People In Care Homes Research Articles

Relationship between caring nurses and elderly loneliness.

Background: Elderly people tend to experience biological, psychological, social, and spiritual changes due to the aging process. Changes in their psychology lead to a feeling of loneliness and depression, which have a negative impact on their physical health and overall well-being. Nurses as care providers, need to ensure they are always beside the elderly to prevent them from being lonely. This study, therefore, aims to determine the relationship between caring nurses and the level of loneliness of elderly.Design and Methods: This is an observational analytic design study with a cross sectional approach. Simple random sampling was used to obtain data from a total of 113 elderly people in home care. Furthermore, the CBI 24 Items and UCLA Loneliness Version 3, were used for data collection, while Spearmen’s Rho Test with a level of ρ <α = 0.05 was used for its analysis.Results: The results showed that caring nurses tend to prevent the emergence of loneliness in the elderly with a Spearmen’s Rho test P at 0.00015 (P≤0.05) and correlation coefficient r of -0.686.Conclusions: In conclusion, there is a relationship between caring nurses and the level of loneliness in the elderly.Significance for public healthElderly people experience biological, psychological, social and spiritual changes. Psychological changes lead to a feeling of loneliness and depression, which have a negative impact on their physical health and overall well-being. Nurses, as care providers, need to ensure they are always beside the elderly to prevent them from being lonely. This study describes the relationship between caring nurses and the level of loneliness in elderly.

Perceptions of Professional Responsibility When Caring for Older People in Home Care in Sweden

ABSTRACT Older people in Sweden are increasingly being cared for in the own home, where professional caregivers play an important role. This study aimed to describe perceptions of caring responsibility in the context of older people’s homes from the perspective of professional caregivers from caring professions. Fourteen interviews were conducted with professional caregivers from different professions. The result show how professional caregivers perceive responsibility as limitless, constrained by time, moral, overseeing, meaningful and lonesome. Responsibility seems to affect caregivers to a large extent when the burden is high. Professional caregivers’ perceptions of responsibility, and the potential consequences of a perceived strained work situation therefore need to be addressed. The findings also indicate a need for professional support and guidance when it is difficult to distinguish between professional and personal responsibility.

Healthy intimacy and safe sexual expression in the care home

Nursing and Residential CareVol. 22, No. 7 CommentHealthy intimacy and safe sexual expression in the care homeAysha MendesAysha MendesFreelance journalist specialising in healthcare, nursing and psychologySearch for more papers by this authorAysha MendesPublished Online:18 Jun 2020https://doi.org/10.12968/nrec.2020.22.7.5AboutSectionsView articleView Full TextPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareShare onFacebookTwitterLinked InEmail View article References Alzheimer's Society. Uncovering the challenge of sex and intimacy in care home. 2018. www.alzheimers.org.uk/blog/uncovering-challenge-sex-and-intimacy-care-home (accessed 19 May 2020) Google ScholarDersch CA, Dersch CA, Harris SM, Kimbal T, Marshall JP, Negretti MA. Sexual issues for aging adults. Lubbock: Texas Tech University; 2007 Google ScholarGarrett D. Psychosocial barriers to sexual intimacy for older people. Br J Nurs. 2014; 23(6):327–331. https://doi.org/10.12968/bjon.2014.23.6.327 Link, Google ScholarHeath H, Garrett D, Butler-Cole V, Phair L. Older people in care homes: sex, sexuality and intimate relationships. London: Royal College of Nursing; 2018 Google ScholarInternational Longevity Centre-UK. The last taboo: a guide to dementia, sexuality, intimacy and sexual behaviour in care homes. 2011. https://ilcuk.org.uk/the-last-taboo-a-guide-to-dementia-sexuality-intimacy-and-sexual-behaviour-in-care-homes/ (accessed 1 June 2020) Google ScholarLee D, Tetley J. ‘How long will I love you?’—sex and intimacy in later life. CITY: International Longevity Centre; 2017 Google ScholarMaslow AH. A theory of human motivation. Psychol Rev. 1943; 50(4): 370–96 Crossref, Google ScholarMendes A. Companionship, intimacy and sexual expression in dementia. Nurs Res Care. 2015;17(7):390–392 Link, Google ScholarOakes N. Sex, intimacy and relationships in care homes. 2018. www.ecmmagonline.co.uk/contents/item/152447-sex-intimacy-and-relationships-in-care-homes (accessed 19 May 2020) Google ScholarThornhill TH. Aging and Sexuality. US Pharm. 2007; 32(6):HS5–HS18. www.uspharmacist.com/article/aging-and-sexuality?utm_source=TrendMD&utm_medium=cpc&utm_campaign=US_Pharmacist_TrendMD_1 (accessed 19 May 2020) Google ScholarWeeks DJ. Sex for the mature adult: health, self-esteem and countering ageist stereotypes. Sex Relationship Ther. 2002; 3:231–240. https://doi.org/10.1080/14681990220149031 Crossref, Google ScholarWorld Health Organization. Sexual Health. 2020. www.who.int/health-topics/sexual-health#tab=tab_1 (accessed 19 May 2020) Google ScholarZeiss AM, Kasl-Godley J. Sexuality in older adults' relationships. Generations. 2001; 25(2):18–25 Google Scholar FiguresReferencesRelatedDetails 2 July 2020Volume 22Issue 7ISSN (print): 1465-9301ISSN (online): 2052-2932 Metrics History Published online 18 June 2020 Published in print 2 July 2020 Information© MA Healthcare LimitedPDF download

