1
|
Caine AM, Gustafsson L, Molineux M, Aplin T. Seeking residents' views regarding Australian residential aged care: A scoping review. Australas J Ageing 2024. [PMID: 38881513 DOI: 10.1111/ajag.13344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 05/09/2024] [Accepted: 05/11/2024] [Indexed: 06/18/2024]
Abstract
OBJECTIVE This scoping review aimed to explore topics on which the views of residents of Australian residential aged care facilities (RACFs) have been sought. METHODS Scoping review methodology as outlined by Arksey and O'Malley was used to identify, explore and report on the range of literature regarding views of RACF residents. Seven electronic databases were searched using broad search terms relevant to the RACF context. Descriptive numerical analysis was completed for publication year, journal name and target profession, research methods and participant types. Thematic analysis then focussed on the aims of the included studies. RESULTS Four thousand two hundred and ninety studies were screened, and 104 publications met the inclusion criteria. A broad range of topics were explored by researchers, with the largest number of papers focused on residents' views of systems within RACFs (n = 24) and new programs and interventions (n = 21). Smaller topic areas included health conditions and health-care services (n = 13), socialisation (n = 13), physical activity (n = 3), self-care (n = 4), leisure (n = 4), general everyday life (n = 20) and aspects of the residential aged care environment (n = 15). There was limited exploration of meaningful activity (n = 13). The inclusion of residents with cognitive impairment was inconsistent, and the voices of other stakeholders were often privileged. CONCLUSION Voices of residents must be heard in order to prioritise the health and well-being of this population. More research which focuses on what is important to residents is needed and must include residents with cognitive impairment more effectively. Identification of optimal research methods with this population would make an important contribution in this area.
Collapse
Affiliation(s)
- Anne-Maree Caine
- School of Health Sciences and Social Work, Griffith University, Brisbane, Queensland, Australia
| | - Louise Gustafsson
- School of Health Sciences and Social Work, Griffith University, Brisbane, Queensland, Australia
| | - Matthew Molineux
- School of Health Sciences and Social Work, Griffith University, Brisbane, Queensland, Australia
| | - Tammy Aplin
- School of Health Sciences and Social Work, Griffith University, Brisbane, Queensland, Australia
| |
Collapse
|
2
|
Ullal A, Tauseef M, Watkins A, Juckett L, Maxwell C, Tate J, Mion LC, Sarkar N. An Iterative Participatory Design Approach to Develop Collaborative Augmented Reality Activities for Older Adults in Long-Term Care Facilities. PROCEEDINGS OF THE SIGCHI CONFERENCE ON HUMAN FACTORS IN COMPUTING SYSTEMS. CHI CONFERENCE 2024; 2024:1009. [PMID: 39015130 PMCID: PMC11251005 DOI: 10.1145/3613904.3642595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/18/2024]
Abstract
Over four million older adults living in long-term care (LTC) communities experience loneliness, adversely impacting their health. Increased contact with friends and family is an evidence-based intervention to reduce loneliness, but in-person visits are not always possible. Augmented Reality (AR)-based telepresence activities can offer viable alternatives with increased immersion and presence compared to video calls. However, its feasibility as an interaction technology for older adults is not known. In this paper, we detail the design of two dyadic collaborative AR activities that accommodate diminished physical and cognitive abilities of older adults. The findings include a general design framework based on an iterative participatory design focusing on preferred activities, modes of interaction, and overall AR experience of eight older adults, two family members, and five LTC staff. Results demonstrate the potential of collaborative AR as an effective means of interaction for older adults with their family, if designed to cater to their needs.
