Journal articles: 'Irish nursing homes'

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O’Neill, Desmond, Tom Grey, Dimitra Xidous, Jennifer O’Donoghue, and Mehak Puntambekar. "RETHINKING NURSING HOME ARCHITECTURE AND DESIGN IN THE LIGHT OF THE COVID-19 PANDEMIC." Innovation in Aging 6, Supplement_1 (November 1, 2022): 790–91. http://dx.doi.org/10.1093/geroni/igac059.2855.

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Abstract Introduction The huge death rate in nursing homes during the COVID-19 pandemic raised serious questions as to whether the built environment of nursing homes was a factor in this very high mortality, as well as a factor in quality of life. Method We embarked on a wide-ranging study involving a review of Irish policy, stakeholder engagement, Irish case studies, literature review, and international case studies to understand the key issues that influence the planning, design, and operation of nursing home settings settings, and to identify how these shape care models and the physical environment. Results The project generated the following key themes: a) including the voices of residents, family and staff in co-creation of design and research; b) integrating nursing homes with the overall housing spectrum; c) linking nursing homes with ageing in place policy; d) further research on optimal design; e) understanding resident diversity; f) greater inclusion of Universal Design principles; g) designing for resilience; and h) Convergence between infection control and quality of life Discussion: Our Research Findings have been developed to identify major current issues related to the built environment and its role in creating a balance between quality of life and COVID-19 infection control in Irish and international nursing home settings. These findings are relevant for a wide range of stakeholders and will be disseminated across a number of channels to continue this conversation and help to continue the evolution of nursing home design.

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Ryan, C., D. O'Mahony, J. Kennedy, P. Weedle, E. Cottrell, M. Heffernan, B. O'Mahony, and S. Byrne. "Potentially inappropriate prescribing in older residents in Irish nursing homes." Age and Ageing 42, no. 1 (July 24, 2012): 116–20. http://dx.doi.org/10.1093/ageing/afs068.

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Kelleher, Jayne E., Peter Weedle, and Maria D. Donovan. "The Prevalence of and Documented Indications for Antipsychotic Prescribing in Irish Nursing Homes." Pharmacy 9, no. 4 (September 30, 2021): 160. http://dx.doi.org/10.3390/pharmacy9040160.

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Background: Antipsychotic medications are often used ‘off-licence’ to treat neuropsychiatric symptoms and disorders of aging and to manage behavioural and psychological symptoms of dementia despite the warnings of adverse effects. Objective: To establish the prevalence of and documented indication for antipsychotic medication use in the Irish nursing home setting. Setting: This study was conducted in six nursing homes located in Co. Cork, Ireland. Method: A retrospective, cross-sectional study was employed. All patients who met the inclusion criteria (≥65 years, residing in a nursing home on a long-term basis) were eligible for inclusion. There were 120 nursing home residents recruited to the study. Main Outcome Measure: The prevalence of antipsychotic medication use in nursing home residents (with and without dementia). Results: The overall prevalence of antipsychotic prescribing was found to be 48% and patients with dementia were significantly more likely to be prescribed an antipsychotic compared to those without dementia (67% vs. 25%) (χ2 (1, N = 120) = 21.541, p < 0.001). In the cohort of patients with dementia, there was a trend approaching significance (p = 0.052) of decreasing antipsychotic use with increasing age (age 65–74 = 90%; age 75–84 = 71%; age 85 and over = 58%). An indication was documented for 84% of the antipsychotic prescriptions in this cohort. Conclusions: The findings of this study highlight that high rates of antipsychotic medication use remains an issue in Irish nursing homes. Further work should explore factors in influencing prescribing of these medications in such settings.

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Wallace, Meredith, Kathy Murphy, Adeline Cooney, and Eamon O'Shea. "A profile of Irish and U.S. nursing homes: evidence for change." Applied Nursing Research 20, no. 3 (August 2007): 158–60. http://dx.doi.org/10.1016/j.apnr.2007.04.006.