Apreensões de trabalhadores hospitalares sobre orientações para o cuidado de pessoas em nutrição enteral domiciliar

Objetivo: Analisar apreensões de trabalhadores hospitalares sobre orientações para o cuidado de pessoas adultas e idosas em nutrição enteral domiciliar. Métodos: Abordagem qualitativa por intervenção hermenêutico-dialética, orientada pela Teoria da Difusão de Inovações. Realizou-se encontro único, mediado por grupo focal em uma oficina de trabalho, em agosto de 2018, junto à equipe multiprofissional de um hospital público de ensino (n=14 participantes). Registros textuais resultantes da oficina foram analisados por categorias semânticas. Resultados: Participantes reportaram tempo médio de atuação de 11 anos no hospital de ensino; 50% apresentavam pós-graduação.Aspectos condicionantes para orientações qualificadas na alta hospitalar e no cuidado doméstico permearam dificuldades relacionadas à rotina e ao trabalho em equipe, como a interação e a comunicação entre as diferentes categorias; dificuldades relacionadas ao cuidado continuado em rede de serviços de saúde devido à fragmentação dos pontos de atenção. A integração ensino-serviço foi apontada como potencialidade para a superação dessas limitações. Conclusão: A abordagem permitiu reconhecer condições contextualizadas para orientação ao cuidado domiciliar de pessoas com sonda e nutrição enteral, a partir das equipes hospitalares, que podem coincidir com cenários similares e também incrementar a produção científica nacional sobre o tema, ainda escassa.

GPs' experience of safeguarding in care homes: what do they see and what do they do?

Abuse of older people in care homes is an on-going problem. GPs, as the most frequent practitioner group visiting care homes, have an important role in detecting and reporting abuse. However, there is little research about GPs' experiences of working in care homes and how they work to safeguard residents. To explore the challenges experienced by GPs working in this unique environment and how these impact on safeguarding. An online survey collected qualitative data about GPs' experiences as visiting professionals to care homes, with an emphasis on safeguarding. A thematic analysis identified key themes. In total, 58 completed surveys were returned, with a range of practitioner experience represented (1-30 years). Approximately 70% were GP partners, with the remainder salaried and locum doctors. Over one third reported they had witnessed signs of definite or possible abuse within care homes. Emerging themes related to the complex care home context, in which residents had multiple health needs and GPs had to build multiple relationships with managers, carers, families, and residents. Difficulties in accessing information were reported; residents could not always provide information, GPs had to rely on others for information, and rarely had access to electronic records. GP work in care homes is a complex and skilled role, in which GPs encounter evidence of poor care and abuse. Key themes in respect of barriers and facilitators of good care were highlighted. The reliance on others for information and the need to build relationships with staff/managers may raise tensions in respect of safeguarding practice.