Collapse
Affiliation(s)
| | | | | | | | | | - Judith Tate
- The Ohio State University, Columbus, Ohio, USA
| | | | | |
Collapse
|
3
|
Tierney L, MacAndrew M, Doherty K, Fielding E, Beattie E. Characteristics and value of 'meaningful activity' for people living with dementia in residential aged care facilities: "You're still part of the world, not just existing". DEMENTIA 2023; 22:305-327. [PMID: 36473712 DOI: 10.1177/14713012221144488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Most residential aged care facilities support residents to participate in activities and the importance of activities that are suited to individual preferences and abilities is widely acknowledged. Participating in activities, including those considered to be 'meaningful' has the potential to improve residents' quality of life. However, what makes activities meaningful for people living with dementia in residential aged care facilities is unclear. The aim of this study was to understand the key characteristics of 'meaningful activity' in residential aged care facilities and the perceived value of residents participating in these activities. Using a qualitative study design, this study explored 'meaningful activities' from the perspectives of people living with dementia in residential aged care facilities, their family members and staff. Across four residential aged care facilities, residents (n = 19) and family members (n = 17) participated in individual interviews while staff (n = 15) participated in focus group interviews. Interviews were recorded, transcribed and analysed using a qualitative content analysis approach. Participant responses suggest that the meaning of an activity is subjective, varying over time and between individuals. Key characteristics of an activity that makes it meaningful include being enjoyable, social and engaging, aligning with the persons' interests, preferences, and abilities. To be considered meaningful, activities need to do more than occupy the person. The activity needs to be linked to a personally relevant goal and an aspect of the individuals' identity. Participating in 'meaningful activities' was perceived as valuable to encourage participation and socialising, provide a sense of normality for residents and improve their wellbeing. The findings of this study further our understanding of the concept of 'meaningful activity' for people living with dementia in residential aged care facilities. Understanding the key attributes of 'meaningful activity' can also provide practical guidance for those supporting people with dementia to participate in these types of activities.
Collapse
Affiliation(s)
- Laura Tierney
- Faculty of Health, School of Nursing, 1969Queensland University of Technology, Brisbane, QLD, Australia
| | - Margaret MacAndrew
- Faculty of Health, School of Nursing, 1969Queensland University of Technology, Brisbane, QLD, Australia
| | - Kathleen Doherty
- Wicking Dementia Research and Education Centre, 3925University of Tasmania, Hobart, TAS, Australia
| | - Elaine Fielding
- Faculty of Health, School of Nursing, 1969Queensland University of Technology, Brisbane, QLD, Australia
| | - Elizabeth Beattie
- Faculty of Health, School of Nursing, 1969Queensland University of Technology, Brisbane, QLD, Australia
| |
Collapse
|
4
|
Resnick B, Zimmerman S, Gaugler J, Ouslander J, Abrahamson K, Brandt N, Colón-Emeric C, Galik E, Gravenstein S, Mody L, Sloane PD, Unroe K, Verbeek H. Pragmatic Trials in Long-Term Care: Research Challenges and Potential Solutions in Relation to Key Areas of Care. J Am Med Dir Assoc 2022; 23:330-338. [PMID: 35219505 PMCID: PMC9446464 DOI: 10.1016/j.jamda.2021.12.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 12/01/2021] [Accepted: 12/05/2021] [Indexed: 01/12/2023]
Abstract
As a method of research, pragmatic trials are recommended so as to generate results that are applicable to real-world care. This intent is especially important for the millions of older adults who receive long-term care in thousands of nursing homes and assisted living communities across the country-and many millions more around the globe. This article presents key points raised by experts participating in a conference funded by the National Institute of Aging held at the 2021 conference of the Society for Post-Acute and Long-term Care Medicine. The purpose of the conference was to convene leading clinicians, researchers, and industry partners to address special considerations of pragmatic trials in long-term care. Cross-cutting and unique challenges and solutions to conducting pragmatic trials were discussed focusing on 3 areas of clinical relevance to long-term care: (1) functional care and outcomes, (2) psychosocial care and quality of life, and (3) medical care and outcomes, with a special focus on persons with dementia. Challenges and innovative solutions were organized across the 9 domains of the revised Pragmatic-Explanatory Continuum Indicator Summary (PRECIS) Tool, and future research recommendations for pragmatic trials in long-term care were identified.
