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Keane J, Ryan C, Usher R. Leisure and social occupational choice within nursing home facilities in Ireland: Residents perspectives. Scand J Occup Ther 2024; 31:2259222. [PMID: 37918009 DOI: 10.1080/11038128.2023.2259222] [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] [Received: 11/29/2021] [Accepted: 09/12/2023] [Indexed: 11/04/2023]
Abstract
BACKGROUND National standards for nursing homes in Ireland require that residents are offered a choice of recreational and stimulating activities to meet their needs and preferences. AIMS/OBJECTIVES To investigate residents' perceptions of leisure and social occupational choice in nursing homes in Ireland to determine if occupational choice is facilitated. MATERIALS AND METHOD Qualitative-descriptive design - nursing home residents completed two semi-structured interviews that explored their experiences of leisure and social occupational engagement. RESULTS Two overarching themes with six associated sub-themes emerged. From residents' perspectives, social and leisure occupational choice was dependent on: Environmental factors (nursing homes' Cultural, Social, Physical, and Temporal Environments) and Personal factors (residents' Health Status and Personal Attitudes). CONCLUSION The cultural environment had the most significant influence on residents' leisure and social occupational choice, highlighting the importance of person-centred care within nursing homes, to promote occupational choice. Resident's health status was also identified as a contributing factor. SIGNIFICANCE Occupational therapists could play a critical role in supporting the leisure and social occupational choices of nursing home residents by developing residents' skills, educating staff and adapting tasks and the environment to limit/reduce occupational deprivation.
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Affiliation(s)
- Jenna Keane
- Department of Occupational Therapy and Occupational Science, University College, Cork, Ireland
| | - Ciara Ryan
- Department of Occupational Therapy and Occupational Science, University College, Cork, Ireland
| | - Ruth Usher
- Department of Occupational Therapy and Occupational Science, University College, Cork, Ireland
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Brouwers M, Broekharst DSE, de Boer B, Groen WG, Verbeek H. An overview of innovative living arrangements within long-term care and their characteristics: a scoping review. BMC Geriatr 2023; 23:442. [PMID: 37464287 PMCID: PMC10355008 DOI: 10.1186/s12877-023-04158-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 07/06/2023] [Indexed: 07/20/2023] Open
Abstract
BACKGROUND Within long-term care, a culture change (e.g. focus on increasing autonomy in everyday life) is leading to the development of innovative living arrangements for older adults. Insight into characteristics of innovative living arrangements, which are described as an alternative to regular nursing homes, is lacking. This review aims to provide an overview of innovative living arrangements and to describe their defining characteristics. METHODS A scoping review was performed following the framework of Arksey and O'Malley. The preferred reporting items for systematic reviews and meta-analyses with extension, for scoping reviews (PRISMA-ScR) was also followed. The databases PubMed, PsycInfo, CINAHL, and Web of Science were searched. Articles, published between 2012 and 2023 were included when they presented an innovative living arrangement as an alternative to regular nursing homes. A thematic analysis was performed, describing the physical, social, and organizational environment of the innovative living arrangements. RESULTS Fifty-six articles were identified describing seven types of distinct innovative living arrangements: small-scale living, the green house model, shared housing arrangements, green care farms, dementia villages, group homes, intergenerational living, and an 'other' category. The themes included supporting autonomy and creating a small-scale and/or homelike environment, which were emphasized in most innovative living arrangements. Other themes, such as involvement of the community, focus on nature, integration of work tasks, and involvement of family members, were emphasized in a subsection of the described living arrangements. Twenty-eight articles reported on the effects of the innovative living environment on residents, family members, or staff members. Most articles (N = 22) studied resident-related outcomes, focusing mainly on quality of life and aspects of daily life. CONCLUSION More insight into the mechanisms of the social and organizational environments is needed, which may lead to greater transparency and homogeneity regarding the description of living arrangements. This review shows that more knowledge is needed about the potential key elements of innovative living arrangements, especially related to their social and organizational environment. This may provide a better guide for developers within long-term care.
