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Plys E, Fleet A, Epstein-Lubow G, Bern-Klug M, Bonner A. Policy Changes to Promote Better Quality of Life for People with Serious Mental Illness Living in U.S. Nursing Homes. THE PUBLIC POLICY AND AGING REPORT 2024; 34:65-70. [PMID: 38946714 PMCID: PMC11214154 DOI: 10.1093/ppar/prae004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Indexed: 07/02/2024]
Affiliation(s)
- Evan Plys
- Center for Health Outcomes and Interdisciplinary Research, Massachusetts General Hospital, Boston, Massachusetts, USA
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
| | - Alexa Fleet
- Department of Behavioral Health Services and Policy Research, New York State Psychiatric Institute, New York, New York, USA
- Department of Gerontology, University of Massachusetts Boston, Boston, Massachusetts, USA
| | - Gary Epstein-Lubow
- Department of Psychiatry & Human Behavior, Alpert Medical School of Brown University, Providence, Rhode Island, USA
- Education Development Center, Boston, Massachusetts, USA
| | | | - Alice Bonner
- Institute for Healthcare Improvement (IHI), Boston, Massachusetts, USA
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Weidner M, Towsley GL. Meaningful connections: An education program to enhance resident-certified nursing assistant relationships. GERONTOLOGY & GERIATRICS EDUCATION 2024; 45:259-275. [PMID: 36752118 DOI: 10.1080/02701960.2023.2174116] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
Close relationships between nursing home residents and Certified Nursing Assistants (CNAs) result in positive outcomes for both residents and staff, including increased well-being for residents. However, many resident-CNA relationships remain superficial, are focused primarily on physical care, and interpersonal skill training for CNAs is sparse. The purpose of this study was to develop an education program to foster CNAs' interpersonal skills and relationship development. We conducted a literature review on CNA interpersonal skill training and disseminated a survey to CNAs to inform the education program. Literature review findings revealed that CNAs value their relationships with residents and desire more interpersonal training, but this training is often limited. The survey, which was disseminated via social media and facility contact referrals, asked responding CNAs (n = 73) to evaluate their perceptions of empowerment, interpersonal skill competency, and learning preferences. We found that most CNAs feel confident in their interpersonal skills, but they lack training in boundary-setting and bereavement support. About one-third of respondents did not feel that their work was valued or their strengths recognized by their supervisors. Most respondents reported that they valued visual (85%), experiential (91%) learning. The final program, Meaningful Connections, includes nine modules covering topics such as person-centered caregiving, empathy, emotional intelligence, and boundary-setting. One supplementary module provides potential adaptations to the curriculum to customize the needs of each participant group. The results of this project suggest a need for more CNA relationship training and support, especially in the areas of boundary-setting and bereavement.
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Affiliation(s)
- Michelle Weidner
- University of Utah College of Nursing, Salt Lake City, UT, United States
| | - Gail L Towsley
- University of Utah College of Nursing, Salt Lake City, UT, United States
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Choi YR, Kwon DY, Chang SO. The Development and Effectiveness of a Web-Based Emergency Management Educational Program for Long-Term Care Facility Interprofessional Practitioners. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182312671. [PMID: 34886397 PMCID: PMC8657401 DOI: 10.3390/ijerph182312671] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 11/19/2021] [Accepted: 11/30/2021] [Indexed: 11/29/2022]
Abstract
Long-term care facility (LTCF) interprofessional practitioners who care for residents at high risk of emergencies due to old age, frailty, and complex diseases must be able to manage such emergencies collaboratively. A shared mental model (SMM) enhances performance toward a common goal by allowing effective collaboration through promoting the sharing of knowledge and skills among interprofessional team members. Therefore, this study developed a web-based educational program for LTCF interprofessional practitioners based on an SMM. We followed a network-based instructional system design that consists of analysis, design, development, implementation, and evaluation for developing the program. A total of 54 participants completed the educational program in four LTCFs in South Korea. A significant improvement was identified in communication knowledge, communication confidence, role recognition, transactive memory system, and team effectiveness in the experimental group. The results show that the program improved the emergency management process and reliability among interprofessional practitioners, positively impacting interprofessional collaboration and ensuring the safety of patients during emergencies in LTCFs.