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Lee, Linda Yin King. "Commentary on “A Profile of Irish and U.S. nursing homes: Evidence for change”." Applied Nursing Research 20, no. 3 (August 2007): 160–61. http://dx.doi.org/10.1016/j.apnr.2007.04.007.

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Ling, Julie. "Palliative care in Irish nursing homes: the work of community clinical nurse specialists." International Journal of Palliative Nursing 11, no. 7 (July 2005): 314–21. http://dx.doi.org/10.12968/ijpn.2005.11.7.18483.

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Houston, Aoibheann, Mary Donnelly, and Shaun T. O'Keeffe. "Will-making in Irish nursing homes: Staff perspectives on testamentary capacity and undue influence." International Journal of Law and Psychiatry 56 (January 2018): 50–57. http://dx.doi.org/10.1016/j.ijlp.2017.12.001.

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Ni Luasa, Shiovan, Declan Dineen, and Marta Zieba. "Technical and scale efficiency in public and private Irish nursing homes – a bootstrap DEA approach." Health Care Management Science 21, no. 3 (October 27, 2016): 326–47. http://dx.doi.org/10.1007/s10729-016-9389-8.

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Kelleher, Margaret, Mary O'Sullivan, and Nuala McMahon. "Mental illness in an elderly rural population in Ireland: a prevalence study." Irish Journal of Psychological Medicine 15, no. 4 (December 1998): 139–41. http://dx.doi.org/10.1017/s0790966700004857.

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AbstractObjectives: The aim of this study was to provide the first Irish prevalence data on mental illness in an elderly, rural, community dwelling population.Method: Subjects were identified from four general practitioners' lists. This included GMS patients, private patients and nursing home residents. Six hundred and fifty people aged 65 years or over were interviewed in their own homes using GMS-AGECAT, a standardised diagnostic instrument.Results: The overall prevalence of mental illness was 14.6%. The prevalence of depression was 9.4%. There was a significantly higher rate among women (13.2%) than men (4.3%). Depression in women was not age related. Of the total sample, 3.7% were classified as organic cases. Of the remaining cases, anxiety disorders occurred most frequently and represented 0.9% of all cases.Conclusions: Elderly people in rural areas experience similar levels of psychiatric morbidity as those in urban centres.

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Wrigley, Margo, and Art O'Connor. "The response of the Irish Division of the Royal College of Psychiatrists to the Health (Nursing Homes) Bill 1989." Irish Journal of Psychological Medicine 7, no. 2 (September 1990): 178–79. http://dx.doi.org/10.1017/s0790966700016840.

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Schlögl, Mathias, and Adam Gordon. "HEARTS, minds and souls—it is time for geriatricians to bring more to continence management." Age and Ageing 50, no. 5 (June 9, 2021): 1508–11. http://dx.doi.org/10.1093/ageing/afab088.

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Abstract Urinary incontinence (UI), the involuntary loss of urine, is a common health condition that may decrease the quality of life and which increases in incidence and prevalence with age. Recent epidemiologic data suggest an overall prevalence of 38% in women older than 60 years, increasing to 77% in older women living in nursing homes. Despite this high prevalence, incontinence remains underdiagnosed and undertreated in this age group. In a representative population of 7,000 participants drawn from the Irish Longitudinal Study of Ageing, 750 had UI of whom 285 (38%) had not sought the help of a health care professional. The reasons that older people do not seek help for incontinence are complex and multiplex. Stigma surrounding diagnosis, a sense of futility coupled to a notion that incontinence is a part of normal ageing and the fact that incontinence simply gets ‘lost’ in the midst of multimorbidity and frailty have all been shown to play a role. Active case finding has therefore been highlighted as a cornerstone of effective care in serial international guidelines.

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Rice, Niamh, and Charles Normand. "The cost associated with disease-related malnutrition in Ireland." Public Health Nutrition 15, no. 10 (February 8, 2012): 1966–72. http://dx.doi.org/10.1017/s1368980011003624.

