Residential care for elderly people: a decade of change.

Stern, Michael; Jagger, Carol; Clarke, Michael; Anderson, Judith; McGrother, Cath; Battock, T; McDonald, Corbett

doi:10.1136/bmj.306.6881.827

Cited by 56 publications

(18 citation statements)

References 10 publications

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“…Thus, a recently reported study of residential care for the elderly in an English health authority area (Stern et al, 1993) found dependency levels to have increased substantially, with the proportion of elderly patients rated as 'dependent' having risen from 34% to 50% between 1979 and 1990, this increase having been most marked among men aged…”

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confidence: 92%

Nurses' job satisfaction and the quality of care received by patients in psychogeriatric wards

Robertson

Gilloran

McGlew

et al. 1995

Int J Geriat Psychiatry

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SUMMARYThe methodology and part of the results of an in-depth observational study of four psychogeriatric hospitals are described, focusing on the quality of care received by patients and how this was affected by the level of job satisfaction among nurses. In all four hospitals two wards were selected for intensive study over a period of 4 5 months each. Quality of care was studied through standardized recording of staff's feeding, toileting and bathing of a stratified sample of patients. The findings point to a very strong relationship between job satisfaction and quality of patient care. Staff and patients in high-satisfaction (HS\ wards proved more likely to initiate a conversation or other interaction. HS staff also offered patients more choice, independence, personal attention, supervision, information and privacy, and were more likely to converse with patients during feeding, toileting and bathing. Toileting and bathing appeared especially sensitive to these effects. Despite these differences, HS staff took no longer to feed, toilet or bathe their patients. These relationships are suggested to be mainly attributable to management practices, particularly at ward level, which influence both job satisfaction and quality of patient care.

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confidence: 92%

Nurses' job satisfaction and the quality of care received by patients in psychogeriatric wards

Robertson

Gilloran

McGlew

et al. 1995

Int J Geriat Psychiatry

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“…Several studies have shown evidence of such an increase [2,3]. Others have considered dependency only in the context of psychiatric morbidity [4,5].…”

Section: Introductionmentioning

confidence: 99%

Dependency in older people recently admitted to care homes

Challis

Mozley

Sutcliffe³

et al. 2000

Age and Ageing

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Objective: to investigate dependency and general health status of a cohort of older people admitted to residential or nursing homes for long-term care. Method: we assessed 308 people aged over 65 years within 2 weeks of admission for long-term care to one of 30 nursing or residential homes in north-west England. Dependency was assessed using the Barthel activities of daily living index and the Crichton Royal Behaviour Rating Scale. We collected information from the homes' records on diagnosed conditions and current medication. Results: 50% of the cohort were in a 'low dependency' band (Barthel score 13-20): 31% of those in nursing homes and 71% of those in residential homes. In nursing homes, low-dependency residents were more likely to be selffunding than those with higher dependency. Of a number of broad diagnostic groupings, only a diagnosis of dementia was associated with nursing-rather than residential-home admission. Of 47 residents who scored 9 or less on the Mini-Mental State Examination (indicating severe cognitive impairment), 85% had no diagnosis of dementia, neurological disorder or other psychiatric disorder. Discussion: the high proportion of new admissions of subjects with low dependency needs raises questions about the effective targeting of resources and about management of the boundary between home-based and institutional care. The existence of an important group of self-funded, low-dependency new admissions to nursing homes suggests a need to provide better assessment and placement services for those who are financially independent of local authorities. Many new admissions had conditions which might benefit from rehabilitation but there were almost no therapy staff in the studied homes. In some cases where severe cognitive impairment was evident, there was no evidence that the result of any formal pre-admission psychiatric evaluation had been communicated to nursing or care staff.

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“…Nursing home residents are frailer than community-dwelling older persons, take more different types of medication which are prescribed more frequently and so are particularly at risk of hospitalisation [16][17][18]. A national policy transferring responsibility for continuing care between health, social work and the individual has increased the demand from patients within nursing homes on general practitioners (GPs) and led to a concern about medical care for this group of people with high morbidity and disability, especially with regard to medication use [19][20][21][22][23]. A recent Parliamentary report on the health care of older people 'expressed concern about the inappropriate use of medication in older people, including the over or under-use of medication and the use of medication as a means of controlling patients and residents' [24].…”

Section: Introductionmentioning

confidence: 99%

An observational study of psychotropic drug use and initiation in older patients resident in their own home or in care

et al. 2012

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Residential care for elderly people: a decade of change.

Abstract: 3 Working group on the confidential enquiry into stillbirths and deaths in infancy. Report of the working group set up by the chief medical officer. London:

Cited by 56 publications

References 10 publications

Nurses' job satisfaction and the quality of care received by patients in psychogeriatric wards

Nurses' job satisfaction and the quality of care received by patients in psychogeriatric wards

Dependency in older people recently admitted to care homes

An observational study of psychotropic drug use and initiation in older patients resident in their own home or in care

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