Experiences of nursing in older care facilities in New Zealand

2010 ◽  
Vol 34 (1) ◽  
pp. 11 ◽  
Author(s):  
Jenny Carryer ◽  
Chiquita O. Hansen ◽  
Judy A. Blakey

To examine issues related to the working life of registered nurses in residential care for older people in New Zealand, 48 registered nurses completed surveys (n = 28) or participated in discussions (n = 26) regarding their work roles, continuing education and interactions with specialist nurse services when providing care for older people living with chronic illnesses. This nursing workforce is characterised by ageing, relative isolation, reduced confidence and few opportunities for induction of new graduates. Registered nurses reported their struggle to deliver the appropriate quality of care to residents as acuity increases, general practitioner availability decreases and the opportunities for increasing their knowledge and competence remain limited. The provision of nursing services in residential care for older people is an area of growing concern to many Western countries. Nurse practitioners offer opportunities to improve the quality of residential care. What is known about the topic?The lack of registered nurses generally and the more critical shortage in residential care is well known. What does this paper add?This paper explains the impact on the current and future viability and the quality of registered nurse services in an area of service where acuity continues to rise and the demand for nursing services is increasing. What are the implications for practitioners?Nurses in older care settings often express a sense of isolation and note limited career development despite their passion for serving the frail older person. The establishment of nurse practitioner (gerontology) roles offers the potential for improved quality of clinical care for residents and clinical champions for development of nursing services.

2016 ◽  
Vol 24 (1) ◽  
pp. 3-13
Author(s):  
Doug Matthews

The article focuses on role of social workers in providing in-home care and assistance with the activities of daily living (ADL) for older people in New Zealand. From the physician- and hospital-based medical care for older people, a shift back to home-based medical care was emphasized by the Ministry of Social Development in April 2001. The New Zealand Health of Older People Strategy was implemented with the aim of achieving positive aging, quality of life and independence.


2016 ◽  
Vol 16 (2) ◽  
pp. 190-206 ◽  
Author(s):  
Eva Ericson-Lidman ◽  
Gunilla Strandberg

Stress of conscience seriously influence the quality of care and the wellbeing of the care providers in care for older people. It is therefore of great importance to take measures to address, and relieve but preferably prevent stress related to troubled conscience. In our participatory action research studies, we have used troubled conscience as a driving force to relieve care providers’ burden and to increase quality of care. The aim with this paper is to present our experiences of using a further developed participatory action research process in practice to deal with care providers' troubled conscience in residential care for older people. The contribution to participatory action research practice in our studies is a support to the participatory action research process through using a modified model of problem processing, an approach which we found fruitful. In the paper, we describe our experiences and discuss them in relation to relevant literature and theory. Our experiences are that in participatory action research it is crucial to build a trusting relationship and striving to create a fruitful dialogue between the researchers and the participants. In our studies, we found that participatory action research is an easy approach to adapt as a problem-solving process in clinical practice and in nursing research.


2015 ◽  
Vol 16 (2) ◽  
pp. 118-128 ◽  
Author(s):  
Ciara O'Dwyer

Purpose – Regulation is the tool preferred by policy-makers to manage the quality of residential care for older people. However, it remains unclear which form of regulation is most effective. The residential care sector for older people in Europe offers a unique opportunity to explore this issue as countries vary in how they control quality in the sector. The paper aims to discuss this issue. Design/methodology/approach – The study used a comparative approach, collating secondary data from various sources and conducting qualitative comparative analysis on the data. Findings – Three regulatory approaches were in operation – many Northern European countries operate on a self-regulatory basis, and are associated with the highest quality. Many continental countries, the UK and Ireland operate a command-and-control regulatory approach, with a moderate standard of care. Mediterranean and Eastern European countries have limited regulation, with care of a lower standard. However, the type of regulation appears to be a product of the prevailing culture and philosophy of care within each country. Thus, quality outcomes are a measure of financial investment in care. Social implications – Consistent calls for command-and-control style regulation may be misguided; high-quality care requires high-public investment and a professional workforce with the freedom to focus on quality improvement mechanisms. Originality/value – The paper provides a framework for analysing outcomes associated with different types of regulation. While a self-regulatory model is linked with the best outcomes, financial investment and the philosophy of care may be more important factors influencing the quality of care.


2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 153-154
Author(s):  
Afeez Hazzan

Abstract Dementia is one of the most rapidly growing diseases in the United States. In 2018, the direct costs to American society of caring for older people with dementia was approximately $277 billion. Primary informal caregivers are mainly responsible for the care of older people with dementia including Alzheimer’s disease. Caregivers perform a myriad of duties ranging from shopping for their loved ones’ groceries, helping with medications, and managing finances. The caregiving role becomes more demanding as the disease progresses over time, and studies have shown that the quality-of-life (QoL) experienced by caregivers of older adults who have dementia is lower than the QoL of caregivers for older people who do not have dementia. To the best of our knowledge, there has been no research conducted to investigate whether lower caregiver QoL affects the level or quality of care that caregivers provide to persons with dementia. In the current study, we interviewed family caregivers living in Rochester, New York to inquire about their quality of life and the care provided to older people living with dementia. Further, caregivers completed the 36-item Short Form Health Survey (SF-36) as well as a draft questionnaire for measuring the quality of care provided to older people living with dementia. Both quantitative and qualitative findings from this study reveals important relationships between family caregiver QoL and the care provided, including the impact of social support and financial well-being. The study findings could have significant impact, particularly for the provision of much needed support for family caregivers.


