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Copeland S, Anderson T, Carter G, Brown Wilson C, Stark P, Doumas M, Rodger M, O'Shea E, Creighton L, Craig S, McMahon J, Gillis A, Crooks S, Mitchell G. Experiences of People Living with Parkinson's Disease in Care Homes: A Qualitative Systematic Review. NURSING REPORTS 2024; 14:428-443. [PMID: 38391078 PMCID: PMC10885076 DOI: 10.3390/nursrep14010033] [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: 12/23/2023] [Revised: 02/08/2024] [Accepted: 02/13/2024] [Indexed: 02/24/2024] Open
Abstract
BACKGROUND Incidence of disability secondary to Parkinson's disease is increasing faster globally than any other neurological condition. The diverse appearance of symptomatology associated with Parkinson's, and the degenerative nature and subsequent functional decline, often increase dependence on caregivers for assistance with daily living, most commonly within a care home setting. Yet, primary literature and evidence synthesis surrounding these unique and complex care needs, challenges and the lived experiences of this population living in long-term nursing or residential facilities remains sparce. The aim of this review is to synthesize qualitative literature about the lived experience of people with Parkinson's disease living in care home settings. METHODS A systematic search of the literature was conducted in October 2023 across six different databases (CINAHL, Medline, EMBASE, PsycINFO, Scopus and Cochrane Library). The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) was used to guide this review. RESULTS Five articles met the inclusion criteria. Four themes were identified following evidence synthesis: (1) Unique pharmacological challenges. (2) Transitioning and adapting to care home life and routines. (3) Dignified care within care homes. (4) Multidisciplinary care vacuum in care homes. CONCLUSION This review revealed the significant and unique challenges for people with Parkinson's disease when transitioning into care homes. These are exacerbated by wider social care challenges such as staffing levels, skill mixes and attitudes as well as a lack of disease-specific knowledge surrounding symptomatology and pharmacology. The lack of multi-disciplinary working and risk-adverse practice inhibited person-centred care and autonomy and reduced the quality of life of people living with Parkinson's disease in care homes. Recommendations for practice highlight training gaps, the need for consistent and improved interdisciplinary working and better person-centred assessment and care delivery.
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Affiliation(s)
- Shannon Copeland
- School of Nursing and Midwifery, Queen's University Belfast, Belfast BT9 7BL, UK
| | - Tara Anderson
- School of Nursing and Midwifery, Queen's University Belfast, Belfast BT9 7BL, UK
| | - Gillian Carter
- School of Nursing and Midwifery, Queen's University Belfast, Belfast BT9 7BL, UK
| | | | - Patrick Stark
- School of Nursing and Midwifery, Queen's University Belfast, Belfast BT9 7BL, UK
| | - Mihalis Doumas
- School of Psychology, Queen's University Belfast, Belfast BT9 7BL, UK
| | - Matthew Rodger
- School of Psychology, Queen's University Belfast, Belfast BT9 7BL, UK
| | - Emma O'Shea
- Centre for Gerontology and Rehabilitation, School of Medicine, University College Cork, T12 YN60 Cork, Ireland
| | - Laura Creighton
- School of Nursing and Midwifery, Queen's University Belfast, Belfast BT9 7BL, UK
| | - Stephanie Craig
- School of Nursing and Midwifery, Queen's University Belfast, Belfast BT9 7BL, UK
| | - James McMahon
- School of Nursing and Midwifery, Queen's University Belfast, Belfast BT9 7BL, UK
| | - Arnelle Gillis
- School of Nursing and Midwifery, Queen's University Belfast, Belfast BT9 7BL, UK
| | - Sophie Crooks
- School of Nursing and Midwifery, Queen's University Belfast, Belfast BT9 7BL, UK
| | - Gary Mitchell
- School of Nursing and Midwifery, Queen's University Belfast, Belfast BT9 7BL, UK
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Hand A, Hill B. Exploring sexual dysfunction in care homes. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2022; 162:135-170. [PMID: 35397784 DOI: 10.1016/bs.irn.2021.12.005] [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: 06/14/2023]
Abstract
Sexual needs and sexuality in older adults continues to be a neglected area of clinical intervention, particularly in longer term care settings. This is often due to older adults in long term care beds presenting with increased frailty, and often with significant neurocognitive disorders, making it difficult for care staff to evaluate the capacity of an older adult resident to participate in sexual activities or a sexual relationship. Talking about sexuality, intimacy and sexual health can be embarrassing at any age and sex is often still considered taboo for people who live in care homes. The World Health Organization recently declared that sexual health is a central aspect of life and that each individual has the right to love and be loved, to receive appropriate information and treatment, and to enable intimate relationships and personal control over sexual behavior. This chapter explores sexual behaviors, and barriers to this, in later life, and focuses on the sexual behavior of care home residents with Parkinson's disease. Reasons for sexual dysfunction, potential age-related changes to sexual functioning, along with issues such as changes to body image, intimacy and hyper sexuality, are examined for people with Parkinson's disease. Recommendations for practice are given, and acknowledge that older people may still want to be sexually active or intimate is the first step to addressing the issues and overcoming any barriers.
