Tesi: "Residential Aged Care Homes"

1

Yeung, Hung-kay Keith. "Residential care home for the elderly". Hong Kong : University of Hong Kong, 1996. http://sunzi.lib.hku.hk/hkuto/record.jsp?B2595166x.

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2

Stone, Timothy T. "Cultures of consumption within residential care homes : understanding elderly bricoleurs' cultural maps of meaning". Thesis, University of Stirling, 2006. http://hdl.handle.net/1893/107.

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Set within the context that the world’s population is ageing at an unprecedented rate, it is argued that care of the elderly, and their everyday lived experiences are poised to become prominent concerns. In the shadow of this, the ageing population poses a myriad of challenges not only for the elderly but also for policy makers who put in place systems for the provision of services within residential care homes. By virtue, given that communities of elderly consumers voices are often muted within many academic analyses of social policy and service provision this study illuminates and distils communities of elderly consumers understandings of residential care homes. Given the absence of suitable literature within the fields of marketing and interpretive consumer research, this study turns to the sociological and anthropological literature of Hall and Jefferson (1976) and Levi-Strauss (1966). In doing so, communities of elderly consumers within residential care homes can be theorised as a cultural community of ‘bricoleurs’ within a ‘cultural map of meaning’. Furthermore, viewed through this lens, such bricoleurs can be seen to understand their meaningful everyday lived experiences within, and through, the use of ‘bricolage’. Emanating from eight existential-phenomenological interviews, a rich picture emerges wherein bricoleurs understandings of residential care homes can be seen to be embedded not only within, but also through, such things as the body, leisure trips, noise disturbances, death, large items of furniture, small hand-sized objects, mobility aids, quality of care and social interaction. Moreover, in the light of the resultant interpretations common themes can be seen to emerge within communities of bricoleurs social and material understandings of residential care homes, namely the notion of cultures of dependency, trauma and comfort. This research contributes to marketing knowledge in that it argues that communities of ‘elderly bricoleurs’ within residential care homes can be seen to be held together by unique understandings of cultures of dependency, trauma and comfort. Furthermore, it is also argued that elderly bricoleurs address themselves to a relatively limited amount of bricolage that enables them to keep alive actual, desired, imagined and fictional community ties. Furthermore, the reality and efficacy of cultural communities of elderly bricoleurs seems to depend on their ability to address ‘whatever is to hand’ (Levi-Strauss, 1966) in order to construct and understand their cultural maps of meaning within residential care homes.

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3

Courtney, Karen Lynne. "Privacy and senior adoption of assistive technology in residential care". Diss., Columbia, Mo. : University of Missouri-Columbia, 2006. http://hdl.handle.net/10355/4399.

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Thesis (Ph. D.)--University of Missouri-Columbia, 2006.
The entire dissertation/thesis text is included in the research.pdf file; the official abstract appears in the short.pdf file (which also appears in the research.pdf); a non-technical general description, or public abstract, appears in the public.pdf file. Vita. "May 2006" Includes bibliographical references.

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4

Leung, Man-fuk Edward. "An analysis of policy on residential nursing care for the elderly in Hong Kong". [Hong Kong : University of Hong Kong], 1992. http://sunzi.lib.hku.hk/hkuto/record.jsp?B13236222.

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5

Bitner, Grace Anne. "The 'home'/'homelessness' continuum in residential aged care". Thesis, Queensland University of Technology, 2019. https://eprints.qut.edu.au/128714/2/Grace_Bitner_Thesis.pdf.

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This project drew on the experiences of residents and staff in two different residential aged care facilities in South East Queensland, in order to better understand the factors that affect residents' ability to feel 'at home'. The resulting theoretical model reveals how the factors interconnect over time to contribute in a unique way to the meaning of home for individual residents. Ultimately, the model invites, and supports, a more sensitised and integrated approach to the design and management of Residential Aged Care Facilities.

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6

Yeung, Hung-kay Keith, e 楊鴻基. "Residential care home for the elderly". Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 1996. http://hub.hku.hk/bib/B31983133.

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7

Phillips, Jane Louise. "Navigating a palliative approach in residential aged care using a population based focus". View thesis, 2008. http://handle.uws.edu.au:8081/1959.7/33324.

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Thesis (Ph.D.)--University of Western Sydney, 2008.
A thesis submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy to the College of Health and Science, School of Nursing, University of Western Sydney. Includes bibliography.

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8

Bland, Rosemary. "Senior citizens, good practice and quality of life in residential care homes". Thesis, University of Stirling, 2006. http://hdl.handle.net/1893/70.

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This thesis is an examination of the definition and implementation of ‘good practice’ in residential care for senior citizens. The central contention is that ‘good practice’ is a term that has been variously defined. Different groups define it in different ways, and their definitions have changed over time. This reflexive qualitative study explores ‘good practice’ in local authority, voluntary and private residential care homes in Scotland from the perspective of policy, practice and the experience of senior citizens who live in them. The study is based on analysis of policy documents, historical studies, and reanalysed interview and survey data from two earlier studies conducted by the author and colleagues. The thesis shows that the notion of ‘good practice’ that emerges in policy and practice documents is a confused and often conflicting set of ideas. Historically, the earliest were driven by concerns over cost. In more modern times, statements about ‘good practice’ have had a more benevolent intent but are frequently flawed by paternalistic and ageist assumptions. It is shown that staff in residential homes typically adopt a different set of attitudes: their preoccupation is with safety and the avoidance of risk. Although benevolent in intention, these interpretations of ‘good practice’ are also at variance with what residents themselves actually want. Two particular models or styles of care are examined in detail. One of these is the use of ‘keyworkers’, often implemented in ways that fail to realise its potential. The other is the ‘hotel’ model of care. The potential of this model as an alternative to the statutory model is explored. The thesis concludes that it is a model that can realise the goal of enabling residents to exercise independence, choice and privacy while meeting their needs in residential care.

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9

Scott, Beverley Margaret. "Situational Positioning: A Grounded Theory of Registered Nurse Decision-making in Western Australian Nursing Homes". Thesis, Curtin University, 2003. http://hdl.handle.net/20.500.11937/1940.

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This grounded theory study investigated how registered nurses (RNs) managed problem-solving and decision-making in residential aged care facilities (nursing homes) in Western Australia. The outcome of the study was the substantive theory of situational positioning, the process used by the RN participants when they were trying to get things right .In-depth interviews were conducted with 25 purposefully selected registered nurses and nursing home management staff. The interviews were transcribed verbatim, and analysed using the constant comparative method. Other sources of data. guided by theoretical sampling. were selected documents such as government reports regarding aged care, and some field observations. Situational positioning was a process that involved physical. cognitive, emotional, and moral dimensions, and reflected how the RN participants acted and responded when dealing with situations at work. Situational positioning was conceptualised as occurring along two intersecting continua of behaviours, and these behaviours emerged from the data as four interrelated categories. Yielding and confronting represented the poles on a continuum of action-oriented behaviour, with being flexible and being rigid on a continuum that reflected more affective or attitudinal responses. The four categories that made up the positioning continua had both positive and negative meanings in relation to the actions and responses of the participants, depending on the particular situation. Yielding was a conceptual category that reflected participants' comments about stopping a particular action and trying something else or giving up completely and even leaving the situation. f he term confronting was used to describe participants' actions that were based on assertiveness that was seen as a constructive behaviour, or anger that tended to be non-productive.Being flexible meant that the participants were responsive to changing situational variables, and this was usually seen as a desirable attribute of effective nursing practice in aged care. However, it could also mean being pliant and ready to compromise in order to get through situations when the participants realised that they would be unable to get things right. At the other end of the response axis, the term being rigid was defined as the opposite of being flexible, that is, having firmly fixed or set ways of responding. or a tendency to respond to situations in the same way in all circumstances. The basic psychosocial problem, being unable to get things right, had two properties. One property was temporal, in that the problem occurred when the participants were getting behind or running late because of having insufficient time. usually due to interruptions. The second property of the problem was more qualitative in that contextual and intervening conditions led the participants to feel that they were not doing things properly because of adverse conditions. Conditions that varied .situational positioning were those that led to the participants being unable to get things right, such as having insufficient time. working with unqualified carers. and trying to meet the differing expectations of various stakeholders. Situations that were easy for the participants to manage involved known routines and few, if any. interruptions. In those circumstances, si uational positioning was intuitive and the phases of recognising, prioritizing, and moving on were negotiated quickly. In more complex situations, or when significant interruptions occurred, the participants followed an alternative pathway, which involved recognising that something in the situation changed. then compromising. that is. choosing a new course of action.Compromising required tolerance, as the participants adjusted their expectations of what could be achieved in the circumstances. Repositioning then occurred belore they moved on to the next task or to the end of their shifts. Moving on. the third phase in the process, involved persevering as they continued trying to get things right. The adverse conditions that prevailed in nursing homes during the time of this study impeded nursing practice and the delivery of consistently good standards of care for all residents. Situational positioning enabled the participants to persevere in their efforts to try to get things right, but their capacity to maintain the effort was eroded by the apparently unrelenting nature of the adverse conditions that existed in nursing homes. The main conclusion of this study was that the RN role in nursing homes in Western Australia was ill-defined, and inefficient in terms of best utilisation of nursing time. Recommendations included a review of the RN role in aged care and implementation of strategies that would enable aged care RNs to focus on their clinical roles.

