The Nursing Home as a Contentious Space for Dementia Care

2010 ◽  
Author(s):  
Athena McLean
Keyword(s):  
Nursing Home ◽  
Dementia Care

scholarly journals Facilitators and barriers to implement nurse-led interventions in long-term dementia care: a qualitative interview study with Swiss nursing experts and managers

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Julian Hirt ◽  
Melanie Karrer ◽  
Laura Adlbrecht ◽  
Susi Saxer ◽  
Adelheid Zeller
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Public Perception ◽  
Dementia Care ◽  
Term Care ◽  
Face To Face ◽  
People With Dementia ◽  
Qualitative Interview Study ◽  
Facilitators And Barriers

Abstract Background To support the implementation of nurse-led interventions in long-term dementia care, in-depth knowledge of specific supporting factors and barriers is required. Conditions and structures of caring for people with dementia differ widely, depending on the country and the care context. Our study aimed to describe the experiences and opinions of nursing experts and managers with regard to facilitators and barriers to the implementation of nurse-led interventions in long-term dementia care. Methods We conducted a qualitative descriptive study using individual interviews based on qualitative vignettes as a useful stimulus to generate narrations allowing to study peoples’ perceptions and beliefs. The study took place in nursing homes in the German-speaking part of Switzerland and in the Principality of Liechtenstein using purposive sampling. We intended to conduct the interviews face-to-face in a quiet room according to the participant’s choice. However, due to the lockdown of nursing homes during the COVID-19 pandemic in spring 2020, we performed interviews face-to-face and by video. We analysed data thematically following Braun and Clarke to achieve a detailed, nuanced description. To verify our interpretation and to ensure congruence with participants’ perspectives, we conducted member checks. The Standards for Reporting Qualitative Research (SRQR) served to structure our manuscript. Results Six dyads of nursing home managers and nursing experts from six nursing homes took part in our study (n = 12). Our thematic analysis yielded seven themes reflecting facilitators and barriers to implementing nurse-led interventions in long-term dementia care: «A common attitude and cohesion within the organization», «Commitment on several levels», «A needs-oriented implementation», «The effect and the public perception of the intervention», «A structured and guided implementation process», «Supporting knowledge and competencies», as well as «Resources for implementing the intervention». Conclusions To support the implementation of nurse-led interventions in long-term dementia care, active commitment-building seems essential. It is necessary that the value of the intervention is perceptible.Commitment-building is the precondition to reach the persons involved, such as nursing home managers, nursing staff, residents and relatives. Furthermore, nurses should precisely inform about the intervention. It is necessary that the value of the intervention is perceptible. In addition, nurses should adjust the interventions to the situational needs of people with dementia, thus. Therefore, it is important to support dementia-specific competencies in long-term care. Findings indicate that the barrier is determined by the intervention and its implementation – and not by the behaviour of the person with dementia.

scholarly journals ENHANCING PERSON-CENTERED DEMENTIA CARE BY NURSING HOME STAFF USING MICROLEARNING: LITTLE MESSAGE WITH A BIG IMPACT

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S3-S3
Author(s):  
Jenny Inker ◽  
Christine J Jensen ◽  
Sonya Barsness
Keyword(s):  
Job Satisfaction ◽  
Nursing Home ◽  
Focus Groups ◽  
Long Term Care ◽  
Dementia Care ◽  
Care Staff ◽  
Training Curriculum ◽  
Term Care ◽  
Online Platform

Abstract Effective training is critical to providing quality care in long-term care environments, where many residents have dementia. Training has been linked to positive resident care outcomes and improved job satisfaction of staff. The aim of this study was to develop, pilot, and evaluate a Microlearning training curriculum, using short (5-10 minute) “bursts” of training available through an online platform on demand (i.e. 24/7). The expected outcomes were to improve staff knowledge, attitudes, and skills regarding person-centered dementia care and to increase job satisfaction. Researchers translated the Centers for Medicare and Medicaid Hand-in-Hand training curriculum into 52 weekly Microlearning lessons delivered via an online platform (accessible by computer, IPad or smart phone) followed by a short quiz. Using pre- and post-tests, nine focus groups, and fourteen telephone interviews, the researchers engaged with a convenience sample of staff (N = 244) working at all levels from direct care to leadership in nine nursing homes in Virginia. Pre- and post-tests comprised items from the Dementia Attitudes Scale and the Nursing Home Nurse Aide Job Satisfaction Scale. Results from a between subjects t-test demonstrated significant improvements in attitudes to people with dementia. Focus groups and interviews revealed high satisfaction with the training with a significant majority agreeing it was a helpful way to learn and that they were able to apply what they had learned to caring for residents. This pilot demonstrates a promising new practice for training long-term care staff. Further research using a control group receiving usual training is indicated.