Collapse
Affiliation(s)
- Barbara Resnick
- University of Maryland School of Nursing, Baltimore, MD, USA.
| | - Sheryl Zimmerman
- Cecil G. Sheps Center for Health Services Research and Schools of Social Work and Pubic Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Joseph Gaugler
- Division of Health Policy & Management, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Joseph Ouslander
- Department of Integrated Medical Sciences, Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL, USA
| | | | - Nicole Brandt
- University of Maryland School of Pharmacy, Baltimore, MD, USA
| | | | - Elizabeth Galik
- University of Maryland School of Nursing, Baltimore, MD, USA
| | - Stefan Gravenstein
- Brown University and Providence Veterans Administration Medical Center, Providence, RI, USA
| | - Lona Mody
- University of Michigan and Veterans Affair, Ann Arbor Healthcare System, Ann Arbor, MI, USA
| | - Philip D. Sloane
- Cecil G. Sheps Center for Health Services Research and Schools of Social Work and Pubic Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Kathleen Unroe
- Indiana University School of Medicine and Regenstrief Institute, Inc, Center for Aging Research, Indianapolis, IN, USA
| | - Hilde Verbeek
- Maastricht University and Living Lab in Ageing and Long-Term Care, Maastricht, the Netherlands
| |
Collapse
|
5
|
Resnick B, Zimmerman S, Gaugler J, Ouslander J, Abrahamson K, Brandt N, Colón-Emeric C, Galik E, Gravenstein S, Mody L, Sloane PD, Unroe K, Verbeek H. Pragmatic Trials in Long-Term Care: Research Challenges and Potential Solutions in Relation to Key Areas of Care. J Am Geriatr Soc 2022; 70:718-730. [PMID: 35195283 PMCID: PMC8904288 DOI: 10.1111/jgs.17699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 02/01/2022] [Indexed: 12/01/2022]
Abstract
As a method of research, pragmatic trials are recommended so as to generate results that are applicable to real-world care. This intent is especially important for the millions of older adults who receive long-term care in thousands of nursing homes and assisted living communities across the country-and many millions more around the globe. This article presents key points raised by experts participating in a conference funded by the National Institute of Aging held at the 2021 conference of the Society for Post-Acute and Long-term Care Medicine. The purpose of the conference was to convene leading clinicians, researchers, and industry partners to address special considerations of pragmatic trials in long-term care. Cross-cutting and unique challenges and solutions to conducting pragmatic trials were discussed focusing on 3 areas of clinical relevance to long-term care: (1) functional care and outcomes, (2) psychosocial care and quality of life, and (3) medical care and outcomes, with a special focus on persons with dementia. Challenges and innovative solutions were organized across the 9 domains of the revised Pragmatic-Explanatory Continuum Indicator Summary (PRECIS) Tool, and future research recommendations for pragmatic trials in long-term care were identified.
Collapse
Affiliation(s)
- Barbara Resnick
- University of Maryland School of Nursing, Baltimore, MD, USA,Address correspondence to Barbara Resnick, PhD, CRNP, University of Maryland School of Nursing, 655 W Lombard St, Baltimore, MD 21201, USA. (B. Resnick)
| | - Sheryl Zimmerman
- Cecil G. Sheps Center for Health Services Research and Schools of Social Work and Pubic Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Joseph Gaugler
- Division of Health Policy & Management, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Joseph Ouslander
- Department of Integrated Medical Sciences, Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL, USA
| | | | - Nicole Brandt
- University of Maryland School of Pharmacy, Baltimore, MD, USA
| | | | - Elizabeth Galik
- University of Maryland School of Nursing, Baltimore, MD, USA
| | - Stefan Gravenstein
- Brown University and Providence Veterans Administration Medical Center, Providence, RI, USA
| | - Lona Mody
- University of Michigan and Veterans Affair, Ann Arbor Healthcare System, Ann Arbor, MI, USA
| | - Philip D. Sloane
- Cecil G. Sheps Center for Health Services Research and Schools of Social Work and Pubic Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Kathleen Unroe
- Indiana University School of Medicine and Regenstrief Institute, Inc, Center for Aging Research, Indianapolis, IN, USA
| | - Hilde Verbeek
- Maastricht University and Living Lab in Ageing and Long-Term Care, Maastricht, the Netherlands
| |
Collapse
