Life Of Long-term Care Residents Research Articles

Provincial policies affecting resident quality of life in Canadian residential long-term care

BackgroundThe precautions and restrictions imposed by the recent Covid-19 pandemic drew attention to the criticality of quality of care in long-term care facilities internationally, and in Canada. They also underscored the importance of residents’ quality of life. In deference to the risk mitigation measures in Canadian long-term care settings during Covid-19, some person-centred, quality of life policies were paused, unused, or under-utilised. This study aimed to interrogate these existing but latent policies, to capture their potentiality in terms of positively influencing the quality of life of residents in long-term care in Canada.MethodsThe study analysed policies related to quality of life of long-term care residents in four Canadian provinces (British Columbia, Alberta, Ontario, and Nova Scotia). Three policy orientations were framed utilising a comparative approach: situational (environmental conditions), structural (organisational content), and temporal (developmental trajectories). 84 long term care policies were reviewed, relating to different policy jurisdictions, policy types, and quality of life domains.ResultsOverall, the intersection of jurisdiction, policy types, and quality of life domains confirms that some policies, particularly safety, security and order, may be prioritised in different types of policy documents, and over other quality of life domains. Alternatively, the presence of a resident focused quality of life in many policies affirms the cultural shift towards greater person-centredness. These findings are both explicit and implicit, and mediated through the expression of individual policy excerpts.ConclusionThe analysis provides substantive evidence of three key policy levers: situations–providing specific examples of resident focused quality of life policy overshadowing in each jurisdiction; structures–identifying which types of policy and quality of life expressions are more vulnerable to dominance by others; and trajectories–confirming the cultural shift towards more person-centredness in Canadian long-term care related policies over time. It also demonstrates and contextualises examples of policy slippage, differential policy weights, and cultural shifts across existing policies. When applied within a resident focused, quality of life lens, these policies can be leveraged to improve extant resource utilisation. Consequently, the study provides a timely, positive, forward-facing roadmap upon which to enhance and build policies that capitalise and enable person-centredness in the provision of long-term care in Canada.

Effectiveness of physical rehabilitation in improving physical functioning and quality of life for long-term-care residents with dementia: a systematic review protocol.

The objective of this review is to evaluate the effectiveness of physical rehabilitation versus non-rehabilitation control in improving physical functioning and quality of life in long-term care residents with dementia. Many long-term-care residents live with dementia and have impaired physical function and poor quality of life. Physical rehabilitation can improve physical function and quality of life for people living with dementia, yet many long-term-care residents with dementia do not receive this intervention, and health care providers are unsure of which rehabilitation interventions are effective. Studies synthesizing effective rehabilitation programs are needed to guide practice in the long-term-care sector where many residents live with dementia. Previous studies have focused broadly on long-term care, specific professions, interventions or outcomes, or people with dementia in the community. Our review will focus on long-term-care residents living with dementia and a broader definition of physical rehabilitation. This review will include studies that evaluate physical rehabilitation in comparison with non-rehabilitation controls among long-term-care residents with any severity of dementia. We will include studies that measure the effect on performance-based physical functioning and self- or proxy-reported quality of life. Searches will be conducted in APA PsycINFO (EBSCO), CINAHL (EBSCO), MEDLINE (Ovid), Embase, Scopus, and the Cochrane CENTRAL database with no date or language limitations. Two independent reviewers will conduct a critical appraisal of eligible studies, assess methodological quality, and extract the data. Where possible, studies will be pooled in a statistical meta-analysis. PROSPERO CRD42022308444.

Impact of sensory interventions on the quality of life of long-term care residents: a scoping review

Introduction and purposeResidents in long-term care exhibit diminishing senses (hearing, sight, taste, smell or touch). The purpose of this study was to examine the available literature on the impact of...

Non-pharmacological interventions for improving quality of life of long-term care residents with dementia: a scoping review protocol

IntroductionEvidence concerning the effectiveness of non-pharmacological interventions that are applied to people with dementia living in long-term care facilities is inconsistent. The purpose of this protocol is to describe the...

