Dementia special care units: a comparison with standard units regarding residents’ profile and care features

Crespo, María; Hornillos, Carlos; Gómez, M. Mar

doi:10.1017/s1041610213001439

Cited by 10 publications

(7 citation statements)

References 24 publications

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“…The literature underlines that the resources allotted to psychogeriatric units should be adapted to residents’ levels of dependence, thus best ensuring the management of the different manifestations of their neurodegenerative illnesses. 65 , 66 In this regard, studies have shown that it is important that care teams have been trained to recognize and manage the BPSD. 28 , 67 , 68 …”

Section: Discussionmentioning

confidence: 99%

Factors influencing the quality of life perceptions of cognitively impaired older adults in a nursing home and their informal and professional caregivers: a mixed methods study

Verloo¹,

Salina²,

Fiorentino³

et al. 2018

CIA

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BackgroundIdentifying the objective and subjective aspects of the quality of life (QoL) of institutionalized cognitively impaired older adults (CIOAs) is a challenge. However, it can reveal which aspects of their care require improvement.AimThe aim of this study was to identify the core aspects of the QoL of CIOAs living in a nursing home (NH) by involving informal and professional caregivers (PCs).MethodsOur sequential, mixed methods study exploring the QoL of CIOAs was based on Lodgson et al’s (2002) quantitative quality of life–Alzheimer’s disease (QoL-AD) questionnaire. Subsequently, a qualitative phase study analyzed perceptions and impressions of QoL using interviews of CIOAs and their most significant informal caregivers (SICs) and PCs.ResultsFifteen CIOAs, 12 SICs, and 2 PCs were recruited. Two-thirds of the older adults were females, overall average age was 86 years (SD=6.1), and all had a severe clinical dementia rating (CDR=3). A high level of comorbidity (measured using the Cumulative Illness Rating Scale for Geriatrics) was significantly associated with a lower QoL-AD score (P=0.046). Higher numbers of visits by SICs or family members had a positive effect on QoL-AD scores (P=0.036). No significant differences were found in overall QoL-AD scores as rated by CIOAs, SICs, and PCs (P=0.080). Combining quantitative and qualitative data analyses revealed four significant themes influencing the QoL of CIOAs: 1) human dignity and acceptance; 2) development and existence; 3) functionality and health; and 4) recognizability and safety.ConclusionSequentially using mixed methods proved an appropriate way to examine the QoL of severe CIOAs living in an NH, and these results were compared with the perceptions of informal and PCs. The factors optimizing overall health were visits by SICs and family members, and the major aspect that increases the QoL was freedom of movement inside and outside the NH.

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Section: Discussionmentioning

confidence: 99%

Factors influencing the quality of life perceptions of cognitively impaired older adults in a nursing home and their informal and professional caregivers: a mixed methods study

Verloo¹,

Salina²,

Fiorentino³

et al. 2018

CIA

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“…The mean age, gender distribution as well as severity of dementia indicates a typical German and international nursing home population [ 15 , 17 , 30 ]. In addition, characteristics (age, proportion of female, etc.)…”

Section: Discussionmentioning

confidence: 99%

“…In various studies, effects of an intervention on proxy-rated QoL were found [ 14 , 15 ]. Other studies did not find convincing effects [ 16 , 17 ].…”

Section: Introductionmentioning

confidence: 99%

Quality of life ratings in dementia care – a cross-sectional study to identify factors associated with proxy-ratings

Gräske

Meyer

Wolf‐Ostermann

2014

Health Qual Life Outcomes

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ObjectiveQuality of life (QoL) is one major outcome parameter in the care for people with dementia (PwD); however, their assessment is lacking a gold standard. The purpose of this study was to evaluate potential factors associated with nurse-rated quality of life of PwD in nursing homes in Berlin, Germany.MethodAn explorative cross-sectional study was performed in five nursing homes to evaluate QoL. Nurses rated the QoL for all residents with dementia by completing two different standardised assessments (ADRQL, QUALIDEM). Potential associated factors were evaluated concerning resident and nurse related factors. A fixed-effects models of analysis of co-variance (ANCOVA) was used to analyse effects of assumed associated factors of the major outcome parameters ADRQL and QUALIDEM. Associated factors were severity of dementia (GDS), challenging behaviour (CMAI), and other characteristics. Regarding the nurses, burnout (MBI), satisfaction with life (SWLS), attitude (ADQ) and empathy toward residents (JSPE), as well as circumstances of the ratings and days worked in advance of the ratings were assessed.ResultsIn total, 133 PwD and 88 nurses were included. Overall, the ratings show moderate to high QoL in every subscale independent of the instrument used. Assumed confounders relevantly influenced 14 out of 17 ratings. Predominantly, residents’ challenging behaviour, nurses’ burnout and satisfaction with life as well as the circumstances of the ratings are significant and clinically relevant associated factors.ConclusionAssessing QoL of PwD is acknowledged as a central component of health care and health care research. In later stages of dementia, proxy-reported information obtained from quality of life questionnaires is and will continue to be essential in this research. However, methodological issues that underline this research - matters of measurement and instrument validity - must receive more attention. Associated factors in proxy-ratings have to be routinely assessed in order to get more valid and comparable estimates.

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“…memory training, reminiscence therapy, validation therapy). The staff is specialised by on-going training and support, and the LUs have a designated leader who is highly educated [ 10 , 16 – 18 ]. The other concept - small scale LUs - is also conceptualised for PwD but differ from large segregated LUs.…”

Section: Introductionmentioning

confidence: 99%

Structural characteristics of specialised living units for people with dementia: a cross-sectional study in German nursing homes

Palm

Bartholomeyczik

Roes

et al. 2014

Int J Ment Health Syst

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BackgroundLiving units (LU) specialised for people with dementia are an important feature of nursing homes. Little is known about their structural characteristics, and an international definition is lacking. This study explored characteristics of the environment and staff from defined LU types to identify differences between them.DesignCross-sectional study comparing five types of LUs. LUs were defined based on their living concept (segregated and integrated), size (small and large scale), and funding (extra funded and not extra funded). Differences were identified using descriptive statistics, Chi-Square resp. Kruskal-Wallis-Test and post-hoc analysis with Bonferroni corrections.ResultsIn total, 103 LUs from 51 nursing homes participated: 63 integrated and 40 segregated LUs; 48 integrated and 31 segregated LUs were large. Sixteen large segregated LUs were extra funded. Regarding the environment, a distinctive feature of small LUs was a higher percentage of single rooms. Small integrated LUs provided and served meals more in a homelike manner than other LUs. LUs did not differ in their interior and access for the residents to use outdoor areas. Regarding the staff, small LUs provided more staff, but they were not exclusively assigned to the LUs. Large segregated LUs with additional funding provided more registered nurses and nurses with a special qualification per resident than the other large LUs.ConclusionNursing homes implemented different features in their specialised LUs. Because single room availability, homelike provision of meals, staff quantity, quality and continuity may influence residents’ outcomes, it is necessary to investigate whether differences are apparent in future evaluation studies of specialised LUs for people with dementia.

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Dementia special care units: a comparison with standard units regarding residents’ profile and care features

Cited by 10 publications

References 24 publications

Factors influencing the quality of life perceptions of cognitively impaired older adults in a nursing home and their informal and professional caregivers: a mixed methods study

Factors influencing the quality of life perceptions of cognitively impaired older adults in a nursing home and their informal and professional caregivers: a mixed methods study

Quality of life ratings in dementia care – a cross-sectional study to identify factors associated with proxy-ratings

Structural characteristics of specialised living units for people with dementia: a cross-sectional study in German nursing homes

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