Статті в журналах: "Home in a nursing home"

1

Hirth, Richard A., Jane C. Banaszak-Holl, and John F. McCarthy. "Nursing Home-to-Nursing Home Transfers." Medical Care 38, no. 6 (June 2000): 660–69. http://dx.doi.org/10.1097/00005650-200006000-00007.

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2

VALEO, TOM. "Home Sweet Nursing Home." Neurology Now 2, no. 4 (July 2006): 42–43. http://dx.doi.org/10.1097/01222928-200602040-00021.

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3

de Veer, Anke J. E., and Ada Kerkstra. "Feeling at home in nursing homes." Journal of Advanced Nursing 35, no. 3 (August 23, 2001): 427–34. http://dx.doi.org/10.1046/j.1365-2648.2001.01858.x.

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4

Cowart, Marie E., and Jill Quadagno. "From Nursing Homes to Home Care." Journal of Aging & Social Policy 7, no. 3-4 (June 26, 1996): 1–2. http://dx.doi.org/10.1300/j031v07n03_01.

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5

Berdes, Celia. "The Modest Proposal Nursing Home: Dehumanizing Characteristics of Nursing Homes in of Nursing Home Residents." Journal of Applied Gerontology 6, no. 4 (December 1987): 372–88. http://dx.doi.org/10.1177/073346488700600402.

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6

Bowblis, John R. "Nursing home prices and market structure: the effect of assisted living industry expansion." Health Economics, Policy and Law 9, no. 1 (July 26, 2013): 95–112. http://dx.doi.org/10.1017/s174413311300025x.

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AbstractSince the 1990s, there has been substantial expansion of facility-based alternatives to nursing home care, such as assisted living facilities. This paper analyzes the relationship between expansion of the assisted living industry, nursing home market structure and nursing home private pay prices using a two-year panel of nursing homes in the State of Ohio. Fixed effect regressions suggest that the expansion of assisted living facilities are associated with increased nursing home concentration, but find no effect on private pay nursing home prices. This would be consistent with assisted livings reducing demand for nursing homes by delaying entry into a nursing home, though assisted livings are not direct competitors of nursing homes.

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7

Xie, Shuyan, Yang Xiao, and Hsiao-Hwa Chen. "Nursing Homes and E-health." International Journal of Healthcare Delivery Reform Initiatives 1, no. 4 (October 2009): 48–67. http://dx.doi.org/10.4018/jhdri.2009100104.

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A nursing home provides skilled nursing care and rehabilitation services to people with illnesses, injuries or functional disabilities, but most facilities serve the elderly. Nursing homes provide various services for different residents’ needs, including daily care, assistance for the mentally disabled, and drug rehabilitation. The levels of care and quality of care provided by nursing homes have increased significantly over the past decade. The trend is toward continuous quality development and resident satisfaction; therefore, healthcare technology plays a significant role in nursing home operations. This article discusses general information about current nursing home conditions and systems in the United States and explores how technology and e-health help improve the nursing home development based on the present needs and trends. The authors also report on Thomasville Nursing Home, discussing current trends in nursing home technologies.

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Hirth, Richard A., Jane C. Banaszak-Holl, Brant E. Fries, and Marc N. Turenne. "Does Quality Influence Consumer Choice of Nursing Homes? Evidence from Nursing Home to Nursing Home Transfers." INQUIRY: The Journal of Health Care Organization, Provision, and Financing 40, no. 4 (November 2003): 343–61. http://dx.doi.org/10.5034/inquiryjrnl_40.4.343.

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9

Lundgren, Dan, Marie Ernsth Bravell, Ulrika Börjesson, and Ingemar Kåreholt. "The Association Between Psychosocial Work Environment and Satisfaction With Old Age Care Among Care Recipients." Journal of Applied Gerontology 39, no. 7 (June 14, 2018): 785–94. http://dx.doi.org/10.1177/0733464818782153.

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This study examines the association between nursing assistants’ perceptions of their psychosocial work environment and satisfaction among older people receiving care in nursing homes and home care. Cross-sectional surveys were conducted among people receiving care ( N = 1,535) and nursing assistants ( N = 1,132) in 45 nursing homes and 21 home care units within municipal old-age care. Better psychosocial work environment was related to higher satisfaction in old-age care among the recipients. Significant and stronger associations were more common in nursing homes than in home care. Perception of mastery and positive challenges at work were associated with higher recipient satisfaction both in home care and in nursing homes: social climate, perception of group work, perception of mastery, and positive challenges at work only in nursing homes. Findings suggest that recipient satisfaction may be increased by improving the psychosocial work environment for nursing assistants, both in nursing homes and in home care.

