Homes In Slovenia Research Articles

The Role of Nursing Homes Architectural Design in Mitigating the Risk of COVID-19 Pandemics: The Case of Slovenia

Currently, many older people live in institutions for various social and health reasons. In Slovenia, this proportion is almost 5% of the population aged 65 and over. In the COVID-19 pandemic, the elderly proved to be the most vulnerable social group, as they are exposed to a number of comorbidities that increase the risk of mortality. At that time, nursing homes represented one of the most critical types of housing, as seen from a disproportionate number of infections and deaths among nursing home residents worldwide, including Slovenia. During the emergency, a number of safety protocols had to be followed to prevent the spread of infection. Unfortunately, it turned out that while the safety measures protected the nursing home residents, they also had a negative effect on their mental health, mainly due to isolation and social distancing. It follows that especially in times of epidemics of infectious respiratory diseases, the quality of life in nursing homes requires special attention. In this context, it is also necessary to consider whether and how an appropriate architectural design can help mitigating the spread of infections, while at the same time enable older people to live in dignity and with a minimum of social exclusion. To this end, the present study examined 97 nursing homes in Slovenia, analysing the number of infections in nursing homes and their correlation with the degree of infection in the corresponding region in Slovenia. Additionally, 2 nursing homes were studied in more detail with the use of newly developed “Safe and Connected” evaluation tool, analysing the architectural features of each building. The advantages identified so far include living in smaller units, single rooms with balconies, the possibility of using green open spaces and the use of an adequate ventilation. Conclusions of this study are useful for further consideration of design of new nursing homes and the refurbishment of existing ones.

Spiritual care in Slovenian nursing homes: a quantitative descriptive study

Introduction:Spiritual care is an important component of holistic care in nursing. However, health care workers are not unanimous in who is responsible for the spiritual care of patients. It is likely that nurses are best suited to provide spiritual care because of the nature of their work, which requires constant contact with patients. Yet, meeting spiritual needs is not well defined in the role of nurses and is not always taught comprehensively in formal nursing education programmes. The aim of this study was to explore the extent to which nurses working in social care settings implement interventions related to spiritual care in their daily practise, how they perceive their knowledge of spiritual care, and the extent to which this dimension of care was included in their nursing education programmes.Methods:A non-experimental quantitative descriptive research study was used. In April 2020, 214 nurse assistants and registered nurses from 12 nursing homes in Slovenia participated in the study. The questionnaire used in the study included 12 statements related to 3 main areas: i) knowledge of the concepts of spirituality and religion, ii) implementation of spiritual/religious interventions in daily practice, iii) spirituality in nursing education. The individual statements were rated by the respondents on a 5-point Likert scale (1 - strongly disagree to 5 - strongly agree). The questionnaire had adequate internal consistency (Cronbach alpha = 0.857). Data were described using calculated means, Mann-Whitney U test, and Spearman correlation coefficient. A p-value ≤ 0.05 was considered significant.Results:Regular spiritual assessment of nursing home residents is rarely performed by nurses (x̄=2.73, s=1.03). Female nurses (U=2191.500, p=0.008) and nurses who described themselves as religious (U=3314.000, p=0.001) implement spiritual/religious interventions in daily practice to a greater extent; they also expressed higher knowledge of the concepts of spirituality and religion compared to the others (religious/non-religious: U=2920.000, p=0.000; female/male: U=1885.000, p=0.000). The implementation of spiritual/religious interventions in daily practice correlated positively and statistically significantly mainly with self-perceived knowledge of the concepts of spirituality and religion (r=0.495, p=0.000) and the extent to which the content of spiritual care was represented in their nursing education program (r=0.494, p=0.000). However, nurses emphasized that the concept of spirituality and spiritual care tended to be poorly represented in formal nursing education programs (x̄=2.76, s=0.89).Discussion and conclusions:Individual characteristics, particularly self-reported religiosity and gender, appear to have an important influence on the implementation of spiritual/religious interventions in daily practise. In addition, our study suggests that the level of knowledge about the concepts of spirituality and religion influences nurses' willingness to implement spiritual care with their residents. Therefore, nursing educators need to develop curricula that include strategies to increase trainees' awareness of spiritual care. Current international research efforts on perceptions of spirituality and spiritual care in nursing offer important contributions to understanding the role of nursing in relation to spirituality and to developing educational content and approaches for both undergraduate and lifelong learning in nursing.