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AbstractObjectiveThe present study aimed to establish the annual public expenditure arising from the health and social care of patients with diet-related malnutrition (DRM) in the Republic of Ireland.DesignCosts were calculated by (i) estimating the prevalence of DRM in health-care settings derived from age-standardised comparisons between available Irish data and large-scale UK surveys and (ii) applying relevant costs from official sources to estimates of health-care utilisation by adults with DRM. No attempt has been made to estimate separately the costs of DRM and any associated disease, since each can be a cause or consequence of the other. The methods used are adapted from an evaluation of the cost of malnutrition in the UK by the British Association for Parenteral and Enteral Nutrition (2009).SettingsHospitals, nursing homes, out-patient clinics, primary-care clinics and home care.SubjectsAll adult patients receiving hospital in-patient, out-patient or specified community health-care services.ResultsThe annual public health and social care cost associated with adult malnourished patients in Ireland is estimated at over €1·4 billion, representing 10 % of the health-care budget. Most of this cost arises in acute hospital or residential care settings (i.e. 70 %), with nutritional support estimated to account for <3 % of spend.ConclusionsThe cost associated with the care of patients with DRM is substantial and may rise as the proportion of older people within the population increases, a group at increased risk of DRM. Despite growing pressure on health-care budgets, little attention has been focused on the economic burden associated with DRM in Ireland or the potential for savings arising from improved detection and treatment of those at risk.

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Sheehy, L. "172 WHAT IS THE KNOWLEDGE OF CARE STAFF AND THE USE OF HEARING AIDS IN IRISH NURSING HOMES? A PILOT STUDY." Age and Ageing 51, Supplement_3 (October 25, 2022). http://dx.doi.org/10.1093/ageing/afac218.147.

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Abstract Background Residents of nursing homes can be dependent on care staff for the insertion and maintenance of their hearing aids. There is no current research carried out in Irish nursing homes on this topic. Methods Using a quantitative study design participants were recruited from two Irish publicly-funded Nursing Homes. 58 Care staff participated in this study. Care staff completed a validated paper-based questionnaire. Descriptive statistics were applied. Kruskal Wallis H tests were used to examine if there was a statistically significant difference in questionnaire answers between three occupations: Healthcare Assistants, Nurses and Nurse Managers Results 15% of care staff agreed that they had received training in the use and care of hearing aids. 20% of care staff agreed that they knew the approximate lifetime of a hearing aid battery.100% of care staff agreed they need more information on the different types of hearing aids. 95% agreed that there is a need for information on hearing aid maintenance, and 88% of care staff agreed that they need more information on hearing loss among the older population. Conclusion This extensive data, the first of its kind in Ireland, shows us that care staff are very candid about the issues they confront and have demonstrated a willingness and openness to learning. It confirms the skills and information gap of care staff and there is great scope for training, and this will have a very positive impact on residents and care staff.

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Molloy, D. W., C. O’Sullivan, R. O’Caoimh, E. Duggan, K. Mcgrath, M. Nolan, J. Hennessy, G. O’Keeffe, and K. O’Connor. "THE EXPERIENCE OF MANAGING COVID-19 IN IRISH NURSING HOMES IN 2020." Journal of Nursing Home Research Sciences, 2020. http://dx.doi.org/10.14283/jnhrs.2020.13.

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Köppe, S., and D. Szelewa. "5 THE WEALTH SHIELD: A MICROSIMULATION OF INEQUALITIES, INHERITANCE AND THE IRISH FAIR DEAL." Age and Ageing 51, Supplement_3 (October 25, 2022). http://dx.doi.org/10.1093/ageing/afac218.002.

