scholarly journals A Digital Platform for Facilitating Personalized Dementia Care in Nursing Homes: A Formative Evaluation Study (Preprint)

2020 ◽  
Author(s):  
GUBING WANG ◽  
Armagan Albayrak ◽  
Gerd Kortuem ◽  
Tischa J. M. van der Cammen
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
User Acceptance ◽  
Assistive Technologies ◽  
Perceived Usefulness ◽  
Technical Feasibility ◽  
Digital Platform ◽  
Person Centered Care ◽  
People With Dementia ◽  
Centered Care

BACKGROUND Person-centered care is key to the wellbeing of people with dementia. A large quantity of personal data can be collected with the development of the Internet of Things, which has the potential to facilitate person-centered care for people with dementia. Yet, there are limited assistive technologies developed for this purpose, and the user acceptance for assistive technologies is low in nursing homes. Through a data-enabled design approach, a digital platform was developed for helping the care team to personalize the management of behavioral and psychological symptoms for people with dementia in nursing homes. OBJECTIVE This study aims to evaluate the digital platform from three aspects, in a real-life context with potential users. First, its technical feasibility in collecting sufficient data for pattern analysis; second, the types of insights and actions generated from the potential users by using it, if any; third, its perceived usefulness and its future improvements that potential users would like to see. METHODS The digital platform was deployed in a nursing home for seven weeks, and the data collected were first analyzed by the researchers for a technical feasibility check. The data were then visualized and presented to the potential users via the digital platform. The potential users were asked to analyze the visualizations and were interviewed on 1) the insights and actions generated, if any; 2) the usefulness of the digital platform and 3) what could be improved. RESULTS The data collected in the digital platform demonstrate its technical potential to reveal behavior patterns for PwD. The insights generated by the potential users were categorized into “client level”, “ward level” and “team level”. The actions taken by the potential users were classified into “investigation” and “implementation”. The user acceptance varied across potential users, and three aspects of improvements for the digital platform were identified. CONCLUSIONS This study provides the first evidence for the technical feasibility of the digital platform; besides, it offers future researchers some recommendations on how to integrate assistive technologies in the nursing home context from exploring the types of insights and actions identified, the varied perceived usefulness, and the areas of improvement for the digital platform.

The experiences, priorities, and perceptions of informal caregivers of people with dementia in nursing homes: A scoping review

Dementia ◽  
2021 ◽  
pp. 147130122110126
Author(s):  
Alexandra E Harper ◽  
Lauren Terhorst ◽  
Marybeth Moscirella ◽  
Rose L Turner ◽  
Catherine V Piersol ◽  
...  
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Home Care ◽  
Scoping Review ◽  
Informal Caregivers ◽  
Nursing Home Care ◽  
Person Centered Care ◽  
People With Dementia ◽  
Centered Care

Background Person-centered care has been shown to increase desired outcomes for people with dementia, yet informal caregivers’ dissatisfaction with care is often reported. For those living in a nursing home, informal caregivers are uniquely situated to provide key insights into the individual’s care. However, little is known of the informal caregivers’ perspective, which hinders efforts to improve their satisfaction with person-centered nursing home care. Thus, we examined the comprehensive experiences, priorities, and perceptions of informal caregivers of nursing home residents with dementia. Methods In collaboration with stakeholders, a scoping review of Medline (Ovid), EMBASE.com , CINAHL (EBSCO), the Cochrane Library (Wiley), and PsycINFO (Ovid) databases from January 2000 to July 2020 was conducted. Data were extracted reflecting the experiences, priorities, and preferences of caregivers of people with dementia residing in nursing homes. Results We identified 114 articles that revealed nine themes: (1) communication, (2) transition to nursing home, (3) quality of care, (4) quality of life, (5) informal caregiver role, (6) knowledge of dementia, (7) end-of-life preferences, (8) medication use to manage neuropsychiatric behaviors, and (9) finances. Conclusion Informal caregivers described aspects of care that led to both positive and negative experiences with and perceptions of nursing home care. The shortcomings in communication were discussed most frequently, indicating a high priority area. While researchers define the identified themes individually, informal caregivers perceive them to be interwoven as they relate to person-centered care delivery. Although we did not assess the quality of included articles, by identifying themes relevant to caregivers’ perspectives of nursing home care, our findings may help to inform efforts to optimize caregivers’ satisfaction with nursing home care for residents with dementia.

scholarly journals The Physical Environment of Nursing Homes for People with Dementia: Traditional Nursing Homes, Small-Scale Living Facilities, and Green Care Farms