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10

Kiata-Holland, Elizabeth. "‘All in a day’s work’ : the lifeworld of older people in New Zealand rest homes". Thesis, University of Auckland, 2010. https://researchspace.auckland.ac.nz/handle/2292/6098.

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This doctoral thesis contributes to critical gerontology research by investigating the lived experiences of residents in the everyday world of New Zealand rest homes. There is a need to understand how frail rest home residents experience "age". This study focuses on describing and understanding residents lived experiences. As the New Zealand population is ageing, this phenomenological focus adds clarity to the poorly understood lived experiences about being aged in rest homes. Policy initiatives such as the Positive Ageing Strategy with its emphasis on keeping older people living in the community largely ignore the life practices of the increasing proportions of frail older people who require long-term residential care. My mixed-methods modified framework approach draws on the lifeworld as understood by Max van Manen (1990) and Alfred Schütz (1972). The lifeworld is made up of thematic strands of lived experience: these being lived space, lived time, lived body and lived relations with others, which are both the source and object of phenomenological research (van Manen, 1990). These strands are temporarily unravelled and considered in-depth for 27 residents who took part in audio-recorded interviews, before being interwoven through a multiple-helix model, into an integrated interpretation of the residents‟ lifeworld. Supplementing and backgrounding the interviews with these residents, are descriptive data including written interview summaries and survey findings about the relationships and pastimes of 352 residents living in 21 rest homes, which are counted and described. The residents day-to-day use of rest home space, mediated temporal order, self-managed bodies and minds, and negotiated relationships are interpreted. The mythology of the misery of rest home life is challenged, and a more constructive critical gerontology approach is offered. Findings of this research reveal how meanings around daily work practices are constructed by the residents. These elders participate in daily rest home life, from the sidelines or not at all, as they choose or are able, and this always involves work for the residents. They continue to actively manage satisfactory and fulfilling pastimes and relationships, because in their ordinary, everyday lifeworld it is “all in a day‟s work”.

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11

Ip, Siu-ming. "Searching for an appropriate mode of service delivery : the contracting out of residential aged care in Hong Kong /". Hong Kong : University of Hong Kong, 2000. http://sunzi.lib.hku.hk/hkuto/record.jsp?B22053323.

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12

Scott, Beverley Margaret. "Situational Positioning: A Grounded Theory of Registered Nurse Decision-making in Western Australian Nursing Homes". Curtin University of Technology, School of Nursing and Midwifery, 2003. http://espace.library.curtin.edu.au:80/R/?func=dbin-jump-full&object_id=13781.

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Abstract (sommario):

This grounded theory study investigated how registered nurses (RNs) managed problem-solving and decision-making in residential aged care facilities (nursing homes) in Western Australia. The outcome of the study was the substantive theory of situational positioning, the process used by the RN participants when they were trying to get things right .In-depth interviews were conducted with 25 purposefully selected registered nurses and nursing home management staff. The interviews were transcribed verbatim, and analysed using the constant comparative method. Other sources of data. guided by theoretical sampling. were selected documents such as government reports regarding aged care, and some field observations. Situational positioning was a process that involved physical. cognitive, emotional, and moral dimensions, and reflected how the RN participants acted and responded when dealing with situations at work. Situational positioning was conceptualised as occurring along two intersecting continua of behaviours, and these behaviours emerged from the data as four interrelated categories. Yielding and confronting represented the poles on a continuum of action-oriented behaviour, with being flexible and being rigid on a continuum that reflected more affective or attitudinal responses. The four categories that made up the positioning continua had both positive and negative meanings in relation to the actions and responses of the participants, depending on the particular situation. Yielding was a conceptual category that reflected participants' comments about stopping a particular action and trying something else or giving up completely and even leaving the situation. f he term confronting was used to describe participants' actions that were based on assertiveness that was seen as a constructive behaviour, or anger that tended to be non-productive.
Being flexible meant that the participants were responsive to changing situational variables, and this was usually seen as a desirable attribute of effective nursing practice in aged care. However, it could also mean being pliant and ready to compromise in order to get through situations when the participants realised that they would be unable to get things right. At the other end of the response axis, the term being rigid was defined as the opposite of being flexible, that is, having firmly fixed or set ways of responding. or a tendency to respond to situations in the same way in all circumstances. The basic psychosocial problem, being unable to get things right, had two properties. One property was temporal, in that the problem occurred when the participants were getting behind or running late because of having insufficient time. usually due to interruptions. The second property of the problem was more qualitative in that contextual and intervening conditions led the participants to feel that they were not doing things properly because of adverse conditions. Conditions that varied .situational positioning were those that led to the participants being unable to get things right, such as having insufficient time. working with unqualified carers. and trying to meet the differing expectations of various stakeholders. Situations that were easy for the participants to manage involved known routines and few, if any. interruptions. In those circumstances, si uational positioning was intuitive and the phases of recognising, prioritizing, and moving on were negotiated quickly. In more complex situations, or when significant interruptions occurred, the participants followed an alternative pathway, which involved recognising that something in the situation changed. then compromising. that is. choosing a new course of action.
Compromising required tolerance, as the participants adjusted their expectations of what could be achieved in the circumstances. Repositioning then occurred belore they moved on to the next task or to the end of their shifts. Moving on. the third phase in the process, involved persevering as they continued trying to get things right. The adverse conditions that prevailed in nursing homes during the time of this study impeded nursing practice and the delivery of consistently good standards of care for all residents. Situational positioning enabled the participants to persevere in their efforts to try to get things right, but their capacity to maintain the effort was eroded by the apparently unrelenting nature of the adverse conditions that existed in nursing homes. The main conclusion of this study was that the RN role in nursing homes in Western Australia was ill-defined, and inefficient in terms of best utilisation of nursing time. Recommendations included a review of the RN role in aged care and implementation of strategies that would enable aged care RNs to focus on their clinical roles.

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13

Watkins, Ross. "Eating well : understanding and shaping the mealtime experience of older adults in residential care". Thesis, University of Exeter, 2018. http://hdl.handle.net/10871/33806.

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Background: Many interventions aim to alleviate well-documented problems of malnutrition in residential care homes and improve residents’ health and wellbeing. Despite some positive findings, little is known about how and why mealtime interventions might be effective, and in particular, what effects residents’ experiences of mealtimes have on health outcomes. Aim: The aim of this project was to gain an insight into residents’ experiences of mealtimes in order to inform the development of a mealtime intervention. By addressing the issues that impact on residents’ enjoyment of meals, interventions may target improvements in the health and wellbeing of residents more effectively. Methods: This thesis is comprised of three pieces of empirical work conducted using multiple methods. In a systematic review of stakeholder perceptions of mealtimes, five databases were searched from inception to November 2015, followed by thematic analysis of extracted data. In a second study, semi-structured interviews were conducted with eleven residents from four care homes in the South West UK. Thematic analysis was used to derive content and meaning from transcribed interviews. These studies informed the development of a staff-focussed training programme (study three) using the process of Intervention Mapping (IM) as a guide. The feasibility of this intervention was assessed using qualitative surveys and analysed using multiple methods. Fourteen staff from two care homes participated in the feasibility study, which investigated the deliverability of the training programme and the acceptability of its content. Findings: The systematic review and resident interview study revealed that the dining experience was a focal point for residents’ broader experiences of residing in a care home. Whilst meal quality and enjoyment impacted on the dining experience, the provision of care was pivotal in determining mealtime culture and resident agency within the home. This had implications for self-efficacy and social relationships, particularly in the context of transitioning from independent living to a care home community. These findings informed the development of a mealtime intervention, which was found to be deliverable and acceptable to staff. Conclusion: Mealtimes are a mainstay of life in a care home through which residents’ experiences are characterised, exemplified and magnified. Understanding how residents interact with one another, accommodating their preferences and encouraging autonomy may enhance their mealtime experiences. Evidence from the empirical work supports the development of interventions aimed at mealtime staff to improve resident self-efficacy. This thesis has established the necessary groundwork for a pilot trial and future definitive trial to assess resident (and staff) outcome measures including social (e.g., collective engagement) and psychological outcomes (e.g., wellbeing), as well as health outcomes (e.g., nutritional status).

