People In Residential Care Research Articles

An Innovative Intervention Model for Children and Young People in Residential Care: The D’ART-TE Project

(1) Background: Residential care (RC) for children and youth should provide a holistic experience of growing up. Currently, RC homes face many challenges, highlighting the need for validated, innovative interventions. D’AR-TE is a pilot project aimed at creating an innovative intervention model for children and youth in RC, promoting protective factors through activities designed to enhance personal skills, socialization, and relationship building. The project spanned three years, focusing on two main areas: “Promoting the SELF” (including Sports, Art, and Virtual Reality) and “Promoting the US” (group activities with families and non-institutionalized peers). (2) Methods: To validate the D’AR-TE model, 46 children and youth in RC, aged between 6 and 20 years, were assessed. They were divided into an experimental group (26 participants) and a control group (20 participants). The evaluation, conducted at the beginning and end of the project, focused on cognitive and neuropsychological domains. (3) Results: By the end of D’AR-TE, the experimental group showed statistically significant improvements, including decreased aggression perception, increased social support, enhanced self-concept, and better cognitive and emotional performance. (4) Conclusions: These results suggest that D’AR-TE had a positive impact and could be a valid and replicable model for children and youth in RC.

Communities of Practice Support Implementation of Power to Kids in Residential Care: The EMBED Model

ABSTRACTChildren and young people in residential care continue to experience significant harmful sexual behaviour, dating violence and child sexual exploitation. Power to Kids is a programme developed in Australia to prevent and respond to these forms of abuse for this cohort. The aim of the study was to explore how a Communities of Practice initiative could further support the implementation of the Power to Kids programme in the residential care practice of a community service organisation. Qualitative data were collected through feedback loops (n = 12) with residential carers and senior staff and focus groups (n = 4). Quantitative data were collected through two surveys (n = 89) and (n = 46). The data revealed inductively the EMBED model: Executive commitment to Communities of Practice, Members of Communities of Practice engage with content, Becoming part of everyday practice, Enhanced knowledge of sexual health and safety and Decline in going missing and better relationships. Findings suggest that a Community of Practice approach to implementing Power to Kids is promising in embedding the sexual health and safety programme.

Carer-led CBT input for young people in residential care: views of carers

ABSTRACT In the literature, there are various models of the use of CBT to support children and young people in residential settings. However, the extent of the involvement of residential staff (carers) in the implementation of CBT is unclear, and little is known about carers’ views on the use of CBT in residential care. In this exploratory study, 12 employees of a private residential care company participated in semi-structured, face-to-face interviews to give their views on a number of CBT techniques, and how carers could be supported to implement them. Thematic analysis identified three overarching themes: Difficulties of young people in residential care, Current practices to support young people in residential care, and Integration of Carer-led CBT into current practice. The study found that formal, formulation-driven CBT was not part of the carers’ current practice, however some techniques they used were broadly similar to CBT. Implications of the findings are that current practices could be expanded and enhanced through training and supervision of carers to give them more tools to support young people in residential care. Ways of integrating carer-led CBT into current practice are discussed.

The Careful Project: Evaluating the acceptability of local virtual reality experiences as a leisure activity for residents in aged care.

The aim of this project was to evaluate the feasibility and acceptability of virtual reality (VR) as a leisure activity for people living in residential aged care. Virtual reality experiences may offer alternatives for residents with limited mobility, or during times when older people are unable to leave residential care. The intervention used VR videos delivered via a head-mounted device. Video content was created by a local artist specifically for use with older Western Australian adults and used local content. VR sessions were videotaped for analysis. The evaluation included structured observation of video content to assess mood and engagement and post-intervention interviews with participants. Mood and engagement scores indicated overall favourable mood and considerable positive engagement with the VR experience. Interview content analysis reflected the enjoyment participants took in visiting places they had once been and the surprising ways that the experience made them feel and act as though they were actually there. Videos featuring coastal visits were the most popular and videos featuring music were the most engaging. Some participants found the head-mounted device uncomfortable. VR was considered potentially beneficial for residents with limited mobility or living with cognitive impairment. Overall VR is a feasible and acceptable leisure activity for older people in residential care. The use of local content has the potential to prompt memories and generate new conversations. Future use of VR may consider different modes of video delivery and advancements in evaluation.

