Defining Safety in the Nursing Home Setting: Implications for Future Research

2016 ◽  
Vol 17 (6) ◽  
pp. 473-481 ◽  
Author(s):  
Sandra F. Simmons ◽  
John F. Schnelle ◽  
Nila A. Sathe ◽  
Jason M. Slagle ◽  
David G. Stevenson ◽  
...  
Keyword(s):  
Nursing Home ◽  
Future Research ◽  
Home Setting ◽  
Nursing Home Setting

scholarly journals The Burden of a Remote Trial in a Nursing Home Setting: Qualitative Study (Preprint)

2017 ◽  
Author(s):  
Susie Donnelly ◽  
Brenda Reginatto ◽  
Oisin Kearns ◽  
Marie Mc Carthy ◽  
Bill Byrom ◽  
...  
Keyword(s):  
Nursing Home ◽  
Data Collection ◽  
Lived Experience ◽  
Personal Space ◽  
Future Research ◽  
Home Setting ◽  
Research Engagement ◽  
Research Activities ◽  
Key Characteristics ◽  
Nursing Home Setting

BACKGROUND Despite an aging population, older adults are typically underrecruited in clinical trials, often because of the perceived burden associated with participation, particularly travel associated with clinic visits. Conducting a clinical trial remotely presents an opportunity to leverage mobile and wearable technologies to bring the research to the patient. However, the burden associated with shifting clinical research to a remote site requires exploration. While a remote trial may reduce patient burden, the extent to which this shifts burden on the other stakeholders needs to be investigated. OBJECTIVE The aim of this study was to explore the burden associated with a remote trial in a nursing home setting on both staff and residents. METHODS Using results from a grounded analysis of qualitative data, this study explored and characterized the burden associated with a remote trial conducted in a nursing home in Dublin, Ireland. A total of 11 residents were recruited to participate in this trial (mean age: 80 years; age range: 67-93 years). To support research activities, we also recruited 10 nursing home staff members, including health care assistants, an activities co-ordinator, and senior nurses. This study captured the lived experience of this remote trial among staff and residents and explored the burden associated with participation. At the end of the trial, a total of 6 residents and 8 members of staff participated in semistructured interviews (n=14). They reviewed clinical data generated by mobile and wearable devices and reflected upon their trial-related experiences. RESULTS Staff reported extensive burden in fulfilling their roles and responsibilities to support activities of the trial. Among staff, we found eight key characteristics of burden: (1) comprehension, (2) time, (3) communication, (4) emotional load, (5) cognitive load, (6) research engagement, (7) logistical burden, and (8) product accountability. Residents reported comparatively less burden. Among residents, we found only four key characteristics of burden: (1) comprehension, (2) adherence, (3) emotional load, and (4) personal space. CONCLUSIONS A remote trial in a nursing home setting can minimize the burden on residents and enable inclusive participation. However, it arguably creates additional burden on staff, particularly where they have a role to play in locally supporting and maintaining technology as part of data collection. Future research should examine how to measure and minimize the burden associated with data collection in remote trials.

scholarly journals Feasibility of an Innovative Rehabilitation Program Adapted for the Post-acute Nursing Home Setting

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 947-947
Author(s):  
Addie Middleton ◽  
Jane Driver ◽  
Marcus Ruopp ◽  
Lindsay Lefers ◽  
Jessica Rawlins ◽  
...  
Keyword(s):  
Nursing Home ◽  
Rehabilitation Program ◽  
Demonstration Project ◽  
Nursing Home Care ◽  
Future Research ◽  
Minimal Detectable Change ◽  
Health Administration ◽  
Post Discharge ◽  
Home Setting ◽  
Nursing Home Setting

Abstract Live Long Walk Strong is a rehabilitation program that produces large clinically meaningful improvements in mobility when implemented as an outpatient program for older adults. We adapted Live Long Walk Strong for the post-acute nursing home setting within the Veterans Health Administration as a clinical demonstration project. The adapted version includes novel elements and bridges the inpatient stay and three months post-discharge. The inpatient phase focuses on maximizing functional recovery and includes activities focused on timing and coordination of gait, leg strength and power, and trunk muscle endurance. The care transition and virtual (telehealth) post-discharge phase focuses on case management and engagement in physical activity programs. Coaching and behavior change are a consistent focus throughout the program. To date, 13 Veterans (mean age 67.9, SD 11.7 years) have completed the inpatient phase, and of those Veterans, six have completed the entire program, five are still active, one was lost to follow-up, and one was rehospitalized. The program demonstrates feasibility, 91% of all inpatient sessions and 81% of all post-discharge sessions were completed. Regarding preliminary efficacy, 83% of Veterans who completed the program exceeded the minimal detectable change score (4 points) on the Activity Measure for Post-Acute Care (AM-PAC) Mobility scale from program enrollment to completion (mean change 6.5, SD 6.9 points). Based on findings from this clinical demonstration project, the program is feasible. However, future research is needed to further examine the program’s impact on mobility and other outcomes important to older Veterans receiving post-acute nursing home care.