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14

Ip, Siu-ming, e 葉小明. "Searching for an appropriate mode of service delivery: the contracting out of residential aged care in Hong Kong". Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2000. http://hub.hku.hk/bib/B31966196.

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15

Mok, Lai-shim Billian, e 莫麗嬋. "To assess the effectiveness of the services of private residential care homes for the elderly in Hong Kong". Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2014. http://hdl.handle.net/10722/207656.

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Hong Kong cannot single out herself from the global problem of increasing elderly population. The increase of elderly population like in other countries is the by-product of dwindling of birth rate and the longevity of life caused by the advanced medical care, enhancement of nutrition and low mortality rate which prolong people's life expectancy. Provision of housing as the integral part of care to the elders at their retirement age becomes a hot topic of the government to deal with. Comprehensive housing services help to develop the concept of ageing in place, care in the community and continuum services for achievement of the healthy ageing and successful ageing of the elders Moreover, government cannot cater for the needs of all elders who require residential care services when all elders becoming old and frail. Private residential care home services fills in the gap to provide such services in the elderly market. This research studies the causes of the requirement of the private residential care homes which under-went the change of family structure, change of status of elders in the traditional families due to low fertility rate, change of economic and social aspects due to urbanization and industrialization. Development of private elderly housing services provided by government and private sector from past to present and future are overviewed. Statistics on provision of private elderly care homes places in the current market are mentioned. The studies focus on the quality of services provided by the private residential care homes for the elderly. Methodology for the research is based on a mix of qualitative and quantitative method. Measurements on the level of satisfaction of the elderly respondents are identified and itemized basing on their required physical daily personal services. Face-to-face personal contact and ' in-person' dialogues with the elderly respondents and the frontline workers and operators were conducted for questionnaires and interview results. The elderly respondents were categorized into 3 ranges, namely, the young-old, old-old and the oldest-old for analysis of their level of satisfaction of services. Different age range respondents expressed different level of satisfaction with same items of services due to different requirements at various age strata. Comparisons on the services provided by sole privately operated residential care homes, NGO and Government Purchasing Scheme are examined. Results of the research are analyzed and finalized for conclusions and recommendations. The elders' willingness of ageing in place is definite yet with expectations of improvement for upgrading life quality.
published_or_final_version
Housing Management
Master
Master of Housing Management

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16

Lee, Yin King. "Promoting psychosocial health of elderly residential care home residents implementation of a Tai Chi program /". online access from Digital Dissertation Consortium, 2006. http://libweb.cityu.edu.hk/cgi-bin/er/db/ddcdiss.pl?3254572.

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17

Iglesia, Fredrick. "Christian education for elementary age children in residential care facilities which house between 35 and 125 children". Theological Research Exchange Network (TREN), 1997. http://www.tren.com.

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18

Leung, Kwok-fai Tony, e 梁國輝. "Relationship between perceived autonomy and depression amongst the elderly living in residential homes". Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 1997. http://hub.hku.hk/bib/B31978320.

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19

Davies, Megan Jean. "Institutionalizing old age : residential accommodation for the elderly in British Columbia, 1920-1960". Thesis, McGill University, 1994. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=28724.

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This dissertation looks at old age homes in British Columbia between 1920 and 1960. It describes and explains how changes in institutional care for aging men and women intersected with professional ideals, welfare state economics and political imperatives. It also considers how broader developments altered the physical and cultural world of the institution and the strategies employed by the elderly.
Facilities for the elderly changed significantly during the period. In 1920 provision of residential care for older British Columbians was extremely limited, and existing institutions operated under a poorhouse model, providing only custodial care. By 1960 a sizeable network of provincially regulated facilities had developed. Medical professionals urged that these establishments be medical facilities and that the elderly receive compassionate, therapeutic care.
However, circumstances inside these facilities limited change. While some institutions were run along medical lines, new policy initiatives were modified by strong historical links with older systems of custodial care and punitive poorhouse ethics.

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20

Fung, Chi-hang, e 馮志恆. "Is government funded elderly residential service a better option? : a comparison of sarisfaction levels of elderlies in government subvented homes and licensed private homes in Hong Kong". Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2006. http://hdl.handle.net/10722/210322.

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21

Kallin, Kristina. "Falls in older people in geriatric care settings : predisposing and precipitating factors". Doctoral thesis, Umeå : Univ, 2004. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-307.

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22

Fan, Lijun. "Effectiveness and cost analysis of a hospital in the nursing home program in Queensland, Australia". Thesis, Queensland University of Technology, 2016. https://eprints.qut.edu.au/101165/1/Lijun_Fan_Thesis.pdf.

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This thesis evaluated the effectiveness and cost-saving potential of a health service delivery model in Queensland Australia, the Hospital in the Nursing Home program. The research adopted a before-after controlled study design, comparing the outcomes between an intervention hospital and a control hospital during the pre- and post-intervention periods. Findings from the research supported that the intervention was preferred over the current practice, which reduced the attendances to emergency departments (EDs) and inpatient hospitals from patients in residential aged care facilities, shortened their length of ED stay, and saved the overall costs.

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23

Wilkinson, Peter. "De concentv amisso qvaerendo: An investigation into the relative benefits of three different types of ambient music on the observed agitated behaviour and quality of life of dementia sufferers in residential aged care facilities". Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 2014. https://ro.ecu.edu.au/theses/1562.

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There is an increasing body of research evidence to support the use of music as a therapeutic modality in reducing the agitated behaviour frequently associated with late-stage dementia. Although much of this evidence suggests that music interventions are most effective when they are “individualized”, this type of intervention is often difficult to implement in large, busy, aged care facilities where residents may be located together in communal areas during the day. The challenge therefore is to try and identify a particular musical genre which, when played as “ambient” or “background” music, demonstrates a consistent capacity to reduce agitated behaviour in late-stage dementia across resident populations in multiple facilities. This study was designed to test the comparative utility of three different types of background music identified in the existing research literature as being of possible benefit in this context. These three types of music were: gentle classical music, familiar music and baroque music. Using a sample of 65 older people with late-stage dementia living in a total of eight residential aged care facilities, this quasi-experimental study used quantitative measures to assess a specific range of agitated behaviours over a one week intervention period. The specific agitated behaviours were documented using the Scale for the Observation of Agitation in Persons with Dementia (SOAP-D) scale (Hurley, Volicer, Camberg, Ashley, Woods, Odenheimer, Ooi, McIntyre, & Mahoney, 1999). In addition, the Quality of Life in Alzheimer’s Disease (QoL-AD) tool (Logsdon, 1999) was used to collect collateral information from family members or experienced care staff at each of the participating facilities about whether they perceived that the playing of music exerted any influence on the quality of life of participants. Participants were randomly assigned to one of five experimental subgroups of equal size. Participants in three of the five groups received exposure to audio recordings of music. Participants in one of the two remaining sub-groups were exposed to a non-musical intervention (audio recordings of storybooks) at the same time of day as the participants in the three music groups. Data relating to behaviour and perceived quality of life were recorded in the same manner for this group. The final group of participants acted as the control group for the study. Quantitative data were collected in the same manner for this group: however, they were exposed to no intervention. In addition, a series of structured interviews was undertaken with experienced care providers at each of the participating residential aged care facilities. The purpose of this procedure was to determine whether the experiences and subjective opinions of staff regarding the utility of music as an intervention to settle agitated behaviour in late-stage dementia and improve quality of life were consistent with the observational data recorded using the SOAP-D scale in conjunction with the proxy-rated QoL-AD scale. Results of the study indicated that overall levels of agitated behaviour were less within the three groups exposed to music compared with the nonmusic intervention group and the control. However, perceived quality of life was not measurably improved in any of the three music intervention groups. This study supports the continued use of music as a therapeutic intervention in the management of maladaptive behaviour associated with late-stage dementia, although the results do not support the preferential use of any of the three selected music forms.