I simply have more of a role as a human being: Psychotherapists' Experience Delivering Psychotherapy to Nursing Home Residents With Depression.

The lack of psychotherapy in nursing homes can be explained by organizational obstacles but also by practitioners' reservations about this patient group and setting. This study aimed to inform practice by qualitatively exploring the experiences of psychotherapists delivering cognitive behavioral therapy to residents of nursing homes diagnosed with depression. Semistructured interviews with 6 psychotherapists, who had delivered treatment within the DAVOS project (Depression in the nursing home: a cluster-randomized stepped-wedge collaborative case management approach to improve treatment) were recorded, transcribed, and analyzed using a deductive-inductive content analysis. Therapists experienced various difficulties, including practical (e.g., multiprofessional collaboration) and existential issues (e.g., confrontation with their own mortality). Participants described correcting some stereotypical images of older people (in need of care) through their work within the DAVOS project. However, evidence of ageism was still included in their reports. In the interviews, psychotherapists more experienced with older patients addressed more existential issues, whereas more novice therapists tended to focus more on practical difficulties. To ensure a more effective implementation of psychotherapeutic treatment in nursing homes, it appears necessary to address important contextual factors that facilitate interdisciplinary collaboration, interference-free treatment rooms, and tele-assisted sessions. Further, more setting-specific training, targeted supervision regarding death and suicide, and interventions that address stereotypical images of age and older people in residential care are needed. DRKS00015686.

Disruption and adaptation: The school mobility experience of young people in residential care

Changing schools can negatively impact educational success. Young people in residential care appear particularly subject to such changes and thereby more likely to experience the associated challenges. This article aims to better understand the experience of changing schools among youth in group or residential care placements. We carried out a qualitative interpretive study based on biographical interviews of 35 young people aged 14 to 18. Results show that school mobility remains in Quebec, Canada, a common practice that disrupts the education of young people. Our analysis of their experiences also illustrates how these disruptions can negatively affect their educational experience. It identifies factors that could facilitate school career continuity and improve adaptation. These include involving young people in decision-making, promoting collaboration between schools and social services and between individual schools, improving understanding of the realities of these young people among teachers, particularly in the regular school system, and providing procedural and relationship support to maintain and develop friendships when changing schools.

Family Support, Resilience, and Life Goals of Young People in Residential Care.

Establishing goals for young people in residential care (RC) is a gap in the literature, especially in terms of the relationship between family support and resilience. The literature suggests that RC is associated with the breakdown of family relationships, so the possibility of the family playing a positive role in establishing life goals for young people is reduced. However, family support in the context of organization and stability can be assumed to be a protective factor for the formulation of life goals and contribute to the resilient development of young people. This study aimed to analyze the role of family support in the process of setting goals for young people in RC, as well as to analyze the potential mediating role of resilience in the previous association. The sample included 124 young people aged between 12 and 23 years living in RC. The results point to a positive association between family support (autonomy) and the planning of life goals and verify the total mediating effect of resilience in this association. The results are discussed considering attachment theory and the role of the family in the adaptive development of young people. This study's findings provide important indications for developing future interventions.

Experiences of Child and Youth Care Workers in Managing Challenging Behaviours of Young People in Residential Care in South Africa

Experiences of Child and Youth Care Workers in Managing Challenging Behaviours of Young People in Residential Care in South Africa

Not All Frailty Assessments Are Created Equal: Comparability of Electronic Health Data-Based Frailty Assessments in Assessing Older People in Residential Care.

Objectives: To evaluate the comparability of frailty assessment tools - the electronic frailty index (eFI), retrospective electronic frailty index (reFI), and clinical frailty scale (CFS) - in older residents of care facilities. Methods: Data from 813 individuals aged 65 or older, with frailty and co-morbidities, collected between 2022 and 2023, were analysed using various statistical methods. Results: The results showed significant differences in frailty classification among the tools: 78.3% were identified as moderately to severely frail by eFI, 59.6% by reFI, and 92.1% by CFS. Statistical tests confirmed significant differences (p < .05) in their assessments, indicating variability in measurement methods. Discussion: This study advances the understanding of frailty assessment within aged-care settings, highlighting the differences in the efficacy of these assessment tools. It underscores the challenges in frailty assessments and emphasizes the need for continuous refinement of assessment methods to address the diverse facets of frailty in aged care.