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Affiliation(s)
- Annette Hand
- Department of Nursing, Midwifery and Health, Northumbria University, Newcastle upon Tyne, United Kingdom; Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom.
| | - Barry Hill
- Department of Nursing, Midwifery and Health, Northumbria University, Newcastle upon Tyne, United Kingdom
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Tan QY, Cox NJ, Lim SER, Coutts L, Fraser SDS, Roberts HC, Ibrahim K. The Experiences of Treatment Burden in People with Parkinson's Disease and Their Caregivers: A Systematic Review of Qualitative Studies. JOURNAL OF PARKINSONS DISEASE 2021; 11:1597-1617. [PMID: 34334419 DOI: 10.3233/jpd-212612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BackgroundHigh treatment burden is associated with poor adherence, wasted resources, poor quality of life and poor health outcomes. Identifying factors that impact treatment burden in Parkinson's disease can offer insights into strategies to mitigate them.ObjectiveTo explore the experiences of treatment burden among people with Parkinson's disease (PwP) and their caregivers.MethodsA systematic review of studies published from year 2006 was conducted. Qualitative and mixed-method studies with a qualitative component that relate to usual care in Parkinson's disease were included. Quantitative studies and grey literature were excluded. Data synthesis was conducted using framework synthesis.Results1757 articles were screened, and 39 articles included. Understanding treatment burden in PwP and caregivers was not the primary aim in any of the included studies. The main issues of treatment burden in Parkinson's disease are: 1) work and challenges of taking medication; 2) healthcare provider obstacles including lack of patient-centered care, poor patient-provider relationships, lack of care coordination, inflexible organizational structures, lack of access to services and issues in care home or hospital settings; and 3) learning about health and challenges with information provision. The treatment burden led to physical and mental exhaustion of self-care and limitations on the role and social activities of PwP and caregivers.Conclusion:There are potential strategies to improve the treatment burden in Parkinson's disease at an individual level such as patient-centered approach to care, and at system level by improving access and care coordination between services. Future research is needed to determine the modifiable factors of treatment burden in Parkinson's disease.