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24

Chiu, Wan-Yu. "Children's rights in residential care homes in Taiwan". Thesis, Durham University, 2014. http://etheses.dur.ac.uk/10682/.

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There are approximately 2000 children living in residential care homes in Taiwan, the result of child abuse, neglect and youth offending. Available literature on residential care in Taiwan focuses on the role of professional workers, and little is known about the experiences of Taiwanese children in residential care. Despite falling outside the family of the United Nations, the notion of children’s rights is articulated in Taiwanese legislation and public policy on child welfare. This offers a strong rationale to explore experiences of children’s rights in Taiwanese children’s homes. An ethnographic approach involving i) participant observation, ii) participatory group activities and iii) semi structured interviews with 50 children was adopted in one public and one private children’s home. Drawing on theoretical and conceptual frameworks of children’s rights, happiness and resilience, the use of mixed methods facilitated a rich understanding of children’s experiences of life in residential care and their understandings and experiences of children’s rights. The findings reveal that while children’s basic survival rights are met, a reality of strict routine and punitive discipline led the children to express their need for supportive companionship (expressed by some children as ‘love’), privacy and freedom to pursue individual interests. The tension between children’s expressed needs and the institutional regimes within which they experienced daily life reflected the cultural values of Confucian familism with expectations of unquestioning obedience to adults. The research also revealed that the children were not only capable of, but also showed enthusiasm for articulating their understanding and experiences of children’s rights and in doing so demonstrated their potential to contribute to the development of social policy and social work practice in Taiwan. This research contributes to the field of social work relating to the nature and development of resilience in children living in residential care homes, and to ongoing debates on the value and reality of children’s rights to be heard and participate in all matters that affect their lives.

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25

Preece, Michael. "Knowledge management : a residential aged care perspective". Thesis, Curtin University, 2011. http://hdl.handle.net/20.500.11937/561.

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This research explores perceptions of knowledge management processes held by managers and employees in a service industry. To date, empirical research on knowledge management in the service industry is sparse. This research seeks to examine absorptive capacity its four absorptive capacity capabilities of acquisition, assimilation, transformation and exploitation and their impact on effective knowledge management. All of these capabilities are strategies that enable external knowledge to be recognised, imported and integrated into, and further developed within the organisation effectively.The research tests the relationships between absorptive capacity and effective knowledge management through analysis of quantitative data (n=549) drawn from managers and employees in 35 Residential Aged Care organisations in Western Australia. Responses were analysed using Partial Least Square-based Structural Equation Modelling. Additional analysis was conducted to assess if the job role (of manager or employee) and three industry context variables of profit motive, size of business and length of time the organisation has been in business, impacted on the hypothesised relationships.Structural model analysis examined the relationships between variables as hypothesised in the research framework. Analysis found that absorptive capacity and the four capabilities correlated significantly with effective knowledge management, with absorptive capacity explaining 56% of the total variability for effective xiv knowledge management. Findings from this research also show that absorptive capacity and the four capabilities provide a useful framework for examining knowledge management in the service industry. Additionally, there were no significant differences in the perceptions held between managers and employees, nor between respondents in for-profit and not-for-profit organisations. Furthermore, the size of the organisation and length of time the organisation has been in business did not impact on absorptive capacity, the four capabilities and effective knowledge management.The research considers implications for business in light of these findings. The role of managers in providing leadership across the knowledge management process was confirmed, as well as the importance of guiding routines and knowledge sharing throughout the organisation. Further, the results indicate that within the participating organisations there are discernable differences in the way that some organisations manage their knowledge, compared to others. To achieve effective knowledge management, managers need to provide a supportive workplace culture, facilitate strong employee relationships, encourage employees to seek out new knowledge, continually engage in two-way communication with employees and provide up to date policies and procedures that guide employees in doing their work. The implementation of knowledge management strategies have also been shown in this research to enhance the delivery and quality of residential aged care.

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26

Shohel, Mohammad. "Antibiotic Stewardship in Residential Aged Care Facilities". Thesis, Curtin University, 2019. http://hdl.handle.net/20.500.11937/86378.

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Aged care residents are at increased risk of infections due to their frailty and comorbidities. This study aimed to identify and reduce the risk of antibiotic-related misadventure in this population. Particular medicines were associated with use of antibiotics, suggesting compromised immunity via numerous mechanisms. Potential interactions between antibiotics and residents’ other medicines were also identified, and may increase morbidity in this vulnerable group. Expanded scope of antimicrobial stewardship in aged care facilities is recommended.

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27

Kaine, Sarah Jane. "Managing labour in the residential aged care sector". Thesis, The University of Sydney, 2010. http://hdl.handle.net/2123/6300.

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Aged care is a critical public policy issue in Australia. The growing significance of the sector raises important and pressing questions about many aspects of care itself, the size of the labour force and employment relations. Answering these questions is vital, with demand for labour in the sector already outstripping supply and with demand certain to grow substantially. The implications of this labour shortfall for the sector have already been the subject of a number of key government reports. Although these reports have begun to construct a more detailed picture of the issues facing aged care workers and employers, significant gaps remain, most notably any explicit examination of approaches to the management of labour or the importance of labour law in determining these approaches. Despite the obvious importance and critical social and economic significance of the ageing population, we do not sufficiently understand many of the critical labour market features, workplace characteristics or management strategies which are evident in the aged care sector. This study seeks to build knowledge of employment and labour management in this growing and crucial sector at a decisive moment in history. It deepens our understanding of these issues and processes through a study of three residential aged care providers in New South Wales during the period from 2005 to 2009. The thesis specifically examines employer strategy in relation to the management of labour in the three cases. Further, it investigates the impact of the regulatory environment on these approaches. In doing so, the case studies reveal the intricate web of internal and external, direct and indirect, formal and informal regulation which shapes the management of labour within the sector. The complexity of the regulatory web in aged care demands the use of an explanatory framework which recognises that labour-management approaches are influenced by constraints not traditionally associated with the direct, legal regulation of employment relations. Consequently, regulation theory is applied here as an organising framework and as an interpretive prism for the research. This allows for an explicit acknowledgment of the importance of non-legal, informal and indirect regulation ‘at work’ in this sector. The study finds that in the period under review labour law was not the primary determinant of labour-management approaches in aged care. The case studies presented here show that it was, in fact, a second order consideration for aged care providers struggling with what they saw as insufficient funding, onerous ‘paperwork’ and staff recruitment and retention difficulties – in short a range of other regulatory influences. This study also shows that, despite the constraints imposed by these other regulatory modes, employers remained free to exercise their prerogative within the workplace; this, in turn, is revealed as a form of internal regulation in aged care.

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28

Kaine, Sarah Jane. "Managing labour in the residential aged care sector". University of Sydney, 2010. http://hdl.handle.net/2123/6300.

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Doctor of Philosophy (PhD)
Aged care is a critical public policy issue in Australia. The growing significance of the sector raises important and pressing questions about many aspects of care itself, the size of the labour force and employment relations. Answering these questions is vital, with demand for labour in the sector already outstripping supply and with demand certain to grow substantially. The implications of this labour shortfall for the sector have already been the subject of a number of key government reports. Although these reports have begun to construct a more detailed picture of the issues facing aged care workers and employers, significant gaps remain, most notably any explicit examination of approaches to the management of labour or the importance of labour law in determining these approaches. Despite the obvious importance and critical social and economic significance of the ageing population, we do not sufficiently understand many of the critical labour market features, workplace characteristics or management strategies which are evident in the aged care sector. This study seeks to build knowledge of employment and labour management in this growing and crucial sector at a decisive moment in history. It deepens our understanding of these issues and processes through a study of three residential aged care providers in New South Wales during the period from 2005 to 2009. The thesis specifically examines employer strategy in relation to the management of labour in the three cases. Further, it investigates the impact of the regulatory environment on these approaches. In doing so, the case studies reveal the intricate web of internal and external, direct and indirect, formal and informal regulation which shapes the management of labour within the sector. The complexity of the regulatory web in aged care demands the use of an explanatory framework which recognises that labour-management approaches are influenced by constraints not traditionally associated with the direct, legal regulation of employment relations. Consequently, regulation theory is applied here as an organising framework and as an interpretive prism for the research. This allows for an explicit acknowledgment of the importance of non-legal, informal and indirect regulation ‘at work’ in this sector. The study finds that in the period under review labour law was not the primary determinant of labour-management approaches in aged care. The case studies presented here show that it was, in fact, a second order consideration for aged care providers struggling with what they saw as insufficient funding, onerous ‘paperwork’ and staff recruitment and retention difficulties – in short a range of other regulatory influences. This study also shows that, despite the constraints imposed by these other regulatory modes, employers remained free to exercise their prerogative within the workplace; this, in turn, is revealed as a form of internal regulation in aged care.

