People In Residential Care Settings Research Articles

Neglecting the care of older people in residential care settings: A national document analysis of complaints reported to the Finnish supervisory authority.

Neglecting to provide older people with the care they need in residential care settings leads to human suffering and increased service needs. Research is lacking on neglect in older people's residential care and one way to assess the key issues is to study complaints. The aim of this study was to analyse official complaints related to allegations of neglect in residential care settings caring for older people in Finland. The data covered 317 complaints that were recorded in the national database in 2018 and 2019. The analysis of the complaints yielded 2,922 observations of neglect in older people's care in residential care settings. Based on our results, most of the complaints were made by family members when the patients were alive and their motivation was to improve the care their relative received, as well as the care of others, in the residential care home. The complaints focused on neglecting clinical care, including restricting older people's movements, not providing daily activities and not paying sufficient attention to their hygiene and secretions. Other complaints included issues relating to nutrition, medication, communication and issues that compromised their privacy, respect and dignity. Nearly three of four complaints identified staffing issues in relation to neglect and most of the complaints concerned private, rather than public, residential care homes. Although the complaints only concerned a small proportion of the annual care provided, more attention should be paid to care practices that prevent neglect in residential care and to multi-level monitoring for dignified care.

The Impacts of COVID-19 on Unpaid Carers of Adults with Long-Term Care Needs and Measures to Address these Impacts: A Rapid Review of Evidence up to November 2020

<strong>Context:</strong> Unpaid carers are the backbone of long-term care (LTC) systems around the world. The COVID-19 pandemic has further increased the pressure many unpaid carers experience; however, their experience has been largely absent from public reporting. <strong>Objective:</strong> We aim to map the available evidence of the impacts of COVID-19 on unpaid carers of adults (&gt;18 years) with LTC needs as well as of measures implemented to mitigate these effects and how well they have worked. <strong>Method:</strong> We conducted a rapid review of the academic and grey literature on unpaid carers of adults with LTC needs during the COVID-19 pandemic, covering the period until November 2020. <strong>Findings:</strong> We identified six key themes that highlight the impacts of COVID-19 on unpaid carers of people living in the community. These are: care commitment, concerns related to COVID-19, availability of formal and informal support, financial implications, carer health and well-being, and carers’ adaptability. In addition, we captured aspects identified by unpaid carers supporting people in residential care settings under the theme ‘carers of people in residential settings’. Finally, we reported evidence of measures implemented to mitigate the impacts on carers. This included the use of technology and the receipt of financial assistance and support for working carers. <strong>Limitations:</strong> The evidence reported in this review is based largely on cross-sectional data and some of the data reported relies on convenience samples. <strong>Implications:</strong> We highlight the financial and health impacts that many unpaid carers experience. Given the vital support carers provide to adults with LTC needs, policy makers should consider supporting unpaid carers to mitigate the negative impacts on their lives.

The role of collaborative working between the arts and care sectors in successfully delivering participatory arts activities for older people in residential care settings.

In the UK support for older people living in residential care to undertake meaningful activities is provided by Activities Co-ordinators. There is also a growing trend for care home providers to invite arts organisations into care settings to deliver a range of arts and cultural activities. These arts and cultural activities are delivered by Arts Facilitators, who are distinct from Activities Co-ordinators because their practice is specifically in an art form. This paper presents findings from the Creative Journeys research project which focused on exploring the role of participatory arts within residential care home in developing and maintaining social relationships between residents and staff. One of the objectives of the research was to identify factors which facilitated or hindered the delivery and impact of the activities. Data collection methods included observations and semi-structured interviews with residents and staff. Thematic analysis was conducted on the qualitative data. It was found that a key factor in the successful delivery of the groups was the working relationship between the Arts Facilitators and the Activities Co-ordinators. This relationship is explored and presented under three main themes: the collaborative process, practicalities and preparation and the approach of the Arts Facilitator. The Activities Co-ordinators' role is an under-researched area, but they play a central role in supporting visiting arts organisations to deliver the sessions and in enabling residents to attend and engage with meaningful activities.