|
6
|
Resnick B, Zimmerman S, Gaugler J, Ouslander J, Abrahamson K, Brandt N, Colón-Emeric C, Galik E, Gravenstein S, Mody L, Sloane PD, Unroe K, Verbeek H. Pragmatic trials in long-term care: Research challenges and potential solutions in relation to key areas of care. Geriatr Nurs 2022; 44:293-301. [PMID: 35219534 PMCID: PMC9446463 DOI: 10.1016/j.gerinurse.2022.02.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
As a method of research, pragmatic trials are recommended so as to generate results that are applicable to real-world care. This intent is especially important for the millions of older adults who receive long-term care in thousands of nursing homes and assisted living communities across the country-and many millions more around the globe. This article presents key points raised by experts participating in a conference funded by the National Institute of Aging held at the 2021 conference of the Society for Post-Acute and Long-term Care Medicine. The purpose of the conference was to convene leading clinicians, researchers, and industry partners to address special considerations of pragmatic trials in long-term care. Cross-cutting and unique challenges and solutions to conducting pragmatic trials were discussed focusing on 3 areas of clinical relevance to long-term care: (1) functional care and outcomes, (2) psychosocial care and quality of life, and (3) medical care and outcomes, with a special focus on persons with dementia. Challenges and innovative solutions were organized across the 9 domains of the revised Pragmatic-Explanatory Continuum Indicator Summary (PRECIS) Tool, and future research recommendations for pragmatic trials in long-term care were identified.
Collapse
Affiliation(s)
- Barbara Resnick
- University of Maryland School of Nursing, Baltimore, MD, USA.
| | - Sheryl Zimmerman
- Cecil G. Sheps Center for Health Services Research and Schools of Social Work and Pubic Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Joseph Gaugler
- Division of Health Policy & Management, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Joseph Ouslander
- Department of Integrated Medical Sciences, Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL, USA
| | | | - Nicole Brandt
- University of Maryland School of Pharmacy, Baltimore, MD, USA
| | | | - Elizabeth Galik
- University of Maryland School of Nursing, Baltimore, MD, USA
| | - Stefan Gravenstein
- Brown University and Providence Veterans Administration Medical Center, Providence, RI, USA
| | - Lona Mody
- University of Michigan and Veterans Affair, Ann Arbor Healthcare System, Ann Arbor, MI, USA
| | - Philip D Sloane
- Cecil G. Sheps Center for Health Services Research and Schools of Social Work and Pubic Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Kathleen Unroe
- Indiana University School of Medicine and Regenstrief Institute, Inc, Center for Aging Research, Indianapolis, IN, USA
| | - Hilde Verbeek
- Maastricht University and Living Lab in Ageing and Long-Term Care, Maastricht, the Netherlands
| |
Collapse
|
7
|
O'Connor CMC, Liddle J, O'Reilly M, Meyer C, Cartwright J, Chisholm M, Conway E, Fielding E, Fox A, MacAndrew M, Schnitker L, Travers C, Watson K, While C, Bail K. Advocating the rights of people with dementia to contribute to research: Considerations for researchers and ethics committees. Australas J Ageing 2021; 41:309-313. [PMID: 34821448 DOI: 10.1111/ajag.13023] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 10/12/2021] [Accepted: 10/14/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Research involving people with dementia is vital to appropriately inform policy and practice decisions affecting this population. As dementia-care researchers, we frequently advocate to Human Research Ethics Committees for the right of people with dementia to choose whether to participate in research. This brief report provides some considerations for researchers and ethics committees. METHOD Descriptive summary of principles that argue for inclusion of people with dementia in research studies. RESULTS Specifically excluding people living with dementia from research because of perceived cognitive impairment is inappropriate in light of human rights principles and the right to contribute to evidence-based care. CONCLUSION There is a difference between capacity to provide informed consent and ability to provide perspectives that are valid for each individual. Providing the opportunity for a person with dementia to participate in research and offering support to do this is a matter of human rights.