SUPPORTING NURSING HOME STAFF THROUGH PERSON-CENTERED CARE PRACTICES

Policies and practices have increasingly focused on person-centered care (PCC) to improve quality of life for long-term care residents and staff. Adequate staffing has been a consistent barrier to implementing and sustaining PCC practices. The purpose of this paper is to explore the association between job satisfaction and PCC practices. This research was conducted in a stratified random sample of 33 Oregon nursing homes which were representative in terms of quality, profit/nonprofit ownership, and urban/rural location. Data were collected from 415 staff who completed the staff assessment of person-directed care, direct care worker job satisfaction scale, turnover intention, and organizational belongingness. Consistent with other research, job satisfaction is significantly and negatively correlated with turnover intention (r=-.66) and positively associated with belongingness (r=.66). It is also significantly correlated with scales related to five PCC practices: personhood, autonomy, knowing the person, individualized care, and relationships. Regression analyses examined how these five aspects of PCC practices were associated with 1) job satisfaction and 2) number of deficiencies. Perceptions of practices to support autonomy, personhood, and relationships were associated with higher ratings of job satisfaction among staff. In general, those reporting these practices were in place at least half of the time or with at least half of the residents, showed significantly greater positive associations with job satisfaction (p<.05). Only lower staff reports of autonomy practices were associated with higher deficiencies (p<.05). Findings from this research suggest that supporting PCC practices benefit staff through increased job satisfaction and potentially reduced turnover.

What is the impact of sensory practices on the quality of life of long-term care residents? A mixed-methods systematic review protocol

BackgroundWith age, the acuity of the five senses (i.e., hearing, sight, taste, smell, touch) is reduced. These types of sensory changes can affect day-to-day activities, making it more difficult for individuals to communicate and to interact with the world around them. The five senses allow us to receive information from the environment in the form of sound, light, smell, taste, and touch. As an older person’s senses decline, they need more stimulation to be aware of these sensations. In long-term care settings, appropriate sensory practices are needed to address the diminishing senses of older adults. The objective of this mixed-methods systematic review is to examine the relationship between the sensory practices and the quality of life of residents living in long-term care settings and to develop an aggregated synthesis of mixed-methods studies to derive recommendations for policy, practice, and research.MethodsWe will conduct a mixed-methods systematic review in accordance with the Cochrane Handbook. A search strategy has been developed with an expert health sciences librarian and peer reviewed using Peer Review for Electronic Search Strategies (PRESS). Seven databases: MEDLINE (Ovid), PubMed (non-MEDLINE—Ovid), CINAHL (EBSCO), Embase (Ovid), Ageline, PsycINFO (Ovid), and Cochrane Central Register of Controlled Trials (CENTRAL) will be searched for studies that meet the inclusion criteria. Two reviewers will independently screen the results of the literature search using a two-step process. Eligible studies will undergo a quality assessment and data extraction. Disagreements will be resolved through consultation with a third reviewer. We will assess the quality of individual studies using the Mixed Methods Appraisal Tool (MMAT). The Grading of Recommendations, Assessment, Development and Evaluation (GRADE) will be used to summarize the strength of the quantitative evidence, and the Confidence in the Evidence from Reviews of Qualitative research (CERQual) tool to assess confidence in the qualitative syntheses.DiscussionThis systematic review will summarize evidence-based knowledge for sensory practices, identify gaps in the literature, and inform an audit program for assessing the presence of sensory practices in the long-term care setting. The results will be relevant to policy makers, decision-makers, clinicians, and residents/families in long-term care settings.Systematic review registrationPROSPERO registration # CRD42017032330.

A Reminiscence Program Intervention to Improve the Quality of Life of Long-term Care Residents with Alzheimer's Disease. A Randomized Controlled Trial

A single-blinded, parallel-groups (intervention, active and passive control groups) randomized controlled trial (RCT) was chosen to investigate whether a specific reminiscence program is associated with higher levels of quality of life in nursing home residents with dementia. The intervention used a life-story approach, while the control groups participated in casual discussions. The Social Engagement Scale (SES) and Self Reported Quality of Life Scale (SRQoL) were used as the outcome measures, which were examined at baseline (T0), 12 weeks (T1), and six months (T2) after the intervention. The final sample had 135 subjects (active control group = 45; passive control group = 45; intervention group = 45). The Wilcoxon test showed significant differences in the intervention group between T2 and T0, and between T1 and T0 in the SES, and there were significant differences between T0 and T1 (intervention effect size = 0.267) and T1 and T2 (intervention effect size = 0.450) in the SRQoL. The univariate logistic regression scores showed that predictors of change in the SRQoL were associated with fewer baseline anxiety symptoms and lower depression scores. The intervention led to significant differences between the three groups over time, showing a significant improvement in the quality of life and engagement of the residents in the intervention group.

