scholarly journals Community nurses’ experiences of the Swedish Dignity Care Intervention for older persons with palliative care needs – A qualitative feasibility study in municipal home health care

2021 ◽  
Author(s):  
Annika Söderman ◽  
Carina Werkander Harstäde ◽  
Ulrika Östlund ◽  
Karin Blomberg
Keyword(s):  
Health Care ◽  
Palliative Care ◽  
Feasibility Study ◽  
Home Health Care ◽  
Older Persons ◽  
Home Health ◽  
Care Needs ◽  
Care Intervention ◽  
Palliative Care Needs

scholarly journals Towards enhanced emotional interactions with older persons. Findings from a nursing intervention in home health care.

2016 ◽  
Vol 6 (3) ◽  
pp. 191-199
Author(s):  
Charlotte Veenvliet ◽  
Hilde Eide ◽  
Martijn de Lange ◽  
Sandra van Dulmen
Keyword(s):  
Health Care ◽  
Home Health Care ◽  
Older Persons ◽  
Nursing Intervention ◽  
Home Health ◽  
Post Intervention ◽  
Audio Feedback ◽  
Feedback Intervention ◽  
Before And After ◽  
Post Test

Background. Living at home with a physical condition that requires assistance places high emotional burden on older persons that needs to be attended to by nurses. However, nurses in home health care have previously been found to communicate primarily in an instrumental way. This increases the risk that emotional concerns are being overlooked or not responded to in an appropriate way.Aims and Objectives. To enhance emotional interactions with older clients in home health care, an individual feedback intervention was developed for these nurses. The first experiences and results are presented in this paper.Design and Methods. Ten nurses/nurse assistants participated in this exploratory pre-post test study. They were asked to audiotape visits with older persons (65+) before and after an audio-feedback intervention. Older clients’ implicit and explicit expressions of emotional concerns as well as nurses’ responses to these expressions were rated with the Verona Coding Definition of Emotional Sequences (VR-CoDES). The nurses were given feedback based on the audio-recordings and the observations and were asked to reflect on the audio-feedback intervention.Results. The nurses valued the audio-feedback. Overall, 201 cues and 35 concerns were expressed during 58 recorded visits. At post-intervention, 29% of identified cues and concerns were nurse-initiated, at pre-intervention 18.8% (NS). Nurses provided space in 73.7% of their responses. During shorter visits nurses tended to provide less space (p=.06). After the intervention, 20.9% of the cues and concerns were ignored, before the intervention this was 25% (NS).Conclusions. Receiving feedback was taken in very well by the nurses working in home health care and the feedback intervention seems to enhance emotional interactions in home health care with older persons. Although, due to the low power of the study, the differences between pre-and post-intervention measurements were not significant. Studies with larger samples are needed to replicate these findings.

An evaluation of home health care needs and Quality of Life among the elderly in a semi-rural area of Western Turkey

2016 ◽  
Vol 7 (1) ◽  
pp. 8-12 ◽  
Author(s):  
R. Aydin ◽  
E. Unal ◽  
M.E. Gokler ◽  
S. Metintas ◽  
G.O. Emiral ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Health Care ◽  
Rural Area ◽  
Home Health Care ◽  
The Elderly ◽  
Home Health ◽  
Health Care Needs ◽  
Care Needs ◽  
Western Turkey

Dying Fit or Not—Physical Activity as Antidote to Death?

2020 ◽  
pp. 003022282091371
Author(s):  
Hanne Bess Boelsbjerg ◽  
Stinne Glasdam
Keyword(s):  
Physical Activity ◽  
Health Care ◽  
Palliative Care ◽  
Field Study ◽  
Advanced Cancer ◽  
Health Care Professionals ◽  
Care Needs ◽  
Palliative Care Needs ◽  
Empirical Material

Physical activity has increasingly gained attention within palliative care. This article aims to explore how the idea of physical activity influences patients with advanced cancer and health-care professionals’ interactions. The empirical material was gathered as part of an anthropological field study about palliative care needs among 16 patients with advanced cancer, consisting of observations and interviews with patients, relatives, and professionals. Two of the patient cases were analyzed, inspired by Goffman’s theory, showing how patients and health-care professionals interact in relation to physical activity. The findings show that patients played roles either embracing physical activity or distancing it by postponement. Professionals played expert roles of duty and attachment, stressing the importance of physical activity. Thus, they accepted a minimum of physical activity when patients were close to death. Professionals regarded patients’ absence of physical activity as a lack of desire to live; patients regard it as a way to live.

scholarly journals A PROFILE OF CAREGIVING AMONG SEPSIS SURVIVORS RECEIVING POST-ACUTE HOME HEALTH CARE

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S218-S218
Author(s):  
Jo-Ana D Chase ◽  
Christina R Whitehouse ◽  
Lizeyka Jordan ◽  
Kathryn H Bowles
Keyword(s):  
Health Care ◽  
Hospital Discharge ◽  
Home Health Care ◽  
Medication Administration ◽  
Home Health ◽  
Future Research ◽  
Medical Procedures ◽  
Care Needs ◽  
Sepsis Survivors ◽  
Training And Support

