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Misiak MM, Bethell J, Chapman H, Sommerlad A. How can care home activities facilitate social connection in residents? A qualitative study. Aging Ment Health 2024:1-10. [PMID: 38669150 DOI: 10.1080/13607863.2024.2345130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 04/13/2024] [Indexed: 04/28/2024]
Abstract
OBJECTIVES Good social connection is associated with better physical and mental health but care home residents experience barriers to social connection. Activities present a potential avenue for improving social connection in care homes but residents often experience loneliness despite access to activity programmes. We therefore aimed to identify what aspects of activities facilitate social connection in care home residents. METHOD Qualitative study using semi-structured interviews that were analysed using Thematic Analysis. A purposive sample of 35 participants, including 12 residents, 10 family caregivers, nine care home staff and four clinicians, recruited from UK care homes. RESULTS We found four main themes describing features of activities important for facilitating social connection: (1) personalisation with respect to residents' interests, social preferences, and cognitive ability; (2) activities which foster a sense of community; (3) finding and emphasising things in common that residents share; and (4) facilitating a sense of involvement with others. CONCLUSION We identified the key aspects of activities which facilitate social connection in care homes. These findings can be applied to a range of existing and newly designed activities in care homes and inform the development and testing of psychosocial interventions aiming to improve social connection.
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Affiliation(s)
| | - Jennifer Bethell
- KITE Research Institute, Toronto Rehabilitation Institute,University Health Network, Toronto, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada
| | | | - Andrew Sommerlad
- Division of Psychiatry, University College London, UK
- Division of Psychiatry, Camden and Islington NHS Foundation Trust, London, UK
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Sturge J, Janus S, Zuidema S, Frederiks B, Schweda M, Landeweer E. The Moral and Gender Implications of Measures Used to Modulate the Mobility of People With Dementia Living in Residential Care Environments: A Scoping Review. THE GERONTOLOGIST 2024; 64:gnad071. [PMID: 37330640 PMCID: PMC10943503 DOI: 10.1093/geront/gnad071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Indexed: 06/19/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Policies and measures often restrict the mobility of people with dementia living in residential care environments to protect them from harm. However, such measures can violate human rights and affect the quality of life. This review aims to summarize the literature on what is known about measures used to modulate the life-space mobility of residents with dementia living in a residential care environment. Furthermore, moral and sex and gender considerations were explored. RESEARCH DESIGN AND METHODS A scoping review framework was referenced to summarize the literature. A total of 5 databases were searched: PubMed, Embase, CINAHL, SCOPUS, and Web of Science. The studies for eligibility using the Rayyan screening tool. RESULTS A total of 30 articles met the inclusion criteria. A narrative description of the findings of the articles is presented across 3 themes: (1) measures and strategies used to modulate the life-space mobility; (2) moral aspects; and (3) sex and gender considerations. DISCUSSION AND IMPLICATIONS Various measures are used to modulate the life-space mobility of people with dementia living in residential care facilities. Research exploring the sex and gender differences of people with dementia is lacking. With a focus on human rights and quality of life, measures used to restrict or support mobility must support the diverse needs, capacity, and dignity of people with dementia. Noting the capacity and diversity of people with dementia will require society and public space to adopt strategies that promote safety and mobility to support the quality of life of people with dementia.