Evaluating the Quality of Life of Long-Term Care Residents With Dementia

This study's purpose was to better understand existing measures of quality of life in dementia residents of long-term care facilities. We gathered data from 421 residents in 45 facilities. Analyses determined the psychometric properties of each measure, estimated the relationship between measures, and identified the extent to which resident characteristics predicted scores. Most instruments had good to excellent dispersion and interrater reliability, and most scales had good to excellent internal consistency. Proxy measures tended to correlate best with each other, less well with observational measures, and least well with resident measures. Resident cognition and activities of daily living (ADLs) function were associated with most quality-of-life measures but predicted no more than a quarter of the observed variance in any measure. Various measures and sources of data provide different perspectives on quality of life. No "gold standard" exists; so a combination of methods and sources is likely to provide the most complete picture of quality of life.

The Elders Drum Project: Enhancing Quality of Life for Long-Term Care Residents

The impact of purposeful activity on quality of life for the residents of a long-term care facility was studied through the examination of the Elders Drum Project. This project is a model occupational therapy program that uses drumming and related activities to achieve therapeutic goals for its' participants.Semi-structured interviews and observations were used to collect data from five program participants. The transcribed interviews and field notes were qualitatively analyzed according to emerging themes. Results indicated that the Elders Drum Project positively impacted each participant's quality of life as reflected in self-concept, health status, life satisfaction, and altruism. Participants' strengths were also enhanced through self-directed engagement in purposeful activity; thereby, contributing to quality of life.

The Elders Drum Project: Enhancing Quality of Life for Long-Term Care Residents

The impact of purposeful activity on quality of life for the residents of a long-term care facility was studied through the examination of the Elders Drum Project. This project is a model occupational therapy program that uses drumming and related activities to achieve therapeutic goals for its' participants.Semi-structured interviews and observations were used to collect data from five program participants. The transcribed interviews and field notes were qualitatively analyzed according to emerging themes. Results indicated that the Elders Drum Project positively impacted each participant's quality of life as reflected in self-concept, health status, life satisfaction, and altruism. Participants' strengths were also enhanced through self-directed engagement in purposeful activity; thereby, contributing to quality of life.

Consumer satisfaction in long-term care: state initiatives in nursing homes and assisted living facilities.

We report the results of a survey of state initiatives that measure resident satisfaction in nursing homes and assisted living facilities, and we describe several model programs for legislators and public administrators contemplating the initiation of their own state programs. Data on state initiatives and programs were collected during March and April 2000 through a mailed questionnaire and follow-up telephone interviews and were current as of September 2002. Of the 50 states surveyed, 50 responses were received (response rate = 100%); 12 states (24%) reported the use of consumer satisfaction measures, and 7 (Florida, Iowa, Ohio, Oregon, Texas, Vermont, and Wisconsin) reported using resident satisfaction data within their consumer information systems for nursing homes or assisted living facilities. Additionally, 2 states (Iowa and Wisconsin) use resident satisfaction data for facility licensing and recertification. The design of the instruments and collection methods vary in these states, as do the reported response rates, per-resident cost, and the purpose for satisfaction data collection. State satisfaction efforts are in an early stage of development. Well-produced, easily understandable reports on nursing home and assisted living quality could provide information and guidance for patients and families contemplating the utilization of long-term care services. Dissemination of quality information may also facilitate sustained quality and efficiency improvements in long-term care facilities and thus enhance the quality of care for and quality of life of long-term care residents.

The Use of Interactive Computer Services To Enhance the Quality of Life for Long-Term Care Residents

This study examines and documents the effects of interactive computer-based education and training on the rehabilitation of long-term care residents. This approach was found to provide mental stimulation and challenge, as well as improving practical skills which directly impact upon the competencies and feelings of autonomy of the participants.