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Scott S, Raynor A, Dare J, Grieve J, Costello L. Improving the Transition of Older Adults into Residential Aged Care: A Scoping Review. Clin Gerontol 2023:1-14. [PMID: 37929882 DOI: 10.1080/07317115.2023.2274042] [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] [Indexed: 11/07/2023]
Abstract
OBJECTIVES The transition into residential aged care (RAC) is often associated with loss, grief, isolation and loneliness. This scoping review aimed to identify quantitative research which focused on reducing the negative effects associated with transition, thereby improving the transition experience. METHODS A scoping review, which concentrated on quantitative research, was conducted. MEDLINE, CINAHL andPSYCHINFO databases were searched using the initial search terms "olderadults", "residential aged care" and "transition". RESULTS From the 457 original citations identified, four met the inclusion criteria. The interventions used a range of professionals and clinicians, diverse content, and a mixture of outcomes. The content of the more successful studies were underpinned by mental wellness themes and helped to reduce depressive symptoms among new residents. CONCLUSIONS Our review provides a summary of interventions aimed at improving the transition experience for older adults moving into RAC and highlights gaps in the literature. This review is limited by the paucity of quantitative research in this area. Further research is required to address the negative psychosocial effects associated with transition into RAC. CLINICAL IMPLICATIONS Assessing which of the transition phases an individual is in can help individualize interventions to reduce negative symptoms relating to transition.
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Affiliation(s)
- Stacey Scott
- School of Medical and Health Sciences, Edith Cowan University, Perth, Western Australia
| | - Annette Raynor
- School of Medical and Health Sciences, Edith Cowan University, Perth, Western Australia
| | - Julie Dare
- School of Medical and Health Sciences, Edith Cowan University, Perth, Western Australia
| | - Jennifer Grieve
- School of Nursing and Midwifery, Edith Cowan University, Perth, Western Australia
| | - Leesa Costello
- School of Medical and Health Sciences, Edith Cowan University, Perth, Western Australia
- Nutrition & Health Innovation Research Institute
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Sun C, Yu Y, Li X, Cui Y, Ding Y, Zhu S, Li X, Chen S, Zhou R. The factors of adaptation to nursing homes in mainland China: a cross-sectional study. BMC Geriatr 2020; 20:517. [PMID: 33256628 PMCID: PMC7708906 DOI: 10.1186/s12877-020-01916-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Accepted: 11/17/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND China is one of the most rapidly ageing countries and has the largest ageing population in the world. The demand for long-term care is increasing. Nursing home placement is one of the most stressful events in a person's life. Although research on relocation adjustment has been conducted in many countries, few studies have been related to the predictors of nursing home adjustment in mainland China. This study aimed to identify the predictors of nursing home adjustment in the context of filial piety in mainland China. METHODS This was a descriptive study that employed a cross-sectional survey. A total of 303 residents from 22 nursing homes in Nanjing, China, were recruited. A structured questionnaire about residents' characteristics, activities of daily living, social support, resilience, and nursing home adjustment was administered. Multiple linear regression was used to identify the predictors of adaptation to nursing homes. RESULTS The predictors of nursing home adjustment were the satisfaction with services(β = .158, P < .01), number of diseases(β = -.091, P < .05), length of stay(β = .088, P < .05), knowledge of the purpose of admission (β = .092, P < .05), resilience(β = .483, P < .001) and social support(β = .186, P < .001). The total explained variance for this model was 61.6%. CONCLUSION Nursing staff members should assess the characteristics of residents to promote their better adjustment. Resilience had the most significant influence on the level of adaptation, which has been the primary focus of interventions to improve adjustment. The management of disease comorbidities in nursing homes should be standardized and supervised by the government. More volunteers from universities and communities should be encouraged to provide social support to residents. Moreover, a caring culture needs to be emphasized, and the value of filial piety should be advocated in nursing homes of East Asian countries.
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Affiliation(s)
- Changxian Sun
- Nanjing Medical University, Nanjing, China.,Jiangsu Vocational Institute of Commerce, Nanjing, China
| | - Yiting Yu
- Nanjing Medical University, Nanjing, China
| | - Xuxu Li
- Landsea Lvy Elder Care Service, Nanjing, China
| | - Yan Cui
- Nanjing Medical University, Nanjing, China.