Abstract Sepsis survivors transitioning from hospital-to-home are clinically complex. Family caregivers can face challenges managing patients’ care needs; however, skilled home health care (HHC) can serve as an important resource during this care transition. This study’s purpose was to describe caregiving needs among older sepsis survivors receiving post-acute HHC, and identify sources of unmet caregiving needs. We conducted a retrospective analysis of a national dataset of Medicare beneficiaries starting a new HHC episode who were after hospital discharge for sepsis between 2013 and 2014 (n=165,228). All patients received at least one HHC visit the first week after hospital discharge. Caregiving activities included seven items from the start of care Outcome and Assessment Information Set. Descriptive statistics were used to examine types of caregiving activities and needs, demographics, and clinical information. Proportions of patients with unmet caregiving needs ranged from 9%-29%, with the largest proportion of unmet needs in activities of daily living (ADL) assistance (29%), medication administration (28%), and medical procedures/treatments (25%). Unmet caregiving needs across activities were largely due to a caregiver needing training/supportive services (75%-88%), suggesting that many sepsis survivors receiving HHC have caregivers who are available to help, but who lack the knowledge and skills to manage patients’ complex care needs. Thus, HHC providers should address caregiving training and support needs, especially related to assistance with ADLs, medication administration, and medical procedures/treatments. Future research is needed to determine specific educational strategies for caregiver training and support, especially related to skills and knowledge assessment, and training delivery and monitoring.

scholarly journals Social Vulnerability and Medical Complexity Among Medicare Beneficiaries Receiving Home Health Without Prior Hospitalization

2020 ◽  
Vol 4 (6) ◽  
Author(s):  
Julia G Burgdorf ◽  
Tracy M Mroz ◽  
Jennifer L Wolff
Keyword(s):  
Health Care ◽  
Home Health Care ◽  
National Health ◽  
Social Vulnerability ◽  
Home Health ◽  
Clinical Severity ◽  
Referral Source ◽  
Care Needs ◽  
Medical Complexity ◽  
Multiple Episodes

Abstract Background and Objectives Recent Medicare home health payment changes reduce reimbursement for care provided to patients without a preceding hospitalization. Beneficiaries may enter home health without a preceding hospitalization via referral from a community provider or through incurring multiple episodes of home health care. We assess potential implications of this change by examining the characteristics of patients accessing Medicare home health through each of these pathways. Research Design and Methods Nationally representative retrospective cohort study of 1,224 (weighted n = 5,913,080) older adults who participated in the National Health and Aging Trends Study between 2011 and 2015 and received Medicare-funded home health within 1 year of interview. Patient characteristics before home health were drawn from the National Health and Aging Trends Study, while characteristics during home health, referral source, and number of episodes incurred were drawn from linked Outcomes and Assessment Information Set and Medicare claims. We tested for differences in characteristics by referral source and number of episodes using weighted chi-square tests and t tests. Results Patients referred to home health from the community were more than twice as likely to be Medicaid-enrolled (24.0% vs 12.5%, p < .001), have dementia (29.5% vs 12.4%, p < .001), and have received 80 or more hours/month of family caregiver assistance (20.7% vs 10.1%, p < .001) prior to home health entry compared to those referred from a hospital or skilled nursing facility. Patients who incurred multiple episodes in a spell of home health care were more likely to have high clinical severity during home health (48.3% vs 28.1%, p < .001), compared to those with a single episode. Discussion and Implications Greater social vulnerability and care needs before home health were associated with community referral, while greater clinical severity during home health was associated with incurring multiple episodes of care. Findings suggest that recent payment changes may threaten home health access among beneficiaries with greater social vulnerability and/or medical complexity.

scholarly journals A novel care guide for personalised palliative care – a national initiative for improved quality of care

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Dröfn Birgisdóttir ◽  
Anette Duarte ◽  
Anna Dahlman ◽  
Bengt Sallerfors ◽  
Birgit H. Rasmussen ◽  
...  
Keyword(s):  
Health Care ◽  
Palliative Care ◽  
Health Care Professionals ◽  
Care Needs ◽  
Comprehensive Overview ◽  
Pilot Studies ◽  
Early Palliative Care ◽  
The Family ◽  
Palliative Care Needs

Abstract Background Even when palliative care is an integrated part of the healthcare system, the quality is still substandard for many patients and often initiated too late. There is a lack of structured guidelines for identifying and caring for patients; in particular for those with early palliative care needs. A care guide can act as a compass for best practice and support the care of patients throughout their palliative trajectory. Such a guide should both meet the needs of health care professionals and patients and families, facilitating discussion around end-of-life decision-making and enabling them to plan for the remaining time in life. The aim of this article is to describe the development and pilot testing of a novel Swedish palliative care guide. Methods The Swedish Palliative Care Guide (S-PCG) was developed according to the Medical Research Council framework and based on national and international guidelines for good palliative care. An interdisciplinary national advisory committee of over 90 health care professionals together with patient, family and public representatives were engaged in the process. The feasibility was tested in three pilot studies in different care settings. Results After extensive multi-unit and interprofessional testing and evaluation, the S-PCG contains three parts that can be used independently to identify, assess, address, follow up, and document the individual symptoms and care-needs throughout the whole palliative care trajectory. The S-PCG can provide a comprehensive overview and shared understanding of the patients’ needs and possibilities for ensuring optimal quality of life, the family included. Conclusions Based on broad professional cooperation, patients and family participation and clinical testing, the S-PCG provides unique interprofessional guidance for assessment and holistic care of patients with palliative care needs, promotes support to the family, and when properly used supports high-quality personalised palliative care throughout the palliative trajectory. Future steps for the S-PCG, entails scientific evaluation of the clinical impact and effect of S-PCG in different care settings – including implementation, patient and family outcomes, and experiences of patient, family and personnel.

scholarly journals Global Survey of the Roles, Satisfaction, and Barriers of Home Health Care Nurses on the Provision of Palliative Care

2019 ◽  
Vol 22 (8) ◽  
pp. 945-960 ◽  
Author(s):  
Jeannine M. Brant ◽  
Regina M. Fink ◽  
Cara Thompson ◽  
Ya Huei Li ◽  
Maryam Rassouli ◽  
...  
Keyword(s):  
Health Care ◽  
Palliative Care ◽  
Home Health Care ◽  
Home Health ◽  
Global Survey
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