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Lundgren, Dan, Marie Ernsth Bravell, Ulrika Börjesson, and Ingemar Kåreholt. "The Impact of Leadership and Psychosocial Work Environment on Recipient Satisfaction in Nursing Homes and Home Care." Gerontology and Geriatric Medicine 5 (January 2019): 233372141984124. http://dx.doi.org/10.1177/2333721419841245.

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This study examines the association between nursing assistants’ assessment of leadership, their psychosocial work environment, and satisfaction among older people receiving care in nursing homes and home care. Cross-sectional surveys were conducted with nursing assistants ( n = 1,132) and people receiving care ( n = 1,535) in 45 nursing homes and 21 home care units. Direct leadership was associated with the psychosocial work environment in nursing homes and home care. Furthermore, better leadership was related to higher satisfaction among nursing assistants and older people in nursing homes. Thus, indirect leadership had no effect on recipients’ satisfaction in either nursing homes or home care. The path analysis showed an indirect effect between leadership factors and recipient satisfaction. The findings suggest that the psychosocial work environment of nursing assistants and recipient satisfaction in nursing homes can be increased by improving leadership.

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11

Haun, Courtney N., Zachary B. Mahafza, Chassidy L. Cook, and Geoffrey A. Silvera. "A Study Examining the Influence of Proximity to Nurse Education Resources on Quality of Care Outcomes in Nursing Homes." INQUIRY: The Journal of Health Care Organization, Provision, and Financing 55 (January 1, 2018): 004695801878769. http://dx.doi.org/10.1177/0046958018787694.

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This examination seeks to determine the influence of proximal density to nurse education resources (nursing schools) on nursing home care quality outcomes in Alabama. Motivated by the social network theory, which highlights the influence of relational closeness on shared resources and values, we hypothesize that nursing homes that have higher levels of nursing education resources within a close proximity will exhibit significantly higher nursing home quality outcomes. As proximal density to nurse education resources increases, the opportunity for nursing homes to build closer, stronger ties increase, leading to higher quality outcomes. We examine this hypothesis via ordered logistic regressions of proximal density measures developed through geographic information systems (GIS) software, nurse education resource data from Johnson & Johnson’s Campaign for Nursing’s Future (n = 37), and nursing home quality outcome data from Centers for Medicare and Medicaid Services’s (CMS) Nursing Home Compare from 2016 (n = 226). The results find that increases in proximal density to nurse education resources have a negative and significant association with nursing home quality outcomes in Alabama. Additional sensitivity analysis, which examines the degree to which the nature of this relationship is sensitive to health care facilities’ location in high-density areas, is offered and confirms principal findings. Because nursing programs generally have stronger ties with hospitals, the findings suggest that the nursing homes in areas with higher nurse education resources may actually face greater competition for nurses.

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12

Peisah, Carmelle, Tiffany Jessop, and Henry Brodaty. "Nursing home." Medical Journal of Australia 209, no. 7 (October 2018): 324. http://dx.doi.org/10.5694/mja17.01196.

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13

Fink, Robert A. "Nursing Home." JAMA 296, no. 2 (July 12, 2006): 146. http://dx.doi.org/10.1001/jama.296.2.146.

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14

Perraillon, Marcelo Coca, Daniel J. Brauner, and R. Tamara Konetzka. "Nursing Home Response to Nursing Home Compare: The Provider Perspective." Medical Care Research and Review 76, no. 4 (August 11, 2017): 425–43. http://dx.doi.org/10.1177/1077558717725165.

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Nursing Home Compare (NHC) publishes composite quality ratings of nursing homes based on a five-star rating system, a system that has been subject to controversy about its validity. Using in-depth interviews, we assess the views of nursing home administrators and staff on NHC and unearth strategies used to improve ratings. Respondents revealed conflicting goals and strategies. Although nursing home managers monitor the ratings and expend effort to improve scores, competing goals of revenue maximization and avoidance of litigation often overshadow desire to score well on NHC. Some of the improvement strategies simply involve coding changes that have no effect on resident outcomes. Many respondents doubted the validity of the self-reported staffing data and stated that lack of risk adjustment biases ratings. Policy makers should consider nursing home incentives when refining the system, aiming to improve the validity of the self-reported domains to provide incentives for broader quality improvement.

