Knowledge translation interventions to sustain direct care provider behaviour change in long‐term care: A process evaluation

2017 ◽  
Vol 24 (1) ◽  
pp. 159-165 ◽  
Author(s):  
Susan E. Slaughter ◽  
Erin Bampton ◽  
Daniel F. Erin ◽  
Carla Ickert ◽  
Adrian S. Wagg ◽  
...  
Keyword(s):  
Knowledge Translation ◽  
Process Evaluation ◽  
Behaviour Change ◽  
Care Provider ◽  
Long Term Care ◽  
Direct Care ◽  
Term Care ◽  
Knowledge Translation Interventions

scholarly journals The Development and Testing of KNACC: Knowledgeable Nursing Assistants as Creative Caregivers

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 675-675
Author(s):  
Jacqueline Eaton ◽  
Kristin Cloyes ◽  
Brooke Paulsen ◽  
Connie Madden ◽  
Lee Ellington
Keyword(s):  
Focus Groups ◽  
Long Term Care ◽  
Family Members ◽  
Nursing Assistants ◽  
Direct Care ◽  
Term Care ◽  
Memory Care

Abstract Nursing assistants (NAs) provide 80% of direct care in long-term care settings, yet are seldom viewed as skilled professionals. Empowering NAs is linked to improved resident outcomes. In this study, we collaborate with NAs to adapt and test the feasibility and acceptability of arts-based creative caregiving techniques (CCG) for use in long-term care. We held a series of focus groups (n=14) to adapt, refine, and enhance usability. We then evaluated implementation in two waves of testing (n=8). Those working in memory care units were more likely to use all techniques, while those working in rehabilitation were more hesitant to implement. Participants reported using CCG to distract upset residents. Family members were excited about implementation, and NAs not participating wanted to learn CCG. Nursing assistants have the potential to become experts in creative caregiving but may require in-depth training to improve use.

scholarly journals #MoreThanAVisitor: Families as “Essential” Care Partners During COVID-19

2020 ◽  
Author(s):  
Candace L Kemp
Keyword(s):  
Family Involvement ◽  
Long Term Care ◽  
Research Policy ◽  
Well Being ◽  
Direct Care ◽  
Negative Consequences ◽  
Public Health Response ◽  
Term Care ◽  
Care Partners

Abstract The public health response to the current Coronavirus pandemic in long-term care communities, including assisted living, encompasses prohibiting visitors. This ban, which includes family members, has been criticized for being unfair, unhealthy, and unsafe. Against this backdrop, I examine the roles family play in residents’ daily lives and care routines. I argue that classifying family as “visitors” rather than essential care partners overlooks their critical contributions and stems from taken-for-granted assumption about gender, families, and care work, and I demonstrate why families are more than visitors. Policies that ban family visits also reflect a narrow understanding of health that focuses on mitigating infection risk, but neglects overall health and well-being. This policy further stems from a limited comprehension of care relations. Research shows that banning family visits has negative consequences for residents, but also families themselves, and direct care workers. I argue that identifying ways to better understand and support family involvement is essential and demonstrate the utility of the Convoys of Care model for guiding the reconceptualization of family in long-term care research, policy, and practice during and beyond the pandemic.

scholarly journals Is Long-Term Care Person Centred? A Case Study

2021 ◽  
Author(s):  
Katarina Young
Keyword(s):  
Long Term Care ◽  
Direct Care ◽  
Care Providers ◽  
Term Care ◽  
Study Approach ◽  
Key Stakeholders ◽  
Direct Care Providers ◽  
Government Legislation