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Affiliation(s)
- Jodi Sturge
- Department of General Practice and Elderly Care Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Sarah Janus
- Department of General Practice and Elderly Care Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Sytse Zuidema
- Department of General Practice and Elderly Care Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Brenda Frederiks
- Department of Ethics, Law and Humanities, University Medical Centre Amsterdam, Amsterdam, The Netherlands
| | - Mark Schweda
- Division of Ethics in Medicine, Department of Health Services Research, School of Medicine and Health Sciences, Carl von Ossietzky University of Oldenburg, Oldenburg, Germany
| | - Elleke Landeweer
- Department of General Practice and Elderly Care Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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Cruise D, Sinden D, Jaana M. Older Adults' Quality of Life in Long-Term Care: A Cross-Sectional Comparison Before and During the COVID-19 Pandemic. Can J Aging 2023; 42:744-753. [PMID: 37424446 DOI: 10.1017/s0714980823000272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/11/2023] Open
Abstract
This study aims to assess changes in long-term care (LTC) residents' quality of life (QoL) before and during the COVID-19 pandemic. A pre-test post-test study of 49 QoL measures, across four dimensions from the interRAI self-reported QoL survey, was conducted. Secondary data from 2019 (n = 116) and 2020 (n = 128) were analysed to assess the change in QoL. A significant decline in 12 measures was observed, indicating a change in QoL of LTC residents during the pandemic. Social life was the dimension mostly affected with residents reporting less opportunities to spend time with like-minded residents, explore new skills and interests, participate in meaningful religious activities, and have enjoyable things to do in the evenings. Several measures of personal control, staff responsiveness and care, and safety also demonstrated a significant change. The results can inform future strategies for pandemic and outbreak preparedness. Balancing the safety of residents with attention to their QoL should be a priority moving forward.
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Affiliation(s)
- Danielle Cruise
- Telfer School of Management, University of Ottawa, Ottawa, ON, Canada
| | - Danielle Sinden
- Centre of Excellence in Frailty-Informed CareTM, Perley Health, Ottawa, ON, Canada
| | - Mirou Jaana
- Telfer School of Management, University of Ottawa, Ottawa, ON, Canada
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Lee LYK, Chu ECP. Tai Chi as a Body-Mind Exercise for Promotion of Healthy Aging in Nursing Home Residents: Appropriateness, Feasibility, and Effectiveness. Clin Interv Aging 2023; 18:1949-1959. [PMID: 38020454 PMCID: PMC10680471 DOI: 10.2147/cia.s430968] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 11/05/2023] [Indexed: 12/01/2023] Open
Abstract
The lack of activity, opportunity for providing input and participation in activities, and interaction with other people are the features of institutional living which reinforces dependency among nursing home residents. Residents are usually frustrated with paternalistic-type care. Arranging health-oriented meaningful activities for residents contributes to health promotion and enhancement of healthy aging. Moreover, it contributes to the cultivation of a positive meaning of life which is particularly important as residents reach the late geriatric stages of their lives. With exercise being seen as generally beneficial for health, Tai Chi as a Chinese-based exercise with a body-mind emphasis and unique characteristics becomes a particularly suitable exercise in aiding the residents in this major shift of lifestyle. This paper analyzes the appropriateness, feasibility, and effectiveness of Tai Chi in promoting healthy aging for residents. Theoretical considerations and scientific evaluations lend it appropriate, feasible, and effective in providing physiological and psychosocial health benefits to the residents. This paper recommends the use of Tai Chi to promote healthy aging in nursing home residents. With a rapidly aging population and mounting demand for residential geriatric care worldwide, this paper's timely findings should provide important implications for adopting Tai Chi to advance the quality of care delivered by nursing homes worldwide.