Collapse
Affiliation(s)
- Claire M C O'Connor
- HammondCare, Centre for Positive Ageing, Sydney, New South Wales, Australia.,School of Population Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Jacki Liddle
- The University of Queensland, Brisbane, Queensland, Australia
| | - Maria O'Reilly
- Central Queensland University, Bundaberg, Queensland, Australia
| | - Claudia Meyer
- Bolton Clarke Research Institute, Melbourne, Victoria, Australia.,Rehabilitation, Ageing and Independent Living Research Centre, Monash University, Melbourne, Victoria, Australia
| | | | | | - Erin Conway
- Faculty of Health Sciences, Australian Catholic University, Brisbane, Queensland, Australia
| | - Elaine Fielding
- Queensland University of Technology, Brisbane, Queensland, Australia
| | - Amanda Fox
- Queensland University of Technology, Brisbane, Queensland, Australia
| | | | - Linda Schnitker
- Bolton Clarke Research Institute, Brisbane, Queensland, Australia
| | - Catherine Travers
- The University of Queensland, Brisbane, Queensland, Australia.,Queensland University of Technology, Brisbane, Queensland, Australia
| | - Karen Watson
- The University of Sydney, Sydney, New South Wales, Australia
| | - Christine While
- Dementia Training Australia, La Trobe University, Melbourne, Victoria, Australia
| | - Kasia Bail
- Faculty of Health, University of Canberra, Canberra, Australian Capital Territory, Australia
| |
Collapse
|
8
|
Paramasivam A, Jaiswal A, Minhas R, Wittich W, Spruyt-Rocks R. Informed Consent or Assent Strategies for Research With Individuals With Deafblindness or Dual Sensory Impairment: A Scoping Review. Arch Rehabil Res Clin Transl 2021; 3:100115. [PMID: 34179751 PMCID: PMC8212005 DOI: 10.1016/j.arrct.2021.100115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE To synthesize evidence on existing informed consent/assent strategies and processes that enable the participation of individuazls with deafblindness or dual sensory impairment in research. DATA SOURCES Five scientific databases (PubMed, MEDLINE, Cumulative Index to Nursing and Allied Health, Web of Science, and PsycINFO) and other sources such as Google Scholar, Journal of Visual Impairment and Blindness, and British Journal of Visual Impairment were hand-searched from January 2015 until July 2020. STUDY SELECTION Studies were selected using a priori inclusion criteria of sensory and cognitive disabilities and focused on consent/assent strategies and processes in research within this population. Articles related to the medical or sexual consent processes were excluded. DATA EXTRACTION An Excel spreadsheet was used to extract data from the eligible sources. Discrepancies were resolved in discussion with team members. DATA SYNTHESIS A total of 2163 sources were screened, and 16 articles were included in the review. Seven sources only examined consent strategies, whereas the remaining 8 included a combination of consent/assent and dissent strategies. Using thematic analysis, 3 key themes emerged: consent/assent strategies, researcher capacity, and capacity to consent tools. Key identified strategies included the accessibility of the consent/assent process, building relationships with participants and caregivers, identifying behavioral cues, and communication training for researchers. CONCLUSIONS Despite the absence of literature on consent/assent strategies within the population with deafblindness, the review found promising strategies applied to individuals with other cognitive or sensory disabilities that researchers can adopt. Researchers are encouraged to use best practices in creating an inclusive research environment to include individuals with deafblindness.