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Affiliation(s)
- Mara Brouwers
- Department of Health Services Research, CAPHRI Care and Public Health Research Institute, Maastricht University, P.O. BOX 616, Maastricht, 6200 MD, the Netherlands.
- Living Lab in Ageing and Long-Term Care, Maastricht, the Netherlands.
| | - Damien S E Broekharst
- Department of Public Health and Primary Care, Leiden University Medical Centre, Leiden, the Netherlands
- University Network for the care sector South Holland, Leiden University Medical Center, Leiden, The Netherlands
| | - Bram de Boer
- Department of Health Services Research, CAPHRI Care and Public Health Research Institute, Maastricht University, P.O. BOX 616, Maastricht, 6200 MD, the Netherlands
- Living Lab in Ageing and Long-Term Care, Maastricht, the Netherlands
| | - Wim G Groen
- Department of Medicine for Older People, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
- Amsterdam Public Health Research Institute, Aging & Later Life, Amsterdam, the Netherlands
- Amsterdam Movement Sciences, Ageing & Vitality, Rehabilitation & Development, Amsterdam, the Netherlands
| | - Hilde Verbeek
- Department of Health Services Research, CAPHRI Care and Public Health Research Institute, Maastricht University, P.O. BOX 616, Maastricht, 6200 MD, the Netherlands
- Living Lab in Ageing and Long-Term Care, Maastricht, the Netherlands
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Morgan JC, Ahmad W, Chen YZ, Burgess EO. The Impact of COVID-19 on the Person-Centered Care Practices in Nursing Homes. J Appl Gerontol 2023:7334648231154544. [PMID: 36727467 PMCID: PMC9899667 DOI: 10.1177/07334648231154544] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
The COVID-19 pandemic has had a significant impact on long-term care residents, family, and staff. Nursing homes are facing persistent challenges such as staff shortage, lack of personal protective equipment (PPE), and staff experiencing mental health issues including burnout. COVID-19 precautions may have made implementing person-centered care (PCC) in nursing homes more difficult. This report provides a descriptive analysis of perceived COVID-19 impact on the PCC practice in nursing homes. Surveys (N = 379) were collected from 11 nursing homes across Georgia. PCC practice barriers include reduced choice for residents, staff anxiety related to COVID-19 precautions, increased prevalence of short-staffing, and expanded duties for direct care workers. Facilitators for PCC were also present and included staff engagement, the provision of mental health resources, supervisor support, and empowerment of staff. Applied practice and research to address these barriers and expand implementation of facilitators is needed.
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Affiliation(s)
- Jennifer Craft Morgan
- Georgia State
University, Atlanta, GA, USA,Jennifer Craft Morgan, Georgia State
University, 1 Park Place NE, Suite 605, Atlanta, GA, USA.
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Abbott KM, Elliot A, Van Haitsma K. Lessons Learned From Ohio's Statewide Implementation of the Preferences for Everyday Living Inventory as a Pay for Performance Initiative to Enhance Person-Centered Care. J Am Med Dir Assoc 2021; 22:2074-2078. [PMID: 34237257 DOI: 10.1016/j.jamda.2021.06.011] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 03/23/2021] [Accepted: 06/04/2021] [Indexed: 10/20/2022]
Abstract
Person-centered care (PCC) in nursing homes is an elusive organizational goal that has attracted the attention of pay-for-performance (P4P) programs. P4P programs are used to incentivize providers to improve the quality of care delivered. However, P4P programs have both overarching policy initiatives (big "P") that must incorporate an implementation framework that is adaptable in practice (little "p"). The purpose of this paper is to apply six key factors that are central to P4P design in long-term care settings: financial incentives, measurement, stakeholder involvement and alignment, feasibility, education and awareness, and reporting and transparency as a framework for a case study of a P4P initiative conducted in Ohio between 2015 and 2019. Notably, the case study is focused on PCC and how the Ohio Department of Medicaid selected the Preferences for Everyday Living Inventory (PELI) for nursing home providers to use with all of their residents. Although inclusion of the PELI met some of the key factors, such as measurement, its implementation did not meet other key factors, such as reporting and transparency. Based on lessons learned from the Ohio P4P, recommendations are presented for use of the PELI as both a process and outcome measure in future P4P initiatives.