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29

Darton, Robin. "The changing landscape of residential care : care homes and alternative forms of housing with care". Thesis, University of Kent, 2014. https://kar.kent.ac.uk/48026/.

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This thesis draws together a series of publications that were based on research studies conducted between 1981 and 2011, covering care homes and alternative forms of housing with care. The majority of the studies were funded by the Department of Health or its predecessors, and were aimed at responding to policy issues, particularly for local authority grant funding. However, the funding provided the opportunity to collect information for broader purposes, and a central feature linking the studies was the collection, as far as possible, of consistent information about the characteristics of residents over time. The thesis includes 12 pieces of work, based on information collected in ten studies, and illustrates the changes in care home provision from 1981 onwards, and the potential role of alternative forms of housing with care. The aim of the thesis is to explore the following themes: the changing role of care homes and the development of the independent sector, particularly the private sector; factors associated with care home costs; changes in the relative role of residential and nursing homes, including changes in the characteristics of residents over time; changes in the quality of provision; the impact of care home closures; provision for self-funders and the expectations of residents; and the development of alternative forms of housing with care, and the degree to which specialised housing can provide an alternative to residential care. Care homes in the UK provide around 470,000 places and account for over half the expenditure on social care for older people in England. However, information about care facilities and residents is very limited. The papers presented here aimed to fill some of the gaps in understanding residential care and possible alternatives by making use of data collected in a unique series of related research studies conducted over a period of 30 years.

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30

Pappne, Demecs Ilona. "Woven narratives: Creative participatory art in residential aged care". Thesis, Queensland University of Technology, 2019. https://eprints.qut.edu.au/133260/2/Ilona_Pappne%2520Demecs_Thesis%5B1%5D.pdf.

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This thesis presents a participatory art project which involved relocating my tapestry weaving studio into an aged care home for six months and working with residents to co-design and co-create a woven tapestry. The project's concept, materials and processes were designed as an interpretation of two theoretical models: the motivation to meaning and transcendence in ageing focusing on subjective experiences. This thesis contributed to the arts and health literature by presenting craft as a practice and method that connects materials, ideas and people through engagement and facilitates wellbeing. It also highlighted the complexity and the advantages of the research context.

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31

Daskein, Robyn. "Nursing Documentation and Quality of Care in Residential Aged Care in Queensland". Thesis, Griffith University, 2008. http://hdl.handle.net/10072/367277.

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Little is known about the relationship between registered nurses’ (RNs’) knowledge of nursing documentation, their attitudes towards this documentation, and how they perceive the importance of the forms used in the documentation process within residential aged care. The current study has several aims. This investigation sought to gain a measure of RNs’ knowledge of, and attitudes towards documentation, and assess their perception of the importance of forms used to document care. There were two phases of study. Study 1 utilised a cross-sectional, retrospective design with a large sample of RNs (n = 360) who completed Edelstein’s (1990) modified questionnaire to identify factors that influence nurses’ documentation in residential aged care in Queensland. A factor analysis was undertaken to extract influencing factors. The second study developed and tested a conceptual model of nursing practice and quality of care to determine relationships between the factors under investigation. This phase used a smaller sample of RNs (n = 46). Participating RNs were asked to provide personal characteristics (e.g. age, gender, first nursing qualification and studies in aged care) and to complete Edelstein’s (1990) modified questionnaire. A chart audit was conducted on residents’ records where the resident required interventions for challenging behaviour. Relatives of residents whose charts were audited also completed a survey to measure their perceived satisfaction with care of their family member. Finally, a model of the relationships between documentation and outcome measures was developed on the basis of prior literature and previous empirical studies. This model was labelled “The Nursing Practice and Quality of Care Model”. This model was then tested with a smaller sample of RNs, seeking to find out if it appropriately represented the relationships that exist between RN documentation and outcomes. Edelstein’s (1990) modified questionnaire was demonstrated to have acceptable reliability and validity. Results of Study 1 revealed that RNs working in aged care in Queensland have high levels of knowledge about documentation, and consider the forms they use to document care to be very important, but have mixed attitudes towards documentation. Several issues influenced the results for the knowledge and attitude scales. These included knowledge factors such as care-reporting guidelines, nurse time issues, legal issues and quality of reporting. Attitudes were influenced by charting, practice and policy issues. These findings provide important information on what variables affect RNs’ documentation. The RN participants in Study 2 were comparable to the national and state figures for RN aged care demographics (Hsu, Moyle, Creedy, & Venturato, 2005; Richardson & Martin, 2004). Overall, the findings of Edelstein’s (1990) modified questionnaire in Study 2 were consistent with Study 1, although different relationships were found between the knowledge and attitude factors. The chart audit revealed that although RNs did complete most items on the forms, no form was fully complete, and suggests that RNs are not generally fully compliant with nursing documentation requirements in residential aged care. Relatives of aged care residents were generally happy with the level of care for their family member, but felt that individual issues such as leisure and activity programs, meals, and dining services could be improved. Analysis of “The Nursing Practice and Quality of Care Model” involved structural equation modeling (SEM) to determine the relationship between experiences, knowledge and attitudes toward nursing documentation, compliance with writing nursing documentation and relatives’ satisfaction. Testing revealed that the model was generally a good fit; however, only some variables predicted to be included in the model were significant. Of greatest interest was the strong predictive relationship between care reporting guidelines and caring behaviour, which suggested that the more RNs knew about documentation, the better they were able to care for residents with challenging behaviour. Positive attitudes to policy issues by RNs, and high completion of charting review items also predicted better outcomes for residents. RNs who had studies in aged care showed a relationship with quality issues suggested that the more education RNs completed the more they knew about quality issues. However, there were some significant negative predictive relationships between variables such as quality issues and caring behaviour that were not anticipated. Overall results suggest that some RN documentation factors did significantly predict residents’ quality of care. This is an important step forward in finding ways to improve the care of residents in aged care facilities.
Thesis (PhD Doctorate)
Doctor of Philosophy (PhD)
School of Nursing and Midwifery
Griffith Health
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32

DeBeyer, Carrie Jeanette. "Diabetes care : the status of diabetes care in Queensland residential aged facilities". Thesis, Curtin University, 2010. http://hdl.handle.net/20.500.11937/2627.

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Diabetes care of the elderly in residential aged care facilities has often been unstructured and non-standardised, with disparities in both the practice and knowledge of health care workers caring for this vulnerable group. Poorly controlled diabetes can contribute to a range of adverse events, including impaired wound health and cardiovascular events. The purpose of this study was to establish if current Australian diabetes management guidelines for the elderly are being met in residential aged care facilities in Queensland and identify areas for clinical practice improvement.A cross-sectional, descriptive design was employed to measure demographic data, perceived and actual diabetes-related knowledge, availability of diabetes management and care guidelines, and facilitators and barriers to meeting diabetes related care. A sample of 109 health care workers from residential aged care facilities completed a postal survey.Diabetes guidelines shown to be available in residential aged care facilities were aimed at care planning, with guidelines for both screening and monitoring of diabetes and diabetes care specific skills more available in private aged care and high care classified facilities. Limited monitoring of outcomes of diabetes care were evident. Overall, participants perceived their diabetes knowledge as “good”, however deficits were found in the level of actual knowledge on diabetes complications and medication management. Ratings for perceived and actual diabetes knowledge was higher with older aged health care workers by those employed in their current position the longest.Furthermore, a positive relationship was shown between perceived and actual diabetes knowledge with years of experience in aged care, employment status (RNs/ENs, AINs and other health care workers) and education status (grade 12 schooling, Technology and Further Education and university award). Diabetes – related knowledge was shown to be the most significant facilitator as well as barrier to diabetes care provision. Factors affecting perceived level of confidence in providing diabetes self-management education included experience in aged care, employment position and level of education.The contribution of this research to the area of study was to provide important data on the availability of diabetes guidelines and protocols and diabetes knowledge base. Data has also been provided for the availability of diabetes guidelines and protocols in different facility types and with different classifications of care as well as data for the perceived level of confidence in providing diabetes care in residential aged care facilities. Study findings indicate a need for an increased focus on diabetes care in residential aged care to improve health outcomes.

