Meeting the Needs in Continuing Care of Facility-Based Residents Diagnosed With Dementia: Comparison of Ratings by Families, Direct Care Staff, and Other Staff

Abstract

Effective facility-based continuing care of persons diagnosed with dementia requires trust and cooperation between the professional caregivers and the families of the residents. Miscommunications may affect many aspects of staff-family relationships. The knowledge and expectations of these groups, however, are typically quite different. The purpose of this study was to compare families, direct caregivers, and other staff and volunteers on their perception of the degree to which residents'needs were being met. Although these groups agreed that the majority of needs were being met adequately, the groups did differ. Specifically, compared to families and other staff and volunteers, the direct caregivers were more critical of bedside care, their own professional training, and the work of others. Families, in contrast, were more critical of their loved ones'limited opportunities for freedom of choice. The findings have value for the care of persons with dementia residing in care facilities.

Supporting Relationships Between Family and Staff in Continuing Care Settings

“…Interrupts the care of other residents to speak to staff Runs away and hides from family members trust were readily and repeatedly communicated: regularity of staff or visiting, regularity of temperament, ability to understand and work within the changing conditions of the environment, and good communication. Good communication between family and staff has long been recognized as essential for a positive, collaborative family-staff relationship (Hertzberg & Ekman, 2000;Hertzberg et al, 2001;Milke, Beck, & Danes, 2006) and something which requires the allocation of time and corresponding resources (Gaugler, 2005;Hertzberg et al, 2003;Ward-Griffin et al, 2003). So, too, has staff competence and good intentions, the essential components of trust (Austin, 2006).…”

Predictors of entry to the nursing home: Does length of follow-up matter?

“…More recently, McCallion et al (2005) found no significant differences between traditional staff and foster family caregivers in reports of subjective or objective caregiver burden with respect to a sample of adults with intellectual disabilities and/or Alzheimer’s disease living in a foster family setting. Another study comparing staff and family ratings of the resident’s unmet need in a sample of adults diagnosed with dementia and living in an assisted living facility, found no differences in the perceptions of these informants (Milke et al, 2006). Similarly, congruence between relatives and adult day care staff was found in the measures used in this study.…”

Noncontingent Reinforcement of Disruptive Behaviors in Personal Care Home Settings

“…Thus, dementia-related behavior occurs because of an inability of the caregiver to understand the needs of the person with dementia and an inability of the person with dementia to make their needs known (Kovach, Noonan, Schlidt, & Wells, 2005). Furthermore, agreement on the needs of residents and whether the needs are being met are critical to delivery of effective care (Milke, Beck, & Danes, 2006).…”