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Abstract Background The article analyses the inequalities resulting from the long-term funding scheme in Ireland with a unique focus on intergenerational obligations. With the Fair Deal scheme of 2009, officially the Nursing Homes Support Scheme (NHSS), Ireland introduced a unique inheritance clawback clause. The state covers long term care costs for those in need up-front and claims the costs back from the estate after the older person deceases. The article focusses on the emerging income and wealth inequalities and intergenerational redistributive effects. Methods We estimate micro simulations to show the distributional effects based on income and housing wealth. The simulations are based on aggregate data from the Central Statistics Office, Nursing Homes Ireland, Eurostat and the European Central Bank. Each simulation estimates the individual contributions based on 50, 100, 150 and 200 percent of average income and wealth, while keeping either income or wealth constant at the average. Based on average nursing home fees, the simulations show the relative contributions from the state, income and wealth. These simulations are contrasted to the funding gaps of the old subvention scheme in place until 2009. Results The Fair Deal has expanded eligibility to the middle class and shields property wealth after three years. Nursing home residents with above average pension income and housing wealth benefit disproportionately from the reform and can pass on more relative wealth to their kin. Overall, the wealth distribution of the Fair Deal scheme is regressive, despite the inclusion of the middle class. Conclusion The increased eligibility of the fair deal has the benefit of increased legitimacy for the welfare state. However, considerable inequalities of risks exposure remain as less than 50 percent of older people will need nursing home care. Estimations for a long-term care insurance scheme at 3 percent social contributions would reduce the lifetime wealth contribution of nursing home residents by about 35 percent.

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Donnelly, S., HR Brennan, K. Quinlan, J. O'Shea, K. Quaid, F. Golden, M. Keating, S. Mackall, R. Parfitt, and G. Paley. "134 ADULT SAFEGUARDING, HUMAN RIGHTS AND PEOPLE LIVING WITH DEMENTIA IN NURSING HOMES: CO-PRODUCING RECOMMENDATIONS FOR BEST PRACTICE." Age and Ageing 51, Supplement_3 (October 25, 2022). http://dx.doi.org/10.1093/ageing/afac218.113.

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Abstract Background People living with dementia (PLwD) in nursing homes have the right to be safe and to live a life free from harm and abuse; all persons are entitled to this right, regardless of their circumstances or where they live. PLwD are at greater risk of abuse and neglect than those without a diagnosis. Such abuse often goes unnoticed, because dementia may affect a person’s ability to recognise abuse or to report it. In 2021, the Alzheimer Society of Ireland’s Irish Dementia Working Group (IDGW) commissioned the development of a briefing paper to outline the key issues relating to upholding the human rights and safeguarding of PLwD in nursing homes including concrete recommendations for policy and practice. Methods A scoping review of the existing literature on this topic was carried out. This was supplemented by adopting a snowball strategy to identify additional relevant literature. Three co-design online sessions were convened with members of the IDWG in order to discuss and agree on the general content and members also provided suggestions for additional research or policy papers that should be included. Co-design sessions were also used to brainstorm and reach a consensus as a group on recommendations. Results This project identified a number of specific risk factors for PLwD, including organisational abuse, the need to move towards a restraint-free environment, addressing barriers to reporting of abuse and promoting agency and autonomy within safeguarding processes. A number of policy and legislative gaps in our current adult safeguarding framework were identified making it more difficult to adequately protect PLwD in nursing homes. Conclusion 22 recommendations for best practice were developed by the IDWG for nursing home service providers (public and private), health and social care practitioners, policymakers, the Department of Health, HIQA and political representatives in order to collectively advocate for meaningful change.

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Killeen, E., S. Horan, A. Pollock, A. Lee, and A. Martin. "744 3 YEAR FOLLOW-UP OF SEDATIVE PRESCRIBING FOR RESPONSIVE BEHAVIOURS IN NURSING HOME RESIDENTS, AN IRISH STUDY." Age and Ageing 51, Supplement_1 (March 2022). http://dx.doi.org/10.1093/ageing/afac034.744.