| | | | - Shuqin Zhu
- Nanjing Medical University, Nanjing, China
| | - Xianwen Li
- Nanjing Medical University, Nanjing, China
| | - Shen Chen
- Nanjing Medical University, Nanjing, China
| | - Rong Zhou
- Nanjing Medical University, Nanjing, China
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Fitzpatrick JM, Tzouvara V. Facilitators and inhibitors of transition for older people who have relocated to a long-term care facility: A systematic review. HEALTH & SOCIAL CARE IN THE COMMUNITY 2019; 27:e57-e81. [PMID: 30239055 DOI: 10.1111/hsc.12647] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Revised: 07/20/2018] [Accepted: 07/21/2018] [Indexed: 05/26/2023]
Abstract
Moving into a long-term care facility to live permanently is a significant life event for older people. Care facilities need to support older people to make a healthy transition following relocation. To help achieve this, we need to understand what facilitates and inhibits the transition process from the perspective of older people, their families, and care facility staff. Our review generated new knowledge to inform this understanding. We addressed the question: what factors facilitate and inhibit transition for older people who have relocated to a long-term care facility? Five electronic databases, PsychINFO, British Nursing Index, CINAHL, MEDLINE and Web of Science were searched for the period January 1990 to October 2017. Grey literature searches were conducted using Google Scholar, and Social Science Research Network. Data were extracted for individual studies and a narrative synthesis was conducted informed by Meleis's Theory of Transition. Thirty-four studies (25 qualitative, 7 quantitative and 2 mixed methods) met the inclusion criteria. Data synthesis identified that transition following relocation was examined using a variety of terms, timelines and study designs. Potential personal and community focused facilitators and inhibitors mapped to four themes: resilience of the older person, interpersonal connections and relationships, this is my new home, and the care facility as an organisation. These findings can inform the development of interventions for these target areas. They highlight also that further research is warranted to understand the organisational culture of long-term care facilities, how this influences transition, and how it might be shaped to create and sustain a caring culture for older people.
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Affiliation(s)
- Joanne M Fitzpatrick
- Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King's College London, London
| | - Vasiliki Tzouvara
- Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King's College London, London
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Wang SC, Creswell JW, Nguyen D. Vietnamese Refugee Elderly Women and Their Experiences of Social Support: A Multiple Case Study. J Cross Cult Gerontol 2017; 32:479-496. [PMID: 29105016 DOI: 10.1007/s10823-017-9338-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
This study sought to address the gaps in the literature on Asian American gerontology with a multiply marginalized group in terms of gender, immigration status, and context. Guided by a multiple case study approach, we sought to explore how social support was experienced by four Vietnamese elderly refugee women residing in different living arrangements (i.e., alone, with spouse, with adult children, or in a multigenerational household). Within-case analyses were conducted to yield descriptive information about each individual. Additionally, three overarching themes emerged across each of the living arrangements: (1) Burden of care-taking, (2) Distinguishing family from nonfamily help, and (3) Ambivalence toward government-sponsored services. Our findings provide a contextualized understanding of social support to explain the inconsistencies that have been found in the literature on Asian American gerontology and family support. The benefits of living alone are described, along with the potential risks of coresidency.
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Affiliation(s)
- Sherry C Wang
- Department of Counseling Psychology, Santa Clara University, 500 El Camino Real, Santa Clara, CA, 95050-0201, USA.
| | - John W Creswell
- Department of Educational Psychology, University of Nebraska-Lincoln, Lincoln, NE, USA
| | - Dau Nguyen
- Vietnamese Community of Lincoln, Lincoln, NE, USA
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Sussman T, Dupuis S. Supporting residents moving into long-term care: multiple layers shape residents' experiences. JOURNAL OF GERONTOLOGICAL SOCIAL WORK 2014; 57:438-59. [PMID: 24372420 DOI: 10.1080/01634372.2013.875971] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
This interpretive grounded theory study explores 10 residents' retrospective accounts of the relocation process, including the decision to move into a long-term care home, the pre-move preparations, the moving day circumstances, and the initial adjustment period following the move. Analysis of the data revealed a complex intersection of conditions at multiple layers that shaped residents' experiences of the transitional process. Recommendations to enhance circumstances at individual, interpersonal, and systemic layers, for each temporal stage of the relocation process are proposed. Implications for social work practice across the continuum of care are also discussed.
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Affiliation(s)
- Tamara Sussman
- a School of Social Work , McGill University , Montreal , Canada
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Johnson RA, Bibbo J. Relocation decisions and constructing the meaning of home: a phenomenological study of the transition into a nursing home. J Aging Stud 2014; 30:56-63. [PMID: 24984908 DOI: 10.1016/j.jaging.2014.03.005] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2014] [Revised: 03/28/2014] [Accepted: 03/28/2014] [Indexed: 11/17/2022]
Abstract
The transition from community dwelling to a nursing home is a common, though idiosyncratic, experience in the United States. This study employed an interpretive phenomenological approach to uncover how eight older adults in nursing homes in the Midwestern U.S. constructed the meaning of home shortly following the relocation and again approximately two months later. The degree to which the individual had been involved in the decision making process was also explored as it related to the meaning of home within the nursing home setting. The majority of individuals did not consider the facility to be "home," but actively changed their attitudes toward the facility and themselves to better adjust to the setting. The findings demonstrate the importance of autonomy in older adults' definitions of home.
