Geriatric care on a ward without nurses

Benjamin, Lisa C.; Spector, John

doi:10.1002/gps.930071010

Cited by 4 publications

(3 citation statements)

References 12 publications

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“…This study reinforces the finding of the previous study that the important features distinguishing units operating the domus philosophy from conventional long-stay hospital wards include greater opportunities for choice and control by residents, more privacy (where the physical design of the unit allows it), and the ready availability of social and recreational activities. Benjamin and Spector (1992) have also found that policy choice and resident control are important in determining the satisfaction and functioning of elderly people in residential care. One respect in which the domuses evaluated in this study differed from each other was in their tolerance for deviance in their residents, with domus A showing the greater toleration.…”

Section: Discussionmentioning

confidence: 99%

The domus philosophy: A prospective evaluation of two residential units for the elderly mentally ill

Dean¹,

Briggs²,

Lindesay³

1993

Int J Geriat Psychiatry

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SUMMARYThis article reports the findings of a prospective study of the first year of operation of two residential domus units for elderly people with dementia (domus A) and chronic schizophrenia (domus B). Residents, staff and the process of care were assessed at baseline in long-stay mental hospital wards, and at 3 months, 6 months and 12 months after the move to a domus. At 12 months, both domuses were providing more policy choice, resident control, provision for privacy and availability of social and recreational activities than a baseline psychogeriatric ward. Residents' cognitive function improved steadily over the follow-up period in both domuses, significantly so in domus A. There was also some improvement in residents' self-care (ADL) skills at follow-up in both domuses. Residents' communication skills were rated as significantly improved by staff in domus A at all follow-up assessments, and by staff in domus B at 6 months. Compared to baseline, substantially higher levels of activities and interpersonal interactions were observed at follow-up in both domuses. There was no evidence that staff suffered from low job satisfaction or psychological impairment at either domus.KEY wows-Domus, nursing home environments, quality of care, dementia, schizophrenia.The domus philosophy of residential care for elderly people with dementia was developed in the Lewisham and North Southwark Health District in inner London, UK by Elaine Murphy and Alastair Macdonald to replace traditional long-stay mental hospital provision for this group, and also to cater for those with particularly challenging behaviour. It is based on four assumptions: that the domus is the residents' home for life; that the needs of the staff are as important as those of the residents; that the domus should aim to correct the avoidable consequences of dementia, and accommodate those that are unavoidable; and that the residents' individual psychological and emotional needs may take precedence over the physical aspects of their care. Overall, the emphasis of the domus is on maintaining residents' independence and residual capacities as far as possible through active participation in life in the domus.

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Section: Discussionmentioning

confidence: 99%

The domus philosophy: A prospective evaluation of two residential units for the elderly mentally ill

Dean¹,

Briggs²,

Lindesay³

1993

Int J Geriat Psychiatry

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“…Like the study drawn on in this article, there have been previous attempts to observe the behaviour either of people with dementia or of families in their own homes. Most of the former have taken place in institutions and group settings, rather than in the home (Godlove et al, 1982;McFadyen, Prior, et al, 1982;Macdonald, Craig, et al, 1985;Benjamin & Spector, 1992;Kitwood & Bredin, 1992;Dean, Briggs, et al, 1993) -for example, Bowie and Mountain (1993), who spent 100 hours observing the ward environment and behaviour of patients with dementia in a long-stay ward. To complement these lengthy observation periods Bowie and Mountain also kept diaries, which yielded descriptive data about the quality of life of the patient.…”

Section: Introductionmentioning

confidence: 99%

Perceptions and Management of Change by People with Dementia and Their Carers Living at Home

et al. 2004

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This article presents findings from a research study that examined, by observation and interview, the nature of care as a form of social organization in the homes of people with dementia whose care was at least partly provided by relatives or friends. Twenty situations were included in which the carers and people with dementia were interviewed. Each participating pair was observed for an average of nine hours. Change was perceived, on the whole, in negative terms for both caregiver and the person with dementia. The main categories of change to emerge were those to do with normal routines or practices, perceived deterioration in the condition of the person with dementia, and changes concerning living arrangements. Coping strategies used reflect those in the general coping literature. They included denial, attempts to restore the situation or regain control, making positive comparisons, attempting to understand dementia and acceptance. de men tia d e m e n t i a

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“…Previous attempts to observe behavior either of people with dementia or their carers have been undertaken. However, most of these studies have taken place in institutions and group settings rather than the home and have used structured observations (Benjamin & Spector, 1992;Dean, Briggs, & Lindesay, 1993;Godlove, Richard, & Rodwell, 1982;Kitwood & Bredin, 1992;Macdonald, Craig, & Warner, 1985;McFadyen, Prior, & Kindness, 1982). Typical of these is an observational study by Davies and Snaith (1980).…”

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confidence: 99%

Accomplishing Care at Home for People With Dementia: Using Observational Methodology

Briggs

Askham

Norman³

et al. 2003

Qual Health Res

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The authors consider the problems and possibilities presented by using unstructured observation in the home setting. The findings of the original study are described elsewhere (Briggs, Askham, Norman, & Redfern 1998; National Health Service [NHS] Executive 1998). In this article, the authors discuss process issues (e.g., gaining and maintaining access to the research setting, disengaging, what can and cannot be observed, and the validity of the data and analysis), drawing on a study of the nature of care as a form of social organization in the homes of people with dementia. They show that observation is not only possible but, when combined with conversational interviewing, essential for understanding the processes of caring and what it means to live with dementia.

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Geriatric care on a ward without nurses

Cited by 4 publications

References 12 publications

The domus philosophy: A prospective evaluation of two residential units for the elderly mentally ill

The domus philosophy: A prospective evaluation of two residential units for the elderly mentally ill

Perceptions and Management of Change by People with Dementia and Their Carers Living at Home

Accomplishing Care at Home for People With Dementia: Using Observational Methodology

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