referral of community hoarders to mental health professionals and may lead to improved outcomes. (Publisher abstract)
The moderating effect of aggressive problem behaviours in the generation of more positive attitudes toward nursing home residents
- Authors:
- HILLMAN J., et al
- Journal article citation:
- Aging and Mental Health, 5(3), August 2001, pp.282-288.
- Publisher:
- Taylor and Francis
This study examines the ability of a social history intervention to generate more positive attitudes toward nursing home patients, and to increase staff members' perceived rewards of care-giving. In contrast to prior studies, residents' problem behaviours were examined as potential moderators in the relationship. Forty-three staff members participated in an experimental, 3 (informational condition: social history, medical, control) x 2 (time: pre-test, post-test) within-subjects factorial design that employed newly admitted residents as target patients. Findings showed that the social history intervention alone did not generate more positive attitudes toward patients or greater rewards of care-giving. Although a larger proportion of target patients manifested other problem behaviours with greater frequency, only aggressive problem behaviour was associated with more negative attitudes toward patients. A post-hoc analysis revealed that after statistically controlling for the impact of patients' aggressive behaviour, the social history information appeared to allow staff members to maintain more neutral attitudes toward patients. Considerations for the use of social history information in long-term care settings are addressed.
“Wish we would have known that!” communication breakdown impedes person-centered care
- Authors:
- KOLANOWSKI Ann, et al
- Journal article citation:
- Gerontologist, 55, Supplement 1 2015, pp.S50-S60.
- Publisher:
- Oxford University Press
Purpose: To understand how nursing home staff obtain information needed for implementing person-centred care (PCC) to residents with dementia who exhibit behavioural and psychological symptoms of dementia (BPSD), and how they communicate this information to other staff. Barriers to PCC and information exchange were also explored. Design and Methods: Participants were 59 staff from two nursing homes. Focus group methodology captured discussions in eight 1-hr sessions. Sessions were audiotaped and transcribed. Data were analysed using qualitative content analysis to provide a comprehensive summary of real world context of implementing PCC. Results: To deliver PCC staff identified a need for access to psychosocial/medical history of the resident and knowledge of strategies families used for managing BPSD in the past. However, resident information is not routinely shared with all staff and written documentation systems for communicating resident-specific information do not support the time-pressured work pattern of certified nursing assistants (CNAs). Word-of-mouth was considered more reliable and expedient than educational sessions. CNAs described themselves as visual learners who prefer educational programs addressing individual resident emergent behaviours and programs that are scheduled at dedicated times. Implications: To improve PCC the flow of information exchange requires: inclusion of all staff, particularly CNAs; systems of communication that consider the time and resource constraints of nursing homes; development of educational programmes for BPSD that are responsive to staff learning styles; administrative investment in nursing leadership to effect these changes; and reimbursement approaches to encourage culture change investments. (Edited publisher abstract)
‘We need to know what’s going on’: Views of family members toward the sexual expression of people with dementia in residential aged care
- Authors:
- BAUER Michael, et al
- Journal article citation:
- Dementia: the International Journal of Social Research and Practice, 13(5), 2014, pp.571-585.
- Publisher:
- Sage
This paper reports on a study which explored the views and attitudes of family members towards the sexual expression of residents with dementia in residential aged care facilities in two states in Australia. Recruitment was challenging and only seven family members agreed to an interview on this topic. Data were analysed using a constant comparative method. Family were generally supportive of residents’ rights to sexual expression, but only some types of behaviours were approved of. There was an acknowledgement that responding to residents’ sexuality was difficult for staff and many families believed that they should be kept informed of their relative’s sexual behaviours and moreover be involved in decision making about it. Findings suggest the need for family education and a larger study to better understand the views and motivations of family carers and how these might impact on the sexual expression of the older person with dementia living in residential aged care. (Publisher abstract)
Non-pharmaceutical management of behavioural symptoms in nursing homes
- Authors:
- DEUDON Audrey, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 24(12), December 2009, pp.1386-1395.