“Medication Is Just One Piece of the Whole Puzzle”: How Nursing Homes Change Their Use of Antipsychotic Medications

2020 ◽  
pp. 073346482095891
Author(s):  
Marsha Rosenthal ◽  
Jessica Poling ◽  
Aleksandra Wec ◽  
Elizabeth Connolly ◽  
Beth Angell ◽  
...  
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Research Policy ◽  
Nursing Home Residents ◽  
Dementia Care ◽  
Policy And Practice ◽  
Antipsychotic Medications ◽  
Positive Attitudes ◽  
National Partnership ◽  
Person Centered Approach

Antipsychotic medication use for nursing home residents with dementia poses major patient safety challenges. This article investigates health professionals’ experiences with decision-making during changes under the National Partnership to Improve Dementia Care in Nursing Homes (National Partnership) and its companion state coalitions. These programs were introduced in 2012 to encourage reductions in antipsychotic use and increased use of nonpharmacological treatments for dementia. Interviews with 40 nursing home physicians and staff in seven states found that reducing antipsychotics is more time and resource-intensive than relying on medication, because it requires a person-centered approach. However, respondents supported reductions in antipsychotic use, and indicated that with sufficient staffing, effective communications, and training, they could create or implement individualized treatments. Their positive attitudes suggest that the National Partnership has been a catalyst in reducing antipsychotic medications, and their perspectives can inform further research, policy and practice in nursing homes toward achieving quality dementia care.

scholarly journals Meaning in Life for Patients With Severe Dementia: A Qualitative Study of Healthcare Professionals' Interpretations

2021 ◽  
Vol 12 ◽  
Author(s):  
Tor-Arne Isene ◽  
Sigrid Helene Kjørven Haug ◽  
Hans Stifoss-Hanssen ◽  
Lars J. Danbolt ◽  
Liv S. Ødbehr ◽  
...  
Keyword(s):  
Nursing Home ◽  
Meaning In Life ◽  
Healthcare Professionals ◽  
Meaning Making ◽  
Round Table ◽  
Dementia Care ◽  
Severe Dementia ◽  
People With Dementia ◽  
Home Context ◽  
High Competence

The need for meaning in life is a key aspect of being human, and a central issue in the psychology of religion. Understanding experience of meaning for persons with severe dementia is challenging due to the impairments associated with the illness. Despite these challenges, this article argues that meaning in life is as important for a person with severe dementia as it is for everyone else. This study was conducted in a Norwegian hospital and nursing home context and was part of a research project on meaning in life for persons with severe dementia. The study builds on two other studies which focused on how meaning-making and experience of meaningfulness appeared in patients with severe dementia. By presenting the findings from these two studies for a group of healthcare professionals and introducing them to research on meaning in life, the aim of this study was to explore how healthcare professionals interpret the patients' experience of meaning in life in practise for patients with severe dementia in a hospital and nursing home context, and to highlight its clinical implications. The study was conducted using a qualitative method with exploratory design. The data were collected at a round table conference, a method inspired by a mode of action research called “co-operative inquiry.” Altogether 27 professional healthcarers, from a variety of professions, with high competence in dementia care participated together with six researchers authoring this article. This study revealed that healthcare professionals were constantly dealing with different forms of meaning in their everyday care for people with dementia. The findings also showed clear connexions between understanding of meaning and fundamental aspects of good dementia care. Meaning corresponded well with the principles of person-centred care, and this compatibility allowed the healthcare professionals to associate meaning in life as a perspective into their work without having much prior knowledge or being familiar with the use of this perspective. The study points out that awareness of meaning in life as an integrated perspective in clinical practise will contribute to a broader and enhanced repertoire, and hence to improved dementia care. Facilitating experience of meaning calls for increased resources in personnel and competence in future dementia care.

scholarly journals Nursing Home COVID-19 Action Network: Responding With Stress First Aid and Caring for Residents With Dementia

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 494-494
Author(s):  
Barbara Ganzel ◽  
Adam Simning ◽  
Thomas Caprio
Keyword(s):  
Mental Health ◽  
New York ◽  
Nursing Home ◽  
Geriatric Medicine ◽  
First Aid ◽  
Dementia Care ◽  
Project Echo ◽  
Trauma Informed Care ◽  
First Aid Training ◽  
Trauma Informed

Abstract The GWEP at the University of Rochester (New York) has an established network of nursing homes participating in Project ECHO. This ECHO hub includes geriatric medicine, psychiatry, pharmacy, aging services network and the Alzheimer’s Association focusing on best practices in geriatric mental health and dementia care. With the COVID-19 pandemic, this infrastructure quickly pivoted to expansion of 80 facilities and the addition of expertise in medical direction, trauma informed care, and infectious disease. A stress first aid training module was developed in partnership with Ithaca College and the National Center for PTSD to support front line nursing home workers. Dementia care experts contributed to practical problem-solving in addressing social isolation and mental health. Work now is focusing on vaccination and how to best support trauma-informed needs of residents with dementia.

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