Old People's Homes Research Articles

Christine Ceci, Kristín Björnsdóttir, and Mary Ellen Purkis, Eds. Perspectives on Care at Home for Older People. New York: Routledge, 2012

Christine Ceci, Kristín Björnsdóttir, and Mary Ellen Purkis, Eds. Perspectives on Care at Home for Older People. New York: Routledge, 2012

Integrated and Seamless Services for Active Aging, a Model for Zhuhai

The Aging Tsunami as it is often quoted to describe the worrying situations of rapidly aging in China has not met with detail planning in facilities upgrade and careful consideration in service models. Broad brushed central policies categorizes services into home care, community care and institutional care and set policy goals at 90-6-4, representing the percentage of older people in receiving respective care. This leaves local officials helpless on how these ideals can be actualized. Some cities have inclined to build huge older people homes and pour resources into institutional care, forgetting the need for older people to be connected with the society. This paper reviews the historical developments of older people services in Hong Kong and recommends an integrative model of social work services connecting institutional, community and home care into a seamless network. The city of Zhuhai will be presented as a perfect experimental city on how its existing facilities can be converted and developed according to the model. Survey on the situations of the 16 public older people homes will be used to illustrate the potentials of an integrative model.

Effects of Donor Trust on Attitudes Toward Giving Behavior Among the Donors Donating to Nursing Homes for Older People：Mediating Effect of Relationship Commitment

Effects of Donor Trust on Attitudes Toward Giving Behavior Among the Donors Donating to Nursing Homes for Older People：Mediating Effect of Relationship Commitment

Independent living in care homes for older people

Purpose – The purpose of this paper is to investigate how care homes can be de-institutionalised and what factors are key in independence for residents? Design/methodology/approach – This paper takes the form of a review of the current life of residents in care homes with insight from My Home Life Cymru. Findings – This research identifies eight best practice themes which together form a vision for care homes in the twenty-first century. Originality/value – Care homes play an important role in social care, providing services to some of our most vulnerable citizens. By focusing on the quality of life in care homes for older people, we can play a part in delivering services that people want, in the way that they want them.

“Make Every Moment Count” in care for older people

Purpose – The purpose of this paper is to highlight the importance of Make Every Moment Count (MEMC) and explain the development of it. Design/methodology/approach – A working group of representatives from key organisations in Scotland developed the resource MEMC. It was tested out in a variety of care settings and issued to all care homes for older people and care at home services in Scotland. Findings – The paper highlights the importance of participating in day-to-day life on health and well-being and provides feedback from care staff on using the resource. Practical implications – The resource is for all those supporting someone to engage in day-to-day life. A lot of good care is given however sometimes the small, everyday interactions are taken for granted and people need reminded about the big difference this can make to someone's life. Social implications – MEMC has the potential to begin to change culture – to rethink “activity” which is often thought of as planned organised events to everyday activities and interactions. Originality/value – This paper describes an initiative which sets out to remind us all of the importance of basic human rights – dignity, respect and choice.

Focus on the micro-relationship in the delivery of care

Recent reports have expressed concerns over the quality of care delivery in care settings and the homes of older people. This study followed 30 older people who had recently been discharged from hospital and were in the transition from re-ablement services to home care. The study focused on the non-clinical elements of care delivery (interpersonal relationships) and what the older patient felt was important in the delivery of their care. This was a qualitative study using semi-structured interviews to gather data on the interpersonal processes involved in the delivery of intimate care to vulnerable older patients. Three key themes were developed as to what the older patient felt was important for good-quality care. These were: The need for social interaction beyond the delivery of clinical healthcare tasks The need for consistent care staff in order to develop a working relationship The need for the older patient to feel they had some control over how their care was delivered. In sum, the patients needed to feel they were working with the care staff rather than purely having the care done to them.

Understanding Daily Life of Older People in a Residential Complex: The Contribution of Lefebvre's Social Space

This article contributes to the theoretical and applied understanding of daily life and the meaning of home for older people living in purpose-built, age-segregated complexes. Whilst gerontology has embraced spatial perspectives, it often fails to capture their diverse and changing nature. This article considers findings from a larger qualitative study that explored the geography of residential complexes in Brisbane, Australia, through the lens of Henri Lefebvre's theory of social space. Data relating to Lefebvre's concepts of spatial practice and spaces of representation clearly capture the routines, activities, attachments and imaginations that help or hinder older people connecting to their living environment. Talking with older people gave a rich account of how they use, think about and produce space and highlighted the tensions in providing this form of specialised housing. As well as providing theoretical insights, a nuanced understanding of social space informs policy and public discussion of older people's living environments.