Healthcare ◽  
2018 ◽  
Vol 6 (4) ◽  
pp. 137 ◽  
Author(s):  
Bram de Boer ◽  
Hanneke Beerens ◽  
Melanie Katterbach ◽  
Martina Viduka ◽  
Bernadette Willemse ◽  
...  
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Physical Environment ◽  
Well Being ◽  
Nursing Home Care ◽  
Small Scale ◽  
People With Dementia ◽  
Different Types ◽  
Centered Care ◽  
Green Care Farms

It is well recognized that the physical environment is important for the well-being of people with dementia. This influences developments within the nursing home care sector where there is an increasing interest in supporting person-centered care by using the physical environment. Innovations in nursing home design often focus on small-scale and homelike care environments. This study investigated: (1) the physical environment of different types of nursing homes, comparing traditional nursing homes with small-scale living facilities and green care farms; and (2) how the physical environment was being used in practice in terms of the location, engagement and social interaction of residents. Two observational studies were carried out. Results indicate that the physical environment of small-scale living facilities for people with dementia has the potential to be beneficial for resident’s daily life. However, having a potentially beneficial physical environment did not automatically lead to an optimal use of this environment, as some areas of a nursing home (e.g., outdoor areas) were not utilized. This study emphasizes the importance of nursing staff that provides residents with meaningful activities and stimulates residents to be active and use the physical environment to its full extent.

scholarly journals 414 - Supporting staff delivering person-centered care to people with dementia in Dutch nursing homes

2021 ◽  
Vol 33 (S1) ◽  
pp. 37-38
Author(s):  
Henriëtte van der Roest ◽  
Milan van der Kuil ◽  
Anouk Overbeek ◽  
Egbert Hartstra
Keyword(s):  
Nursing Homes ◽  
Living Arrangements ◽  
Online Survey ◽  
Dementia Care ◽  
Person Centered Care ◽  
People With Dementia ◽  
Modifiable Factors ◽  
Centered Care ◽  
Organizational Features

BackgroundPositive evidence has been found for person-centered care provisioning (PCC), the level of person- centeredness of care is positively associated with residents’ quality of life, quality of care an wellbeing.When providing PCC, care and support are provided in line with the needs, preferences and capacities of people with dementia. PCC is seen as the golden standard for dementia care. However, in nursing homes, needs and preferences of people with dementia are not always obvious, due to the relatively high levels of cognitive impairment. This, and amongst others time constraints might hinder high PCC by care professionals. Limited evidence show that certain organizational and environmental conditions, such as satisfactory leadership, interdisciplinary collaboration, and continuing education, lead to higher PCC. In order to facilitate care professionals as much as possible in providing PCC, more insight is desirable.ObjectiveThis study aims to provide more insight into the modifiable factors that contribute to PCC for people with dementia in Dutch nursing homes.MethodsA cross-sectional design was applied. Data were collected during the fifth assessment of the Living Arrangements for people with Dementia (LAD)-study from April 2019 until February 2020. Care professionals working in psychogeriatric units in nursing homes filled in an online survey. Organizational characteristics of participating nursing homes were inventoried.The level of PCC was assessed with the Dutch version of the ‘Person-centred care questionnaire’ (PCCq). Modifiable factors potentially impacting the level of provided PCC with regard to staff characteristics (e.g. autonomy, education), organizational features (e.g. size, involvement of family in care), and culture (e.g. learning climate) were included in multiple linear modelling.Preliminary resultsIn total 58 nursing home facilities were included in the study, and 814 care professionals completed the survey. Average PCCq score was 3.2 (SD = 0.4; range 0 to 4, higher scores indicating higher PCC).ConclusionFactors related to staff, and organizational features and culture, that contribute to PPC will be presented. The outcomes of the study will provide input for the optimal organization of dementia care, in order to support care professionals working in nursing homes to provide PCC.

scholarly journals THE SUPPORT OF AUTONOMY FOR NURSING HOME RESIDENTS WITH DEMENTIA: OBSERVATION OF MORNING CARE

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S73-S73
Author(s):  
Linda J Hoek ◽  
Hilde Verbeek ◽  
Erica De Vries ◽  
Jolanda C Van Haastregt ◽  
Ramona Backhaus ◽  
...  
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Nursing Home Residents ◽  
Relational Autonomy ◽  
Staff Members ◽  
People With Dementia ◽  
Centered Care ◽  
Field Notes ◽  
Almost All ◽  
Physical Care