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Affiliation(s)
- Linda Yin-King Lee
- School of Nursing and Health Studies, Hong Kong Metropolitan University, Hong Kong, People’s Republic of China
| | - Eric Chun-Pu Chu
- New York Chiropractic and Physiotherapy Centre, EC Healthcare, Hong Kong, People’s Republic of China
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Nguyen N, Thalhammer R, Meyer G, Le L, Mansmann U, Vomhof M, Skudlik S, Beutner K, Müller M. Effectiveness of an individually tailored complex intervention to improve activities and participation in nursing home residents with joint contractures (JointConEval): a multicentre pragmatic cluster-randomised controlled trial. BMJ Open 2023; 13:e073363. [PMID: 37899149 PMCID: PMC10619003 DOI: 10.1136/bmjopen-2023-073363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 10/01/2023] [Indexed: 10/31/2023] Open
Abstract
OBJECTIVE This study aims to examine the effects of the individually tailored complex intervention Participation Enabling Care in Nursing (PECAN) on activities and participation of residents with joint contractures. DESIGN Multicentre pragmatic cluster-randomised controlled trial. SETTING 35 nursing homes in Germany (August 2018-February 2020). PARTICIPANTS 562 nursing home residents aged ≥65 years with ≥1 major joint contracture (303 intervention group, 259 control group). INTERVENTIONS Nursing homes were randomised to PECAN (18 clusters) or optimised standard care (17 clusters) with researcher-concealed cluster allocation by facsimile. The intervention targeted impairments in activities and participation. Implementation included training and support for selected staff. Control group clusters received brief information. PRIMARY AND SECONDARY OUTCOME MEASURES The primary endpoint PaArticular Scales combined residents' activities and participation at 12 months. The secondary outcome comprised quality of life. Safety measures were falls, fall-related consequences and physical restraints. Residents, staff and researchers were unblinded. Data collection, data entry and statistical analysis were blinded. Primary analyses were intention-to-treat at cluster level and individual level using a generalised mixed-effect regression model and imputation of missing data. RESULTS Primary outcome analyses included 301 intervention group residents and 259 control group residents. The mean change on the Activities Scale was -1.47 points (SD 12.2) in the intervention group and 0.196 points (SD 12.5) in the control group and -3.87 points (SD 19.7) vs -3.18 points (SD 20.8) on the Participation Scale. The mean differences of changes between the groups were not statistically significant: Activities Scale: -1.72 (97.5% CI -6.05 to 2.61); Participation Scale: -1.24 (97.5% CI -7.02 to 4.45). We found no significant difference in the secondary outcome and no effects on safety measures. CONCLUSION The complex intervention did not improve the activities and participation of nursing home residents on the PaArticular Scales at 12 months. Current nursing conditions in Germany may hamper implementation. TRIAL REGISTRATION NUMBER DRKS00015185.
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Affiliation(s)
- Natalie Nguyen
- Medical Faculty, Institute of Health and Nursing Sciences, Martin Luther University Halle-Wittenberg, Halle, Germany
| | - Regina Thalhammer
- Faculty of Applied Health and Social Sciences, Rosenheim Technical University of Applied Sciences, Rosenheim, Germany
| | - Gabriele Meyer
- Medical Faculty, Institute of Health and Nursing Sciences, Martin Luther University Halle-Wittenberg, Halle, Germany
| | - Lien Le
- Faculty of Medicine, Institute for Medical Information Processing, Biometry and Epidemiology, Ludwig Maximilians University Munich, Munich, Germany
| | - Ulrich Mansmann
- Faculty of Medicine, Institute for Medical Information Processing, Biometry and Epidemiology, Ludwig Maximilians University Munich, Munich, Germany
| | - Markus Vomhof
- Faculty of Medicine, Centre for Health and Society, Institute for Health Services Research and Health Economics, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
- Institute for Health Services Research and Health Economics, German Diabetes Center, Leibniz Institute for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Stefanie Skudlik
- Faculty of Applied Health and Social Sciences, Rosenheim Technical University of Applied Sciences, Rosenheim, Germany
| | - Katrin Beutner
- Medical Faculty, Institute of Health and Nursing Sciences, Martin Luther University Halle-Wittenberg, Halle, Germany
| | - Martin Müller
- Faculty of Applied Health and Social Sciences, Rosenheim Technical University of Applied Sciences, Rosenheim, Germany
- Medical Faculty Heidelberg, Department for Primary Care and Health Services Research, Nursing Science and Interprofessional Care, Heidelberg University, Heidelberg, Germany
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Cyarto EV, Dickins M, Meyer C, Lowthian JA. Cycling Without Age: An Australian residential aged care home experience. Australas J Ageing 2022; 41:e249-e256. [PMID: 35864590 PMCID: PMC9546311 DOI: 10.1111/ajag.13114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 06/16/2022] [Accepted: 06/20/2022] [Indexed: 12/03/2022]
Abstract
Objective Cycling Without Age (CWA) involves taking residents on outdoor trishaw (electric bicycle) rides driven by trained ‘pilots’. This study explored the CWA experience from the perspective of residents and family members, staff and volunteer pilots from a residential aged care home in Queensland, Australia. Methods A qualitative descriptive design was used. Interviews were conducted with 21 participants. Transcripts were analysed thematically, with the interview questions determining a priori categories followed by coding of central themes. Results Several themes emerged. For residents, seeing familiar places prompted reminiscences, and being outdoors elicited positive emotions. Family members reported CWA was a novel way to be with their loved one. Enabling residents to have time away from the care home with community contact was rewarding for pilots. Staff noted improvement in residents' mood post‐ride, however, rides needed to be scheduled to fit in with their workflow. Conclusions Cycling Without Age was perceived to offer a unique and meaningful experience, with benefits including sharing stories, being outside, and feeling part of the community.