Determinants of the Willingness to Continue to Donate to Nursing Homes for Older People

Determinants of the Willingness to Continue to Donate to Nursing Homes for Older People

The impact of ICT services on perceptions of the quality of life of older people

PurposeThe aim of this paper is to report results of the impact of the information and communication technology (ICT) platform and telecare services developed by the MonAMI consortium on the quality of life (QOL) of older people in three European communities.Design/methodology/approachIn a three‐month trial, the MonAMI technology was installed in the homes of older people with various needs, in the cities of Stockholm, Sweden; Zaragoza, Spain; and Kosice, Slovakia. Evaluation criteria and instrumentation were developed to assess the effects of the services on users' perceived QOL in the domains of independence, physical health, psychological wellbeing, social networking, and physical environment.FindingsA total of 62 users, with a mean age of 79 years, participated in the trial. Results demonstrate that the MonAMI services had some positive, significant effects on users' QOL. For instance, users with a higher number of disabilities at baseline reported greater confidence in keeping intruders from entering their home compared to users with fewer disabilities (OR=2.51, 0.01 p<0.05). However, overall findings show that healthier, more independent users perceived more benefits from the services compared to users who report more health problems and are less independent.Research limitations/implicationsThe complexities of conducting the MonAMI trial led to a small, heterogeneous sample of users over a short time span. This in turn created difficulties in observing the potential effects of the services and achieving significance on some indicators of QOL.Originality/valueThis paper provides quantitative analyses around the impact of telecare services; suggests important directions for further research; and highlights the methodological challenges of evaluating ICT‐based care services in a community setting.

Practice Learning in Private Care Homes for Older People—A Two-Way Resource

This paper reports on three evaluated projects of social work placements in private care homes for older people in Scotland. This was a new situation for each of the care homes. They were uncertain about the student role and this was initially challenging for the students. Reported outcomes of these placements include deep learning for the students who developed core social work skills and an understanding of ageism within a relationship-based model of social work. The care homes reported considerable benefit from the presence of the student in terms of raising overall standards of practice and enhancing the opportunities which they could offer to residents. An increase in inter-professional understanding was reported by all respondents and this had been a major factor in the motivation of care home managers in agreeing to participate in the projects. Planning, preparation and communication were cited as challenges in some of the studies. Because they are new and different in the UK, such developments must be supported and nurtured, and considering groups of such placements as projects to be managed holistically would work to the advantage of all stakeholders, especially the care home residents who gained so much from these projects.

Quality of life and attitudes to ageing in Turkish older adults at old people's homes

The purpose of this study was to investigate quality of life (QOL) and attitudes to ageing in Turkish older adults at two old people's homes (nursing homes) and to explain relationship between QOL and attitudes to ageing. This study is a quantitative and descriptive exploratory study of QOL and attitudes to ageing of older adults in nursing homes in a developing country. Two international data measurement tools were used for data collection. Data measurement instruments in this study are The World Health Organization Quality of Life Instrument-Older Adults Module (WHOQOL-OLD) and the WHO - Attitudes to Ageing Questionnaire (AAQ). The WHOQOL-OLD module consists of 24 items assigned to six facets (sensory abilities, autonomy, past, present and future activities, social participation, death and dying and intimacy) AAQ consists of 24 items classified in three domains (psychosocial loss, physical change and psychological growth) with eight items each. The Turkish version of the WHOQOL-OLD and AAQ was administered to 120 older (>65 years) adults living in two old people's homes in Samsun Province, Turkey. This study was conducted and planned between on 1 November 2011 and on 31 November, 2011. The results indicated that there was significant relationship between QOL and attitudes to ageing of older adults. In this study, the highest significant relationship is between psychological growth subscale of attitudes to ageing and sensory abilities subscale of QOL (r = 0.579; P < 0.01). Overall QOL and overall attitudes to ageing had a significant and positive relationship (r = 0.408; P < 0.01). The dimensions of attitudes to ageing (psychosocial loss, physical change and psychological growth) were significant predictors for QOL in older adults in Turkey. It was found that the gender does not affect overall QOL in older adults. However, happiness is significant variable for overall QOL in this study. The results suggest that QOL is a complex, multidimensional concept that should be studied at different levels of analysis in Turkey and other developing countries. The results of this study emphasize the importance of QOL in older adults in older people's homes in Turkey and attitudes to ageing of nursing home residents in Turkey.