Collapse
Affiliation(s)
| | - Atul Jaiswal
- School of Optometry, Université de Montréal, Montreal, Quebec, Canada
| | - Renu Minhas
- DeafBlind Ontario Services, Newmarket, Ontario, Canada
| | - Walter Wittich
- School of Optometry, Université de Montréal, Montreal, Quebec, Canada
| | | |
Collapse
|
9
|
Evaluation of decision-making capacity in patients with dementia: challenges and recommendations from a secondary analysis of qualitative interviews. BMC Med Ethics 2020; 21:55. [PMID: 32631304 PMCID: PMC7339476 DOI: 10.1186/s12910-020-00498-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Accepted: 06/26/2020] [Indexed: 11/24/2022] Open
Abstract
Background Evaluation of decision-making capacity to consent to medical treatment has proved to be difficult in patients with dementia. Studies showed that physicians are often insufficiently trained in the evaluation of decision-making capacity. In this study, we present findings from a secondary analysis of a qualitative interviews with physicians. These interviews were initially used to assess usability of an instrument for the evaluation of decision-making capacity. By looking at difficult cases of decision-making capacity evaluation in patients with dementia, we provide recommendations for such evaluations in clinical practice. Methods We used thematic coding to analyse physicians’ narratives of problematic decision-making capacity evaluations in patients with dementia to uncover challenging issues of decision-making capacity evaluation. Results In this study, decision-making capacity evaluations in patients with dementia were mainly perceived as challenging when they pertained to treatment refusals and treatment unrelated circumstances, such as psychiatric consultation, advance directives, and new living arrangements. Furthermore, the physicians reported training needs regarding situation-independent challenges with decision-making capacity evaluation. Conclusions Upon further examining self-reported training needs and challenging cases, we have developed recommendations to improve decision-making capacity evaluations in clinical practice. In these recommendations, we argue that being able to evaluate decision-making capacity is an integral part of the informed consent process.
Collapse
|
10
|
Tori K, Kalligeros M, Shehadeh F, Khader R, Nanda A, van Aalst R, Chit A, Mylonakis E. The process of obtaining informed consent to research in long term care facilities (LTCFs): An Observational Clinical Study. Medicine (Baltimore) 2020; 99:e20225. [PMID: 32481294 PMCID: PMC7249968 DOI: 10.1097/md.0000000000020225] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
We examined the process of obtaining informed consent (IC) for clinical research purposes in long-term care facilities (LTCFs) in Rhode Island (RI), USA. We assessed factors that were associated with resident ability to consent, such as Brief Interview for Mental Status scores. We used a self-administered questionnaire to further understand the effect of LTCF staff evaluation of ability to consent on residents' autonomy and control over their medical decision making.Observational clinical studyLong-term care setting.LTCF personnel provided us with residents' names, as well as their professional assessment of resident ability to consent. We used Brief Interview for Mental Status (BIMS) scores to assess the cognitive capacity of all residents to assess, and compare it to the assessment provided by LTCF personnel. A logistic regression analysis was performed to determine the relationship between LTCF assessment of resident ability to consent and BIMS score or confirmed diagnosis of dementia as seen from residents' medical charts. A self-administered questionnaire was filled out by the personnel of 10 LTCFs across RI, USA.LTCF personnel in 9 out of 10 recruited facilities reported that their assessment of resident ability to consent was based on subjective assessment of the resident as alert and oriented. There was a statistically significant relationship between the LTCF assessment of resident ability to consent and previously diagnosed dementia (OR: 0.211, 95% CI 0.107-0.415). Therefore, as BIMS scores increased, the likelihood that the resident would be deemed able to consent by LTCF personnel also increased. Furthermore, there was a statistically significant relationship between LTCF assessment of resident ability to consent and BIMS scores (OR: 1.430, 95% CI 1.274-1.605).There is no standard on obtaining IC for research studies conducted in LTCFs. We recommend that standardizing the process of obtaining IC in LTCFs can enhance the ability to perform research with LTCF residents.
Collapse
Affiliation(s)
| | | | | | | | - Aman Nanda
- Division of Geriatrics and Palliative Medicine, Warren Alpert Medical School, Providence, Rhode Island
| | - Robertus van Aalst
- Regional Epidemiology and Health Economics, Sanofi Pasteur, Swiftwater, PA
- Faculty of Medical Sciences, University of Groningen, Groningen, The Netherlands
| | - Ayman Chit
- Regional Epidemiology and Health Economics, Sanofi Pasteur, Swiftwater, PA
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada
| | | |
Collapse
|