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Affiliation(s)
- Rebecca A Johnson
- Millsap Professor of Gerontological Nursing and Public Policy, Sinclair School of Nursing, S413 Sinclair School of Nursing, University of Missouri, Columbia, MO 65211, United States
| | - Jessica Bibbo
- Department of Human Development and Family Studies, University of Missouri, 314 Gentry Hall, Columbia, MO 65211, United States.
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Baldacchino DR, Bonello L. Anxiety and depression in care homes in Malta and Australia: part 2. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 2013; 22:780-785. [PMID: 24261094 DOI: 10.12968/bjon.2013.22.13.780] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
This cross-sectional comparative study, conducted in two phases, assessed the levels of and factors contributing to anxiety and depression in older people in residential homes in Malta and Australia. Part 1 presented the methodology of this cross-sectional study and presented the quantitative findings; this constituted phase 1. Part 2 presents the qualitative findings on the contributing factors to anxiety and depression and discusses the overall findings. Maltese residents were recruited from four church homes in Malta and Australia and two state residences in Malta; there was a high response rate in phase 2 of 89.4% (n=42, mean age 71.9 years). The residents were all mobile Roman Catholics who had lived in the homes for a minimum of 6 months. Data was collected using audiotaped focus groups. The qualitative data generated three contributing factors: physical functional abilities, adaptation to institutionalisation, and personal outlook towards the future. Mobility was found to foster an active life, which appeared to help residents to control their anxiety and depression. Rehabilitation programmes and facilitation of strategies were recommended to strengthen relationships with family members, room mates, health professionals and pets to help residents live meaningfully. Further cross-cultural longitudinal research would identify the role of other influencing variables such as culture, spirituality and caring relationships.
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Baldacchino DR, Bonello L. Anxiety and depression in care homes in Malta and Australia: part 1. ACTA ACUST UNITED AC 2013; 22:677-8, 680-3. [DOI: 10.12968/bjon.2013.22.12.677] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Donia R Baldacchino
- Faculty of Health Sciences, University of Malta, Malta, Visiting Fellow, University of South Wales, Wales, and Adjunct Faculty Member, Johns Hopkins University, Maryland, US
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Abad-Corpa E, Gonzalez-Gil T, Martínez-Hernández A, Barderas-Manchado AM, De la Cuesta-Benjumea C, Monistrol-Ruano O, Mahtani-Chugani V. Caring to achieve the maximum independence possible: a synthesis of qualitative evidence on older adults' adaptation to dependency. J Clin Nurs 2013; 21:3153-69. [PMID: 23083390 DOI: 10.1111/j.1365-2702.2012.04207.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
AIMS AND OBJECTIVES To understand the process of adaptation to dependency in older adults and their families. BACKGROUND Dependency and family care giving are attracting the attention of policymakers, service providers and researchers. DESIGN An interpretative synthesis of qualitative studies has been conducted. METHODS An extensive search without time and idiom limitations was conducted using the main databases (MEDLINE, CINAHL, EMBASE, PsycINFO, SSCI, LILACS, CUIDEN, Cochrane Library and JBI): personal communication from expert panel was used to detect filters strategies to find qualitative studies; these strategies were combined with search terms for dependence in older adults. The studies (2164 potentially relevant papers) were judged by two reviewers based on reading title, abstract, keywords and/or full text (English, Spanish, French and Portuguese) to determine their inclusion. After, 203 papers were critically appraised by two reviewers (disagreements were resolved by discussions). Finally, the synthesis of the 20 studies with best interpretative character was carried out based on the principles and procedures of Grounded Theory. RESULTS The findings were related to the process of adaptation to dependency, the factors and the strategies used, the emotions, perceptions and feelings of care givers and older adults. The central category that emerged was 'Caring to achieve the maximum independence possible', and this could be seen as a transition period in which older adults and their families progressed in a mutually determined adaptation process. This category is made up of several redefinitions of concepts, phases, adaptation strategies and final responses to the process. CONCLUSIONS The findings show the interconnected nature of physical, material, social and emotional aspects of care; and the profound social impact of providing and receiving care. Relevance to clinical practice. The nurses can assist families and older adults to enhance adaptation to dependency, anticipating and helping to redefine the concepts of care.
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Affiliation(s)
- Eva Abad-Corpa
- Research Department, Murcia Health Service, Murcia and Carlos III Health Institute, Nursing and Healthcare Research Unit (Investen-isciii), Madrid, Spain.