Cross-sectional study of prevalence and correlates of fear of falling in the older people in residential care in India: the Hyderabad Ocular Morbidity in Elderly Study (HOMES)

ObjectiveTo report the prevalence and risk factors for the fear of falling (FOF) among older individuals living in residential care facilities in India.DesignCross-sectional study.SettingHomes for the aged centres in Hyderabad,...

A new scale for older resident satisfaction with residential integrated care in China: Development and validation

The factors that affect resident satisfaction with emerging residential integrated care for older people in China have been unclear due to a lack of validated instruments. Based on psychometric assessment procedures, we developed a new scale for older resident satisfaction with residential integrated care (SORSRIC). The scale was developed using a two-step process and a sample of 16 Chinese institutions and 333 residents. Exploratory and confirmatory factor analysis was used to evaluate reliability and validity. Principal component analysis and maximum variance methods were used to orthogonally rotate the items to extract seven factors. These were: resident expectations, perceived quality (physical care), perceived quality (mental care), perceived value, resident satisfaction, resident complaints, and resident loyalty. The CR value of each dimension of the pre-tested, formal scale was greater than 0.80, and the AVE value was greater than 0.50. This 24-item instrument showed good reliability and structural validity and can be applied to improve the experience and outcomes for older people in residential care.

Integrating oral health assessment in the care for older people by means of the interRAI oral health section: an implementation and evaluation study.&amp;nbsp;

Background: Oral health of care-dependent older people is generally poor which can affect their general health and well-being. In nursing homes, caregivers such as nurses and nurse aids are important actors for delivering oral care and detecting oral health problems. Performing regular oral health assessments is a key element to improve oral health in older people. The interRAI instrument used in the long-term care facilities (LTCF) includes an oral health section (OHS) and holds the potential to integrate oral care in the general care planning. Since the standard OHS fails to adequately detect oral health problems, an optimized section was developed. The study evaluates the optimized OHS of the interRAI suite of instruments in order to integrate oral health assessment in the daily practice. &#x0D; Setting and participants: Care-dependent older people living in 11 nursing homes in Flanders, Belgium, who are 65 years or older. Their professional caregivers are also included in the study.&#x0D; Methods: This 2-year longitudinal cluster randomized controlled trial is set up in three parallel groups (2 test groups and 1 control group) to evaluate the effectiveness and the usability of the optimized and validated OHS for use in the interRAI-LTCF. In the intervention groups T1 and T2, trained caregivers use the interRAI-LTCF with the optimized OHS. Additionally, caregivers in T2 receive support to use new guidelines for oral care. In the control group, caregivers assess oral health using the standard OHS. The study has a longitudinal design with a mixed methods approach.&#x0D; The data collected about oral health and general health will be coupled with a national registry database on dental care consumption to analyze the outcome of the OHS regarding dental referral and actual dental care utilization. At the caregiver level, changes in knowledge and attitude regarding oral health will be evaluated using questionnaires. Interviews with older people and focus group discussions with caregivers will help to understand the usability of the optimized OHS and associated training.&#x0D; Results: The quantitative results will show whether the use of the optimized OHS enables improved oral health in care-dependent older people in residential care and improves the knowledge, attitude and perception of caregivers towards oral health and oral care. The qualitative data will show how older people and their caregivers experience the use of this OHS and to what extent daily and professional oral health care changes for the older people, being more intensively integrated in general care planning.&#x0D; Discussion: In residential care settings, prioritizing care tasks often brings neglect regarding oral care for care-dependent older people. Professional dental care is also difficult to deliver, due to mobility or lack of resources. This study evaluates whether regular oral health assessments performed by caregivers in residential care improve oral health in older people and to what extent these oral health assessments lead to better integration of oral care in general care. The results will shed light on the ongoing situation and will provide evidence to support the use of the optimized OHS and accompanying oral care guidelines in daily practice.