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Affiliation(s)
- Qian Yue Tan
- Academic Geriatric Medicine, Faculty of Medicine, University of Southampton, Southampton, UK.,National Institute for Health Research Applied Research Collaboration Wessex, University of Southampton, Southampton, UK
| | - Natalie J Cox
- Academic Geriatric Medicine, Faculty of Medicine, University of Southampton, Southampton, UK.,National Institute for Health Research Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Trust, Southampton, UK
| | - Stephen E R Lim
- Academic Geriatric Medicine, Faculty of Medicine, University of Southampton, Southampton, UK.,National Institute for Health Research Applied Research Collaboration Wessex, University of Southampton, Southampton, UK
| | - Laura Coutts
- Academic Geriatric Medicine, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Simon D S Fraser
- National Institute for Health Research Applied Research Collaboration Wessex, University of Southampton, Southampton, UK.,School of Primary Care, Population Sciences and Medical Education, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Helen C Roberts
- Academic Geriatric Medicine, Faculty of Medicine, University of Southampton, Southampton, UK.,National Institute for Health Research Applied Research Collaboration Wessex, University of Southampton, Southampton, UK.,National Institute for Health Research Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Trust, Southampton, UK
| | - Kinda Ibrahim
- Academic Geriatric Medicine, Faculty of Medicine, University of Southampton, Southampton, UK.,National Institute for Health Research Applied Research Collaboration Wessex, University of Southampton, Southampton, UK
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Heffels JCF, Everink IHJ, Oosterloo M, Roos RAC, Schols JMGA. Measuring the quality of care in nursing home residents with early-onset neurodegenerative diseases: a scoping review. BMC Palliat Care 2020; 19:25. [PMID: 32106849 PMCID: PMC7047396 DOI: 10.1186/s12904-020-0528-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Accepted: 02/17/2020] [Indexed: 11/23/2022] Open
Abstract
Background Nursing home residents with early-onset neurodegenerative diseases are often younger in comparison with other residents, and need different, often more complex care. Accordingly, the measurements currently used for measuring quality of care in nursing homes may not be suitable for use in this target group. Little is known about the experiences of these residents and of their (in) formal caregivers regarding the quality of care they receive. Therefore, the aim of this scoping review is to explore which instruments are available for measuring the quality of care for nursing home residents with early-onset neurodegenerative diseases (excluding dementia), from the perspective of the resident and of (in) formal caregivers. Methods A literature search was performed in the databases Pubmed, Embase, Web of Science and Cinahl. The search strategy consisted of four main concepts: neurodegenerative diseases, quality of care, nursing homes and perspectives of residents, (in) formal caregivers. Studies were included if they used instruments and/or strategies to measure quality of care, focused on nursing home residents with early-onset neurodegenerative diseases and the perspective of either the resident or (in) formal caregiver. Results From a total of 809 identified articles, 87 full text articles were screened for eligibility. Five studies were included, only one of which described an instrument. The other four used topic lists and/or themes to measure quality of care. In total, 60 items related to quality of care could be derived. From these 60 items, eight overarching domains were found, with a subdivision into items derived, respectively, from the residents’, informal and formal caregivers’ perspective: ‘emotional support’, ‘physical support’, ‘social support’, ‘care’, ‘care content’, ‘expertise’, ‘communication’ and ‘organization of care’. Conclusions Currently, there are no methods for assessing the quality of care specifically focused on nursing home residents with early-onset neurodegenerative diseases. Therefore, the items retrieved in this review give an overview of important topics for measuring the quality of care for this target group, from the perspective of the resident, and of the informal and formal caregivers. These items might be used to develop a tailored instrument for assessing the quality of care for nursing home residents with early-onset neurodegenerative diseases.
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Affiliation(s)
- Joyce C F Heffels
- Department of Health Services Research and Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands. .,Huntington Disease Center Land van Horne, Vogelsbleek 1, 6001 BE, Weert, The Netherlands.
| | - Irma H J Everink
- Department of Health Services Research and Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
| | - Mayke Oosterloo
- Department of Neurology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Raymund A C Roos
- Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands
| | - Jos M G A Schols
- Department of Health Services Research and Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands.,Department of Family Medicine and Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
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Jackson K, Hamilton S, Jones S, Barr S. Patient reported experiences of using community rehabilitation and/or support services whilst living with a long-term neurological condition: a qualitative systematic review and meta-aggregation. Disabil Rehabil 2018; 41:2731-2749. [PMID: 29911901 DOI: 10.1080/09638288.2018.1473508] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Objectives: The objective of this study is to identify patient reported experiences of using community rehabilitation and/or support services whilst living with a long-term neurological condition, and perceptions of their impact on quality of life.Methods: Nine electronic databases were searched for peer-reviewed qualitative studies from 2005 to 2016, which met the inclusion criteria. Critical appraisal, data extraction, and quality assessment of 37 included papers were performed by three reviewers. One hundred and one findings were extracted. Meta-aggregation was used to synthesize findings.Findings: Seven 'synthesized findings' [SF] were produced: Interactions with some professionals provide active participation, choice, confidence and autonomy [SF1]; Interactions with some professionals are disempowering and depersonalized [SF2]; Effective communication, specialist knowledge and an individualized approach to information provision is needed [SF3]; Indicators of success vary and may not be clear [SF4]; Informal support from family/friends is valued [SF5]; Opportunities for peer support/social interaction is valued [SF6]; Coordination required to ensure continuity during transition to community [SF7].Conclusion: Patient reported experiences identified common factors associated with process quality (respect, choice, autonomy, information provision, communication) and activities of patient centered care (personalized care, shared decision-making, self-management support) despite heterogeneity of neurological conditions, service configurations, and geographical location. These factors impact quality of life.Implications for RehabilitationPatient reported experiences provide useful information about courtesy, respect, choice, autonomy, information provision, and communication.Outcomes of self-efficacy and self-management are important for people with stable and progressive long-term neurological conditions.Interactions with individual professionals influence engagement, self-efficacy, and self-management for people with long-term neurological conditions.Training for health and social care professionals should develop the advanced communication skills and behavior required to facilitate self-efficacy and self-management.