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Affiliation(s)
- Elizabeth V Cyarto
- Bolton Clarke Research Institute, Bolton Clarke, Brisbane, Queensland, Australia.,Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane, Queensland, Australia.,Department of Psychiatry, The University of Melbourne, Melbourne, Victoria, Australia
| | - Marissa Dickins
- Bolton Clarke Research Institute, Bolton Clarke, Brisbane, Queensland, Australia.,Southern Synergy, Department of Psychiatry at Monash Health, Southern Clinical School, Monash University, Melbourne, Victoria, Australia
| | - Claudia Meyer
- Bolton Clarke Research Institute, Bolton Clarke, Brisbane, Queensland, Australia.,Centre for Health Communication and Participation, La Trobe University, Melbourne, Victoria, Australia.,Rehabilitation, Ageing and Independent Living Research Centre, Monash University, Melbourne, Victoria, Australia
| | - Judy A Lowthian
- Bolton Clarke Research Institute, Bolton Clarke, Brisbane, Queensland, Australia.,Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane, Queensland, Australia.,School of Public Health & Preventive Medicine, Monash University, Melbourne, Victoria, Australia
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Clemens S, Aelick K, Babineau J, Bretzlaff M, Edwards C, Gibson J, Hewitt Colborne D, Iaboni A, Lender D, Schon D, Snowball E, McGilton KS, Bethell J. Home- and community-level predictors of social connection in nursing home residents: A scoping review. Health Sci Rep 2022; 5:e743. [PMID: 35873395 PMCID: PMC9297378 DOI: 10.1002/hsr2.743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 06/15/2022] [Accepted: 06/16/2022] [Indexed: 11/09/2022] Open
Abstract
Background and Aims Social connection is associated with better physical and mental health and is an important aspect of the quality of care for nursing home residents. The primary objective of this scoping review was to answer the question: what nursing home and community characteristics have been tested as predictors of social connection in nursing home residents? The secondary objective was to describe the measures of social connection used in these studies. Methods We searched MEDLINE(R) ALL (Ovid), CINAHL (EBSCO), APA PsycINFO (Ovid), Scopus, Sociological Abstracts (ProQuest), Embase and Embase Classic (Ovid), Emcare Nursing (Ovid), and AgeLine (EBSCO) for research that quantified associations between nursing home and/or community characteristics and resident social connection. Searches were limited to English-language articles published from database inception to search date (July 2019) and update (January 2021). Results We found 45 studies that examined small-scale home-like settings (17 studies), facility characteristics (14 studies), staffing characteristics (11 studies), care philosophy (nine studies), and community characteristics (five studies). Eight studies assessed multiple home or community-level exposures. The most frequent measures of social connection were study-specific assessments of social engagement (11 studies), the Index of Social Engagement (eight studies) and Qualidem social relations (six studies), and/or social isolation (five studies) subscales. Ten studies assessed multiple social connection outcomes. Conclusion Research has assessed small-scale home-like settings, facility characteristics, staffing characteristics, care philosophy, and community characteristics as predictors of social connection in nursing home residents. In these studies, there was no broad consensus on best approach(es) to the measurement of social connection. Further research is needed to build an evidence-base on how modifiable built environment, staffing and care philosophy characteristics-and the interactions between these factors-impact residents' social connection.