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Abstract Introduction Sedative medications are commonly prescribed for older adults; these include neuroleptics, benzodiazepines, opioids, ‘z’ drugs and trazadone. The prevalence of sedative drug prescriptions is increasing (1). Nursing home residents are three times more likely to be prescribed benzodiazepines (2). Regular medication review and education have been shown to reduce rates of sedative use in nursing homes (3). We previously demonstrated a significant reduction in prescription of these target medications at an Irish nursing home with specific focus, within scheduled medication reviews, on reduction or discontinuation of the target drugs in combination with education on management of Behavioural and Psychological symptoms (BPSD). This audit examines the prescribing patterns 3 years on from the initial audit. Methods Point prevalence study of sedative prescriptions and BPSD of all 95 nursing home residents on 6/5/21. Comparison with data from two previous audits in the same unit. All data was anonymised. Data analysed with SPSS statistical software. Results Sustained significant drop in quetiapine use from 30% of residents to 14% post-intervention in 2018 and three-year follow-up (p = 0.06). Borderline significant reduction in overall neuroleptics (from 39% to 25%, p = 0.06). Significant rise in ‘z’ drug prescription (from 8% to 17%, p = 0.03). BPSD reported in 33%, compared to 49% pre-intervention. Conclusion Regularly scheduled medication reviews can effectively rationalise sedative prescription rates in nursing home residents. Increasing ‘z’ drug prescription likely represents the appropriate replacement of neuroleptics. Reduced BPSD may be due to reporting bias of staff since regular education has been introduced or changing cohort of residents. References numbered above not included given limited word count.

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O’Sullivan, Ronan, Aileen Murphy, Rónán O’Caoimh, Nicola Cornally, Anton Svendrovski, Brian Daly, Carol Fizgerald, Cillian Twomey, Ciara McGlade, and D. William Molloy. "Economic (gross cost) analysis of systematically implementing a programme of advance care planning in three Irish nursing homes." BMC Research Notes 9, no. 1 (April 26, 2016). http://dx.doi.org/10.1186/s13104-016-2048-9.

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Kennelly, Sean P., Adam H. Dyer, Claire Noonan, Ruth Martin, Siobhan M. Kennelly, Alan Martin, Desmond O’Neill, and Aoife Fallon. "Asymptomatic carriage rates and case fatality of SARS-CoV-2 infection in residents and staff in Irish nursing homes." Age and Ageing, September 28, 2020. http://dx.doi.org/10.1093/ageing/afaa220.

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Abstract Background SARS-CoV-2 has disproportionately affected nursing homes (NH). In Ireland, the first NH case COVID-19 occurred on 16 March 2020. A national point-prevalence testing programme of all NH residents and staff took place (18 April 2020 to 5 May 2020). Aims to examine characteristics of NHs across three Irish Community Health Organisations, proportions with COVID-19 outbreaks, staff and resident infection rates symptom profile and resident case fatality. Methods in total, 45 NHs surveyed, requesting details on occupancy, size, COVID-19 outbreak, outbreak timing, total symptomatic/asymptomatic cases and outcomes for residents from 29 February 2020 to 22 May 2020. Results surveys were returned from 62.2% (28/45) of NHs (2,043 residents, 2,303 beds). Three-quarters (21/28) had COVID-19 outbreaks (1,741 residents, 1,972 beds). Median time from first COVID-19 case in Ireland to first case in these NHs was 27.0 days. Resident incidence was 43.9% (764/1,741)—40.8% (710/1,741) laboratory confirmed, with 27.2% (193/710) asymptomatic and 3.1% (54/1,741) clinically suspected. Resident case fatality was 27.6% (211/764) for combined laboratory-confirmed/clinically suspected COVID-19. Similar proportions of residents in NHs with ‘early-stage’ (<28 days) versus ‘later-stage’ outbreaks developed COVID-19. Lower proportions of residents in ‘early’ outbreak NHs had recovered compared with those with ‘late’ outbreaks (37.4 versus 61.7%; χ2 = 56.9, P < 0.001). Of 395 NH staff across 12 sites with confirmed COVID-19, 24.7% (99/398) were asymptomatic. There was a significant correlation between the proportion of staff with symptomatic COVID-19 and resident numbers with confirmed/suspected COVID-19 (Spearman’s rho = 0.81, P < 0.001). Conclusion this study demonstrates the significant impact of COVID-19 on the NH sector. Systematic point-prevalence testing is necessary to reduce risk of transmission from asymptomatic carriers and manage outbreaks in this setting.