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Affiliation(s)
- Young-Rim Choi
- Institute of Nursing Research, College of Nursing, Korea University, Seoul 02841, Korea;
| | - Dai-Young Kwon
- Gifted Education Center, Korea University, Seoul 02841, Korea;
| | - Sung-Ok Chang
- BK21 FOUR R&E Center for Learning Health Systems, College of Nursing, Korea University, Seoul 02841, Korea
- Correspondence:
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Gammonley D, Wang X, Simons K, Smith KM, Bern-Klug M. Serious Mental Illness in Nursing Homes: Roles and Perceived Competence of Social Services Directors. JOURNAL OF GERONTOLOGICAL SOCIAL WORK 2021; 64:721-739. [PMID: 33851901 DOI: 10.1080/01634372.2021.1912241] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Revised: 03/27/2021] [Accepted: 03/30/2021] [Indexed: 06/12/2023]
Abstract
Providing nursing home psychosocial care to persons with serious mental illnesses (SMI) requires understanding of comorbidities and attention to resident rights, needs and preferences. This quantitative study reports how 924 social service directors (SSDs) taking part in the National Nursing Home Social Service Director survey identified their roles and competence, stratified by the percentage of residents with SMI. More than 70% of SSDs, across all categories of homes, reported the social services department was "always" involved in conducting depression screening, biopsychosocial assessments and PASRR planning. SSDs in homes with lower concentrations of residents with SMI reported less involvement in anxiety screening. Those employed in homes with higher concentrations of residents with SMI reported lower involvement conducting staff interventions for resident aggression or making referrals. More than one-fifth of SSDs lacked confidence in their ability to compare/contrast dementia, depression, and delirium or to develop care plans for residents with SMI. SSDs' perceived competence in developing care plans for residents with SMI was associated with education and involvement in care planning. About one-quarter of social services directors reported not being prepared to train a colleague on how to develop care plans for residents with SMI. Training in SMI could enhance psychosocial care.
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Affiliation(s)
- Denise Gammonley
- School of Social Work, College of Health Professions and Sciences, University of Central Florida, Orlando, Florida, USA
| | - Xiaochuan Wang
- School of Social Work, College of Health Professions and Sciences, University of Central Florida, Orlando, Florida, USA
| | - Kelsey Simons
- University of Rochester School of Medicine & Dentistry, Department of Psychiatry, Rochester, New York, USA
| | - Kevin M Smith
- Department of Psychological and Quantitative Foundations, University of Iowa, Iowa City, Iowa, USA
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Walker VG, Walker EK. Older Adults Diagnosed With Schizophrenia in Long-term Care Facilities: Life Course Theory for Holistic Nursing Research and Practice. J Holist Nurs 2021; 40:181-192. [PMID: 34106020 DOI: 10.1177/08980101211025372] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Older adults diagnosed with schizophrenia (OADWS) often enter long-term care facilities with unique challenges related to trauma and stress experienced throughout their life course. Health care workers often report that when they work with this population, they feel unprepared due to limited training. In this article, life course theory is presented as a lens for holistic nursing research and as a way for nurses to adapt interventions already used with cognitively impaired older adults (e.g., those diagnosed with Alzheimer's disease) for OADWS in long-term care. It is hoped that these ideas will facilitate discussion of ways to inform training for holistic long-term care of OADWS. Holistic principles of nursing addressed with life course theory as a lens include the following: (a) accounting for strengths and challenges; (b) honoring experiences, values, and health beliefs; (c) viewing interrelationships with the environment; and (d) nurturing of peace, wholeness, and healing.
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Molinari V. Commentary: "Trends in Serious Mental Illness in US Assisted Living Compared to Nursing Homes and the Community: 2007-2017". Am J Geriatr Psychiatry 2021; 29:445-447. [PMID: 33023800 DOI: 10.1016/j.jagp.2020.09.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Accepted: 09/21/2020] [Indexed: 10/23/2022]
Affiliation(s)
- Victor Molinari
- School of Aging Studies, University of South Florida, Tampa, FL.