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15

Susanti, Nurvi, Zulfan Saam, Nofrizal Nofrizal, Zahtamal Tamal, and Nofri Hasrianto. "Elderly Psychological Conditions in the Nursing Home Tresna Werdha (Pstw): A Study Descriptive Riau and West Sumatra Indonesia." Open Access Macedonian Journal of Medical Sciences 9, E (November 15, 2021): 1393–97. http://dx.doi.org/10.3889/oamjms.2021.6219.

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The aspects of emotion, memory, motivation and independence are psychological conditions that are often experienced by the elderly who live in nursing homes. experienced by the elderly who are in the nursing home environment. This study aims to describe the psychological condition of the elderly in the Husnul Khotimah Pekanbaru social home for 35 elderly and 45 elderly Sabai Nan Aluih Pariaman nursing home. This research is a descriptive survey. The research subjects were 80 elderly who were taken with the total sampling technique. Data were collected using questionnaire sheets and descriptive analysis, this study shows that the psychological condition of the elderly which includes emotional aspects of the nursing home in the second category of the Husnul Khotimah nursing home is (69%) and the Sabai Nan Aluih nursing home is 73%.(80%) in the Husnul Khotimah nursing home and 69% in the good category in the Sabai Nan Aluih nursing home. Motivational aspectat both nursing homes is in the moderate category (51%) The independence aspect is in the good category (80%) in the Husnul Khotimah nursing home while the sufficient category is 67% in the Sabai Nan Aluih nursing home. Broadly speaking, the aspects of emotion, memory, motivation are good categories, category motivation is sufficient and the category independence is good at the Husnul Khotimah nursing home and sufficient at the Sabai Nan Aluih nursing home.

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16

HARNETT, TOVE, and HÅKAN JÖNSON. "Shaping nursing home mealtimes." Ageing and Society 37, no. 4 (January 13, 2016): 823–44. http://dx.doi.org/10.1017/s0144686x1500152x.

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ABSTRACTA number of studies stress the importance of positive mealtime experiences for nursing home residents. However, the components that comprise an ideal nursing home meal remain unclear, reflecting the ambiguity of whether nursing homes should be framed as institutions, domestic settings or a type of hotel. In this study, nursing home meals were viewed as situations that the involved parties could continuously modify and ‘work on’. The aim was to analyse how the staff and residents shaped mealtimes by initiating frames and acting according to established social scripts. The study was based on semi-structured interviews with staff and residents and on ethnographic data, consisting of 100 hours of observations at two nursing home settings in Sweden. The analysis revealed how staff and residents interactively shaped meals using institutional, private or restaurant frames. There were three important findings: (a) an institutional meal frame was dominant; (b) there were substantial difficulties in introducing private frames and established private scripts for meals, since such meal versions are personal and not easy to transport into collective settings; (c) successful creation of private or home-like meal situations illustrates an often overlooked skill in care work. Making meals as ‘care-free’ as possible can be viewed as a way to operationalise the goal of providing a non-institutional environment in nursing homes.

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17

Hammerschmidt, Judith, Lina Heier, and Nicole Ernstmann. "Enablement of nursing home residents in infection prevention during general practitioner visits: A qualitative study." PLOS ONE 17, no. 4 (April 7, 2022): e0266502. http://dx.doi.org/10.1371/journal.pone.0266502.