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Affiliation(s)
- Sara Clemens
- KITE Research InstituteToronto Rehabilitation Institute‐University Health NetworkTorontoOntarioCanada
| | - Katelynn Aelick
- Behavioural Supports Ontario Provincial Coordinating OfficeNorth Bay Regional Health CentreNorth BayOntarioCanada
| | - Jessica Babineau
- Library and Information ServicesUniversity Health NetworkTorontoOntarioCanada
- The Institute for Education ResearchUniversity Health NetworkTorontoOntarioCanada
| | - Monica Bretzlaff
- Behavioural Supports Ontario Provincial Coordinating OfficeNorth Bay Regional Health CentreNorth BayOntarioCanada
| | | | - Josie‐Lee Gibson
- Ontario Association of Residents' CouncilsNewmarketOntarioCanada
| | - Debbie Hewitt Colborne
- Behavioural Supports Ontario Provincial Coordinating OfficeNorth Bay Regional Health CentreNorth BayOntarioCanada
| | - Andrea Iaboni
- KITE Research InstituteToronto Rehabilitation Institute‐University Health NetworkTorontoOntarioCanada
- Department of PsychiatryUniversity of TorontoTorontoOntarioCanada
| | - Dee Lender
- Ontario Association of Residents' CouncilsNewmarketOntarioCanada
| | - Denise Schon
- Lakeside Long‐Term Care Centre Family CouncilTorontoOntarioCanada
| | - Ellen Snowball
- KITE Research InstituteToronto Rehabilitation Institute‐University Health NetworkTorontoOntarioCanada
| | - Katherine S. McGilton
- KITE Research InstituteToronto Rehabilitation Institute‐University Health NetworkTorontoOntarioCanada
- Lawrence S. Bloomberg Faculty of NursingUniversity of TorontoTorontoOntarioCanada
| | - Jennifer Bethell
- KITE Research InstituteToronto Rehabilitation Institute‐University Health NetworkTorontoOntarioCanada
- Institute of Health Policy, Management and EvaluationUniversity of TorontoTorontoOntarioCanada
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Motivators and barriers to social participation in two Chinese long-term care institutions: A focus-group study. Geriatr Nurs 2022; 44:90-96. [DOI: 10.1016/j.gerinurse.2022.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 01/05/2022] [Accepted: 01/07/2022] [Indexed: 11/23/2022]
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Everyday Life and Social Contacts of Dementia and Non-Dementia Residents over 80 Years in Long-Term Inpatient Care: A Multi-Level Analysis on the Effect of Staffing. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182111300. [PMID: 34769817 PMCID: PMC8583643 DOI: 10.3390/ijerph182111300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 10/14/2021] [Accepted: 10/25/2021] [Indexed: 11/16/2022]
Abstract
The relationship between nurse staffing, physical outcomes of residents, as well as quality of care receives major attention. The impact of staffing levels on residents’ ability to organize their everyday life and maintain social contacts, however, has not been analyzed to date. This study examines whether a relationship between the staff-to-resident ratio for registered nurses and nursing home residents with and without dementia aged over 80 exists. Secondary data collected in the project inQS (indikatorengestützte Qualitätsförderung) were used (n = 1782, mean age = 88.14). The analyzed cross-sectional data were collected in winter 2019 in facilities of the Diocesan Caritas Association in Germany. A sum score formed from variables measuring residents’ abilities to independently organize their everyday life and maintain social contacts functioned as the dependent variable. A multi-level regression analysis was performed. The results revealed that the ability of residents without dementia was significantly associated with the staff-to-resident ratio of registered nurses. This was not true for residents with dementia. For the latter, however, whether the facility offers a segregated care unit turned out to be significant. Additional and longitudinal research is indispensable to explain the inequality between the two groups analyzed.
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