CARE PLANNING for Nursing Home Residents: Incorporating the Minimum Data Set Requirements Into Practice

Abstract

This study was designed to describe the care-planning process used in nursing homes and identify links among care planning, care provided, and the Resident Assessment Instrument and Minimum Data Set (MDS). Study participants in three Midwestern nursing homes included residents and family members, MDS coordinators, direct care staff, administrators, directors of nursing, and medical directors. Data were collected via semi-structured interview, observation, and resident record audit. The care-planning process differed among the three facilities despite the common MDS system structure. Care planning and the MDS system were linked to the care provided to residents through documentation in residents' records, translation of the MDS care plan to the documents used for daily care, and ongoing communication through end-of-shift report and other venues.

Experience With Implementation of a Quality Improvement Project for the Care of Nursing Home Residents

“…Despite excellent intentions by the facility's staff and its board of directors, care planning for the end of life was not systematic or consistent. Our experience is consistent with the literature [14][15][16] and reflects a major barrier to the success of any QI initiative for end-of-life care in a nursing home.…”

Dementia Prevalence And Care In Assisted Living

“…5 In terms of care provision, a similar caveat related to charts is indicated: Staff provide care based more on residents' needs than on what is written on their charts. 5,16 The most important issue relating to care for people with dementia is the extent to which their care needs are being met. The cross-sectional design of the NSRCF cannot address that point.…”

“…5 Scores range from 0 to 10. Zero is no cognitive impairment (for purposes of comparison, the comparable Mini-Mental State Examination [MMSE] scores are greater than 23), 1-2 is mild impairment (MMSE, 19-23), 3-5 is moderate impairment (MMSE,(12)(13)(14)(15)(16)(17)(18), and 6-10 is severe impairment (MMSE, less than 12).…”

Neglecting the Importance of the Decision Making and Care Regimes of Personal Support Workers: A Critique of Standardization of Care Planning Through the RAI/MDS

“…Research suggests that care plans do not guide daily care in nursing homes (Dellefield, 2006; Schnelle, Bates-Jensen, Chu, & Simmons, 2004). Instead, features of daily care are greatly dependent on the activities of unlicensed personal support workers (PSWs) (Bowers, Esmond, & Jacobson, 2000; Taunton, Swagerty, Smith, Lasseter, & Lee, 2004), who provide 80%–90% of all direct care in nursing homes (Caspar & O’Rourke, 2008). …”