Znanje, odnos in dojemanje dela s starejšimi osebami pri zaposlenih v zdravstveni negi in oskrbi v domovih za starejše

Uvod: Ustrezen odnos, splošna in strokovna znanja ter razumevanje vloge strokovnjakov, ki delajo s starejšimi osebami, lahko pripomorejo k odpravljanju stereotipov in prispevajo h kakovostni obravnavi starejših oseb. Namen raziskave je bil proučiti odnos do dela s starejšimi osebami, znanje o njem in njegovo dojemanje ter povezanost naštetega z izobraževanji zaposlenih v domovih za starejše.Metoda: Izvedena je bila kvantitativna eksplorativna raziskava na populaciji izvajalcev zdravstvene nege in oskrbe (n = 266) v 13 domovih za starejše v Sloveniji. Podatki so bili zajeti z že razvitimi merskimi instrumenti (FAQ-R, POWP, ASD, ADKS). Raziskava je bila izvedena v obdobju med junijem in avgustom 2017. Podatki so bili obdelani z opisno in bivariantno statistiko.Rezultati: Test FAQ-R je pokazal 65,2 % uspešnost anketirancev, ki se je povečala z večanjem stopnje izobrazbe (p < 0,001). Pri 7,8 % anketirancev je bil ugotovljen negativni odnos do starejših oseb. Na ADKS-testu je bilo zbranih 64,9 % možnih točk (s = 14,86); dosežek se razlikuje glede na stopnjo izobrazbe (p < 0,001) in starost anketirancev (p = 0,022).Diskusija in zaključek: Splošno znanje o starejših osebah in staranju je pomanjkljivo; stopnja znanja o Alzheimerjevi bolezni je zadovoljiva, a se niža z nižanjem izobrazbe. Raziskava opozori na pomen številnih medsektorskih ukrepov, ki so odziv na potrebe dolgožive družbe. Področje je odprto za nadaljnje raziskovanje in razvoj novih instrumentov, ki bodo omogočili vzročno raziskovanje.

Innovations in Long-Term Care: The Case of Old People’s Homes in Slovenia

Institutional care for older people in Slovenia is one of the most developed forms of care for older people. The paper aims to present a specific role of homes in the existing and the future systems of long-term care from the perspective of the implementation of the national strategy of social welfare which highlights the individual treatment of its users, their inclusion in implementing and planning of care, as well as in strengthening their independence. On the basis of the survey research which covered all old people's homes in Slovenia, a series of interviews with social workers and residents and field visits to the selected homes excelling in innovative practice, we aim to show the most evident innovations. Among the most visible ones are social innovations, innovations in social welfare and home innovations. The impetus for the emerging innovations depends on the internal factors of care institutions (orientation of management, changes in the quality of services, personal relations) and external factors (cooperation with local authorities, implementation of the national strategy of social welfare). They also have an impact on the effects of innovations which may be short-term or they may have a direct impact on the quality of life in old people's homes. Identifying innovations proves that old people's homes are actively stepping into the area of long-term care which is expected to regulate their future role.

Family Care Experience in a Decentralized Social Home Care Context

This survey analyses the scope and intensity of informal care for the elderly residing in their homes in Slovenia and their determinants: the residing municipality of the care recipient, geographical distance between the informal carer and the care recipient, to the care recipients’ and the care givers’ individual characteristics. With the increasing private out-of-pocket financial contribution, which is determined by municipality, the scope and intensity of informal care shows a significant increase as shown by regression analysis. Inter-municipal cooperation and the introduction of gradual private financial contribution are proposed as tools for improving accessibility of social home care in Slovenia.

The Status of Nursing Documentation in Slovenia: a Survey.

