scholarly journals INDIVIDUAL AND INTERPERSONAL INFLUENCERS OF MEALTIME EXPERIENCES: PERSPECTIVES OF NURSING ASSISTANTS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S505-S505
Author(s):  
Joy W Douglas ◽  
Seung Eun Jung ◽  
Hyunjin Noh ◽  
Amy Ellis ◽  
Christine Ferguson
Keyword(s):  
Focus Groups ◽  
Ecological Model ◽  
The United States ◽  
Nursing Assistants ◽  
Direct Care ◽  
Turnover Rates ◽  
High Turnover ◽  
Term Care ◽  
Interpersonal Barriers ◽  
The Individual

Abstract In the United States, long-term care Certified Nursing Assistants (CNAs)’s central role is to provide direct care to residents, including mealtime assistance. It has been reported that employee turnover among CNAs is nearly 75% annually. High turnover rates of CNAs can increase the workload for remaining CNAs, interrupt quality of care for residents, and require extra resources for recruiting new staff. The aim of this qualitative study was to explore the individual and interpersonal barriers and facilitators CNAs experience when providing mealtime assistance to residents with dementia. Using purposive sampling, nine focus groups were conducted with a total of 53 CNAs who had at least one year of experience as a CNA working with older adults. Focus group questions were developed using the Social Ecological Model. All focus groups were audio recorded and transcribed verbatim. Data were analyzed using the directed content analysis approach. At the individual level, CNAs identified that communication skills with residents and coworkers, and the ability to accurately interpret resident behavior positively affected their ability to provide mealtime assistance. At the interpersonal level, interdisciplinary collaboration was identified as a significant facilitator. Reported barriers included negative interference from residents’ family members, unpredictable resident behaviors, and lack of support from coworkers. CNAs reported individual and interpersonal factors that may influence their ability to effectively feed residents with dementia. Our findings will inform future investigations regarding job turnover. Equally important, providing CNAs with the training and opportunity to perform their duties efficiently can ultimately benefit the residents’ mealtime experiences.

scholarly journals ORGANIZATIONAL AND POLICY FACTORS INFLUENCING FEEDING IN RESIDENTS WITH DEMENTIA: NURSING ASSISTANTS’ EXPERIENCES

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S702-S703
Author(s):  
Joy W Douglas ◽  
Seung Eun Jung ◽  
Hyunjin Noh ◽  
Amy Ellis ◽  
Christine Ferguson
Keyword(s):  
Nursing Home ◽  
Focus Groups ◽  
Ecological Model ◽  
Interdisciplinary Collaboration ◽  
Nursing Home Residents ◽  
The United States ◽  
State Inspection ◽  
Nursing Assistants ◽  
Direct Care ◽  
Staffing Ratios

Abstract In the United States, Certified Nursing Assistants (CNAs) are critical in providing direct care to nursing home residents with dementia, which includes the challenging task of feeding residents. Guided by the Social Ecological Model (SEM), this qualitative study aimed to gain an in-depth understanding of organizational and policy constructs that CNAs encounter when feeding residents with dementia. Using purposive sampling, nine semi-structured focus groups were conducted with 53 CNAs. Each participant had at least one year of experience working as a CNA with older adults. Focus groups were audio recorded and transcribed verbatim. Data were analyzed using the directed content analysis. Factors that emerged were organized into organizational and policy categories within the SEM levels. CNAs identified organizational barriers such as exclusion from the interdisciplinary team, inability to meet resident needs and wants due to budgetary constraints, and inadequate staffing to function efficiently. Organizational facilitators included teamwork, interdisciplinary assistance, and varying dining styles and meal times to accommodate resident needs. Policy-related barriers included funding concerns, staffing ratios, and frustration with unrealistic regulations and state inspections. These results suggest that organizational and policy factors have a large influence on the ease of feeding nursing home residents with dementia. Involving CNAs in interdisciplinary collaboration, resident-centered accommodations, and subtler state inspection behaviors could improve the mealtime experience for both residents and CNAs. Careful attention to these factors may enhance facilitators and minimize barriers to improve the feeding experience of CNAs and residents with dementia.

scholarly journals NURSING ASSISTANTS’ OPINIONS ON CREATING THE PERFECT DINING EXPERIENCE FOR RESIDENTS WITH DEMENTIA

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S507-S508
Author(s):  
Christine Ferguson ◽  
Joy W Douglas ◽  
Seung Eun Jung ◽  
Hyunjin Noh ◽  
Amy Ellis
Keyword(s):  
Food Intake ◽  
Dietary Intake ◽  
Focus Groups ◽  
Long Term Care ◽  
Ecological Model ◽  
Nursing Assistants ◽  
Term Care ◽  
Increased Risk ◽  
The Individual