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Affiliation(s)
- Katherine M Abbott
- Department of Sociology and Gerontology, Scripps Gerontology Center, Miami University, Oxford, OH, USA.
| | - Amy Elliot
- The John Glenn College of Public Affairs, The Ohio State University, Columbus, OH, USA
| | - Kimberly Van Haitsma
- The Polisher Research Institute at Abramson Senior Care, College of Nursing, The Pennsylvania State University, University Park, PA, USA
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Hrybyk RL, Frankowski AC, Nemec M, Peeples AD. "It's a lot!" the universal worker model and dementia care in assisted living. Geriatr Nurs 2020; 42:233-239. [PMID: 33317815 DOI: 10.1016/j.gerinurse.2020.08.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 08/14/2020] [Accepted: 08/19/2020] [Indexed: 10/22/2022]
Abstract
The culture change movement aims to create a more home-like environment in long-term care settings, promote person-centered care, and support the well-being of staff and residents. One feature of Culture Change is the Universal Worker (UW) model where direct care workers (DCWs) are responsible for housekeeping, laundry, and activities in addition to administering medication and personal support. The longitudinal approach in the ethnographic study on which this paper is based compares data collected from one assisted living across three NIA-supported research grants. This paper focuses on modifications to the UW model following the implementation of culture change over a period of ten years. As DCWs cared for residents with increasing levels of dementia, time constraints under the UW model led to sporadic attention to housekeeping chores and challenged person-centered care. Modifying the UW model, by using dedicated cleaning staff and other support workers, better preserves the intent of the culture change movement.
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Affiliation(s)
- Regina L Hrybyk
- Department of Sociology, Anthropology, and Public Health, University of Maryland, Baltimore County 1000 Hilltop Circle, Baltimore, MD 21250, United States.
| | - Ann Christine Frankowski
- Department of Sociology, Anthropology, and Public Health, University of Maryland, Baltimore County 1000 Hilltop Circle, Baltimore, MD 21250, United States
| | - Mary Nemec
- Department of Sociology, Anthropology, and Public Health, University of Maryland, Baltimore County 1000 Hilltop Circle, Baltimore, MD 21250, United States
| | - Amanda D Peeples
- Department of Sociology, Anthropology, and Public Health, University of Maryland, Baltimore County 1000 Hilltop Circle, Baltimore, MD 21250, United States
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Resnick B, Kolanowski A, Van Haitsma K, Galik E, Boltz M, Zhu S, Ellis J, Behrens L, Eshraghi K, Viviano N, Jao YL. Reliability and Validity Testing of the Assessment of the Environment for Person-Centered Management of BPSD and Assessment of Policies for Person-Centered Management of BPSD Measures. JOURNAL OF AGING AND ENVIRONMENT 2020. [DOI: 10.1080/02763893.2019.1683670] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Barbara Resnick
- School of Nursing, University of Maryland School of Nursing, Baltimore, MD, USA
| | - Ann Kolanowski
- School of Nursing, Pennsylvania State University, PA, USA
| | | | - Elizabeth Galik
- School of Nursing, University of Maryland School of Nursing, Baltimore, MD, USA
| | - Marie Boltz
- School of Nursing, Pennsylvania State University, PA, USA
| | - Shijun Zhu
- School of Nursing, University of Maryland School of Nursing, Baltimore, MD, USA
| | - Jeanette Ellis
- School of Nursing, University of Maryland School of Nursing, Baltimore, MD, USA
| | - Liza Behrens
- School of Nursing, Pennsylvania State University, PA, USA
| | - Karen Eshraghi
- School of Nursing, Pennsylvania State University, PA, USA
| | - Nicole Viviano
- School of Nursing, University of Maryland School of Nursing, Baltimore, MD, USA
| | - Ying-Ling Jao
- School of Nursing, Pennsylvania State University, PA, USA
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