Later Life Care Planning Conversations for Older Adults and Families
This study found strong support for planning for LLC before the need arises, as well as important potential benefits for older adults, family members, and health professionals. There is interest in, and need for, resources to guide families in LLC planning. (Source: Journal of Applied Gerontology)
Source: Journal of Applied Gerontology - August 20, 2014 Category: Geriatrics Authors: Stolee, P., Zaza, C., Sharratt, M. T. Tags: Articles Source Type: research
Autonomy, Choice, Patient-Centered Care, and Hip Protectors: The Experience of Residents and Staff in Long-Term Care
The purpose of this study was to examine long-term care (LTC) resident and staff perceptions on the decision to use hip protectors and identify the factors that influence attitudes toward hip protector use. Staff (N = 39) and residents (N = 27) at two residential care facilities in British Columbia, Canada were invited to participate in focus groups on fall prevention and hip protector use. A total of 11 focus groups were conducted. Using framework analysis results show that residents and staff shared concerns on aesthetic and comfort issues with hip protectors. Residents also generally felt they did not need, or want to u...
Source: Journal of Applied Gerontology - August 20, 2014 Category: Geriatrics Authors: Sims-Gould, J., McKay, H. A., Feldman, F., Scott, V., Robinovitch, S. N. Tags: Articles Source Type: research
Explaining the Success or Failure of Quality Improvement Initiatives in Long-Term Care Organizations From a Dynamic Perspective
The purpose of this study was to better understand why change initiatives succeed or fail in long-term care organizations. Four case studies from Québec, Canada were contrasted retrospectively. A constipation and restraints program succeeded, while an incontinence and falls program failed. Successful programs were distinguished by the use of a change strategy that combined "let-it happen," "help-it happen," and "make-it happen" interventions to create senses of urgency, solidarity, intensity, and accumulation. These four active ingredients of the successful change strategies propelled their respective change process...
Source: Journal of Applied Gerontology - August 20, 2014 Category: Geriatrics Authors: Etheridge, F., Couturier, Y., Denis, J.-L., Tremblay, L., Tannenbaum, C. Tags: Articles Source Type: research
The Value of Resident Choice During Daily Care: Do Staff and Families Differ?
This study examined whether staff and family rated care episodes involving choice differently from care episodes not involving choice. Seventeen nurse aide and 15 family participants were shown paired video vignettes of care interactions. Participants were asked to rate their preferred care vignette using a standardized forced-choice questionnaire. Focus groups were held separately for staff and family members following this rating task to determine reasons for their preferences. Both staff and family rated the vignettes depicting choice as "strongly" preferred to the vignettes without choice. Reasons provided for the pref...
Source: Journal of Applied Gerontology - August 20, 2014 Category: Geriatrics Authors: Simmons, S. F., Durkin, D. W., Rahman, A. N., Schnelle, J. F., Beuscher, L. M. Tags: Articles Source Type: research
Long-Term Care: Multiple Methods and Multiple Perspectives
(Source: Journal of Applied Gerontology)
Source: Journal of Applied Gerontology - August 20, 2014 Category: Geriatrics Authors: Gaugler, J. E. Tags: Editorial Source Type: research
Identifying At-Risk Dementia Caregivers Following Institutionalization: The Nursing Home Admission-Burden and Nursing Home Admission-Depression Prognostic Tools
The current study developed prognostic tools to identify dementia caregivers at-risk for clinically relevant burden or depressive symptoms following nursing home admission (NHA) of their family members. A retrospective, longitudinal design was used that included 1,610 dementia caregivers who provided data prior to and up to 6 months following nursing home admission. Response operant characteristic (ROC) curves were constructed to test and validate two prognostic tools: the NHA-Burden and NHA-Depression tools. An ROC curve yielded a sensitivity of 77% and a specificity of 62.5% at a cutoff score of 5.41 for the NHA-Burden P...
Source: Journal of Applied Gerontology - June 24, 2014 Category: Geriatrics Authors: Gaugler, J. E., Mittelman, M. S., Hepburn, K., Newcomer, R. Tags: Articles Source Type: research
Does Empowering Resident Families or Nursing Home Employees in Decision Making Improve Service Quality?
This research examines how the empowerment of residents’ family members and nursing home employees in managerial decision making is related to service quality. The study was conducted using data from 33 nursing homes in the United States. Surveys were administered to more than 1,000 employees on-site and mailed to the primary-contact family member of each resident. The resulting multilevel data were analyzed using hierarchical linear modeling. The empowerment of families in decision making was positively associated with their perceptions of service quality. The empowerment of nursing staff in decision making was more...
Source: Journal of Applied Gerontology - June 24, 2014 Category: Geriatrics Authors: Hamann, D. J. Tags: Articles Source Type: research
The Impact of Family Visitation on Feeding Assistance Quality in Nursing Homes
The purpose of this study was to determine: (a) the frequency of family visitation during mealtime and (b) whether the presence of family during meals had an impact on the quality of feeding assistance care and resident intake. Participants included 74 nursing home residents from two Veterans Affairs (VA) and four community facilities in one geographic region. Mealtime periods in which family was present were compared with mealtime periods when family was not present for the same resident. Results showed that family visitation was infrequent during mealtime; however, feeding assistance time was significantly higher when vi...