The effect of indoor thermal and humidity condition on the oldest-old people's comfort and skin condition in winter

In winter, dry indoor air is a common phenomenon which is considered to be the cause for dry skin. A field study was carried out to investigate the thermal and humidity environment and its effect on the oldest-old people (80+ years old) residents' thermal and humidity comfort and skin condition in a Scottish care home in winter. Eleven oldest-old residents participated voluntarily in the research. The room temperature and humidity were measured together with two skin parameters: Transepidermal Water Loss (TEWL) and Stratum Corneum Hydration (SCH). The participants’ personal thermal and humidity comfort was studied by a questionnaire survey and short interviews.The monitoring results show that the average relative humidity (RH) in the bedrooms was lower than 40%, the minimum RH level in winter recommended by the CIBSE Guide A. The SCH appeared to be a good indicator for humidity comfort as it was significantly correlated with the room absolute humidity. The correlation makes it possible to predict the minimum humidity to prevent dry skin. The questionnaire results show the participants perceived a change in the room temperature but did not perceive the humidity changes. These research findings provide evidence-based data that could help to develop the indoor environment standard for these special occupants group of elderly people in care homes.

Improving fluid consumption of older people in care homes: an exploration of the factors contributing to under-hydration

Age-related changes put older people at risk of dehydration, and care home residents are particularly vulnerable. Researchers at the University of West London outline their study that identifies the possible barriers and facilitators to optimising hydration in nursing homes, offering guidance for service improvement initiatives

Managing patients in care homes

Older people in care homes deserve the best health and social care we can offer. Their care needs are usually high and they are vulnerable either physically, cognitively or both. They are likely to have several long-term conditions and be in the last year or so of life. Although some may have families and friends supporting them with regular visits and advocacy, others may be more alone and socially isolated. Care homes are traditionally classed as either residential homes or nursing homes, with some being dual registered. The main difference is the presence of 24-hour on-site qualified nursing support in nursing homes. This means that, in general, the residents of nursing homes are more dependent and complex. This article will first describe how to approach the planning and delivery of primary care services to nursing homes, and then consider some of the most common problems and conditions. Much of this also applies to residential home residents.

Home Care for People with Suspected or Confirmed Coronavirus Disease “Covid-19”

Home Care for People with Suspected or Confirmed Coronavirus Disease “Covid-19”

Barriers and facilitators for caregiver involvement in the home care of people with pressure injuries: A qualitative study.

AimTo explore the barriers and facilitators perceived by home caregivers regarding their involvement in the home care of people with pressure injuries.BackgroundAlthough home caregivers are key in the process of caring for people with pressure injuries, little is known about their perceptions regarding their involvement in the same.MethodsA qualitative study based on grounded theory involving a theoretical sample of 15 home caregivers of people with pressure injuries within the health district of Puertollano, Spain.ResultsThis study identified three barriers (feminization of care, necessary life adaptations as a home caregiver, and the organization of health services) and three facilitators (the perceived family duty for caring, willingness to provide care, and satisfaction with the care received on behalf of primary care services) associated with caregiver involvement in the home care of pressure injuries.ConclusionsThe care of a person with pressure injuries is perceived as a duty and requires important adaptations affecting the home caregiver’s personal, social and work life. The emotional closeness and trust that develops between a patient and the primary care staff equals an involvement which, in turn, also has positive results for both the home caregiver and the patient.