In Ontario long-term care (LTC) settings, person-centred care (PCC) is promoted by government legislation, accreditation organizations and professional practice guidelines aiming to integrate this approach. However, there is currently no standardized approach to providing PCC in LTC. The purpose of this study was to examine public policies on PCC in Ontario and explore how they are interpreted and translated into practice in LTC. A qualitative case study approach was used to examine the perspectives of key stakeholders at one LTC facility in Ontario. Focus groups were conducted with residents, family members, direct care providers and managers. Through content analysis, findings were organized into four categories showcasing both overlapping and differential understandings of PCC in practice: 1) conceptualization, 2) barriers, 3) facilitators, and 4) evaluation. Identified tensions between policy and the delivery of PCC highlight systemic issues that must be addressed to enable equitable person-centred LTC rooted in resident-identified priorities.

scholarly journals It Is Time to Resolve the Direct Care Workforce Crisis in Long-Term Care

2020 ◽  
Author(s):  
Kezia Scales
Keyword(s):  
Long Term Care ◽  
The United States ◽  
Direct Care ◽  
Direct Care Workers ◽  
Term Care ◽  
Home Health Aides ◽  
Emerging Trends ◽  
Care Workers ◽  
Direct Care Workforce

Abstract Nearly 4.6 million direct care workers—including personal care aides, home health aides, and nursing assistants—provide daily support to older adults and people with disabilities across a range of settings in the United States, predominantly in long-term care (LTC). Even as the population grows older and drives up demand for LTC, the sector continues its decades-long struggle to fill direct care positions and stabilize this essential workforce. Recent events and emerging trends have converged, however, to produce new opportunities to address this longstanding workforce crisis, including the unprecedented attention generated by the coronavirus disease 2019 (COVID-19) pandemic and the systemic shifts to managed care and value-based payment in LTC. This Forum article outlines the pressing direct care workforce challenges in LTC before describing these potential levers of change, emphasizing the importance of not just expanding the workforce but also maximizing direct care workers’ contributions to the delivery of high-quality services for a growing and evolving population of LTC consumers.

scholarly journals Feasibility of a Mobile Meal Assistance Program for Direct Care Workers in Long-Term Care Facilities in South Korea

2020 ◽  
Vol Volume 15 ◽  
pp. 2019-2029
Author(s):  
Dukyoo Jung ◽  
Jennie C De Gagne ◽  
Minkyung Lee ◽  
Hyesoon Lee ◽  
Kyuri Lee ◽  
...  
Keyword(s):  
South Korea ◽  
Long Term Care ◽  
Direct Care ◽  
Direct Care Workers ◽  
Assistance Program ◽  
Term Care ◽  
Care Workers ◽  
Care Facilities

scholarly journals Adaptations for TAP in a Long-Term Care Setting

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 631-631
Author(s):  
Katherine Marx ◽  
Lauren Parker ◽  
Laura Gitlin
Keyword(s):  
Behavioral Interventions ◽  
Long Term Care ◽  
Clinical Symptoms ◽  
Functional Decline ◽  
Care Facility ◽  
Direct Care ◽  
Care Staff ◽  
Term Care ◽  
Long Term Care Facility

Abstract One of the most difficult aspects of caring for people living with dementia is managing neuropsychologic symptoms and functional decline. Although there are hundreds of efficacious non-pharmacologic interventions tested in homes, few are adapted for and tested in long-term care. The purpose of this pilot study was to identify the adaptations needed for the Tailored Activity Program (TAP) to make it feasible and acceptable in a long-term care facility. TAP provides tailored activities matched to interests and abilities to address dementia-related clinical symptoms. Two sites, under the umbrella of one company, participated. A total of five persons living with dementia, their family caregivers, two direct care staff and an interventionist participated, and occupational therapist who contracts with the site on a regular basis. Adaptations included shorter sessions and changes to forms to fit with workflows and documentation. Additional considerations challenging implementation of TAP included staff turn-over and training. Part of a symposium sponsored by the Behavioral Interventions for Older Adults Interest Group.

scholarly journals Mechanisms Of Impact And Contextual Aspects of A Care Concept From A Dementia Special Care Unit In Long-Term Care: Process Evaluation As Part of A Theory-Driven Evaluation