Source: Journal of Applied Gerontology - June 24, 2014 Category: Geriatrics Authors: Durkin, D. W., Shotwell, M. S., Simmons, S. F. Tags: Articles Source Type: research
Staff-Family Relationships in Residential Aged Care Facilities: The Views of Residents' Family Members and Care Staff
The aim of the study was to examine staff and family members’ perceptions of each other’s roles and responsibilities in the Australian residential aged care setting. Data was collected by interview and focus group from 27 staff and 14 family members at five residential aged care facilities in the state of Victoria, Australia. Findings highlight "communication" as the core category supporting the formation of constructive staff–family relationships, as described by three main themes; "building trust," "involvement," and "keeping the family happy." Staff attitudes, mutual cooperation, meaningful engagement,...
Source: Journal of Applied Gerontology - June 24, 2014 Category: Geriatrics Authors: Bauer, M., Fetherstonhaugh, D., Tarzia, L., Chenco, C. Tags: Articles Source Type: research
Transitions to Long-Term Care: How Do Families Living With Dementia Experience Mealtimes After Relocating?
This study is a secondary analysis of a subset of data collected from a 6-year longitudinal qualitative study called Eating Together (ET), which sought to better understand the experiences around food and mealtimes for community dwelling persons with dementia (PWD) and their primary care partners (CP). Several PWD and, in some cases, their spousal CP, relocated to long-term care (LTC) during the conduct of the ET study. To understand how this relocation influenced the meaning of meals, a subset of those who experienced this transition were selected and analysis specific to this issue was undertaken. Seven families were inc...
Source: Journal of Applied Gerontology - June 24, 2014 Category: Geriatrics Authors: Henkusens, C., Keller, H. H., Dupuis, S., Schindel Martin, L. Tags: Articles Source Type: research
Dementia in Relation to Family Caregiver Involvement and Burden in Long-Term Care
To better understand the process and outcomes of family involvement for long-term care residents with varying stages of dementia, we analyzed family and staff data for 467 residents of 24 residential care/assisted living and nursing-home settings. Adjusted analyses found that although the amount of family visitation did not significantly vary by resident cognitive status (15 versus 20 visits/month to persons with and without dementia, respectively), the nature of the visit did. Families of cognitively intact residents spent more time in activities related to social and community engagement, such as taking residents on trip...
Source: Journal of Applied Gerontology - June 24, 2014 Category: Geriatrics Authors: Cohen, L. W., Zimmerman, S., Reed, D., Sloane, P. D., Beeber, A. S., Washington, T., Cagle, J. G., Gwyther, L. P. Tags: Articles Source Type: research
The Turning Point: Family Caregiving and Residential Long-Term Care
(Source: Journal of Applied Gerontology)
Source: Journal of Applied Gerontology - June 24, 2014 Category: Geriatrics Authors: Gaugler, J. E. Tags: Editorial Source Type: research
Fatigue and Depressive Symptoms in Older People
Fatigue is considered an important indicator of aging-related declines in health and functional abilities. Previous studies have indicated strong associations between fatigue and depressive symptoms among younger populations and in patient groups with specific diseases. However, it is not known how different measures of fatigue are associated with depressive symptoms among general older populations. The purpose of this study is to describe the prevalence of depressive symptoms among community-dwelling older adults reporting mobility-related or general feelings fatigue. The study population consisted of 75-year-old communit...
Source: Journal of Applied Gerontology - April 28, 2014 Category: Geriatrics Authors: Manty, M., Rantanen, T., Era, P., Avlund, K. Tags: Brief Reports Source Type: research
Going Digital: Adoption of Electronic Health Records in Assisted Living Facilities
This pilot study examines the associations between structural characteristics and the adoption and subsequent use of electronic health records (EHR; resident demographics, clinical notes, medication lists, problem lists, discharge summaries, and advance directives) as a process characteristic in assisted living facilities (ALFs). The study is guided conceptually by Donabedian’s Structure-Process-Outcome (SPO) model. Primary survey data were collected from a randomly selected sample (N = 76) in Florida during 2009-2010. Analysis included descriptive and bivariate statistics. Descriptive results indicated that ALFs mos...
Source: Journal of Applied Gerontology - April 28, 2014 Category: Geriatrics Authors: Holup, A. A., Dobbs, D., Temple, A., Hyer, K. Tags: Brief Reports Source Type: research
Risk Factors for Hospitalization in a National Sample of Medicare Home Health Care Patients
Acute care hospitalization during or immediately following a Medicare home health care (HHC) episode is a major adverse outcome, but little has been published about HHC patient-level risk factors for hospitalization. The authors determined risk factors at HHC admission associated with subsequent acute care hospitalization in a nationally representative Medicare patient sample (N = 374,123). Hospitalization was measured using Medicare claims data; risk factors were measured using Outcome Assessment and Information Set data. Seventeen percent of sample members were hospitalized. Multivariate logistic regression analysis foun...
Source: Journal of Applied Gerontology - April 28, 2014 Category: Geriatrics Authors: Fortinsky, R. H., Madigan, E. A., Sheehan, T. J., Tullai-McGuinness, S., Kleppinger, A. Tags: Articles Source Type: research