Abstract Feeding residents with dementia in long-term care settings can be challenging, partly related to environmental factors. Certified Nursing Assistants (CNAs) are primarily responsible for feeding residents with dementia who need assistance. Given that older adults with dementia have an increased risk of developing malnutrition, there is a need to develop standards in place for constructing an ideal dining environment to optimize residents’ dietary intake. This qualitative study was conducted to explore CNA’s perspectives of how dining areas could be enhanced to improve food intake of residents with dementia. Nine focus groups were conducted with a total of 53 CNAs who had at least one year of experience feeding residents. Focus groups were audio recorded and transcribed verbatim. Data were analyzed using directed content analysis guided by the Social Ecological Model. CNAs reported that distractions can significantly inhibit residents’ food intake; therefore, limiting distractions such as noise and crowding is important. CNAs also reported the benefit of playing music in the dining area depended on the individual resident. Additionally, CNAs emphasized the importance of offering a variety of appetizing menu choices tailored to residents’ preferences. CNAs have firsthand experience with residents with dementia and can provide valuable insights. Long-term care administration should consider interdisciplinary support to improve the mealtime experience of residents with dementia in an effort to enhance their dietary intake. In particular, providing a variety of menu choices in a well-lit, calm, spacious, and homelike dining environment can be beneficial.

scholarly journals The Development and Testing of KNACC: Knowledgeable Nursing Assistants as Creative Caregivers

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 675-675
Author(s):  
Jacqueline Eaton ◽  
Kristin Cloyes ◽  
Brooke Paulsen ◽  
Connie Madden ◽  
Lee Ellington
Keyword(s):  
Focus Groups ◽  
Long Term Care ◽  
Family Members ◽  
Nursing Assistants ◽  
Direct Care ◽  
Term Care ◽  
Memory Care

Abstract Nursing assistants (NAs) provide 80% of direct care in long-term care settings, yet are seldom viewed as skilled professionals. Empowering NAs is linked to improved resident outcomes. In this study, we collaborate with NAs to adapt and test the feasibility and acceptability of arts-based creative caregiving techniques (CCG) for use in long-term care. We held a series of focus groups (n=14) to adapt, refine, and enhance usability. We then evaluated implementation in two waves of testing (n=8). Those working in memory care units were more likely to use all techniques, while those working in rehabilitation were more hesitant to implement. Participants reported using CCG to distract upset residents. Family members were excited about implementation, and NAs not participating wanted to learn CCG. Nursing assistants have the potential to become experts in creative caregiving but may require in-depth training to improve use.

scholarly journals “If They Don’t Like You, They Are Not Going to Eat for You”: Individual and Interpersonal Factors Affecting Certified Nursing Assistants’ Ability to Provide Mealtime Assistance to Residents With Dementia

2020 ◽  
Author(s):  
Joy W Douglas ◽  
Seung Eun Jung ◽  
Hyunjin Noh ◽  
Amy C Ellis ◽  
Christine C Ferguson
Keyword(s):  
Focus Groups ◽  
Communication Skills ◽  
Caregiver Burden ◽  
Health Care Professionals ◽  
Family Members ◽  
Skills Training ◽  
The United States ◽  
Nursing Assistants ◽  
Certified Nursing Assistants ◽  
Term Care

Abstract Background and Objectives In long-term care facilities in the United States, certified nursing assistants (CNAs) provide mealtime assistance to residents with dementia, a task that substantially increases caregiver burden due to the time and attention required. The aim of this qualitative study was to explore the individual and interpersonal barriers and facilitators CNAs experience when providing mealtime assistance to residents with dementia. Research Design and Methods Focus group questions were developed based on the corresponding levels of the Social Ecological Model. Using purposive sampling, 9 focus groups were conducted with 53 CNAs who had at least 1 year of experience as a CNA working with older adults. Focus groups were audio-recorded and transcribed verbatim. Data were analyzed using the directed content analysis approach. Results CNAs reported individual skills, training, and personal characteristics that affected their ability to provide mealtime assistance. At the interpersonal level, CNAs identified their relationships with residents, residents’ family members, and other health care professionals as factors that affect their ability to provide mealtime assistance. Discussion and Implications These findings provide evidence for strategies that administrators can utilize to reduce caregiver burden by improving the mealtime experience. First, CNAs need adequate training, particularly to develop communication skills. Developing verbal communication skills may improve interpersonal relationships between CNAs and residents’ family members and other coworkers. Developing nonverbal communication skills may foster an improved relationship between CNAs and their residents with dementia. Future research should evaluate interventions that seek to improve these skills to determine their impact on the mealtime experience.

scholarly journals Certified Nursing Assistants’ Experiences of Workplace Violence Caring for Persons With Dementia