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Aminzadeh F, Molnar FJ, Dalziel WB, Garcia LJ. An Exploration of Adjustment Needs and Efforts of Persons with Dementia After Relocation to a Residential Care Facility. ACTA ACUST UNITED AC 2013. [DOI: 10.1080/02763893.2012.754824] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Mulry CM. Transitions to Assisted Living: A Pilot Study of Residents’ Occupational Perspectives. PHYSICAL & OCCUPATIONAL THERAPY IN GERIATRICS 2012. [DOI: 10.3109/02703181.2012.741190] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Claire M. Mulry
- Department of Occupational Therapy, Quinnipiac University, Hamden, Connecticut, USA
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Hersch G, Hutchinson S, Davidson H, Wilson C, Maharaj T, Watson KB. Effect of an Occupation-Based Cultural Heritage Intervention in Long-Term Geriatric Care: A Two-Group Control Study. Am J Occup Ther 2012; 66:224-32. [DOI: 10.5014/ajot.2012.002394] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Abstract
OBJECTIVE. We investigated the effectiveness of an occupation-based cultural heritage intervention to facilitate adaptation to relocation into long-term care (LTC) facilities as measured by quality of life, activity engagement, and social participation.
METHOD. We used a quasi-experimental nonequivalent control group design with pre- and posttests. Residents receiving the cultural intervention were compared with residents in a typical activity group. Eight sessions, two per week for 4 wk, were facilitated by certified occupational therapy assistants.
RESULTS. Twenty-nine participants completed the group sessions. Quality-of-life scores improved significantly over time for both groups. Statistically, a greater percentage of time was spent in discretionary than obligatory time, pretest and posttest, with no significant difference between groups.
CONCLUSION. The study demonstrated effectiveness of a structured, occupation-based social group intervention that improved quality of life, an indicator of adaptation. It also provided a description of activity patterns and social participation of LTC residents.
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Affiliation(s)
- Gayle Hersch
- Gayle Hersch, PhD, OTR, is Professor, School of Occupational Therapy, Texas Woman’s University, 6700 Fannin Street, Houston, TX 77030, and served as Principal Investigator on the grant;
| | - Shirley Hutchinson
- Shirley Hutchinson, DrPH, RN, is Associate Professor, Nelda C. Stark College of Nursing, Texas Woman’s University, Houston, and served as Co-Principal Investigator
| | - Harriett Davidson
- Harriett Davidson, MA, OTR, is Associate Professor, School of Occupational Therapy, Texas Woman’s University, Houston, and served as Co-Principal Investigator
| | - Christine Wilson
- Christine Wilson, OTR, is Former Clinical Rehabilitation Director, Park Plaza Hospital, Houston, and served as Project Coordinator and Recruiter on the grant
| | - Teresa Maharaj
- Teresa Maharaj, MSN, RN, is Assistant Clinical Professor, Nelda C. Stark College of Nursing, Texas Woman’s University, Houston, and served as Data Collector
| | - Kathleen B. Watson
- Kathleen B. Watson, PhD, was Instructor, Baylor College of Medicine, Houston, TX, at the time of the grant and served as Statistician
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Predictors of Psychosocial Adaptation Among Elderly Residents in Long-Term Care Settings. J Nurs Res 2008; 16:149-59. [DOI: 10.1097/01.jnr.0000387300.22172.c6] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Mead LC, Eckert JK, Zimmerman S, Schumacher JG. Sociocultural Aspects of Transitions From Assisted Living for Residents With Dementia. THE GERONTOLOGIST 2005; 45 Spec No 1:115-23. [PMID: 16230758 DOI: 10.1093/geront/45.suppl_1.115] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
PURPOSE Negotiating transitions and residential relocation are especially difficult for residents with dementia and their families. This article examined the decision-making process regarding retention or transfer of persons with dementia in assisted living facilities. DESIGN AND METHODS Using an ethnographic approach, this study observed residents and facility life, and interviewed residents, staff, and family members in three assisted living facilities. RESULTS Facility managers and administrators are pivotal figures in determining the timing of transitions and transitional care. Operating within the context of care requirements of dementia, they, the facility culture, and the family members' involvement in resident care mediate interpretations of and responses to change and decline, and ultimately influence decision making regarding retention or transfer. IMPLICATIONS Transfer or retention may occur differently depending on whether managers are on- or off-site, the assisted living culture is dementia-friendly, and families are involved in care. Sensitizing assisted living managers and educating potential residents and family members to the importance of these factors may affect the eventual likelihood and timing of discharge.
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Affiliation(s)
- Louise Crawford Mead
- Center for Aging Studies, University of Maryland Baltimore County, Baltimore, MD 21250, USA
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