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33

Johansson, Jan. "Residential care for young people in Sweden : homes, staff, and residents /". Göteborg : Göteborg University, Department of Psychology, 2007. http://www.loc.gov/catdir/toc/fy0712/2007413997.html.

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34

Flesner, Marcia K. "Person centered care : a model for nursing homes /". free to MU Campus, others may purchase, 2003. http://wwwlib.umi.com/cr/mo/fullcit?p3091924.

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35

Grenade, Linda Elise. "Accreditation of residential aged care facilities: experiences of service providers". Thesis, Curtin University, 2003. http://hdl.handle.net/20.500.11937/1306.

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The need to address the issue of quality in aged care service provision in Australia has received increasing emphasis in recent decades. Particularly since the 1980s, the federal government has played a key role in ensuring that this is the case through the implementation of various reforms and regulatory strategies. In 1998, the national standards monitoring system which had been in place since the mid 1980s was replaced with a new system based on an accreditation model. In contrast to the former system which was wholly controlled by government and involved one-off inspections by government standards monitors, responsibility for managing the new system has been devolved to an independent body, the Aged Care Standards and Accreditation Agency. One of the Agency's primary functions is to assess compliance with the accreditation standards. A key component of the new system is its emphasis on continuous improvement which has been incorporated into the accreditation standards. As a consequence, the new system requires a much greater level of involvement and commitment by providers than previously. In order to continue receiving government funding all facilities had to be accredited by January 1st 2001. This study represents an evaluation of the accreditation system based on the views and experiences of service providers in Western Australia. It explored a number of issues relating to the basic philosophy and principles underlying the new system, the implementation process, the accreditation standards that are used as a basis for assessing service quality and the overall impact of the system on providers. It also sought providers' views about the strengths and limitations of the system and any areas in need of change or improvement. A descriptive design, using in-depth interviews as the method of data collection, was adopted for the study.Participants from three levels of service provision, namely, facilities, organisations and peak bodies were selected on a stratified purposive basis. A total of 45 informants were interviewed. The findings indicated that, overall, as a regulatory approach the accreditation system was generally supported by providers and was regarded as having a number of positive features, particularly in comparison to the previous system. At the same time a number of concerns were identified. These related in particular to the assessment process, specifically the lack of consistency amongst assessors and the self assessment tool, and to the extent of information and guidance provided by the Agency. Concerns regarding the latter's role in relation to, and extent of independence from, the federal government were also identified. The study also found that the introduction of the system had impacted on providers in a variety of ways, both positive and negative, but particularly in terms of the demands on staff and financial resources. A number of 'broader' level factors, such as funding, nursing shortages and other often competing demands (e.g. assessing residents according to the Resident Classification Scale) were also felt to be impacting on providers' capacity to meet the requirements of the system. These concerns, along with concerns about the way in which the system would develop in the future, appear to have created a degree of uncertainty and in some cases apprehension amongst many providers. Although this study has focused on the experiences of Western Australian service providers, evidence from other reviews of the accreditation system where providers' views have been sought has indicated a widespread similarity in perceptions. This suggests, therefore, that there is a need for further review and refinement of certain aspects of the system as it moves into the second round.

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36

Grenade, Linda Elise. "Accreditation of residential aged care facilities : experiences of service providers /". Curtin University of Technology, School of Public Health, 2003. http://espace.library.curtin.edu.au:80/R/?func=dbin-jump-full&object_id=15068.

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Abstract (sommario):

The need to address the issue of quality in aged care service provision in Australia has received increasing emphasis in recent decades. Particularly since the 1980s, the federal government has played a key role in ensuring that this is the case through the implementation of various reforms and regulatory strategies. In 1998, the national standards monitoring system which had been in place since the mid 1980s was replaced with a new system based on an accreditation model. In contrast to the former system which was wholly controlled by government and involved one-off inspections by government standards monitors, responsibility for managing the new system has been devolved to an independent body, the Aged Care Standards and Accreditation Agency. One of the Agency's primary functions is to assess compliance with the accreditation standards. A key component of the new system is its emphasis on continuous improvement which has been incorporated into the accreditation standards. As a consequence, the new system requires a much greater level of involvement and commitment by providers than previously. In order to continue receiving government funding all facilities had to be accredited by January 1st 2001. This study represents an evaluation of the accreditation system based on the views and experiences of service providers in Western Australia. It explored a number of issues relating to the basic philosophy and principles underlying the new system, the implementation process, the accreditation standards that are used as a basis for assessing service quality and the overall impact of the system on providers. It also sought providers' views about the strengths and limitations of the system and any areas in need of change or improvement. A descriptive design, using in-depth interviews as the method of data collection, was adopted for the study.
Participants from three levels of service provision, namely, facilities, organisations and peak bodies were selected on a stratified purposive basis. A total of 45 informants were interviewed. The findings indicated that, overall, as a regulatory approach the accreditation system was generally supported by providers and was regarded as having a number of positive features, particularly in comparison to the previous system. At the same time a number of concerns were identified. These related in particular to the assessment process, specifically the lack of consistency amongst assessors and the self assessment tool, and to the extent of information and guidance provided by the Agency. Concerns regarding the latter's role in relation to, and extent of independence from, the federal government were also identified. The study also found that the introduction of the system had impacted on providers in a variety of ways, both positive and negative, but particularly in terms of the demands on staff and financial resources. A number of 'broader' level factors, such as funding, nursing shortages and other often competing demands (e.g. assessing residents according to the Resident Classification Scale) were also felt to be impacting on providers' capacity to meet the requirements of the system. These concerns, along with concerns about the way in which the system would develop in the future, appear to have created a degree of uncertainty and in some cases apprehension amongst many providers. Although this study has focused on the experiences of Western Australian service providers, evidence from other reviews of the accreditation system where providers' views have been sought has indicated a widespread similarity in perceptions. This suggests, therefore, that there is a need for further review and refinement of certain aspects of the system as it moves into the second round.

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37

Curry, Robert John. "Residential homes and development of non-residential community care services : the role of the private sector". Thesis, Keele University, 1998. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.263201.

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38

Horner, Barbara Joan. "The impact and influence of change on a residential aged care community: an action research study". Thesis, Curtin University, 2005. http://hdl.handle.net/20.500.11937/1924.

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This study was an investigation of the complexities and challenges of change in a community-based aged care facility in Western Australia, to reveal the impact and influence of change on the community. It explored the impact of change on both the residents and the senior management team, as leaders of the organisation, and explored how change influenced the redevelopment process and future of the organisation. There is considerable literature on organisational change including the impact of change on the structure, function, process, workforce and leaders of the organisation. There is, however, little literature on organisational change within aged care communities, particularly with an emphasis on the complexities and challenges associated with change within an organisation that is both a business and a home for its residents. The study took the form of a participative action research study, occurring predominantly over two years (2002-2003) with some continuation into a third year (2004). The study had three phases and included two action research cycles and a critical reference group (CRG), comprising the senior management team (SMT) and researcher. It adopted a broadly qualitative methodology, using data from participatory observation and semi-structured interview; however, it did include quantitative and qualitative data from two 'quality of service' surveys for independent living residents and a staff satisfaction survey. The finding of this study are presented as a narrative account of the experiences of the participants. The study reveals that change associated with the redevelopment impacted on residents' wellbeing, described by them as quality of life.The redevelopment process and associated change also emphasised the importance of communication and explanation with residents to understand elements of quality of life and to monitor and manage the impact of change. The findings of the study highlight the challenge faced by community-based aged care communities classified by government, the industry and the wider community as primarily not-for-profit, to balance financial accountability and social conscience. The perception of benevolence influenced the attitudes of residents and staff and made business accountability more difficult to explain and realise. The study reveals that change also impacted on the structure and function of the organisation as it built its capacity for change. It reshaped the relationship between the Board and senior management team (SMT), which was reported as an improvement in communication, work relations and leadership effectiveness. The development of the leadership team, being the senior management team, was influenced by change and the change process enabled this team to become a competent, confident, cohesive senior team, with a preferred leadership style. A further finding was the realisation of the value and appropriateness of the action research process. It provided tools and processes that were used to plan, act, analyse and reflect on the many aspects of organisational change and enabled the organisation, principally the SMT, to reflect on the impact and influence of change. The research process supported their development as leaders as well as the development of the team. The process of planning, collecting data, analysing data, reflection and action provided a structure and process that they continued to use in their management practices, as new situations continued to arise with the redevelopment process.