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 260-261
Author(s):  
Chunhong Xiao ◽  
Vicki Winstead ◽  
Corteza Townsend ◽  
Rita Jablonski
Keyword(s):  
Workplace Violence ◽  
Physical Violence ◽  
Nursing Assistants ◽  
Direct Care ◽  
Cognitively Impaired ◽  
Certified Nursing Assistants ◽  
Snowball Sampling ◽  
Term Care ◽  
Face To Face ◽  
Emerging Risk

Abstract Problem: Certified nursing assistants (CNAs) are the primary providers of direct care to persons residing in long term care facilities (LTCFs), many of whom have dementia. The need to deliver direct and intimate care increases CNAs’ exposure to verbal and physical workplace violence. Purpose: To describe CNAs’ experiences of physical and verbal workplace violence experienced during direct care activities in LTCFs. Design: Qualitative. Sample & Procedure: Ten African-American CNAs (9 female, 1 male) were recruited using snowball sampling from multiple LTCFs. Interviews were recorded and transcribed. NVivo12 software was used to manage the thematic analyses. Results: The identified themes were: 1) CNAs’ perception that verbal and physical abuse was “part of the job” and unavoidable; 2) CNAs’ feelings of minimization of the abuse by administration; and 3) inadequate CNA training to recognize and de-escalate triggers of verbal and physical violence, notably care-resistant behavior. Conclusion: The combination of institutional tolerance of workplace violence, coupled with CNAs’ insufficient training in de-escalating volatile interactions with cognitively-impaired residents, is creating an unfavorable, possibly dangerous, workplace environment for CNAs. Implications: As more states elevate assaults on healthcare workers to felony crimes, there is an emerging risk of criminalizing dementia-related behavior in an attempt to address workplace violence. Interventions focused on helping CNAs recognize and de-escalate care-resistant behavior are necessary for violence prevention programs in LTCFs. Limitations: CNAs may have self-censored and under-described the severity of their experiences during face-to-face interviews, even with confidentiality protocols and the practice of off-site interviews.

scholarly journals It Is Time to Resolve the Direct Care Workforce Crisis in Long-Term Care

2020 ◽  
Author(s):  
Kezia Scales
Keyword(s):  
Long Term Care ◽  
The United States ◽  
Direct Care ◽  
Direct Care Workers ◽  
Term Care ◽  
Home Health Aides ◽  
Emerging Trends ◽  
Care Workers ◽  
Direct Care Workforce

Abstract Nearly 4.6 million direct care workers—including personal care aides, home health aides, and nursing assistants—provide daily support to older adults and people with disabilities across a range of settings in the United States, predominantly in long-term care (LTC). Even as the population grows older and drives up demand for LTC, the sector continues its decades-long struggle to fill direct care positions and stabilize this essential workforce. Recent events and emerging trends have converged, however, to produce new opportunities to address this longstanding workforce crisis, including the unprecedented attention generated by the coronavirus disease 2019 (COVID-19) pandemic and the systemic shifts to managed care and value-based payment in LTC. This Forum article outlines the pressing direct care workforce challenges in LTC before describing these potential levers of change, emphasizing the importance of not just expanding the workforce but also maximizing direct care workers’ contributions to the delivery of high-quality services for a growing and evolving population of LTC consumers.

scholarly journals CNA WORK IS BETTER LEARNED HANDS-ON: TRAINING CERTIFIED NURSING ASSISTANTS TO FEED RESIDENTS WITH DEMENTIA

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S663-S664
Author(s):  
Joy W Douglas ◽  
Seung Eun Jung ◽  
Hyunjin Noh ◽  
Amy Ellis ◽  
Christine Ferguson
Keyword(s):  
Focus Groups ◽  
Nursing Home Residents ◽  
Role Playing ◽  
The United States ◽  
Nursing Assistants ◽  
Certified Nursing Assistants ◽  
Job Experience ◽  
Training Modality ◽  
Hands On ◽  
One Year

Abstract In nursing homes across the United States, Certified Nursing Assistants (CNAs) provide essential mealtime assistance to residents with dementia who have difficulty feeding themselves. However, dementia-related training content in CNA programs can vary. In this qualitative study, we sought to understand the training provided to CNAs in Alabama, and to identify the ideal training modality for content related to feeding residents with dementia. Nine focus groups were conducted with 53 CNAs. Each participant had at least one year of working experience as a CNA caring for older adults. Focus groups were audio recorded and transcribed verbatim. Data were analyzed using the directed content analysis approach. Analyses revealed several key themes related to training CNAs to feed residents with dementia. Across focus groups, CNAs agreed that they needed additional training about feeding residents with dementia. They unanimously agreed that the best person to provide such training should be an experienced CNA, not a nurse or other healthcare provider. In terms of delivery, they preferred hands-on training and role playing. CNAs also emphasized that while some learning takes place in a didactic setting, the most valuable learning moments involve on-the-job experience in feeding residents, where they are mentored by seasoned CNAs. Findings from this study revealed the need for providing CNAs training on feeding residents with dementia. CNA training programs that includes hands-on activities mentored by seasoned CNAs could increase CNAs’ ability to provide optimal meal assistance to nursing home residents with dementia.