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Tandan, Meera, Rory O’Connor, Karen Burns, Helen Murphy, Sarah Hennessy, Fiona Roche, Sheila Donlon, Martin Cormican, and Akke Vellinga. "A comparative analysis of prophylactic antimicrobial use in long-term care facilities in Ireland, 2013 and 2016." Eurosurveillance 24, no. 11 (March 14, 2019). http://dx.doi.org/10.2807/1560-7917.es.2019.24.11.1800102.

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Background Long-term care facilities (LTCFs) are important locations of antimicrobial consumption. Of particular concern is inappropriate prescribing of prophylactic antimicrobials. Aim We aimed to explore factors related to antimicrobial prophylaxis in LTCFs in Ireland. Methods The point prevalence surveys of Healthcare-Associated Infections in Long-Term Care Facilities (HALT) were performed in Ireland in May 2013 and 2016. Data were collected on facility (type and stewardship initiatives) and resident characteristics (age, sex, antimicrobial and indication) for those meeting the surveillance definition for a HAI and/or prescribed an antimicrobial. Results In 2013, 9,318 residents (in 190 LTCFs) and in 2016, 10,044 residents (in 224 LTCFs) were included. Of the 10% of residents prescribed antimicrobials, 40% were on prophylaxis, most of which was to prevent urinary tract infection. The main prophylactic agents were: nitrofurantoin (39%) and trimethoprim (41%) for urinary tract (UT); macrolides (47%) for respiratory tract and macrolides and tetracycline (56%) for skin or wounds. More than 50% of the prophylaxis was prescribed in intellectual disability facilities and around 40% in nursing homes. Prophylaxis was recorded more often for females, residents living in LTCFs for more than 1 year and residents with a urinary catheter. No difference in prophylactic prescribing was observed when comparing LTCFs participating and not participating in both years. Conclusions Forty per cent of antimicrobial prescriptions in Irish LTCFs were prophylactic. This practice is not consistent with national antimicrobial prescribing guidelines. Addressing inappropriate prophylaxis prescribing in Irish LTCFs should be a key objective of antimicrobial stewardship initiatives.

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Feerick, F., C. O. Connor, P. Hayes, and D. Kelly. "Introducing Advanced Paramedics into the rural general practice team in Ireland – general practitioners attitudes." BMC Primary Care 23, no. 1 (May 26, 2022). http://dx.doi.org/10.1186/s12875-022-01740-9.

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Abstract Introduction As Ireland's population increases and chronic disease becomes more prevalent, demand on limited general practice services will increase. Nursing roles within general practice are now considered to be standard, yet alternative allied health professional roles are under explored within an Irish context. Allied health personnel such as Advanced Paramedics (APs) may have the capability to provide support to general practice. Aim To explore General Practitioners’ (GPs) attitudes and opinions of integrating Advanced Paramedics (APs) into rural general practice in Ireland. Methods A sequential explanatory mixed methodology was adopted. A questionnaire was designed and distributed to a purposeful sample of GPs attending a rural conference followed by semi-structured interviews. Data was recorded and transcribed verbatim and thematically analysed. Results In total n = 27 GPs responded to the survey and n = 13 GPs were interviewed. The majority of GPs were familiar with APs and were receptive to the concept of closely collaborating with APs within a variety of settings including out-of-hours services, home visits, nursing homes and even roles within the general practice surgery. Conclusion General Practitioner and Advanced Paramedic clinical practice dovetail within many facets of primary care and emergency care. GPs recognise that current rural models are unsustainable and realise the potential of integrating APs into the general practice team to help support and sustain the future of rural general practice services in Ireland. These interviews provided an exclusive, detailed insight into the world of general practice in Ireland that has not been previously documented in this way.

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Willemsen, Ina, Jolande Nelson-Melching, Yvonne Hendriks, Ans Mulders, Sandrien Verhoeff, Marjolein Kluytmans-Vandenbergh, and Jan Kluytmans. "Measuring the quality of infection control in Dutch nursing homes using a standardized method; the Infection prevention RIsk Scan (IRIS)." Antimicrobial Resistance and Infection Control 3, no. 1 (August 18, 2014). http://dx.doi.org/10.1186/2047-2994-3-26.

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Journal articles on the topic 'Irish nursing homes'

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