Independence and Dependence in Self-Care Behaviors in Nursing Home Residents: An Operant-Observational Study

1980 ◽  
Vol 3 (4) ◽  
pp. 489-500 ◽  
Author(s):  
Margret M. Baltes ◽  
Robert L. Burgess ◽  
Robert B. Stewart
Keyword(s):  
Nursing Home ◽  
Interrater Reliability ◽  
Self Care ◽  
Nursing Home Residents ◽  
Staff Members ◽  
Dependent Behavior ◽  
Independent Behavior ◽  
Independent Behaviors ◽  
The Relationship ◽  
Behavior Sequences

In the present research project, an attempt is made to delineate the relationship between dependent/independent behaviors of nursing home residents and the consequent behaviors of the staff. In this context, dependence in residents is limited to self-care behaviors during morning care in the nursing home. Subjects were six staff members of one ward in a nursing home and the 48 patients they cared for. Observations of behavior sequences were recorded with the BOSS system by four observers over 11 days for one hour each morning. Interrater reliability, established during eight sessions, ranged from 0.89 to 1.00 (X= 0.946). In terms of frequencies of behaviors, elderly residents exhibited significantly more independent behaviors than dependent behaviors. Staff engaged significantly more often in 'no response', followed by dependence-supporting behavior, and lastly by independencesupporting behavior. In terms of interactive sequences, an independent response by a resident was most often followed by 'no response' from staff. In contrast, staff members almost invariably responded to the dependent behavior of the residents with dependencesupporting behavior. These temporal contingencies when interpreted within an operant paradigm should have consequences for the maintenance of dependent and independent behavior in elderly residents.

scholarly journals Nothing to complain about? Residents’ and relatives’ views on a “good life” and ethical challenges in nursing homes

2014 ◽  
Vol 23 (2) ◽  
pp. 142-153 ◽  
Author(s):  
Georg Bollig ◽  
Eva Gjengedal ◽  
Jan Henrik Rosland
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Good Life ◽  
Ethical Issues ◽  
Nursing Home Residents ◽  
Well Being ◽  
Ethical Challenges ◽  
Staff Members ◽  
Group Interviews ◽  
The Relationship

Background: Nursing home residents are a vulnerable population. Most of them suffer from multi-morbidity, while many have cognitive impairment or dementia and need care around the clock. Several ethical challenges in nursing homes have been described in the scientific literature. Most studies have used staff members as informants, some have focused on the relatives’ view, but substantial knowledge about the residents’ perspective is lacking. Objective: To study what nursing home residents and their relatives perceive as ethical challenges in Norwegian nursing homes. Research design: A qualitative design with in-depth interviews with nursing home residents, and focus-group interviews with relatives of nursing home residents. The digitally recorded interviews were transcribed verbatim. Analysis was based on Interpretive Description. Participants and research context: A total of 25 nursing home residents from nine nursing homes in Norway, and 18 relatives of nursing home residents from three of these nursing homes. Ethical considerations: This study was reported to and approved by the Regional Ethics Committee in Oslo, Norway. Findings and discussion: The main ethical challenges in Norwegian nursing homes from the residents’ and relatives’ perspective were as follows: (a) acceptance and adaptation, (b) well-being and a good life, (c) autonomy and self-determination, and (d) lack of resources. The relationship with the staff was of outmost importance and was experienced as both rewarding and problematic. None of the residents in our study mentioned ethical challenges connected to end-of-life care. Conclusion: Residents and relatives experience ethical challenges in Norwegian nursing homes, mostly connected to “everyday ethical issues.”

scholarly journals Outbreaks of COVID-19 in Nursing Homes: A Cross-Sectional Survey of 74 Nursing Homes in a French Area

2021 ◽  
Vol 10 (18) ◽  
pp. 4280
Author(s):  
Emilie Piet ◽  
Alexis Maillard ◽  
Franck Olivier Mallaval ◽  
Jean Yves Dusseau ◽  
Murielle Galas-Haddad ◽  
...  
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Nursing Home Residents ◽  
Bivariate Analysis ◽  
Strong Positive Correlation ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Staff Members ◽  
The Relationship ◽  
Univariate Analyses