Clarity and adaptability of instructions preventing the spread of the COVID-19 virus and its association with individual and organisational factors regarding the psychosocial work environment: a cross-sectional study

BackgroundIn Sweden, older people in residential care had the highest mortality rates, followed by those who received home care, during the coronavirus disease 2019 (COVID-19) pandemic. Staff working in the care of older people assumed responsibility for preventing the spread of the virus despite lacking the prerequisites and training. This study aimed to investigate the psychosocial work environment during the COVID-19 pandemic among staff in the care of older people and examine the factors associated with staff’s perceptions of the clarity of instructions and the ability to follow them.MethodsA cross-sectional study design was employed using a web survey. The staff’s perceptions of their psychosocial environment were analysed using descriptive statistics. The association between organisational and individual factors, as well as the degree of clarity of the instructions and the staff’s ability to follow them, were assessed using multivariate (ordinal) regression analysis.ResultsThe main findings show that perceptions of the clarity and adaptability of the instructions were primarily correlated with organisational factors, as higher responses (positive) for the subscales focusing on role clarity, support and encouragement in leadership at work were associated with the belief that the instructions were clear. Similarly, those indicating high job demands and high individual learning demands were less likely to report that the instructions were clear. Regarding adaptability, high scores for demands on learning and psychological demands were correlated with lower adaptability, while high scores for role clarity, encouraging leadership and social support, were associated with higher adaptability.ConclusionsHigh job demands and individual learning demands were demonstrated to decrease the staff’s understanding and adoption of instructions. These findings are significant on an organisational level since the work environment must be prepared for potential future pandemics to promote quality improvement and generally increase patient safety and staff health.

Moving house: How much choice do people with learning disabilities have about where they live?

AbstractBackgroundPeople with learning disabilities have the right to choose where they live. However, evidence suggests people's choices are limited due to a shortage of housing.Methods200 Lives was a mixed methods research project, which evaluated supported living and residential care for people with learning disabilities in England; 107 people with learning disabilities took part, 77 from supported living and 30 from residential care.FindingsTwo‐thirds of people in supported living compared to half of those in residential care chose the place they were currently living in; however, less than half of all participants looked at another property before moving to their current house. People in supported living were significantly more likely to have chosen who they lived with. Reasons for moving mainly consisted of reactive moves following an issue with the previous living situation. Many people had not considered moving in the future.ConclusionFindings suggest that people's choices about where to live were constrained regarding the properties on offer and who to live with. This suggests that people's housing rights were not being upheld. Support and housing providers should ensure that housing can adapt to people's changing needs and wishes over the course of their lives.

The educational experience of young people in residential care through the lens of learning careers

AbstractTo complement previous research investigating the educational attainment of young people in out‐of‐home care reporting lower educational outcomes and risk factors, a more comprehensive approach is necessary. Our objective with this article is to better understand the learning careers of young people in residential care. That includes documenting their experience and the meaning they attribute to learning in formal settings over time and identifying critical turning points in each young person's learning career. Based on an interpretative paradigm, we conducted a qualitative study using biographical interviews with young people aged 14–18 in residential care in Quebec, Canada. We first demonstrate that the learning careers of young people in residential care are unique and non‐linear. Second, by studying turning points, we highlight the critical role that institutions, teachers and youth workers can play in fostering a positive or negative learning career. Finally, we noted learners’ different responses to these circumstances and differences in learners’ perception of their measured performance and their influence on their engagement with formal learning. We discuss why considering young people as the main actors and producers of meaning regarding their educational experience and learning careers appears necessary.

Purpose and Mattering as Dimensions of Meaning for Young People in Residential Care from Romania

Purpose and Mattering as Dimensions of Meaning for Young People in Residential Care from Romania

Provision of domiciliary dental service to residential aged care facilities: A 3-year descriptive summary.

This cross-sectional descriptive study described the oral health status and types of domiciliary dental treatment received by residents living in residential care after an oral health assessment (OHAT). Twenty-one facilities were recruited where consenting participants received OHAT followed by a referral for further domiciliary dental treatments. Data were captured and stored as Reach-OHT database where 2017-2019 data were analyzed. Overall, 88% of residents consented. 69.1% were referred for treatment after completion of OHAT. More than half had one or more caries; 40% showed sign of periodontal disease; a higher proportion of dentate participants had an unsatisfactory level of oral cleanliness. Of those received domiciliary dental treatment, diagnostic and preventive service was the combination most frequently provided. These comprised an average of 71.9% of total treatment provided across the 3-year period. This study contributes to the understanding and knowledge around the provision of domiciliary dental services in residential care. A large number of older people in residential care can be assessed and treated through a domiciliary service pathway. As the vast majority of services provided were diagnostic, preventive, and restorative care, the feasibility of utilizing the skillset of the entire dental team should be explored.