‘I’m not getting out of bed!’ The criminalisation of young people in residential care

Evidence from both Australian and international jurisdictions show that children in residential care are over-represented in the criminal justice system. In the current study, we interviewed 46 professionals who had contact with young people in residential care settings in New South Wales, Australia. Our sample included police officers, residential care service providers, legal aid lawyers and juvenile justice workers, about their perceptions of the link between residential care and contact with the criminal justice system. Factors identified by the participants included the care environment itself, use of police as a behavioural management tool, deficient staff training and inadequate policies and funding to address the over-representation. These factors, combined with the legacy of Australia’s colonial past, were a particularly potent source of criminalisation for Aboriginal children in care.

Massage, a complementary therapy effectively promoting the health and well-being of older people in residential care settings: a review of the literature.

To explore the potential benefits of massage within daily routine care of the older person in residential care settings. Globally, the proportion of people over 65years is rapidly rising. Increased longevity means older people may experience a rise in physiological and psychological health problems. These issues potentially place an increased demand for quality long-term care for the older person. Complementary approaches such as massage appear to be needed in quality residential care. A critical literature review was undertaken. A literature review pertaining to massage in the older resident was conducted using a range of online databases. Fourteen studies dated 1993-2012 met the inclusion criteria and were critically evaluated as suitable resources for this review. Evidence suggests massage may be advantageous from client and nursing perspectives. Clients' perceive massage to positively influence factors such as pain, sleep, emotional status and psychosocial health. Evidence also demonstrates massage to benefit the client and organisation by reducing the necessity for restraint and pharmacological intervention. Massage may be incorporated into care provision and adopted by care providers and family members as an additional strategy to enhance quality of life for older people. Massage offers a practical activity that can be used to enhance the health and well-being of the older person in residential care. Massage offers benefit for promoting health and well-being of the older person along with potential increased engagement of family in care provision. Integration of massage into daily care activities of the older person requires ongoing promotion and implementation.

'There's a hell of a noise': living with a hearing loss in residential care

Hearing loss is common in older age. Research with older people in residential care settings has identified high prevalence of hearing loss and low uptake of hearing aids. Hearing loss in these settings is associated with reduced social engagement. Although hearing aids remain the default treatment for presbyacusic hearing loss, these are not well used. We do not know what other modifiable factors contribute to communication problems for older people with hearing loss living in residential care. To explore the factors affecting communicating with a hearing loss in residential care. An ethnographic study in two residential care homes comprised 19 sessions of observation, and in-depth interviews with 18 residents. Observations explored communication behaviour in everyday interactions, including mealtimes, structured groups and informal group activities. Interviews were informed by the observations and identified reasons for these behaviours and communication preferences. Observational data were recorded in field notes and interviews were audio-recorded and transcribed. Analysis was conducted using constant comparison methods. Hearing loss affected whether residents were able to access social opportunities. Two key themes influenced this (i) contextual issues compounded communication difficulties and (ii) environmental noise restricted the residents' communication choices. Problems were observed at every mealtime and during formal and informal group activities. The use of hearing aids and access to hearing services did not improve social engagement. Environmental and social factors are key to maximising communication opportunities. Improvements to communication in residential care settings could be based on changes in these with input from residents and staff. Further work is needed to develop effective communication strategies in residential care.

Public Funding for Long-Term Care Services for Older People in Residential Care Settings

State interest in funding residential care through Medicaid is fueled by a desire to offer a full array of home and community-based services (HCBS), reduce nursing home utilization, and achieve the economies of scale of nursing home care without the undesirable institutional characteristics. This paper focuses on state policiesparticularly Medicaid policies that affect access to and the availability and quality of publicly financed residential care for people of limited financial means.