In this multi-centric cross-sectional survey conducted in nursing homes of the French Alps, from 1 March to 31 May 2020, we analyze the relationship between the occurrence of an outbreak of COVID 19 among residents and staff members. Out of 225 eligible nursing homes, 74 (32.8%) completed the survey. Among 5891 residents, the incidence of confirmed or probable COVID-19 was 8.2% (95CI, 7.5% to 8.9%), and 22 (29.7%) facilities had an outbreak with at least 3 cases. Among the 4652 staff members, the incidence of confirmed or probable COVID-19 was 6.3% (95CI, 5.6% to 7.1%). A strong positive correlation existed between residents and staff members for both numbers of cases (r2 = 0.77, p < 0.001) and the incidence (r2 = 0.76, p < 0.001). In univariate analyses, cases among the staff were the only factor associated with the occurrence of an outbreak among residents (OR = 11.2 (95CI, 2.25 to 53.6)). In bivariate analysis, this relationship was not influenced by any nursing home characteristics, nor the action they implemented to mitigate the COVID-19 crisis. Staff members were, therefore, likely to be a source of contamination and spread of COVID-19 among nursing home residents during the first wave of the pandemic.

Disruptive Vocalization and Depression in Older Nursing Home Residents

2000 ◽  
Vol 12 (4) ◽  
pp. 463-471 ◽  
Author(s):  
Michael Dwyer ◽  
Gerard J. A. Byrne
Keyword(s):  
Nursing Home ◽  
Cognitive Impairment ◽  
Depressive Symptoms ◽  
Mini Mental State Examination ◽  
Mmse Score ◽  
Nursing Home Residents ◽  
Confounding Variables ◽  
The Relationship ◽  
State Examination ◽  
Age And Sex

Screaming and other types of disruptive vocalization are commonly observed among nursing home residents. Depressive symptoms are also frequently seen in this group, although the relationship between disruptive vocalization and depressive symptoms is unclear. Accordingly, we sought to examine this relationship in older nursing home residents. We undertook a controlled comparison of 41 vocally disruptive nursing home residents and 43 non-vocally-disruptive nursing home residents. All participants were selected to have Mini-Mental State Examination (MMSE) scores of at least 10. Participants had a mean age of 81.0 years (range 63-97 years) and had a mean MMSE score of 17.8 (range 10-29). Nurse ratings of disruptive vocalization according to a semioperationalized definition were validated against the noisy behavior subscale of the Cohen-Mansfield Agitation Inventory. Subjects were independently rated for depressive symptoms by a psychiatrist using the Dementia Mood Assessment Scale, the Cornell Scale for Depression in Dementia, and the Depressive Signs Scale. Vocally disruptive nursing home residents scored significantly higher than controls on each of these three depresion-in-dementia scales. These differences remained significant when the effects of possible confounding variables of cognitive impairment, age, and sex were removed. We conclude that depressive symptoms are associated with disruptive vocalization and may have an etiological role in the generation of disruptive vocalization behaviors in elderly nursing home residents.

Covid-19-vaccinatie en antistofbepaling bij bewoners en personeel van 2 Lanakense woonzorgcentra in de lente van 2021

2021 ◽  
Author(s):  
F. BUNTINX ◽  
I. ASNONG ◽  
M. GULIKERS ◽  
G. VAES ◽  
H. DEWITTE ◽  
...  
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Vaccination Campaign ◽  
Nursing Home Residents ◽  
Young Female ◽  
Negative Association ◽  
Antibody Testing ◽  
Post Vaccination ◽  
Staff Members ◽  
Antibody Titres

Uptake and results of Covid-19 vaccination during a pandemic in nursing home residents and staff This study involves the participation of residents and staff of 2 Flemish nursing homes in the Covid-19 vaccination program, as well as the subsequent presence and titres of Covid-19 antibodies. With 1 exception, all 259 residents and 94% of the eligible staff members (n = 237) were vaccinated, 16 young female staff members were vaccinated with some delay because of pregnancy and fertility related fears. Post-vaccination SARS-CoV-2 antibody testing was performed in 214 (83%) residents and 201 (85%) staff members. Of these, respectively 98% and 100% had SARS-CoV-2 antibodies. A clear negative association was found between antibody titres and age. Within these nursing homes (and a number of surrounding nursing homes) the vaccination campaign was successful as well as effective.