Abstract People with dementia in nursing homes need their social environment in supporting their autonomy. This study explored how this relational autonomy is supported by staff for residents with dementia during morning care in nursing homes. Structured observations (n=1815) were carried out to assess how resident choice is supported within staff-resident interaction. Observation of morning care consisted of four main categories: ‘getting up’, ‘physical care’, ‘physical appearance’ and ‘breakfast’. In addition, qualitative field notes were taken to support observations. In total, 55 residents with dementia were included from eight nursing home wards in The Netherlands. Results indicated that resident autonomy during morning care was only limitedly supported. Individual staff members took over tasks, regardless of resident’s individual capabilities to make a choice. Staff controlled resident’s choice for almost all observed categories. The findings of this study implicate that person-centered care during morning routine can be improved by addressing individual needs

scholarly journals Person-centered care in Norwegian nursing homes and its relation to organizational factors and staff characteristics: a cross-sectional survey

2017 ◽  
Vol 30 (9) ◽  
pp. 1279-1290 ◽  
Author(s):  
Irene Røen ◽  
Øyvind Kirkevold ◽  
Ingelin Testad ◽  
Geir Selbæk ◽  
Knut Engedal ◽  
...  
Keyword(s):  
Job Satisfaction ◽  
Nursing Homes ◽  
Physical Environment ◽  
Organizational Factors ◽  
Structural Factors ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Person Centered Care ◽  
People With Dementia ◽  
Centered Care

ABSTRACTBackground:Person-centered care (PCC) is regarded as good quality care for persons with dementia. This study aimed to explore and understand the association between PCC and organizational, staff and unit characteristics in nursing homes (NHs).Methods:Staff from 175 NH units in Norway (n = 1,161) completed a survey, including measures of PCC and questions about staff characteristics and work-related psychosocial factors. In addition, data about organizational and structural factors and assessment of the physical environment in the units were obtained. The distribution of these factors in regular units (RUs) and special care units (SCUs) is described, and the differences between the two types of units are analyzed. Furthermore, multilevel linear regression analyses explored the extent to which variables were associated with PCC.Results:Higher levels of PCC were associated with a greater job satisfaction, three years or more of health-related education, a lower level of quantitative demands and role conflict, a higher level of perception of mastery, empowering leadership, innovative climate and perception of group work, in addition to the type of unit and the physical environment in the NH unit designed for people with dementia. SCU and staff job satisfaction explained most of the variation in PCC.Conclusion:This study shows an association between PCC and organizational, staff and unit characteristics in NH. These findings indicate that providing PCC in NH care is closely linked to how the staff experiences their job situation in addition to both organizational and structural factors and the physical environment. Attention needs to be given to such factors when planning NH care.

scholarly journals Determinants of Successful Nursing Home Accreditation

2021 ◽  
Vol 58 ◽  
pp. 004695802110599
Author(s):  
Shu-Chuan Yeh ◽  
Shwu-Feng Tsay ◽  
Wen Chun Wang ◽  
Ying-Ying Lo ◽  
Hon-Yi Shi
Keyword(s):  
Quality Control ◽  
Nursing Home ◽  
Nursing Homes ◽  
Integrated Care ◽  
Organizational Factors ◽  
Minor Role ◽  
Person Centered Care ◽  
Nursing Skills ◽  
Centered Care ◽  
Care Nursing

Objectives: This study examined the factors associated with better accreditation outcomes among nursing homes. Method: A total of 538 nursing homes in Taiwan were included in this study. Measures included accreditation scores, external factors (household income, Herfindahl–Hirschman Index, old-age dependency ratio, population density, and number of older adult households), organizational factors (hospital-based status, chain-affiliated status, occupancy rate, the number of registered nurses or nurse aides per bed, and bed size), and internal factors (accountability, deficiencies, person-centered care, nursing skills, quality control, and integrated care). Results: Bed size, hospital-based status, accountability, deficiencies, person-centered care, nursing skills, quality control, and integrated care were found to predict accreditation. Conclusion: Among all variables in this study, the quality indicators contributed to the most variation, followed by organizational factors. External environmental factors played a minor role in predicting accreditation. A focus on quality of care would benefit not only the residents of a nursing home but also facilitate its accreditation.

scholarly journals COVID-19 and Person-Centered Care: Lessons Learned Through a Statewide Program for Nursing Homes

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 270-271
Author(s):  
Migette Kaup ◽  
Laci Cornelison
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Infection Control ◽  
Pay For Performance ◽  
Control Strategies ◽  
Lessons Learned ◽  
Frail Elders ◽  
Person Centered Care ◽  
Centered Care ◽  
The Impact