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Introduction Hand hygiene measures are essential to protect nursing home residents against nosocomial infections. Evidence on the prevention of nosocomial infections for nursing home residents by general practitioners during their medical visits in nursing homes or how they enable nursing home residents to perform hand hygiene measures is lacking. This study aimed to explore hand hygiene behaviors of general practitioners in nursing homes, their attitudes toward infection prevention measures, and the enablement of nursing home residents in performing hand hygiene measures. Materials and methods Semi-structured interviews were conducted with general practitioners and nursing home residents in Germany. Interviews were audio-recorded and transcribed. Data were analyzed using thematic content analysis. Results Overall, 12 general practitioners and 12 nursing home residents participated in the study. The general practitioners expressed the fact that the possibilities for practicing hand hygiene differ in individual nursing homes. For nursing home residents, the availability of hand rub solutions was limited. Instructions for residents on hand disinfection from general practitioners was not described. Due to the lack of enablement, the residents’ knowledge on how to correctly perform hand hygiene was low, although some of the nursing home residents have experience with multidrug-resistant organisms. The nursing home residents varied in their needs for active participation and enablement during the general practitioners visit. Conclusion Nursing home residents require continuous enablement by their general practitioners to maintain adequate hand hygiene. Therefore, general practitioners should consider the different needs of nursing home residents to ensure adequate individual hand hygiene and safety for the residents. Existing guidelines for infection prevention and control do not adequately cover the nursing home care setting for the enablement of residents to enquire about hand hygiene.

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18

HIGGS, PAUL F. D., LEA D. MACDONALD, JOHN S. MACDONALD, and MICHAEL C. WARD. "Home from home: residents' opinions of nursing homes and long-stay wards." Age and Ageing 27, no. 2 (1998): 199–205. http://dx.doi.org/10.1093/ageing/27.2.199.

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19

Yu, Lei. "Covid-19 Swept Nursing Homes in the United States." Innovation in Aging 4, Supplement_1 (December 1, 2020): 939. http://dx.doi.org/10.1093/geroni/igaa057.3439.

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Abstract Nursing Homes experienced a colossal loss impacted by the Covid-19 pandemic in the United States. This study applied Covid-19 Nursing Home Dataset (updated on 08/16/2020) released by Data.CMS.gov to explore possible factors behind the death s at nursing homes. The results indicated 2.55 residents died per week at a nursing home averagely. Besides, the absence of nursing staff, aides, clinical physicians, PPE supplies contributes to more deaths at nursing homes. Lastly, the number of positive COVID-19 cases of nursing home staff positively associate with the number of total deaths of residents（R=0.65). These findings provide more pieces of evidence for nursing home administrators and policymakers to make adjustments to help nursing home residents better cope with challenges caused by the pandemic; however, this dataset is not the final data for the pandmic is not over. Also, the dataset covers few demographic information (gender, race, ethinicty and so on) ; therefore, researchers could explore the relationship between the demographic features and COVID-19 deaths at nursing homes.

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20

Mikkelsen, Anne Sophie, and Maria Kristiansen. "Qualitative Study of the Implementation and Potential of a Social Intervention at Nursing Homes in Denmark." International Journal of Environmental Research and Public Health 18, no. 4 (February 12, 2021): 1808. http://dx.doi.org/10.3390/ijerph18041808.

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(1) Background: The effect of social relations on health and wellbeing is well documented. However, knowledge about social interventions specifically in nursing homes and their potential for health and wellbeing is inadequate. In this qualitative study, we explore the implementation of a social intervention entitled Tell Stories for Life implemented in Danish nursing homes. (2) Methods: Through a qualitative multi-perspective longitudinal approach, nursing home residents and employees were interviewed from May–December 2016 (N = 14). The authors made participatory observations and took field notes. (3) Results: The intervention did not appear to establish or strengthen social relations between nursing home residents. However, nursing home residents enjoyed participating, narrating and having someone listen to their stories. The identity of nursing home residents and their relationships to nursing home employees facilitating the intervention appeared to be strengthened. Barriers were related to lack of support from management, nursing home employees’ educational backgrounds and experiences, and nursing home residents’ cognitive ability. (4) Conclusions: This study found that the Tell Stories for Life intervention did not appear to strengthen and establish social relations among nursing home residents. However, we found that there might be potential for strengthening residents’ sense of identity and the relation between residents and nursing home employees.

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21

Dixon, Diane L. "Creating Home in the Nursing Home." Caring for the Ages 9, no. 7 (July 2008): 10. http://dx.doi.org/10.1016/s1526-4114(08)60182-1.

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22

Mody, Lona, Suzanne F. Bradley, and Susan S. Huang. "Keeping the “Home” in Nursing Home." JAMA Internal Medicine 173, no. 10 (May 27, 2013): 853. http://dx.doi.org/10.1001/jamainternmed.2013.330.