The perspectives of bereaved family carers on dying at home: the study protocol of ‘unpacking the home: family carers’ reflections on dying at home

BackgroundRecent end of life care policy prioritises patient choice over place of care and in particular promotes dying at home. This policy is predicated on the assumption that there are family carers able and willing to provide care for the dying person. Through the accounts of bereaved family members, the ‘Unpacking the home’ study aims to gain an in-depth understanding of ‘home’ and the issues faced by family members caring for a dying older person at home; it also aims to examine the way the home is transformed in the process of providing end of life care, and offer a critical analysis of policies that aim to increase home deaths. This paper presents the protocol for this study.Methods/designA cross-sectional qualitative study has been designed to achieve the study aims. In-depth interviews will be conducted in the north and south of England with 50 bereaved family carers to elicit their accounts of witnessing the dying in the home of an older person (50+ years). All interviews will be subjected to thematic analysis, and narrative analysis will be undertaken on a subset of 30 interview transcripts. A final phase of integration and policy analysis will be conducted towards the end of the study. User involvement is integral to this study, with service users actively engaged at every stage.DiscussionThis study will seek to take a qualitative approach by explicitly recognising that family carers are central to the experience of dying at home for older people, and they have needs that may be amenable to support and anticipatory planning. The strengths of this study, which include its interdisciplinary and participatory approach, and in-depth data collection and analysis methods, will be explored. The limitations and challenges of this research will also be considered. This study seeks to make recommendations that will ensure that family carers receive appropriate and adequate support in caring for their loved ones at the end of life.

Exploring the Nature of Peer and Academic Supervision on a Role-Emerging Placement

Introduction: This small-scale study explores the experiences of staff and students in using a pyramidal model of peer-assisted and long-arm supervision in a role-emerging practice placement in the United Kingdom (UK). Method: Two final year postgraduate diploma occupational therapy students from a UK university entered into a peer-assisted learning arrangement with two occupational therapy students from a Polish university, with UK university staff acting as long-arm supervisors. The setting was a home for older people with no occupational therapy service. This participatory action research preliminary study used interviews to explore the student and supervisor experiences whilst on placement. Findings and discussion: The findings suggest that high levels of personal and professional development can develop in students when this model is used.

Do nurses and social workers have different values? An exploratory study of the care for older people

This study explored the different values of staff from two care homes for older people in which the managers had different qualifications (social worker vs. nursing). Their views were examined to explore whether the values of the staff might reflect any value difference originating in the professional backgrounds of the managers. There was little evidence of awareness in either home of the ethical principles underlying day-to-day decisions. However, a distinction based on care qualification did appear with “care-qualified” staff (defined in terms of qualification requirements for this care work) demonstrating a more reflective response and fewer ageist assumptions than their non-care-qualified colleagues. The study found no difference in values between the nursing and social worker-led homes. All respondents, regardless of the profession of their manager, were keenly aware that they have a “duty of care” and overwhelmingly they defined that as their duty to keep the resident safe, as opposed to allowing her to exercise autonomy. The study results suggest that value base constitutes a commonality between professions involved in the care of older people rather than a barrier to collaboration, as is sometimes posited.

A Novel Video Game–Based Device for Measuring Stepping Performance and Fall Risk in Older People

Schoene D, Lord SR, Verhoef P, Smith ST. A novel video game–based device for measuring stepping performance and fall risk in older people. Objective To determine whether a dance mat test of choice stepping reaction time (CSRT) is reliable and can detect differences in fall risk in older adults. Design Randomized order, crossover comparison. Setting Balance laboratory, medical research institute, and retirement village. Participants Older (mean age, 78.87±5.90y; range, 65–90y) independent-living people (N=47) able to walk in place without assistance. Interventions Not applicable. Main Outcome Measures Reaction (RT), movement, and response times of dance pad–based stepping tests, Physiological Profile Assessment (PPA) score, Digit Symbol Substitution Test (DSST) score, time to complete the Trail Making Test (TMT) A+B, Fall Efficacy Scale International (FES-I) score, Activities-specific Balance Confidence (ABC) Scale score, and Incidental and Planned Exercise Questionnaire (IPEQ) incidental IPEQ activity subscore. Results Test-retest reliability of the dance mat CSRT response time was high (intraclass correlation coefficient model 3,k=.90; 95% confidence interval [CI], .82–.94; P<.001) and correlated highly with the existing laboratory-based measure ( r=.86; 95% CI, .75–.92; P<.001). Concurrent validity was shown by significant correlations between response time and measures of fall risk (PPA: r=.42; 95% CI, .15–.63; P<.01; TMT A: r=.61; 95% CI, .39–.77; TMT B: r=.55; 95% CI, .31–.72; DSST: r=−.53; 95% CI, −.71 to −.28; P<.001; FES-I: Spearman ρ=.50; 95% CI, .25–.69; ABC Scale: Spearman ρ=−.58; 95% CI, −.74 to −.35; P<.01). Participants with moderate/high fall-risk scores (PPA score >1) had significantly slower response times than people with low/mild fall-risk scores (PPA score <1) at 1146±182 and 1010±132ms, respectively ( P=.005), and multiple fallers and single/nonfallers showed significant differences in RT (883±137 vs 770±100ms; P=.009) and response time (1180±195 vs 1031±145ms; P=0.017). Conclusions The new dance mat device is a valid and reliable tool for assessing stepping ability and fall risk in older community-dwelling people. Because it is highly portable, it can be used in clinic settings and the homes of older people as both an assessment and training device.