Abstract Frail elders in nursing homes are the highest risk group for developing complications of COVID-19. This lead to a response from CMS and state regulators that was heavily focused on protection and safety through segregation and infection control. The purpose of this study was to gather the narrative of this pandemic response and understand the impact on person-centered care and be able to address provider needs in real-time. This qualitative method focused on nursing home providers who are a part of PEAK 2.0, a Medicaid pay-for-performance program in Kansas. Interviews with nursing home staff (n=168) revealed two critical themes of need; mandated responses disregarded elders’ autonomy and self-determination in decision making, and infection control strategies required new approaches to facets of resident care that still maintained dignity. This data, along with COVID-19 guidance were then used to inform feasible resource development and education to maintain PCC practices during the pandemic.

scholarly journals A QUALITATIVE STUDY OF NURSING HOME STAFF CONCEPTUALIZATION OF EVERYDAY DECISION-MAKING CAPACITY

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S700-S700
Author(s):  
Whitney L Mills ◽  
Mark E Kunik ◽  
Lea Kiefer ◽  
Hannah Curren-Vo ◽  
Amy Mochel ◽  
...  
Keyword(s):  
Decision Making ◽  
Nursing Home ◽  
Nursing Homes ◽  
Qualitative Content Analysis ◽  
Daily Basis ◽  
Care Providers ◽  
Nursing Home Staff ◽  
Person Centered Care ◽  
Decision Making Capacity ◽  
Centered Care

Abstract Because nursing homes are both a residence and a treatment setting, care providers are faced with the challenge of balancing resident autonomy and safety on a daily basis. While there are standardized approaches for determining a capacity to make larger decisions such as providing consent for medical procedures, there are virtually no methods for assessing capacity to make everyday decisions (e.g., food choices, smoking, navigating outside the nursing home). While it is easier for staff to prevent residents from making decisions they deem risky, to truly offer person-centered care, it is important to support a resident’s right to make decisions if they have the capacity to do so. Currently, little is known about how nursing home staff conceptualize and determine everyday decision-making capacity and how that information is used in care planning. To understand the current processes and language nursing home staff use when considering a resident’s decision-making capacity, we conducted interviews with 37 staff at two Veterans Affairs (VA) Community Living Centers (VA-operated nursing homes; CLCs). Using qualitative content analysis, we coded the transcribed interviews and identified several overarching themes: autonomy vs. safety, communication (e.g., pathways, with caregivers, with residents), determining capacity (e.g., information gathering, assessment, assumptions, indicators, interdisciplinary team member roles, referrals), interventions (e.g., legal and staff-led), and terminology used. We will describe how the findings from this study can be used to tailor development and adaptation of tools to help nursing home staff assess resident everyday decision-making capacity and to incorporate the results into person-centered care approaches.

scholarly journals Social Innovation Toward a Meaningful Everyday Life for Nursing Home Residents: An Ethnographic Study

2021 ◽  
Vol 12 ◽  
Author(s):  
Åshild Slettebø ◽  
Ragnhild Skaar ◽  
Kari Brodtkorb
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Everyday Life ◽  
Social Innovation ◽  
Nursing Home Residents ◽  
Ethnographic Study ◽  
Main Theme ◽  
Person Centered Care ◽  
Centered Care ◽  
Innovation Practices

Background: The literature shows that innovation, which includes culture change, may be important to create a meaningful everyday life for nursing home residents. However, there is a gap in how social innovation practices may contribute to this. The theoretical discourse for the study is person-centered care.Aim: The main aim was to explore phenomena within social innovation that can contribute to improving nursing home residents’ everyday lives.Design and Method: This study uses an ethnographic design with observations and interviews in two nursing homes in Southern Norway.Findings: The main theme was that social innovation within working practices in nursing homes includes phenomena that contribute to a meaningful everyday life for the residents. This main theme includes five subthemes: (1) opening the nursing home to the surroundings; (2) expanding and strengthening the community of practice; (3) facilitating customized activities; (4) ensuring sufficient nutrition and facilitating enjoyable mealtimes; and (5) preventing unrest and disturbing behavior.Conclusion: The study reveals that innovation practices grounded in person-centered care in nursing homes may contribute to opening the nursing home to the community and establishing a common community practice for all members of the nursing home. This enables residents to experience meaningful everyday life through customized activities, sufficient nutrition, and a pleasant milieu during mealtimes. Disturbing behavior is also prevented, making it possible to promote meaningful lives in nursing homes.

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