Parkinson rehabilitation in nursing homes: a qualitative exploration of the experiences of patients and caregivers

Spiritual Care Perspectives of Elderly Individuals with Parkinson's Disease and Formal Caregivers: A Qualitative Study in Turkish Nursing Homes

This study aimed to determine the perceptions and experiences of elderly individuals with Parkinson's disease and formal caregivers regarding spiritual care. A qualitative study was conducted using a descriptive phenomenological design. Fifteen formal caregivers and eight elderly individuals with Parkinson's disease from two nursing homes in Türkiye participated in the study. Data were collected through face-to-face individual interviews, and thematic analysis was employed to examine the data. Two themes were obtained from the data analysis: (I) spiritual care in nursing homes and (II) living with Parkinson's disease in nursing homes. Findings showed that living in a nursing home with Parkinson's disease affects the spiritual dimensions of elderly individuals and increases their spiritual needs. Additionally, it was found that although formal caregivers implemented a diverse range of practices to address the spiritual care needs of individuals residing in a nursing home, they did not offer any specific spiritual care practices for individuals with Parkinson's disease. Based on our findings, it is considered necessary to have spiritual counselors and formal caregivers with expertise in Parkinson's disease in nursing homes.

Experiences of People Living with Parkinson's Disease in Care Homes: A Qualitative Systematic Review

BACKGROUND

Incidence of disability secondary to Parkinson's disease is increasing faster globally than any other neurological condition. The diverse appearance of symptomatology associated with Parkinson's, and the degenerative nature and subsequent functional decline, often increase dependence on caregivers for assistance with daily living, most commonly within a care home setting. Yet, primary literature and evidence synthesis surrounding these unique and complex care needs, challenges and the lived experiences of this population living in long-term nursing or residential facilities remains sparce. The aim of this review is to synthesize qualitative literature about the lived experience of people with Parkinson's disease living in care home settings.

METHODS

A systematic search of the literature was conducted in October 2023 across six different databases (CINAHL, Medline, EMBASE, PsycINFO, Scopus and Cochrane Library). The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) was used to guide this review.

RESULTS

Five articles met the inclusion criteria. Four themes were identified following evidence synthesis: (1) Unique pharmacological challenges. (2) Transitioning and adapting to care home life and routines. (3) Dignified care within care homes. (4) Multidisciplinary care vacuum in care homes.

CONCLUSION

This review revealed the significant and unique challenges for people with Parkinson's disease when transitioning into care homes. These are exacerbated by wider social care challenges such as staffing levels, skill mixes and attitudes as well as a lack of disease-specific knowledge surrounding symptomatology and pharmacology. The lack of multi-disciplinary working and risk-adverse practice inhibited person-centred care and autonomy and reduced the quality of life of people living with Parkinson's disease in care homes. Recommendations for practice highlight training gaps, the need for consistent and improved interdisciplinary working and better person-centred assessment and care delivery.