Feasibility of self-reported health related quality of life assessment with older people in residential care: insights from the application of eye tracking technology

PurposeIncreasingly there are calls to routinely assess the health-related quality of life (HRQoL) of older people receiving aged care services, however the high prevalence of dementia and cognitive impairment remains a challenge to implementation. Eye-tracking technology facilitates detailed assessment of engagement and comprehension of visual stimuli, and may be useful in flagging individuals and populations who cannot reliably self-complete HRQoL instruments. The aim of this study was to apply eye-tracking technology to provide insights into self-reporting of HRQoL among older people in residential care with and without cognitive impairment.MethodsResidents (n = 41), recruited based on one of three cognition subgroups (no, mild, or moderate cognitive impairment), completed the EQ-5D-5L on a computer with eye tracking technology embedded. Number and length of fixations (i.e., eye gaze in seconds) for key components of the EQ-5D-5L descriptive system were calculated.ResultsFor all dimensions, participants with no cognitive impairment fixated for longer on the Area of Interest (AOI) for the response option they finally chose, relative to those with mild or moderate cognitive impairment. Participants with cognitive impairment followed similar fixation patterns to those without. There was some evidence that participants with cognitive impairment took longer to complete and spent relatively less time attending to the relevant AOIs, but these differences did not reach statistical significance generally.ConclusionsThis exploratory study applying eye tracking technology provides novel insights and evidence of the feasibility of self-reported HRQoL assessments in older people in aged care settings where cognitive impairment and dementia are highly prevalent.

Effect of need-based care on behavioural and psychological symptoms in residents with dementia and formal caregivers' distress in nursing homes: a three-arm cluster randomized controlled trial.

To evaluate to what extent the standardized concept of need-based care on Behavioural and Psychological Symptoms of Dementia (BPSD), and formal caregiver distress, is superior when compared to spending more time or standard care with residents with BPSD. A longitudinal cluster randomized controlled study in 23 nursing homes in Belgium with 3 parallel groups was set up. A total of 481 residents with dementia participated. Formal caregivers in the need-based care group treated residents who displayed agitated or aggressive behaviour with a non-pharmacological intervention, tailored to unmet needs, twice a week with re-evaluation every 8weeks. In the time group, formal caregivers spent 'extra time'. In the standard care group, it was 'care as usual'. Outcomes were measured at four different time points with the Doloplus-2 (to assess pain behaviour), Cohen-Mansfield Agitation Inventory (CMAI) for agitation, the Neuropsychiatric Inventory (NPI-NH) for BPSD and formal caregivers' distress. Need-based interventions had a significant effect on residents' levels of pain behaviour. In the need-based care group, scores on overall BPSD (agitation and aggression, depression, euphoria, irritability, sleep and night-time behaviour) improved significantly from baseline when compared to other timepoints. No significant different interactions over time were found between all three groups for categorized versions of NPI scores (ever versus never). Need-based care reduced the level of BPSD in residents with dementia as well as formal caregivers' distress. The study supports the importance of tailored non-pharmacological interventions in the residential care for people with dementia. Trial registration number B300201942084 (18/11/2019).

Placement Matching of Children and Young People within Out-of-Home Residential Care: A Qualitative Analysis

Residential care for children and young people is typically regarded as the least preferred option in out-of-home care by child welfare and protection practitioners. Increasingly, residential care is only used to place young people after multiple unsuccessful placements in kinship or foster care. Consequently, these young people often come into residential care with complex needs and entrenched emotional and behavioural difficulties. Coplacement of these young people in residential care has raised significant and persistent concern of peer victimisation while in residential care. Improved matching of peers within residential care may enhance safety and stability, a proposal for which young people themselves have expressed support. However, the matching of young people in residential care has received little attention in research. This article reports the qualitative findings of a multiinformant study, drawing on the first-hand experiences of 34 participants comprising eight young people and 26 practitioners in residential care, to identify the considerations they perceived as important when matching young people in residential care. Framework analysis of young people's and practitioners’ perspectives identified three matching strategies that may more effectively address the concern of peer victimisation in residential care including (1) balancing risks and strengths; (2) steering into collective duty of care; and (3) involving young people in planning and transition. Implications of the findings directly point to the need to prioritise young people’s rights to protection and participation, and to provide independent oversight to assist residential care organisations and the broader child welfare system to navigate the complexity in the practice of matching young people in residential care.