scholarly journals Between Social Inclusion and Exclusion: Integration of Daycare Guests in the Nursing Home Setting

2020 ◽  
Author(s):  
Kerstin Hämel ◽  
Gundula Röhnsch
Keyword(s):  
Nursing Home ◽  
Social Inclusion ◽  
Nursing Home Residents ◽  
Community Dwelling ◽  
Cognitive Capacity ◽  
Home Setting ◽  
Residential Care Facilities ◽  
Care Approach ◽  
Nursing Home Setting ◽  
Close Relatives

Abstract Background and Objectives In integrated daycare, community-dwelling older people in need of care join existing groups in residential care facilities during the day. This study focuses on how nursing home residents experience the integrative care approach, exploring opportunities for social inclusion and mechanisms of exclusion. Research Design and Methods A purposive sample of residents differing in cognitive capacity and level of (non)conflictual interaction with daycare guests was selected. Episodic interviews with residents (N = 10) and close relatives (N = 2) were conducted in 3 pilot facilities in Germany and analyzed using thematic coding. Results The analysis revealed different orientation patterns towards the presence of daycare guests: respondents (a) demonstrated indifference to the daycare guests, (b) saw bonding with guests as a means to connect to the outside world, and (c) perceived incompatibility between in-group and out-group. Criticisms included disruption of daily routines and loss of privacy. Most interviewees came to terms with the care situation using rational and moral arguments. Discussion and Implications The study reveals the importance of residents’ participation when integrating daycare guests. Institutional procedures are required to prevent exclusion of daycare guests and avoid overtaxing residents.

scholarly journals To what extent is clinical and laboratory information used to perform medication reviews in the nursing home setting? the CLEAR study

2015 ◽  
pp. 767 ◽  
Author(s):  
Carlota Gonzalvo ◽  
Kim Hurkens ◽  
Hugo de Wit ◽  
Brigit van Oijen ◽  
Rob Janknegt ◽  
...  
Keyword(s):  
Nursing Home ◽  
Home Setting ◽  
Nursing Home Setting ◽  
Medication Reviews

Recognition and assessment of resident’ deterioration in the nursing home setting: A critical ethnography

2018 ◽  
Vol 27 (7-8) ◽  
pp. 1452-1463 ◽  
Author(s):  
Bridget Laging ◽  
Amanda Kenny ◽  
Michael Bauer ◽  
Rhonda Nay
Keyword(s):  
Nursing Home ◽  
Critical Ethnography ◽  
Home Setting ◽  
Nursing Home Setting

Choice

2021 ◽  
pp. 47-60
Author(s):  
Joe Ungemah
Keyword(s):  
Nursing Home ◽  
Conventional Wisdom ◽  
Farmers Market ◽  
Home Setting ◽  
Cause And Effect ◽  
Cognitive Overload ◽  
Nursing Home Setting ◽  
Worker Autonomy ◽  
Successes And Failures

This chapter dives into why people sometime feel paralyzed by decisions. Challenging conventional wisdom that more choice is better, the chapter explains how choice can lead to cognitive overload, as demonstrated first by the story of a failed electronics retailer and then by a study involving a fruit jam display at a California farmers market. Yet choice is critical to a happy and prolonged life, as shown with some novel research involving houseplants in a nursing home setting. The chapter concludes on the compounding nature of decisions, where cause and effect is never as simple as it seems, as demonstrated by the Hindenburg disaster. Implications for the workplace include providing employee choice where it matters most, promoting worker autonomy, and recognizing human biases toward oversimplifying successes and failures.

scholarly journals Barriers and facilitators to implementing a pragmatic trial to improve advance care planning in the nursing home setting

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Jennifer A. Palmer ◽  
Victoria A. Parker ◽  
Vincent Mor ◽  
Angelo E. Volandes ◽  
Lacey R. Barre ◽  
...  
Keyword(s):  
Nursing Home ◽  
Advance Care Planning ◽  
Pragmatic Trial ◽  
Barriers And Facilitators ◽  
Care Planning ◽  
Home Setting ◽  
Nursing Home Setting ◽  
Advance Care
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