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23

Lee, Jung-Joo, Tse Pei Ng, Ivan Kurniawan Nasution, Jia Yen Eng, Renee Desneige Christensen, and John Chye Fung. "Implementation of a Sense of Home in High-Density Multicultural Singapore Nursing Homes: Challenges and Opportunities." International Journal of Environmental Research and Public Health 19, no. 11 (May 27, 2022): 6557. http://dx.doi.org/10.3390/ijerph19116557.

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Many studies have introduced principles for creating a sense of home in nursing homes, yet they mostly feature cases from low-density developments in Western countries. This raises a question about how those principles are interpreted and implemented in other cultural contexts, especially in high-density, multicultural environments such as Singapore. This paper examines how a sense of home is implemented in Singapore nursing homes, with a specific focus on the role of the built environment. Participant observations were conducted in five nursing homes in Singapore comprising various architectural design typologies, with the focus on the residents’ everyday interactions with their built environment. The study identified the extent of the presence of a sense of home in Singapore’s nursing homes and the prevalence of an institutional care model. More specifically, the study explicates Singapore nursing home residents’ management of privacy and personalization in shared spaces, illuminates the need for holistic implementation of homelike environments integrated with building designs and care programs and reiterates the pivotal role of social relationships in fostering a sense of home for the residents in the nursing homes.

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24

Ryskina, Kira L., R. Tamara Konetzka, and Rachel M. Werner. "Association Between 5-Star Nursing Home Report Card Ratings and Potentially Preventable Hospitalizations." INQUIRY: The Journal of Health Care Organization, Provision, and Financing 55 (January 1, 2018): 004695801878732. http://dx.doi.org/10.1177/0046958018787323.

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Nursing homes’ publicly reported star ratings increased substantially since Centers for Medicare & Medicaid Services’s Nursing Home Compare adopted a 5-star rating system. Our objective was to test whether the improvements in nursing home 5-star ratings were correlated with reductions in rates of hospitalization. We hypothesized that increased attention to 5-star star ratings motivated nursing homes to make changes that improved their star ratings but did not affect their hospitalization rate, resulting in a weakened association between ratings and hospitalizations. We used 2007-2010 Medicare hospital claims and nursing home clinical assessment data to compare the correlation between nursing home 5-star ratings and hospitalization rates before versus after 5-star ratings were publicly released. The correlation between the rate of hospitalization and a nursing home’s 5-star rating weakened slightly after the ratings became publicly available. This decrease in correlation was concentrated among patients receiving post-acute care, who experienced relatively more hospitalizations from best-rated nursing homes. The improvements in nursing home star ratings after the release of Medicare’s 5-star rating system were not accompanied by improvements in a broader measure of outcomes for post-acute care patients. Although this dissociation may be due to better matching of sicker patients to higher-quality nursing homes or superficial improvements by nursing homes to increase their ratings without substantial investments in quality improvement, the 5-star ratings nonetheless became less meaningful as an indicator of nursing home quality for post-acute care patients.

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25

Bollig, Georg, Eva Gjengedal, and Jan Henrik Rosland. "Nothing to complain about? Residents’ and relatives’ views on a “good life” and ethical challenges in nursing homes." Nursing Ethics 23, no. 2 (December 8, 2014): 142–53. http://dx.doi.org/10.1177/0969733014557719.

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Background: Nursing home residents are a vulnerable population. Most of them suffer from multi-morbidity, while many have cognitive impairment or dementia and need care around the clock. Several ethical challenges in nursing homes have been described in the scientific literature. Most studies have used staff members as informants, some have focused on the relatives’ view, but substantial knowledge about the residents’ perspective is lacking. Objective: To study what nursing home residents and their relatives perceive as ethical challenges in Norwegian nursing homes. Research design: A qualitative design with in-depth interviews with nursing home residents, and focus-group interviews with relatives of nursing home residents. The digitally recorded interviews were transcribed verbatim. Analysis was based on Interpretive Description. Participants and research context: A total of 25 nursing home residents from nine nursing homes in Norway, and 18 relatives of nursing home residents from three of these nursing homes. Ethical considerations: This study was reported to and approved by the Regional Ethics Committee in Oslo, Norway. Findings and discussion: The main ethical challenges in Norwegian nursing homes from the residents’ and relatives’ perspective were as follows: (a) acceptance and adaptation, (b) well-being and a good life, (c) autonomy and self-determination, and (d) lack of resources. The relationship with the staff was of outmost importance and was experienced as both rewarding and problematic. None of the residents in our study mentioned ethical challenges connected to end-of-life care. Conclusion: Residents and relatives experience ethical challenges in Norwegian nursing homes, mostly connected to “everyday ethical issues.”