- Publisher:
- Wiley
Behavioural and psychotic symptoms of dementia (BPSD), such as agitation, aggression, oppositional behaviour and psychotic disturbances, are often reported in institutions for the elderly. This study evaluates the effectiveness of a staff educational programme to help staff manage these symptoms. The study was conducted in 16 nursing homes in 2 French regions (Alpes Maritimes and Gironde). Three hundred and six patients with a diagnosis of dementia and presenting BPSD were selected. The nursing homes were randomly allocated to an intervention group or a control group, and 8-week staff educational and training programmes were conducted in the nursing homes in the intervention group. The training programme provided a 90 minute training session including the use of instruction cards which summarised practical advice on how to deal with BPSD, and individual interactive sessions in which trainers provided constructive feedback on how the staff dealt with BPSD. The results demonstrated that agitation and aggressiveness decreased significantly immediately after the 2-month programme and was still present 3 months later. The results demonstrate that a programme including a group teaching session for staff, individual instruction cards and interactive coaching sessions can be an effectively strategy for managing BPSB.
Singing as a therapeutic intervention in dementia care
- Authors:
- BROWN Steven, et al
- Journal article citation:
- Journal of Dementia Care, 9(4), July 2001, pp.33-37.
- Publisher:
- Hawker
The value of background music or dedicated music therapy sessions in enhancing well-being for people with dementia is well known, but they have limitations. Proposes the third way of singing as a therapeutic intervention to accompany daily routines and activities.
Before and after training: a case study of intervention
- Authors:
- LINTERN Tracey, WOODS Bob, PHAIR Lynne
- Journal article citation:
- Journal of Dementia Care, 8(1), January 2000, pp.15-17.
- Publisher:
- Hawker
Asks whether staff training and development can improve residents' well being. The authors describe the assessment and initial training phases.
Campaign: no fear. Zero tolerance
- Author:
- WHITE Caroline
- Journal article citation:
- Community Care, 16.9.99, 1999, p.31.
- Publisher:
- Reed Business Information
Brent staff have had to face abuse from older clients and their relatives at homes across the borough. Looks at how the department has responded.
The deep roots of folklore and superstition
- Authors:
- MONIZ-COOK Esme, GILL Alec
- Journal article citation:
- Journal of Dementia Care, 4(2), March 1996, pp.12-13.
- Publisher:
- Hawker
The authors argue that traditional superstitions - often unknown to young care staff - can sometimes be the root cause of "problem" behaviour in people with dementia.
Questionable practices despite good intentions: coping with risk and impact from dementia-related behaviours in care homes
- Authors:
- BACKHOUSE Tamara, et al
- Journal article citation:
- Ageing and Society, 38(9), 2018, pp.1933-1958.
- Publisher:
- Cambridge University Press
Care-home residents with dementia can experience behavioural and psychological symptoms such as aggression, agitation, anxiety, wandering, calling out and sexual disinhibition. Care-home staff have a duty to keep residents safe. However, residents with dementia can pose particular challenges in this area. In this paper, we draw on a study which explored how care-home staff manage dementia-related behaviours. In-depth ethnographic case studies at four separate care homes were conducted in England. These involved interviews with 40 care-home staff and 384 hours of participant observation. Our analysis showed that some residents with dementia experience behaviours which can either create risks for, or negatively impact on, themselves and/or other residents or staff members. It emerged that the consequences of the behaviours, rather than the behaviours themselves, created difficulties for staff. To cope with the risk and impact of behaviours, staff employed multiple strategies such as surveillance, resident placement, restrictions and forced care. Using the data, we explore how actions taken by staff to manage the risk and impact of behaviours in these communal settings relate to residents’ human rights. Our findings have particular relevance for care-home staff who need support and guidance in this area, for service development worldwide and for the global ageing population whose valued human rights may become under threat, if they require long-term care. (Edited publisher abstract)