Care planning practices for behavioural and psychological symptoms of dementia (BPSD) in residential aged care: A pilot of an education toolkit informed by the Aged Care Funding Instrument (ACFI)

2013 ◽  
pp. 3209-3249 ◽  
Author(s):  
Yun-Hee Jeon ◽  
Janelle Govett ◽  
Lee-Fay Low ◽  
Lynn Chenoweth ◽  
Georgene McNeill ◽  
...  
Keyword(s):  
Psychological Symptoms ◽  
Aged Care ◽  
Residential Aged Care ◽  
Care Planning ◽  
Behavioural And Psychological Symptoms

scholarly journals Evaluating the Utility of a Structured Clinical Protocol for Reducing the Impact of Behavioural and Psychological Symptoms of Dementia in Progressive Neurological Diseases: A Pilot Study

2018 ◽  
Vol 2018 ◽  
pp. 1-9
Author(s):  
Nicholas P. Ryan ◽  
Laura Scott ◽  
Maryanne McPhee ◽  
Susan Mathers ◽  
Marie-Claire Davis ◽  
...  
Keyword(s):  
Job Stress ◽  
Psychological Symptoms ◽  
Neurological Diseases ◽  
Aged Care ◽  
Medium Effect ◽  
Residential Aged Care ◽  
Secondary Outcome ◽  
Clinical Protocol ◽  
Behavioural And Psychological Symptoms ◽  
The Impact

Objectives. Behavioural and psychological symptoms of dementia (BPSD) cause significant distress to both aged care residents and staff. Despite the high prevalence of BPSD in progressive neurological diseases (PNDs) such as multiple sclerosis, Huntington’s disease, and Parkinson’s disease, the utility of a structured clinical protocol for reducing BPSD has not been systematically evaluated in PND populations. Method. Staff (n=51) and individuals with a diagnosis of PND (n=13) were recruited into the study, which aimed to evaluate the efficacy of a PND-specific structured clinical protocol for reducing the impact of BPSD in residential aged care (RAC) and specialist disability accommodation (SDA) facilities. Staff were trained in the clinical protocol through face-to-face workshops, which were followed by 9 weeks of intensive clinical supervision to a subset of staff (“behaviour champions”). Staff and resident outcome measures were administered preintervention and immediately following the intervention. The primary outcome was frequency and severity of BPSD, measured using the Neuropsychiatric Inventory-Nursing Home Version (NPI-NH). The secondary outcome was staff coping assessed using the Strain in Dementia Care Scale (SDCS). Results. In SDA, significant reductions in staff ratings of job-related stress were observed alongside a statistically significant decrease in BPSD from T1 to T2. In RAC, there was no significant time effect for BPSD or staff coping; however, a medium effect size was observed for staff job stress. Conclusions. Staff training and clinical support in the use of a structured clinical protocol for managing BPSD were linked to reductions in staff job stress, which may in turn increase staff capacity to identify indicators of resident distress and respond accordingly. Site variation in outcomes may relate to organisational and workforce-level barriers that may be unique to the RAC context and should be systematically addressed in future RCT studies of larger PND samples.

scholarly journals ‘Traversing difficult terrain’. Advance care planning in residential aged care through multidisciplinary case conferences: A qualitative interview study exploring the experiences of families, staff and health professionals

2021 ◽  
pp. 026921632110132
Author(s):  
Suzanne Rainsford ◽  
Sally Hall Dykgraaf ◽  
Rosny Kasim ◽  
Christine Phillips ◽  
Nicholas Glasgow
Keyword(s):  
Advance Care Planning ◽  
Health Professionals ◽  
Aged Care ◽  
Shared Responsibility ◽  
Care Staff ◽  
Residential Aged Care ◽  
Care Planning ◽  
Qualitative Interview Study ◽  
Case Conferences ◽  
Advance Care

Background: Advance care planning improves the quality of end-of-life care for older persons in residential aged care; however, its uptake is low. Case conferencing facilitates advance care planning. Aim: To explore the experience of participating in advance care planning discussions facilitated through multidisciplinary case conferences from the perspectives of families, staff and health professionals. Design: A qualitative study (February–July 2019) using semi-structured interviews. Setting: Two residential aged care facilities in one Australian rural town. Participants: Fifteen informants [family ( n = 4), staff ( n = 5), health professionals ( n = 6)] who had participated in advance care planning discussions facilitated through multidisciplinary case conferences. Results: Advance care planning was like navigating an emotional landscape while facing the looming loss of a loved one. This emotional burden was exacerbated for substitute decision-makers, but made easier if the resident had capacity to be involved or had previously made their wishes clearly known. The ‘conversation’ was not a simple task, and required preparation time. Multidisciplinary case conferences facilitated informed decision-making and shared responsibility. Opportunity to consider all care options provided families with clarity, control and a sense of comfort. This enabled multiple stakeholders to bond and connect around the resident. Conclusion: While advance care planning is an important element of high quality care it involves significant emotional labour and burden for families, care staff and health professionals. It is not a simple administrative task to be completed, but a process that requires time and space for reflection and consensus-building to support well-considered decisions. Multidisciplinary case conferences support this process.

Understanding how advance care planning is approached in the residential aged care setting: A continuum model of practice as an explanatory device

2009 ◽  
Vol 28 (4) ◽  
pp. 211-215 ◽  
Author(s):  
Christopher Shanley ◽  
Elizabeth Whitmore ◽  
Angela Khoo ◽  
Colleen Cartwright ◽  
Amanda Walker ◽  
...  
Keyword(s):  
Advance Care Planning ◽  
Continuum Model ◽  
Care Setting ◽  
Aged Care ◽  
Residential Aged Care ◽  
Care Planning ◽  
Advance Care ◽  
Model Of Practice
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