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Poirier, Donald, and Ginette Thériault. "Les normes juridiques et administratives en matière de droits des résidents de foyers de soins." Canadian Journal on Aging / La Revue canadienne du vieillissement 12, no. 1 (1993): 16–32. http://dx.doi.org/10.1017/s0714980800008242.

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ABSTRACTThe research stems from a legal pluralism approach to law which postulates that different levels of law can operate simultaneously in a given situation. The concept is applied to nursing homes in New Brunswick. The research had three phases. A grid of the rights of nursing home residents was first built. Secondly, New Brunswick law was analysed with that grid. Thirdly, administrative policies gathered from nursing homes were also analysed. The law is often silent with respect to the rights of nursing home residents. However, that vacuum is filled by administrative policies which vary from one nursing home to another. Statistical differences are found between nursing homes administered by religious organizations and those administered by non-profit corporations. Recommendations are made to better protect the rights of nursing home residents.

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Chisholm, Latarsha, Akbar Ghiasi, Justin Lord, and Robert Weech-Maldonado. "Culture Change Initiatives in High Medicaid Nursing Homes: Does Time of Adoption Make a Difference?" Innovation in Aging 4, Supplement_1 (December 1, 2020): 22–23. http://dx.doi.org/10.1093/geroni/igaa057.072.

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Abstract Racial/ethnic disparities have been well documented in long-term care literature. As the population ages and becomes more diverse over time, it is essential to identify mechanisms that may eliminate or mitigate racial/ethnic disparities. Culture change is a movement to transition nursing homes to more home-like environments. The literature on culture change initiatives and quality has been mixed, with little to no literature on the use of culture change initiatives in high Medicaid nursing homes and quality. The purpose of this study was to examine how the involvement of culture change initiatives among high Medicaid facilities was associated with nursing home quality. The study relied on both survey and secondary nursing home data for the years 2017-2018. The sample included high Medicaid (85% or higher) nursing homes. The outcome of interest was the overall nursing home star rating obtained from the Nursing Home Compare Five-Star Quality Rating System. The primary independent variable of interest was the years of involvement in culture change initiatives among nursing homes, which was obtained from the nursing home administrator survey. The final model consisted of an ordinal logistic regression with state-level fixed effects. High-Medicaid nursing homes with six or more years in culture change initiatives had higher odds of having a higher star rating, while facilities with one year or less had significantly lower odds of having a higher star rating. Culture change initiatives may require some time to effectively implement, but these initiatives are potential mechanisms to improve quality in high Medicaid nursing homes.

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Salawu, Adefunke, Jaimon Palatty, and Marian Glynn. "163 Rehabilitation to Nursing Home - The Waiting Period." Age and Ageing 48, Supplement_3 (September 2019): iii17—iii65. http://dx.doi.org/10.1093/ageing/afz103.96.

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Abstract Background The average application processing time for the National Nursing Home Support Scheme (NHSS) has seen drastic improvement from 15 weeks in 2014 to 4 weeks in 20161. There is no available data of the duration of stay in rehabilitation beds after approval of NHSS application and reasons for delay in transition to nursing home. Aims (1) To examine average length of stay in rehabilitation before multidisciplinary team (MDT) decision is made for nursing home care. (2) To examine average length of stay in rehabilitation bed from the time of NHSS approval to discharge into nursing home. (3) To examine reasons for delay in discharge to nursing home after NHSS approval. Methods A retrospective chart review of patients discharged into nursing homes between January to June, 2018 from geriatric rehabilitation units. Data collected include age, length of stay in rehabilitation unit before multidisciplinary decision was made in conjunction with patients/family to seek nursing home care (LOS1), Length of stay in rehabilitation bed following decision for nursing home care (LOS 2). Reasons for the delay in the transition from rehabilitation bed to nursing home bed were also documented. Results Seventeen patients were discharged into nursing homes, LOS1 of 43.12 days and LOS2 of 50 days. Complexity of application in terms of financial evaluation especially for patients who were deemed cognitively incapable of managing their finances, lack of suitable nursing homes for patients with complex needs/challenging behaviours, family dynamics with regards to choice of nursing homes and medical stability to facilitate such transfers were reasons for delay in transition to nursing home beds. Conclusion Transitional care beds, which are generally acknowledged to be more appropriate to these patients' care needs and are less expensive than rehabilitation beds, need to be utilized more. Education of healthy adults over 65 years to proactively plan for future care needs and promote awareness of legislatures regarding capacity and decision making.