The vulnerability of nursing home residents to the Covid-19 pandemic

2020 ◽  
Vol 23 (2-3) ◽  
pp. 57-60 ◽  
Author(s):  
Edward H Wagner
Keyword(s):  
Nursing Home ◽  
Long Term Care ◽  
Nursing Home Residents ◽  
Nursing Assistants ◽  
Nursing Home Care ◽  
Term Care ◽  
Staff Members ◽  
Care Facilities

Residents in nursing homes and other long-term care facilities comprise a large percentage of the deaths from Covid 19. Is this inevitable or are there problems with NHs and their care that increase the susceptibility of their residents. The first U.S. cluster of cases involved the residents, staff, and visitors of a Seattle-area nursing home. Study of this cluster suggested that infected staff members were transmitting the disease to residents. The quality of nursing home care has long been a concern and attributed to chronic underfunding and resulting understaffing. Most NH care is delivered by minimally trained nursing assistants whose low pay and limited benefits compel them to work in multiple long-term care settings, increasing their risk of infection, and work while ill. More comparative studies of highly infected long-term care facilities with those organizations that were able to better protect their residents are urgently needed. Early evidence suggests that understaffing of registered nurses may increase the risk of larger outbreaks.

scholarly journals The relationship of nursing home price and quality of life

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Sarah Raes ◽  
Sophie Vandepitte ◽  
Delphine De Smedt ◽  
Herlinde Wynendaele ◽  
Yannai DeJonghe ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Nursing Home ◽  
Nursing Homes ◽  
Research Question ◽  
Nursing Home Residents ◽  
Cross Sectional Study ◽  
Ownership Type ◽  
Cross Sectional ◽  
The Relationship

Abstract Background Knowledge about the relationship between the residents’ Quality of Life (QOL) and the nursing home price is currently lacking. Therefore, this study investigates the relationship between 11 dimensions of QOL and nursing homes price in Flemish nursing homes. Methods The data used in this cross-sectional study were collected by the Flemish government from years 2014 to 2017 and originates from 659 Flemish nursing homes. From 2014 to 2016, data on the QOL of 21,756 residents was assessed with the InterRAI instrument. This instrument contains 11 QOL dimensions. Multiple linear regression analyses were conducted to examine the research question. Results The multiple linear regressions indicated that a 10 euro increase in the daily nursing home price is associated with a significant decrease (P <  0.001) of 0.1 in 5 dimensions of QOL (access to services, comfort and environment, food and meals, respect, and safety and security). Hence, our results indicate that the association between price and QOL is very small. When conducting a subgroup analysis based on ownership type, the earlier found results remained only statistically significant for private nursing homes. Conclusion Our findings show that nursing home price is of limited importance with respect to resident QOL. Contrary to popular belief, our study demonstrates a limited negative effect of price on QOL. Further research that includes other indicators of QOL is needed to allow policymakers and nursing home managers to improve nursing home residents’ QOL.

Correlates of agitation and depression in nursing home residents with dementia

2012 ◽  
Vol 24 (11) ◽  
pp. 1779-1789 ◽  
Author(s):  
Tomislav Majić ◽  
Jan P. Pluta ◽  
Thomas Mell ◽  
Yvonne Treusch ◽  
Hans Gutzmann ◽  
...  
Keyword(s):  
Nursing Home ◽  
Mini Mental State Examination ◽  
Nursing Home Residents ◽  
Regression Analyses ◽  
Dementia Severity ◽  
Advanced Stages ◽  
Severity Of Depression ◽  
And Gender ◽  
The Relationship ◽  
State Examination

ABSTRACTBackground:The purpose of this study was to investigate the relationship between dementia severity, age, gender, and prescription of psychotropics, and syndromes of agitation and depression in a sample of nursing home residents with dementia.Methods:The Cohen-Mansfield Agitation Inventory (CMAI) was administered to residents with dementia (N= 304) of 18 nursing homes. Agitation symptoms were clustered using factorial analysis. Depression was estimated using the Dementia Mood Assessment Scale (DMAS). Dementia severity was assessed categorically using predefined cut-off scores derived from the Mini-Mental State Examination (MMSE). The relationship between agitation and its sub-syndromes, depression, and dementia severity was calculated usingχ2-statistics. Linear regression analyses were used to calculate the effect of dementia severity and psychotropic prescriptions on agitation and depression, controlling for age and gender.Results:Increasing stages of dementia severity were associated with higher risk for physically aggressive (p< 0.001) and non-aggressive (p< 0.01) behaviors, verbally agitated behavior (p< 0.05), and depression (p< 0.001). Depressive symptoms were associated with physically aggressive (p< 0.001) and verbally agitated (p< 0.05) behaviors, beyond the effects of dementia severity. Prescription of antipsychotics was correlated with depression and all agitation sub-syndromes except hiding and hoarding.Conclusions:Dementia severity is a predictor for agitation and depression. Beyond that, depression increased with dementia severity, and the severity of depression was associated with both physically and verbally aggressive behaviors, indicating that, in advanced stages of dementia, depression in some patients might underlie aggressive behavior.

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