2021 ◽  
Author(s):  
Laura Adlbrecht ◽  
Sabine Bartholomeyczik ◽  
Hanna Mayer
Keyword(s):  
Social Interaction ◽  
Process Evaluation ◽  
Long Term Care ◽  
Complex Interventions ◽  
Well Being ◽  
Special Care ◽  
Care Process ◽  
Special Care Unit ◽  
Term Care

Abstract Background: In long-term care, persons with dementia are often cared for in specialised facilities, which are rather heterogeneous in regard to their design and care concepts. Little information is available on how these facilities and care concepts bring about changes in the targeted outcomes. Such knowledge is needed to understand the effects of care concepts and to consciously shape further developments. This study aimed to explore the mechanisms of impact of a specific care concept from a dementia special care unit and the contextual aspects that influence its implementation or outcomes.Methods: Using a qualitative approach to process evaluation of complex interventions, we conducted participating observations and focus groups with nurses and single interviews with ward and nursing home managers. Data were collected from two identical dementia special care units to enhance the contrasts in the analysis of two non-specialised nursing homes. We analysed the data thematically. We conducted 16 observations, three group interviews and eleven individual interviews.Results: We identified seven themes in three domains related to mechanisms that lead to outcomes regarding residents’ and nurses’ behaviour and well-being. The development of nurses' skills and knowledge changes team-level competence and leads to an altered understanding of nursing. The promotion of a positive work climate reduces distress and promotes the long-term implementation of the care concept. Adjusted spatial structures and personnel strategies facilitate the implementation of interventions for residents and promote the fulfilment of their needs. Personalised psychosocial interventions promote residents' relaxation, engagement in activities and social interaction and thereby empower them to become part of the social community, to spend their time purposefully, to have positive experiences and to experience belonging and affection. The implementation and outcomes of the care concept are influenced by contextual aspects relating to the (target) population and cultural, organisational and financial features.Conclusions: The care concept of the dementia special care unit results in higher levels of relaxation, activities, and social interaction of residents. Its implementation highly depends on the shared understanding of nursing and the skills of the nursing team. Changes in residents’ characteristics result in altered effects of the concept.Trial registration: DRKS00011513

scholarly journals Recommendations from long-term care reports, commissions, and inquiries in Canada

F1000Research ◽  
2021 ◽  
Vol 10 ◽  
pp. 87
Author(s):  
Eric K. C. Wong ◽  
Trina Thorne ◽  
Carole Estabrooks ◽  
Sharon E. Straus
Keyword(s):  
Long Term Care ◽  
National Level ◽  
Indirect Costs ◽  
Median Number ◽  
Primary Objective ◽  
Direct Care ◽  
Term Care ◽  
Total Cost ◽  
Governmental Agencies

Background: Multiple long-term care (LTC) reports have issued similar recommendations for improvement across Canadian LTC homes. Our primary objective was to identify the most common recommendations made over the past 10 years. Our secondary objective was to estimate the total cost of studying LTC issues repeatedly from 1998 to 2020. Methods: The qualitative and cost analyses were conducted in Canada from July to October 2020. Using a list of reports, inquiries and commissions from The Royal Society of Canada Working Group on Long-Term Care, we coded recurrent recommendations in LTC reports. We contacted the sponsoring organizations for a cost estimate, including direct and indirect costs. All costs were adjusted to 2020 Canadian dollar values. Results: Of the 80 Canadian LTC reports spanning the years of 1998 to 2020, 24 (30%) were based on a national level and 56 (70%) were focused on provinces or municipalities. Report length ranged from 4 to 1491 pages and the median number of contributors was 14 (interquartile range, IQR, 5–26) per report. The most common recommendation was to increase funding to LTC to improve staffing, direct care and capacity (67% of reports). A median of 8 (IQR 3.25–18) recommendations were made per report. The total cost for all 80 reports was estimated to be $23,626,442.78. Conclusions: Problems in Canadian LTC homes and their solutions have been known for decades. Despite this, governments and non-governmental agencies continue to produce more reports at a monetary and societal cost to Canadians.

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