Interventions to optimise prescribing for older people in care homes

Interventions to optimise prescribing for older people in care homes

Performative Compliance and the State\u2013Corporate Structuring of Neglect in a Residential Care Home for Older People

The abuse and neglect of older people in care homes is widespread across England, but current causative explanations are limited and frequently fail to highlight the economic and political factors underpinning poor care. Informed by social harm and state–corporate crime perspectives, this study uses ethnographic data gathered through a nine-month period of working in an older person’s residential care home to show how neglect is embedded in working routines. Three aspects of care are interrogated to reveal the embedded nature of harm in the home; all reveal the rift between official, regulatory rules and informal working practices shaped by material constraints of the labor process. This article explores the role of regulatory regimes in actively legitimizing sectors, such as the residential care industry, even in the face of routine violence, by bureaucratically ensuring the appearance of compliance with formal rules. While the harms of contemporary institutionalized care for older people have its roots in material conditions, performative compliance through regulation guarantees that these injurious outcomes are concealed. This article contends that malpractice (and harm) can be explained with reference to conjoint state–corporate relationships and practices.

Depression in residential care

Nursing and Residential CareVol. 21, No. 11 CommentDepression in residential careAysha MendesAysha MendesFreelance journalist, specialising in health, psychology and nursingSearch for more papers by this authorAysha MendesPublished Online:23 Oct 2019https://doi.org/10.12968/nrec.2019.21.11.616AboutSectionsView articleView Full TextPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareShare onFacebookTwitterLinked InEmail View articleReferencesChew Graham C, Campion J, Kaiser P, Edwards K. Management of depression in older people: why this is important in primary care. 2011. http://tinyurl.com/oeumcgo (accessed 2 October 2019) Google ScholarHarbottle L. The effect of nutrition on older people's mental health. Br J Community Nurs. 2019; 24(Suppl 7):S12—S16. Link, Google ScholarJackson A, Murphy B. Loneliness, social isolation and cardiovascular risk. Br J Cardiac Nurs. 2019; 14(10): in press. Google ScholarMendes A. Dementia: breaking down mental barriers to physical activity. Nurs Res Care. 17(5):27—72. https://doi.org/10.12968/nrec.2015.17.5.270 Google ScholarMind. Depression. 2019. www.mind.org.uk/media/34696345/depression-2019-web-pdf.pdf (accessed 2 October 2019) Google ScholarMilne A. Depression in care homes. In: Chew-Graham CRay MG. Mental health and older people: a guide for primary care practitioners. Cham (Switzerland): Springer International Publishing; 2016: 14—60. https://doi.org/10.1007/97—-31—949—_13 Crossref, Google ScholarNational Institute for Health and Care Excellence. Mental wellbeing of older people in care homes. 2013. https://www.nice.org.uk/guidance/QS50 (accessed 11 October 2019) Google ScholarPublic Health England. Dependence and withdrawal associated with some prescribed medicines: an evidence review. 2019. https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/829777/PHE_PMR_report.pdf (accessed 22 September 2019) Google ScholarStickland N, Gentry T. Hidden in plain sight: the unmet mental health needs of older people. London: Age UK; 201. https://tinyurl.com/y4w6p48m (accessed 2 October 2019) Google Scholar FiguresReferencesRelatedDetails 2 November 2019Volume 21Issue 11ISSN (print): 1465-9301ISSN (online): 2052-2932 Metrics History Published online 23 October 2019 Published in print 2 November 2019 Information© MA Healthcare LimitedPDF download

Managing health changes for people with a learning disability in a residential care home setting.

People with learning disability (LD) have complex comorbidities that develop at an earlier age than the general population and with which they are now living longer. Identification, assessment and management of these conditions is important but challenging. To develop resources with care staff to enable them to recognise and manage changes and decline in the health of a person with a LD. Two resources (PIP-LD and CIRC) were developed through undertaking a literature review; networking with experts; and collaborating with staff in the care homes for people with a LD. Care staff then used these resourcesto review their residents. The PIP-LD and CIRC were used in 39 care homes. The PIP-LD empowered staff to meet people's immediate health needs, and the CIRC helped them to recognise changes or a decline. The combined use of the PIP-LD and the CIRC enabled care staff to recognise the signs and symptoms of each person's comorbidities early, and to identify and manage changes when their health declined.