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Muralidharan A, Mills WL, Evans DR, Fujii D, Molinari V. Preparing Long-Term Care Staff to Meet the Needs of Aging Persons With Serious Mental Illness. J Am Med Dir Assoc 2019; 20:683-688. [PMID: 31056455 PMCID: PMC6611673 DOI: 10.1016/j.jamda.2019.03.018] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Revised: 03/14/2019] [Accepted: 03/15/2019] [Indexed: 11/19/2022]
Abstract
OBJECTIVES Individuals with serious mental illness (SMI; schizophrenia spectrum disorders and affective psychoses) are increasingly aging into older adulthood and are overrepresented in residential long-term care settings. The present study aimed to examine the preparedness of staff in these settings to care for individuals with SMI. DESIGN A multidisciplinary US Department of Veterans Affairs (VA) workgroup of professionals with expertise in geriatric mental health collected voluntary feedback via online questionnaire as part of a quality improvement project. SETTING AND PARTICIPANTS Respondents were mental health providers (N=51) embedded in VA nursing homes called Community Living Centers (CLCs). MEASURES The questionnaire contained multiple-choice, Likert-type scale, and open-ended questions regarding the opportunities and challenges associated with caring for Veterans with SMI in CLCs. RESULTS Respondents identified a lack of training of front-line staff as a key challenge in providing high-quality care to residents with SMI. Specifically, respondents indicated a need to increase staff knowledge about SMI symptoms and diagnoses, to improve staff communication and interactions with residents with SMI, and to decrease mental illness stigma among staff. CONCLUSIONS/IMPLICATIONS The present study revealed significant areas of training need for front-line staff in nursing homes. Many perceived staff training needs overlap with the knowledge and skill set required to provide high-quality dementia care. Integrating training regarding the care of residents with SMI into dementia care training efforts may be a fruitful future direction. Strategies for this and a suggested curriculum are provided.
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Affiliation(s)
- Anjana Muralidharan
- VA Capitol Healthcare Network, Mental Illness Research Education and Clinical Center, Baltimore, MD; Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD.
| | - Whitney L Mills
- Center of Innovation in Long-Term Services and Supports, Providence VA Medical Center, Providence, RI; Department of Health Services, Policy and Practice, School of Public Health, Brown University, Providence, RI
| | - Denise R Evans
- Charlie Norwood VA Medical Center, Augusta, GA; Department of Psychiatry and Health Behavior, Medical College of Georgia, Augusta University, Augusta, GA
| | - Daryl Fujii
- VA Pacific Islands Healthcare System, Honolulu, HI
| | - Victor Molinari
- School of Aging Studies, University of South Florida, Tampa, FL
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Dobbs D, Hobday J, Roker R, Kaas MJ, Molinari V. Certified nursing assistants' perspectives of the CARES® activities of daily living dementia care program. Appl Nurs Res 2018; 39:244-248. [DOI: 10.1016/j.apnr.2017.11.016] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2017] [Revised: 11/01/2017] [Accepted: 11/02/2017] [Indexed: 11/26/2022]
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Brody AA. Moving the needle: Providing evidence based care to older adults with behavioral issues through knowledge translation. GERONTOLOGY & GERIATRICS EDUCATION 2017; 38:355-358. [PMID: 28598728 DOI: 10.1080/02701960.2017.1339036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Implementing evidence based practices into practice settings is exceedingly difficult. Knowledge translation is a framework used for moving practices from the literature into the real world. This article discusses how six articles in this special issue of Gerontology and Geriatrics Education use various knowledge translation approaches to implement evidence based practices in older adults with behavioral health issues including dementia, delirium and serious mental illness across a variety of settings, as well as lessons learned for future knowledge translation and implementation science studies.
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Affiliation(s)
- Abraham Aizer Brody
- a Hartford Institute for Geriatric Nursing , Institution NYU Rory Meyers College of Nursing , New York , NY , USA
- b James J Peters Bronx VA , Bronx , NY , USA
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