2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 168.2-168
Author(s):  
L. Wagner ◽  
S. Sestini ◽  
C. Brown ◽  
A. Finglas ◽  
R. Francisco ◽  
...  

Background:Inborn metabolic disorders (IMDs) currently encompass more than 1,500 diseases with new ones still to be identified1. Each of them is characterised by a genetic defect affecting a metabolic pathway. Only few of them have curative treatments, that target the respective metabolic pathway. Commonly, treatment examples include diet, substrate reduction therapies, enzyme replacement therapies, gene therapy and biologicals, enabling IMD-patient now to survive to adulthood. About 30 % of all IMDs involve the musculoskeletal system and are here referred to as rare metabolic RMDs. Generally, IMDs are very heterogenous with respect to symptoms and severity, often being systemic and affecting more children than adults. Thus, challenges include certified advanced training of adult metabolic experts, standardised transition plans, social support and development of therapies for diseases that do not have any cure yet.Objectives:Introduction of MetabERN, its structure and objectives, highlighting on the unique features and challenges of metabolic RMDs and describing the involvement of patient representation in MetabERN.Methods:MetabERN is stratified in 7 subnetworks (SNW) according to the respective metabolic pathways and 9 work packages (WP), including administration, dissemination, guidelines, virtual counselling framework, research/clinical trials, continuity of care, education and patient involvement. The patient board involves a steering committee and single point of contacts for each subnetwork and work package, respectively2. Projects include identifying the need of implementing social science to assess the psycho-socio-economic burden of IMDs, webinars on IMDs and their transition as well as surveys on the impact of COVID-193 on IMD-patients and health care providers (HCPs), social assistance for IMD-patients and analysing the transition landscape within Europe.Results:The MetabERN structure enables bundling of expertise, capacity building and knowledge transfer for faster diagnosis and better health care. Rare metabolic RMDs are present in all SNWs that require unique treatments according to their metabolic pathways. Implementation of social science to assess the psycho-socio-economic burden of IMDs is still underused. Involvement of patient representatives is essential for a holistic healthcare not only focusing on clinical care, but also on the quality of life for IMD-patients. Surveys identified unmet needs of patient care, patients having little information on national support systems and structural deficits of healthcare systems to ensure HCP can provide adequate clinical care during transition phases. These results are collected by MetabERN and forwarded to the Directorate-General for Health and Food Safety (DG SANTE) of the European Commission (EC) to be addressed further.Conclusion:MetabERN offers an infrastructure of virtual healthcare for patients with IMDs. Thus, in collaboration with ERN ReCONNET, MetabERN can assist in identifying rare metabolic disorders of RMDs to shorten the odyssey of diagnosis and advise on their respective therapies. On the other hand, MetabERN can benefit from EULAR’s longstanding experience regarding issues affecting the quality of life, all RMD patients are facing, such as pain, stiffness, fatigue, rehabilitation, maintaining work and disability claims.References:[1]IEMbase - Inborn Errors of Metabolism Knowledgebase http://www.iembase.org/ (accessed Jan 29, 2021).[2]MetabERN: European Refence Network for Hereditary Metabolic Disorders https://metab.ern-net.eu/ (accessed Jan 29, 2021).[3]Lampe, C.; Dionisi-Vici, C.; Bellettato, C. M.; Paneghetti, L.; van Lingen, C.; Bond, S.; Brown, C.; Finglas, A.; Francisco, R.; Sestini, S.; Heard, J. M.; Scarpa, M.; MetabERN collaboration group. The Impact of COVID-19 on Rare Metabolic Patients and Healthcare Providers: Results from Two MetabERN Surveys. Orphanet J. Rare Dis.2020, 15 (1), 341. https://doi.org/10.1186/s13023-020-01619-x.Acknowledgements:The authors thank the MetabERN collaboration group, the single point of contacts (SPOC) of the MetabERN patient board and the Transition Project Working Group (TPWG)Disclosure of Interests:None declared


2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 152-152
Author(s):  
Afeez Hazzan

Abstract Family caregivers of older people living with dementia are relatives, friends, or neighbors who provide assistance related to this condition, but who are unpaid for the services they provide. Although caregiving could be personally rewarding, many caregivers report a high level of strain. Compared to caregivers of older adults who do not have dementia, family caregivers of older people living with dementia report lower quality-of-life (QoL). In a published systematic review examining the relationship between family caregiver QoL and the quality of care provided, only one study was found to be somewhat relevant. The study suggested that the primary reason for an absence of research into the link between family caregiver QoL and quality of care was the absence of a questionnaire for measuring quality of care in dementia. Therefore, any attempt to investigate the impact of caregiver QoL on the care provided to older people with dementia must first address the lack of an instrument to measure quality of care. To address this issue, we interviewed approximately 20 family caregivers in order to elicit feedback on measurements and interpretation of the quality of care provided by family caregivers of older people living with dementia. Content analysis of the interview transcripts revealed that the quality of relationships with family, caregiver availability to provide or supervise care, and availability of paid or volunteer help are important for the quality of care provided. These results have important implications, particularly for the development of an instrument to measure quality of care in dementia.


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