Health documentation is a prerequisite for good and sustainable health and social care. It is especially important for patient involvement and their empowerment. A transition from paper to e-documentation together with the electronic patient record should be based on thorough knowledge of the current state of documentation and its usages. The main objective of this paper was to analyse which documents and work methods of documenting processes within nursing are being used within different environments. Furthermore, what are the main reasons for their discrepancies from theoretical approaches and best practices. The analysis is based on a survey carried out on all three levels of healthcare. The survey questionnaire consisted of 12 questions to which responded 286 nursing teams from community health centres, hospitals and retirement homes in Slovenia. The results point to diversity in documenting as well as lack of interoperability. This is reflected in a great number of different documents. All phases of the nursing process were being documented in only 31.8% of cases. The main reasons for this can be attributed to work organisation, different definitions of data-set requirements and inadequate knowledge by nurses. Survey results pointed out a need for the renewal of nursing documentation towards a more uniform system based on contemporary health technologies.

Family members’ involvement in elder care provision in nursing homes and their considerations about financial compensation: A qualitative study

The aim of this study was to establish how family members are involved in elder care provision in nursing homes; this included research into their feelings about potentially extending their involvement to obtain financial benefits as compensation for high accommodation costs. Family members remain involved in the caring process after their relatives have been admitted to an institution. On average, accommodation costs in nursing homes in Slovenia have risen above the residents’ retirement pension, and families must supplement the difference. Because of this, familial involvement should be linked to reduced accommodation costs. This research employed a non-experimental, descriptive study design through unstructured interviews. Participants included fifty family members (n=50) who visit their relatives in nursing homes. Data were collected in 2010 at five nursing homes in Slovenia and processed by means of conventional content analysis. The major themes that emerged from the content analysis, describing family involvement, were as follows: visiting and making oneself useful, delivery of items for personal use, hands-on care, physical therapy and organization of nursing home activities. Family members showed some interest in receiving financial compensation for their involvement. The proposed financial compensation may be a delicate and morally questionable matter but would involve fairness and transparency, while enabling easier organization of elder care provision. Eventually, nursing home residents’ well-being could be improved.

Challenges for institutional elder care in Slovenian nursing homes

To investigate deficiencies in the institutional elder care that is being offered to residents of nursing homes in Slovenia. Public criticism of the provision of elder care in nursing homes is growing all over the world, including in Slovenia. Many studies on this issue have been conducted, but seldom have assessed different viewpoints simultaneously. A qualitative research design that involved individual unstructured interviews was used in 2007. The participants (n=48) comprised 16 residents, 16 relatives and 16 members of the nursing staff from four nursing homes in Slovenia. The data generated were subjected to qualitative content analysis. The major themes that emerged from this analysis were neglect, unprofessional communication, uncomfortable physical environment and inadequate administration. The participants of the study identified issues in institutional elder care in Slovenia that have also been highlighted by international research. Due to staff shortages, low motivation, insufficient communication skills and inexperience, members of the nursing staff reported that they were not in a position to offer the best possible quality of care. To improve the living environment in nursing homes, it is important to consider the opinions of all those who are involved closely in institutional elder care. Correction of deficiencies should be a priority and should result in more engagement with residents.

Oral health of the elderly living in residential homes in Slovenia

To evaluate oral health status of the elderly, living in eight randomly selected residential homes for senior citizens across the country. The percentage of the elderly is growing worldwide. With ageing, risks of various oral diseases, including dental caries and periodontal disease, are growing. Altogether 296 elderly people (88 men, 208 women) of average age 79.89 ± 7.4 years were questioned about their medical condition and oral health practice and examined orally. Evaluation of clinical examination was carried out by DMFT, plaque index (Silness and Löe, 1964) and Community Periodontal Index of Treatment Need (CPITN). Of 296 participants, 106 (35.8%) were edentulous, 95 (32.1%) had one to nine teeth and 95 persons (32.1%) had 10 or more teeth. The average number of teeth in an individual was small: 6.76 ± 7.47. The average number of teeth with caries lesions was 3.59 ± 4.70, filled teeth 1.94 ± 3.63 and teeth without caries or fillings 1.19 ± 2.41. The average DMFT value was 30.75. In 69.5% of participants, dental plaque was visible with the naked eye. Of 171 subjects, in whom CPITN index was appraised, 81.9% would need oral hygiene education, 56.7% would need scaling and root planning and 21.6% would need periodontal surgical treatment. The results of this study indicate poor oral health of the elderly living in residential homes situated in different towns in Slovenia. It is of utmost importance to highlight the necessity of improving oral health care of this population.