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39

Huda, Fahmia. "Total quality management in voluntary service organisations : residential and nursing care homes". Thesis, University of Westminster, 1997. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.480907.

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40

Darwesh, Nizam Muhammad. "Low vision and diabetes in older people living in residential care homes". Thesis, University of Bedfordshire, 2015. http://hdl.handle.net/10547/622491.

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Background: Worldwide one in twelve people are living with diabetes and one in two people do not know they have diabetes. Currently large numbers of the older people live in residential care homes in the UK, and up to one in four older people living in residential care homes present with diabetes. Low vision is one of the complications associated with diabetes in older people. In those aged 75 and over, one in five, and in those aged over 90, one in two people are affected by low vision and they are at an increased risk of developing other eye diseases. Within 20 years of diagnosis nearly all people with Type 1 and almost two thirds of people with Type 2 diabetes (60%) have some degree of diabetic retinopathy. Aims and Objectives: This study aimed to investigate the issues and problems faced by older people living in residential care homes with low vision and diabetes; to evaluate health professionals’ knowledge and understanding of the impact of low vision associated with diabetes in older people living in residential care homes; and to develop an educational toolkit which aimed to educate health care assistants about low vision and diabetes. Methods: This study is an exploratory investigation of older people living in residential care homes with low vision and diabetes. Adopting an open-ended qualitative approach using focus groups, interviews and a health professional’s survey, 116 participants were involved. These included GPs, ophthalmologists, nurses, optometrists, health care assistants and older people with low vision and diabetes. The data was analysed thematically. The educational toolkit was developed in the second part of this study, and 20 healthcare assistants were trained using this toolkit. Their knowledge was tested before the training, immediately after the training and one month after the initial training. Following Kirkpatrick’s model, the skills and practical use of the educational toolkit was assessed using an open-ended qualitative approach. Results: The results found that many older people and the health care assistants had the perception that low vision was a normal ageing process and could not be rectified. The study found that there was evidence to suggest that eye health was not considered to be a priority; instead, it was considered to be a natural part of the ageing process. The results found that 82% of the HCAs had not had any training in the area, and more than half of the nurses and GPs did not have sufficient knowledge of low vision and diabetes. After training, however, their knowledge was increased. This suggested that low vision and diabetes toolkit training could be used to educate healthcare assistants on a regular basis. The study also found that knowledge does decline over time, and therefore regular training for HCAs is required in order to maintain eye health and diabetes in older people, as well as improving their quality of life. Conclusion: In the research findings it was found that 50% to 70% of low vision was preventable or treatable if detected in its early stages and could be avoided by simply wearing appropriate spectacles, or possible surgery. However, in order to identify these 50% to 70% with low vision, everyone concerned should be able to recognise the signs and symptoms of preventable low vision, particularly health care assistants, as according to this study, health care assistants spent large amount of time in the residential care homes compared to the other health professionals.

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Ng, Lily. "Family involvment and residential care : decision making about adolescents with behavioural problems /". Hong Kong : University of Hong Kong, 1994. http://sunzi.lib.hku.hk/hkuto/record.jsp?B2066588X.

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42

Bhandari, Kunwar Sushma. "End-of-life care in residential aged care: The perceptions of bereaved family members". Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 2022. https://ro.ecu.edu.au/theses/2590.

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Background In recent years, life expectancy has increased causing a higher global percentage of older people living with multiple chronic health problems including dementia. This increase in the aged population with complicated health issues has required governments and health care systems internationally to provide suitable accommodation and health care support such as residential aged care facilities. In residential aged care facilities comprehensive and holistic health care and assessment should ensure good quality of life and a supported death. The Australian Royal Commission into Aged Care Quality and Safety (2021) recognised a need for improvement in the residential aged care sector highlighting end of life care as a core business in aged care. Little research has been completed to explore the family perspective of end of life care provided in the residential aged care setting. Methods This study used an inductive interpretive research method to explore participants’ experiences of their relatives’ end of life care within two residential aged care facilities in Western Australia. Two facilities assisted with the recruitment of participants (n=5) and provided letters of support, and one participant (n=1) was recruited via an advertisement and did not disclose the facility. Fifty one potential participants from two residential aged care facilities were invited to participate in the study, with (n=5) family members agreeing. Qualitative data collection was undertaken using semi-structured face to face individual interviews with six participants utilising predesigned interview questions. The interviews were conducted in the aged care facilities’ meeting rooms (n=5), and Edith Cowan University’s meeting room (n =1) with each interview lasted for approximately 60 to 90 minutes. The eight Principles for Palliative and End of Life Care in Residential Aged Care from Palliative Care Australia were applied as the conceptual framework for the study. Results Through the analysis of data collected from participants, two themes and subthemes were identified about their experiences during the end of life care period of their family member. Family reflecting on care described their experiences of personal care, emotional and spiritual care, symptom management, grief and bereavement, and concerns about care. Providing a supportive environment was related to the palliative care plan, involving families in care, care delivery, staff communication with family, and the physical environment. Families generally observed and expressed satisfaction to the emotional and spiritual care, and to some degree to personal care and pain management. Additionally, most of the families stated that the physical environment of the facility was appropriate, however, key aspects of care highlighted for improvement included bereavement support, and the need for improved communication with families, and in providing timely information. Participants further observed that care staff were attentive, however, two participants mentioned that their expectations of professional behaviour was not met by all staff as they experienced poor communication from a few staff and one participant perceived a personality clash with care staff member. Conclusion This thesis explored the end of life care in Australian residential aged care facilities from the perspective of bereaved family members using a qualitative interpretative methodology. Findings from this study suggest that bereaved families perceived personal, emotional and spiritual care of the residents as satisfactory. Similarly, medication and pain symptoms management were observed to have met most of the families’ expectation. Additionally, emotional, psychological and religious supports was offered to the residents and their family, and they were involved in care discussions and decisions. Issues in communication and post death support and a lack of awareness to the cultural sensitivity were the key aspects identified for improvement.

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McKenzie-Green, Barbara. "Living life in residential aged care: A process of continuous adjustment". Thesis, Australian Catholic University, 2010. https://acuresearchbank.acu.edu.au/download/320774175c89792c3179b6b3583c698b49a8502b130a6659b78c752f33a2bc23/2084272/Barbara_McKenzie_Green_2010_Living_life_in_residential__aged_care.pdf.

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The aim of this study was to examine whether, and how, residents living in residential aged care homes become involved in their care, and what areas of their care and life they work to influence or negotiate.

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Johnson, Eleanor. "The costs of care : an ethnography of care work in two residential homes for older people". Thesis, Cardiff University, 2018. http://orca.cf.ac.uk/115107/.

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This thesis is an ethnography of care work conducted in two differently priced private residential homes for older people in Southern England. Drawing upon around eight hundred hours of participant observation and interviews undertaken with thirty care workers, I examine the everyday interactions, routines, and rituals of care work. I identify how political-economic factors, working conditions, material resources, and workplace cultures produce particular kinds of care and I consider the contribution which social theory can make to sharpening our understanding of the care industry. I begin by exploring how work is divided-up, scheduled, and allocated to care workers and how, by defining what activities are of value, these forms of organising work shape the content and nature of caregiving. I extend this analysis of the everyday rituals and routines of care work by focusing in particular on care workers’ attitudes and practices concerning hygiene and bodily waste, and dying and death. Here, care workers’ ideas about the private and the public, the dirty and the clean, and the profane and the sacred, are established and reaffirmed by marking out boundaries between materials, spaces, and persons. The research shows how the availability of material resources, by facilitating or impeding such symbolic work, shapes care workers’ ability to show respect and moral regard towards the individuals in their care. Whilst it is undeniable that the funding of care is directly linked to the quality of the service provided, this research argues that we also need a cultural and material architecture of care that is sensitive to our need for moral and symbolic treatment.

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De, Bellis Anita Marie, e anita debellis@flinders edu au. "Behind Open Doors - A Construct of Nursing Practice in an Australian Residential Aged Care Facility". Flinders University. School of Nursing & Midwifery, 2006. http://catalogue.flinders.edu.au./local/adt/public/adt-SFU20061107.122002.