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Affiliation(s)
- Katherine Jackson
- School of Health and Social Care, Teesside University, Middlesbrough, UK
| | - Sharon Hamilton
- School of Health and Social Care, Teesside University, Middlesbrough, UK.,Teesside Centre for Evidence Informed Practice: A Joanna Briggs Institute Centre of Excellence, Teesside University, Middlesbrough, UK
| | - Susan Jones
- School of Health and Social Care, Teesside University, Middlesbrough, UK
| | - Steven Barr
- School of Health and Social Care, Teesside University, Middlesbrough, UK
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Powell C, Blighe A, Froggatt K, McCormack B, Woodward-Carlton B, Young J, Robinson L, Downs M. Family involvement in timely detection of changes in health of nursing homes residents: A qualitative exploratory study. J Clin Nurs 2017; 27:317-327. [PMID: 28557103 PMCID: PMC5767757 DOI: 10.1111/jocn.13906] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/25/2017] [Indexed: 12/02/2022]
Abstract
Aims and objectives To explore family perspectives on their involvement in the timely detection of changes in their relatives' health in UK nursing homes. Background Increasingly, policy attention is being paid to the need to reduce hospitalisations for conditions that, if detected and treated in time, could be managed in the community. We know that family continue to be involved in the care of their family members once they have moved into a nursing home. Little is known, however, about family involvement in the timely detection of changes in health in nursing home residents. Design Qualitative exploratory study with thematic analysis. Methods A purposive sampling strategy was applied. Fourteen semi‐structured one‐to‐one interviews with family members of people living in 13 different UK nursing homes. Data were collected from November 2015–March 2016. Results Families were involved in the timely detection of changes in health in three key ways: noticing signs of changes in health, informing care staff about what they noticed and educating care staff about their family members' changes in health. Families suggested they could be supported to detect timely changes in health by developing effective working practices with care staff. Conclusion Families can provide a special contribution to the process of timely detection in nursing homes. Their involvement needs to be negotiated, better supported, as well as given more legitimacy and structure within the nursing home. Relevance to clinical practice Families could provide much needed support to nursing home nurses, care assistants and managers in timely detection of changes in health. This may be achieved through communication about their preferred involvement on a case‐by‐case basis as well as providing appropriate support or services.
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Affiliation(s)
- Catherine Powell
- Faculty of Health Studies, School of Dementia Studies, University of Bradford, Bradford, UK
| | - Alan Blighe
- Faculty of Health Studies, School of Dementia Studies, University of Bradford, Bradford, UK
| | | | - Brendan McCormack
- School of Health Sciences, Queen Margaret University Edinburgh, Musselburgh, UK
| | | | - John Young
- Bradford Teaching Hospital, Academic Unit of Elderly Care and Rehabilitation Care, Temple Bank House Bradford Royal Infirmary Duckworth Lane, Bradford West Yorkshire, UK
| | - Louise Robinson
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
| | - Murna Downs
- Faculty of Health Studies, School of Dementia Studies, University of Bradford, Bradford, UK
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Jackson G, Newbronner L, Chamberlain R, Borthwick R, Yardley C, Boyle K. Caring for people with dementia with Lewy bodies and Parkinson's dementia in UK care homes – A mixed methods study. Eur Geriatr Med 2017. [DOI: 10.1016/j.eurger.2017.01.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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