Psychotropic medication use among elderly nursing home residents in Slovenia: cross-sectional study

AimTo determine the prevalence of psychotropic medication prescribing in elderly nursing home residents in Slovenia and to explore the residents’, physicians’, and nursing home characteristics associated with prescribing.MethodsIn a cross-sectional study, we collected the data for 2040 nursing home residents aged 65 years and older in 12 nursing homes in Slovenia between September 25 and November 30, 2006. Prescribed medications lists were retrieved from patients’ medical records. Psychotropic medications were coded according to Anatomical Therapeutic Chemical Classification 2005, which we adjusted for the purposes of the study. Multivariate logistic regression analysis was performed to determine the residents’, physicians’, and nursing home characteristics associated with prescribing.ResultsResidents were from 65 to 104 years old (median, 83 years) and 1606 (79%) of them were female. A total of 970 (48%) residents had dementia and 466 had depression (23%). In 1492 (73%) residents, at least one psychotropic medication was prescribed. Nine hundred sixty residents were prescribed hypnotics and sedatives (47%), 572 (28%) antipsychotics, 460 (23%) antidepressants, and 432 (21%) anxiolytics. Residents’ characteristics associated with psychotropic medication use were female sex (odds ratio [OR], 1.36; 95% confidence interval [CI], 1.03-1.80), age (OR, 0.97; 95% CI, 0.95-0.98), permanent restlessness (OR, 2.54; 95% CI, 1.71-3.78), dementia (OR, 1.76; 95% CI, 1.33-2.34), depression (OR, 5.51; 95% CI, 3.50-7.58), and the number of prescribed medications (OR, 1.29; 95% CI, 1.23-1.35). Of physicians’ characteristics (sex, age, specialization in general practice, years of working experiences as a general practitioner, and years of experiences working in a nursing home), male sex was associated with psychotropic medication prescribing (OR, 1.80; 95% CI, 1.17-2.76).ConclusionFrequency of psychotropic medication prescribing in elderly nursing home residents in Slovenia is high and is comparable to Western European countries. Our next step should be optimizing the prescribing in patients with the highest prescription rate.

Individual and social identity of residents of old people's homes in Slovenia

Individual and social identity of residents of old people's homes in SloveniaAim: The aim of the study was to assess the degree of individual and social identity of the elderly in institutional care. The paper analyses the data, hitherto unavailable in Slovenia, in order to contribute to the caregivers' knowledge of how to help their clients preserve and maintain their dignity, self-respect and identity.Methods: A cross-sectional study was conducted during the period December 2005-January 2006. Included in the study were 164 elderly residents of 20 old people's homes. The study instrument incorporated 36 statements addressing individual (15), narrow social (18), and broad social identity (3), which the respondents were asked to agree or disagree with. The Mann-Whitney and Kruskal-Wallis tests were used to facilitate data analysis of the respondents' gender, age, education and original residence environment.Results: The results of the study showed no correlation between the degree of individual identity and the respondents' gender, age, education and original residence environment. The correlation between the narrow (p=0.007) and broad (p=0.016) social identity and the residents' educational level, however, was statistically significant. In the latter two cases identity was least pronounced in most educated respondents.Conclusion: Educational level of old people's home residents