The road goes ever on: evidence of the continuing abuse of older people in care homes

PurposeThe purpose of this paper is to present findings from a research project designed to enhance knowledge of the current extent and nature of abuse in contemporary care homes for older people.Design/methodology/approachA self-completion, postal questionnaire was used to elicit both numerical and textual data that were subsequently subjected to both quantitative and qualitative analysis. The questionnaire was distributed to newly appointed care staff in five participating care homes providing care to older people to determine the nature of any abuse they may have witnessed in the homes in which they had previously worked.FindingsA significant proportion of respondents had witnessed numerous occurrences of primarily psychological and physical abuse and neglect, perpetrated against the older people living in the care homes in which they had previously worked.Research limitations/implicationsAlthough the research draws upon the experiences of only 197 anonymous questionnaire respondents, of whom 180 had witnessed abuse, data suggest that abuse continues to occur in some care homes for older people.Originality/valueThe research has revealed staffs’ recent experiences of a range of abusive acts and practices. When combined with two previous studies using the same or a similar methodology, the research also confirms the enduring presence of abuse in care homes. Findings again suggest that changes are required to current methods of external scrutiny and investigation of practices in care homes.

Identifying and Managing Hearing and Vision Loss in Older People in Care Homes: A Scoping Review of the Evidence.

Poor identification of sensory impairments in care homes can be due to multiple factors. This scoping review identifies and synthesizes the literature into the detection of hearing and vision loss in the care home environment, and the management of these sensory losses once identified. A scoping review methodology was used to identify primary research of any design published from 1985 to September 2018. Six electronic databases were searched, and articles were also sourced from reference lists, relevant charity organizations and published experts. Six electronic databases and multiple gray literature sources identified 51 articles for inclusion. The evidence confirmed that lack of knowledge in care home staff, poor management of assistive aids, unsuitable environment, lack of connections with optometrists and audiologists, underuse of effective screening tools, and the added complexity of assisting those with dementia are all barriers to effective practice. Conversely, flexible training programs, availability of a variety of assistive aids, simple screening tools, and adaptions to the environment are effective facilitators. This review acknowledges that the barriers to identification and management of hearing and vision loss in care homes are multifaceted and that collaboration of multiple stakeholders is required to implement change and improve the residents' ear and eye care. Recommendations are offered to support more effective service provision tailored to meet the needs of people with sensory impairments living in care homes, and this could subsequently improve best practice.

Does older adults' use of social care influence their healthcare utilisation? A systematic review of international evidence.

Improving our understanding of the complex relationship between health and social care utilisation is vital as populations age. This systematic review aimed to synthesise evidence on the relationship between older adults' use of social care and their healthcare utilisation. Ten databases were searched for international literature on social care (exposure), healthcare use (outcome) and older adults (population). Searches were carried out in October 2016, and updated May 2018. Studies were eligible if they were published after 2000 in a high income country, examined the relationship between use of social care and healthcare utilisation by older adults (aged ≥60years), and controlled for an indicator of need. Study quality and bias were rated using the National Institute of Health (NIH) Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies. Study data were extracted and a narrative synthesis was conducted. Data were not suitable for quantitative synthesis. Thirteen studies were identified from 12,065 citations. Overall, the quality and volume of evidence was low. There was limited evidence to suggest that longer lengths of stay in care homes were associated with a lower risk of inpatient admissions. Residents of care homes with onsite nursing had fewer than expected admissions to hospital, compared to people in care homes without nursing, and adjusting for need. Evidence for other healthcare use outcomes was even more limited and heterogeneous, with notable gaps in primary care. We conclude that older adults' use of care homes may moderate inpatient admissions. In particular, the presence of registered nurses in care homes may reduce the need to transfer residents to hospital. However, further evidence is needed to add weight to this conclusion. Future research should build on this evidence and address gaps regarding the influence of community based social care on older adults' healthcare use. A greater focus on primary care outcomes is imperative.

Interventions to optimize prescribing for older people in care homes.