Model of Welfare Capitalism? The United States Rubber Company in Southeast Asia, 1910–1942

2007 ◽  
Vol 8 (1) ◽  
pp. 136-174
Author(s):  
Shakila Yacob
Keyword(s):  
United States ◽  
Southeast Asia ◽  
The United States ◽  
Profit Sharing ◽  
Pension Plans ◽  
American Business ◽  
Turnover Rates ◽  
Labor Costs ◽  
High Turnover ◽  
Welfare Capitalism

Welfare capitalism, the management ethos adopted by American business leaders in the early twentieth century, emphasizes the role of business rather than trade unions or government in taking care of its workers. This article focuses on the reasons why the United States Rubber Company (USRC), one of the four largest U.S. rubber manufacturers, promoted welfare capitalism at its rubber plantations on the east coast of Sumatra and Malaya between 1910 and 1942. In addition, this study assesses the development of USRC's system of welfare in the areas of housing, profit sharing, pension plans, health care, and recreation. This article argues that USRC's intention was not to forestall unionization (the intention of U.S.-based companies in adopting welfare capitalism), as union formation in Southeast Asia during that period was very unlikely, but to overcome labor shortages and high turnover rates and to ensure labor stability. With reduced labor costs, the availability of financial resources allowed for technical innovations and R & D, which ultimately would lead to increased productivity.

scholarly journals Affective Commitment to Organizations: A Comparison Study of Reverse Mentoring Versus Traditional Mentoring Among Millennials

2017 ◽  
Vol 8 (2) ◽  
pp. 157
Author(s):  
Catrin Hechl
Keyword(s):  
Affective Commitment ◽  
Online Survey ◽  
Average Length ◽  
The United States ◽  
Sample Population ◽  
Turnover Rates ◽  
High Turnover ◽  
Significant Difference ◽  
Traditional Mentoring ◽  
Quasi Experimental

A current topic of interest in management and organization research is the phenomenon of a generation shift in the workforce and how this shift will affect organizations in the near future.  Millennials represent the largest generational cohort in the American workforce.  Organizations find themselves challenged with retention efforts as Millennials tend to leave an organization after short tenures.  The problem this study addressed is the high turnover rates among millennial employees. Specifically, it was unknown whether Millennials who received reverse mentoring evidenced greater affective commitment to the organization as compared to Millennials who received standard mentoring.  The purpose of this study was to investigate the hypothesis that Millennials who received reverse mentoring evidenced greater affective commitment to the organization as compared to Millennials who received standard mentoring.  A two group post-test only quasi-experimental design was conducted.  A total of 90 participants (45 per group) completed the survey.  The survey was conducted by Qualtrics, an online survey company.  The sample population included male and female individuals, born between 1982 and 1998, employed by all types of organizations in the United States and participating in a mentoring program at the time the survey was taken.  Affective commitment was greater in the reverse mentoring group (M = 36.683, SE = .959) compared to the traditional mentoring group (M = 34.984, SE = .959).  However, after adjustment for quality of relationship (LMX) and length and frequency of mentoring (LFM) there was no statistically significant difference (p < .05) between traditional mentoring and reverse mentoring on affective commitment to the organization indicated by F(1,86) = 1.569, p = .214.  Additional results of this study showed that two-thirds of the surveyed millennial employees had already exceeded the average length of employment of 12 to 18 months with the organization they were employed with at the time of the survey.  This finding indicated the importance of investing in workplace relationships, such as mentoring, regardless of traditional or reverse.

scholarly journals Job Turnover and Divorce

2017 ◽  
Author(s):  
Philip N. Cohen
Keyword(s):  
Population Survey ◽  
Community Survey ◽  
New Combination ◽  
Job Turnover ◽  
American Community Survey ◽  
Turnover Rates ◽  
High Turnover ◽  
Individual Level ◽  
One Year ◽  
The Individual

Inspired by Pugh (2015), this paper explores the connection between work and couple stability, using a new combination of data from the Current Population Survey (CPS) and the American Community Survey (ACS). I test the association between job turnover, a contextual variable, and divorce at the individual level. Results show that people who work in jobs with high turnover rates – that is, jobs which many people are no longer working in one year later – are also more likely to divorce. One possible explanation is that people exposed to lower levels of commitment from employers, and employees, exhibit lower levels of commitment to their own marriages

Sign in / Sign up

Export Citation Format

Share Document