Strategy for care for the elderly persons in Slovenia

Introduction: The size and age-structure of Europe’s population is undergoing dramatic changes due to low fertility rates, continuous increases in life expectancy and the retirement of the baby-boom generation. ‘The Strategy for care for the elderly till 2010—Solidarity, good intergenerational relations and quality ageing of the population’, prepared by Ministry of Labour, Family and Social Affairs, is the response of the Republic of Slovenia to the ageing society and to the European demands for new solidarity between the generations. The main purpose of the strategy is to create good conditions for preserving and strengthening solidarity, for good intergenerational relations and to ensure quality ageing and care for the fast growing third generation. Special attention is given to the long-term care and the implementation of the new insurance for it. Description of care: Slovenia was 40 years ago one of the first countries with an efficient gerontological institute. The social welfare system in Slovenia today is based on the welfare system of public social insurance implemented in former Yugoslavia, which for elderly primarily developed nursing homes. Nursing homes in Slovenia are fully occupied at the moment. There are approximately 3.8% of people older than 65 live in nursing homes. The number of applications has been growing and waiting list for a bed to become available has been prolonging. Discussion: Like in other European countries, there are also in Slovenia trends toward developing specific services for the elderly, adjusted to their needs and preferences. However, to a large share of the elderly population these services are not accessible—partly due to their small number and partly due to their high price. Furthermore, the majority of the elderly people wish to live in their current dwelling and familiar environment. Conclusion: In developed societies the quality of life of the elderly population is coming to the forefront of research, as well as political agendas. This strategy is the only Slovenian document of this kind, in which different ministries took part in setting goals regarding ageing population. The strategy covers work of the governmental departments of work, employment, social care, health care, education, economy, traffic, science and other relevant areas and the civil society of the Third sector.

Coping with radon problem in a private house

In one of the 50 houses in which, during a national radon survey of 1000 homes in Slovenia, indoor radon concentrations exceeded 1000 Bq m −3, radon was further investigated. Except in the attic, elevated radon concentrations were found everywhere in the home, ranging from 0.5 to 12 kBq m −3. Applying ICRP 65 methodology, an annual effective dose in the range from 9 to 35 mSv was estimated for an inhabitant for different exposure scenarios. The radon problem was successfully mitigated and radon concentration reduced below 200 Bq m −3.

Iodine in daily diet samples from some old people's homes in Slovenia

In July 1992 we collected samples of daily meals in 51 old people's homes in the Republic of Slovenia to establish their iodine contents. The average content found was 79.6±31.9 μg of iodine in the daily meal, or 0.212±0.083 mg iodine kg–1 dry substance. In only 15 cases of 51 analysed samples, did the quantity of iodine exceed two thirds of the recommended daily intake of iodine, i.e. more than 100 μg.

Elemental Composition (Ca, Mg, Mn, Cu, Cr, Zn, Se, and I) of Daily Diet Samples from Some Old People's Homes in Slovenia

Modern analytical methods such as radiochemical and instrumental neutron activation analysis (RNAA and INAA), and electrothermal and flame atomic absorption spectrometry (ETAAS and FAAS), were used to determine concentration levels of elements Ca, Mg, Mn, Cu, Zn, Cr, I, and Se in 51 carefully prepared composite samples of total daily diets from some old people's homes in different parts of Slovenia for the summer period of the year 1992. The reliability of the results was checked by the analysis of compositionally similar certified standard reference materials (SRMs). Concentration levels of all essential elements were mostly below the recommended dietary allowance values (RDA) even when only 60% of the RDA value was taken into account.

Atmospheric radon concentrations in dwellings in Slovenia, Yugoslavia

About 120 homes in Slovenia, Yugoslavia, were selected in urban areas, in a uranium raine and mill region, around coal-fired plants and around a phosphate mill. Radon-222 in air was determined using alpha scintillation cells and the gamma dose rate measured with thermoluminescent dosimeters. The levels obtained were explained by differences in building materials and ventilation rates of homes, as well as by the influence of man-made radioactivity sources. The results show that in the same region radon concentration, expressed as geometric mean, can be up to eight times higher in winter than in the autumn (Pohorje) or nine times higher in one region relative to another (Zirovski vrh - Zasavje).