In 2017, the United Nations reported that the world's population aged 60 years and over was 962 million people, over twice as many older persons than was reported in 1980. This number is expected to double again by 2050, reaching nearly 2.1 billion older persons. Within this projection, the number of persons aged 80 years or over will increase more than threefold, increasing from 137 million to 425 million (United Nations, 2017). Growing old is often accompanied by a higher prevalence of medical conditions which can result in the development of moderate to severe functional and/or cognitive impairments to the extent that long‐term accommodation and care is needed. According to the Organization for Economic Cooperation and Development (OECD, 2017), across their participating countries, there is on average 46 long‐term care beds per 1000 people aged 65 years and over. Prevention and management of medical conditions and comorbidities typically requires the use of medicines leading to often complex regimes. Polypharmacy, where four or more different medicines are prescribed, may be the unintended consequence. Polypharmacy can be appropriate and necessary, but inappropriate polypharmacy is common in this population. Underprescription may also be a concern, for example, pain medicines for a person unable to express themselves. Prescribing is further complicated by age‐related changes that influence how drugs move around the body and how this impacts on the therapeutic effects of drugs (Kim & Luck Parish, 2017). Nurses caring for older people in care homes play a vital role in the optimization of medicines. As part of a multidisciplinary team, nurses are in the position to closely assess, monitor, and report the need for medicines and any potential or real adverse outcomes of already prescribed medicines (Halvorsen, Stensland, & Granas, 2011). Nurses need to know about evidence‐based interventions to optimize prescribing and the quality of the evidence given the frailty and vulnerability of older people residing in care homes.

The feasibility of increasing physical activity in care home residents: Active Residents in Care Homes (ARCH) programme

ObjectivesMaintaining physical activity for older residents in care homes maximises their physical and mental health and wellbeing, independence, dignity and quality of life. Unfortunately, most residents do not participate in regular physical activity. Active Residents in Care Homes, ARCH, was designed to increase physical activity by facilitating whole-system change in a care home. We evaluated whether ARCH can be delivered, its effects on resident’s physical activity, wellbeing and costs. DesignFeasibility study. SettingThree residential care homes. ParticipantsCare home residents and staff. InterventionOccupational and physiotherapists implemented ARCH over 4 months with an 8-month follow-up. Main outcome measuresAssessment of Physical Activity, Pool Activity Level, EQ5D-5L, Dementia Care Mapping, cost of implementing ARCH, health and social care utilisation. ResultsAfter implementing ARCH, residents displayed more positive behaviours, better mood and engagement and higher physical activity levels, but these improvements were not sustained at 8-month follow-up. The cost (2016 prices) of implementing ARCH was £61,037, which equates to £1,650/resident. Healthcare utilisation was £295/resident (SD320) in the 4 months prior to ARCH, £308/resident (SD406) during the 4-month implementation and £676/resident (SD438) in the 8-month follow-up. ConclusionsThe ARCH programme can be delivered, it may have some short-term benefits and is affordable. Rather than have unrealistic increases in the health and longevity of older care home residents, ARCH may slow the decline in physical, mental and emotional well-being usually seen in older people in care homes, return some dignity and improve their quality of life in their last months or years.

A Universal Design Perspective on Care Homes for Elderly People with and Without Dementia.

Within the coming years considerable resources will be spent on designing assisted living facilities for elderly people with dementia. Traditionally care homes are designed for elderly with physical impairment. However, people with dementia have others and supplementary needs. An important challenge is therefore to identify differences and similarities in what makes supportive, pleasant environments for both groups. As the group of people with Alzheimer's disease is numerous, this paper focuses on characteristics related to Alzheimer's - typically difficulties related to orientation, coping with larger groups of residential units and a lack of ability to handle welfare technology. In these respects, care homes for people with dementia differ from other settings. However, people with dementia are known to be positively sensitive to a wide range of architectural qualities such as sensory experiences, atmosphere and access to green outdoor areas. The paper argues that since these qualities have importance for a wider group of elderly, the design of care homes in this respect can be considered as an example of universal design in general. Pointing out some similarities and differences in demands for elderly with and without dementia the paper raises the question in how far it might be possible to apply some architectural qualities to care homes in general. If possible, it may lift the quality of the physical environment and at the same time make fewer alterations necessary when care homes are changed to house other inhabitants. The analysis is based on existing literature combined with own studies.