Integrated working between primary health care services and care homes for older people: challenges from the approach study

IntroductionWithin the UK health and social care policy is placing an increasing emphasis on improving the quality of care for older people in care homes through integrated working between health and social care services. This study aims to clarify the research available on integrated working and evaluate its impact on older people in order to devise a typology for informing future service development.TheoryKodner and Spreeuwenberg [1] argue that patient/person centred integrated working between health and social care should include methods and models which involve the different levels of organisation, management, funding and clinical care within and between them.MethodsPhase one included a systematic review to evaluate interventions utilising integrated working between care home staff and health care practitioners, and a survey to describe care homes’ experiences of integrated working. Phase one will inform phase two; a case study evaluating six different approaches to integrated working currently in use in three different areas of England.Results and conclusionsThe review found evidence of integrated working between health care and care homes at the patient level of care, but minimal evidence of models that extended beyond this level. Findings from the survey, currently in progress, will also be presented.DiscussionThe discussion will provide an overview of the challenges and issues surrounding integrated working.

A ‘home for life’ in residential homes for older people in England: exploring the enhancers and inhibitors

A three‐year in‐depth study has examined three models to improvecare in residential homes for older people in England. The study showed that each aimed to provide a ‘home for life’ for residents. Using multi‐source data gained from a range of qualitative and quantitative methods involving residential home managers, care staff and extensive review of documentation related to key care functions, inhibitors and enhancers to the achievement of this aim were identified. Inhibitors were lack of available top‐up funding to meet increased care needs, care staff's inadequate knowledge of behaviour‐disordered residents, workload, cross‐sector barriers and environmental problems. Among the enhancers were flexible regulation, up‐skilling of care staff, care staff's achievement in palliative care, perceived avoidance of hospital admission, and sound practice‐led relationships with nurses. The implications for practice are of relevance to policy makers, educators, community health and social care professionals, and older residents, their relatives and representative organisations.

Healthcare associated infection in care homes for older people in Scotland: results from a pilot survey

The prevalence of infection in Scottish care homes is currently unknown. The aim of this survey was to estimate the prevalence of infection within a small sample of care homes for older people and to develop and test a methodology for point prevalence surveys which would allow local care home staff to monitor infection in care homes for older people that employ trained nurses. The pilot survey was undertaken by Health Protection Scotland (HPS) in collaboration with the Care Commission and two volunteer service providers. Data collection within 18 volunteer care homes was undertaken between 6 April 2009 and 1 May 2009. A total of 922 residents from 18 care homes were included. On the day of survey, 87 infections were identified in 86 residents. The prevalence of infection was 9.3%. The most common infections types were urinary tract infections and respiratory tract infections. The results from this small survey of volunteer care homes have provided valuable insight into the previously unmeasured prevalence of infection in Scottish care homes for older people. It is hoped that the rollout of a larger scale survey that includes a representative sample of all Scottish care homes can be implemented.

Introducing novel technology into care homes for older people with dementia

Introducing novel technology into care homes for older people with dementia

Uncovering History: Private Sector Care Homes for Older People in England

AbstractIn conducting his research for The Last Refuge (1962), Peter Townsend visited 173 public, voluntary and private residential care homes for older people in England and Wales. Drawing on his data, now archived at the University of Essex, we traced the subsequent history of these homes and revisited a sample that were still functioning as care homes in 2006. In this article, we focus on the 42 private homes he visited, some of which remain open and were revisited by us in 2005–06. The pre-1980 history of private sector residential care provision for older people is an elusive and poorly charted topic. Drawing on the two data sets for then and now, this article contributes new insights into this area of UK policy and practice.