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This thesis explored the relationship between the discourses of nursing care, the nursing care provision, and the perceived nursing care needs of three highly dependent residents in a residential aged care facility in Australia. Residential aged care in this country has undergone major reforms since 1987 and the nursing profession has struggled with these changes because of the documentation, validation, and accreditation requirements; the inadequate determination of dependency on nursing care for funding; the Registered Nurse (RN) being removed from the bedside to a role of scribe and delegator; the increasing acuity and complexity of the residents' needs; an increase in the turnover of residents; a rise in the nursing staff attrition rate; the delivery of care by untrained and unqualified persons; the RN being accountable and responsible for the care given by 'non-nurses' from a distance; and, the inadequate skill mix and staff to resident ratios provided in these institutions. The interest of this thesis was to research gerontological nursing practice in the context of residential aged care. Residential Aged Care Facilities (RACFs) in Australia that care for the highly dependent elderly were identified in the thesis as disciplinary institutions that used 'subjectivation' as a means to control the efficiency and effectiveness of the labour force and the 'docile' bodies of the residents, whilst at the same time the government rhetoric is that of the quality of life standards and the rights of residents in these institutions. As well as the discourse analysis, an historical overview of the aged care reforms in Australia was undertaken for the period from 1975 to 2006 that demonstrated the effects the reforms have had on the voice of nurses and nursing care in these institutions. This analysis highlighted where nurses have been silenced and found the federal government determining what is nursing care and what is not nursing care, and also who is providing this nursing care. Using a case study approach and discourse analysis each of the three residents was studied using data from five sources namely the resident or relative, a RN, a careworker (CW), the current documentation pertaining to the resident's nursing care, and the non-participant observation of the nursing care provided. These discourses on the nursing care and perceived residents' nursing care needs were analysed using the theoretical base developed from the philosophy and research interest of Michel Foucault (1926-1984), who questioned the apparatus and institutions of Western cultures and searched for discontinuities in the practices of what he termed 'disciplines'. The results of the discourse analysis found nursing care practices that were alarming around the residents' perceived nursing care needs, the documentation of the nursing care provision, and the observed 'actual' nursing care provided. A questionable standard of nursing care was evidenced even though this facility had recently been accredited. A custodial level of mechanistic care was provided to residents in an extremely noisy and public environment within a culture of haste and bustle by unknowledgeable CWs, under the distant gaze of a RN, and the direction of the government documentation requirements. This resulted in unsafe, unethical, unprofessional, and negligent practices, as well as fraudulent, illegal, and dangerously out of date documentation practices. This was ultimately affecting each resident's quality of life, nursing care, and wellbeing and was an added burden on the residents' relatives. Many discontinuities, dissonances, conflicts, and contradictions in nursing practice were uncovered for these three highly dependent residents that may be transferable and similar to other highly dependent residents in this and other institutions. Indeed it may mirror other disciplines that provide care services, such as mental health care, acute care, and disability care provision. The concerns for the nursing profession have epistemological, ethical, and political ramifications for the residents and their relatives, the nurses, the non-nurses doing nursing work, the government, and the industry. Epistemologically new nursing 'knowledges' were being developed that were not resident focussed or based on evidence. Ethically, the legislated rights of residents were not being supported, despite the accreditation, funding, and complaint mechanisms in place - and this has the potential to have punitive ramifications for the industry. Professionally and politically, CWs were identified as non-nurses doing nursing work of a poor standard. This care was not based on accepted nursing practice, but developed through the documentation requirements of the federal government department, the applied constraints, and the CWs themselves. Furthermore, the documentation requirements were found to be a pretence in regard to funding through validation and accreditation, as well as a charade in nursing practice. There is presently a substantial third level of nurses who are identified legally and political as non-nurses doing non-nursing work (known as 'personal' care); but these non-nurses are doing nursing work and are identified by the nursing profession and the public as 'nurses' doing nursing work. These non-nurses who provided nursing care are not educated, licensed, or regulated, and are not accountable professionally to nurses or legally to the public. It is proposed that CWs are in need of licensing under nurses' boards requiring at the very least a minimum of training and education. It is further proposed that documentation requirements resort back to professional nursing documentation; funding be dependent on an predetermined minimum skill mix and staff/resident ratio; and the funding of residents be based on a minimum data set and untied from nursing practice. The professional nursing practice of assessment, planning, implementation, and evaluation of nursing care needs resorting to a nursing domain of knowledge, practice, accountability, responsibility, and documentation. If an acceptable quality of life is to be realised for residents in the residential aged care system, given that highly dependent residents are reliant on quality nursing care that is fundamentally imperative to their very quantity and quality of life, then changes in the residential aged care system and the nursing profession will be necessary. This thesis will contribute to opening up such dialogue between the government, the industry, and the nursing profession in Australia, and it also highlights areas of aged care nursing practice in need of further research.

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Häggström, Elisabeth. "Municipal care for older people : experiences narrated by caregivers and relatives /". Stockholm : Gävle : Neurotec Department, Division of Gerontological Science, Karolinska institutet ; University of Gävle, 2005. http://diss.kib.ki.se/2005/91-7140-186-5/.

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Moxon, Sallie. "The role of care staff in identifying and managing depression in residential homes". Thesis, University of York, 2003. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.399259.

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Horner, Barbara Joan. "The impact and influence of change on a residential aged care community: an action research study". Curtin University of Technology, Centre for Research into Aged Care Services, 2005. http://espace.library.curtin.edu.au:80/R/?func=dbin-jump-full&object_id=16051.

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This study was an investigation of the complexities and challenges of change in a community-based aged care facility in Western Australia, to reveal the impact and influence of change on the community. It explored the impact of change on both the residents and the senior management team, as leaders of the organisation, and explored how change influenced the redevelopment process and future of the organisation. There is considerable literature on organisational change including the impact of change on the structure, function, process, workforce and leaders of the organisation. There is, however, little literature on organisational change within aged care communities, particularly with an emphasis on the complexities and challenges associated with change within an organisation that is both a business and a home for its residents. The study took the form of a participative action research study, occurring predominantly over two years (2002-2003) with some continuation into a third year (2004). The study had three phases and included two action research cycles and a critical reference group (CRG), comprising the senior management team (SMT) and researcher. It adopted a broadly qualitative methodology, using data from participatory observation and semi-structured interview; however, it did include quantitative and qualitative data from two 'quality of service' surveys for independent living residents and a staff satisfaction survey. The finding of this study are presented as a narrative account of the experiences of the participants. The study reveals that change associated with the redevelopment impacted on residents' wellbeing, described by them as quality of life.
The redevelopment process and associated change also emphasised the importance of communication and explanation with residents to understand elements of quality of life and to monitor and manage the impact of change. The findings of the study highlight the challenge faced by community-based aged care communities classified by government, the industry and the wider community as primarily not-for-profit, to balance financial accountability and social conscience. The perception of benevolence influenced the attitudes of residents and staff and made business accountability more difficult to explain and realise. The study reveals that change also impacted on the structure and function of the organisation as it built its capacity for change. It reshaped the relationship between the Board and senior management team (SMT), which was reported as an improvement in communication, work relations and leadership effectiveness. The development of the leadership team, being the senior management team, was influenced by change and the change process enabled this team to become a competent, confident, cohesive senior team, with a preferred leadership style. A further finding was the realisation of the value and appropriateness of the action research process. It provided tools and processes that were used to plan, act, analyse and reflect on the many aspects of organisational change and enabled the organisation, principally the SMT, to reflect on the impact and influence of change. The research process supported their development as leaders as well as the development of the team. The process of planning, collecting data, analysing data, reflection and action provided a structure and process that they continued to use in their management practices, as new situations continued to arise with the redevelopment process.

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Deadrick-Boone, Karima Aisha. "The perceived influence of spirituality in adolescent residential group homes". CSUSB ScholarWorks, 2004. https://scholarworks.lib.csusb.edu/etd-project/2647.

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This qualitative study explores the perceived influence of spirituality on ethnic minority adolescent's outcomes in faith-based residential group homes. Study results offer a deeper understanding of the influence and implementation of spiritual practices among children impacted by child welfare.

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Bostick, Jane E. "The relationship of nursing personnel and nursing home care quality". MU has:, 2002. http://wwwlib.umi.com/cr/mo/fullcit?3052150.

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Tesi sul tema "Residential Aged Care Homes"

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