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Lan, Xiuyan, Huimin Xiao, and Ying Chen. "Psychosocial Reactions to Relocation to Nursing Homes in Chinese Older Adults." Innovation in Aging 4, Supplement_1 (December 1, 2020): 385. http://dx.doi.org/10.1093/geroni/igaa057.1240.

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Abstract This study aimed to elicit psychosocial reactions to relocation to nursing homes from older adults’ perspectives with a qualitative interview design. Narratives from 23 Chinese nursing home residents from Fuzhou, China in a life review program were recorded, transcribed into sentences, and analyzed with the qualitative content analysis. It revealed five stages of psychosocial reactions to relocation to nursing homes as fear, struggle, compromise, acceptance, and contribution. The first stage resulted from negative labels attached to nursing homes, disconnection to the society, difficulties in establishing new relationships, and being abandoned by their families. The second stage described the behaviors of struggle: complain about family members, think of going back home, pray to have a change, and take action to leave. The third stage described the keys to compromise: choices between maintaining the harmony in family relation and companionship of relatives, choices between professional care and family care, and choices between costs and effects of family care and nursing home care. The fourth stage described how they accept nursing home life: accept the life and yet with worries, affirm benefits of living in nursing homes, and embrace the nursing home life. The last stage resulted from sense of ownership and giving full play to self-worth. This study generated new insights into the knowledge on psychosocial reactions to relocation to nursing homes and provided both family members and nursing home staff with a direction for how to promote a smoother relocation process.

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Schols, J. M. G. A., H. F. J. M. Crebolder, and C. van Weel. "Nursing Home and Nursing Home Physician: The Dutch Experience." Journal of the American Medical Directors Association 5, no. 3 (May 2004): 207–12. http://dx.doi.org/10.1016/s1525-8610(04)70116-4.

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31

Chisholm, Latarsha, Ning J. Zhang, Kathryn Hyer, Rohit Pradhan, Lynn Unruh, and Feng-Chang Lin. "Culture Change in Nursing Homes: What Is the Role of Nursing Home Resources?" INQUIRY: The Journal of Health Care Organization, Provision, and Financing 55 (January 1, 2018): 004695801878704. http://dx.doi.org/10.1177/0046958018787043.

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Quality of care has been a long-standing issue in US nursing homes. The culture change movement attempts to transition nursing homes from health care institutions to person-centered homes. While the adoption of culture change has been spreading across nursing homes, barriers to adoption persist. Nursing homes that disproportionately serve minority residents may have additional challenges implementing culture change compared with other facilities due to limited financial and staffing resources. The objective of this study was to examine how nursing home characteristics are associated with culture change adoption in Central Florida nursing homes. This cross-sectional study included 81 directors of nursing (DONs) who completed the Artifacts of Culture Change survey. In addition, nursing home organizational data were obtained from the Certification and Survey Provider Enhanced Reports (CASPER). A logistic regression was conducted to examine the relationship between high culture change adoption and nursing home characteristics. The overall adoption of culture change scores in Central Florida nursing homes was low. Nevertheless, there was variability across nursing homes in the adoption of culture change. High culture change adoption was associated with nursing homes having lower proportions of Medicaid residents.

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Tingvold, Laila, and Oddvar Førland. "Does context matter? Voluntary work in long-term care." Nordic Journal of Social Research 12, no. 1 (August 11, 2021): 155–80. http://dx.doi.org/10.7577/njsr.3698.

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Introduction: Increased voluntary work in long-term care (LTC) is encouraged in white papers in Norway as well as in many other western states. This is due to the growth in the number of service recipients and a subsequent economic burden for the state. Voluntary work in nursing homes and home care services take place in different spatial contexts, but little attention has been paid to how the different contexts may potentially influence the possibilities for voluntary work. The aim of this study is to obtain new knowledge of the significance of context in recruitment of volunteers in LTC. Method: A cross-sectional study was conducted among leaders in nursing homes and home services in 50 municipalities across all regions of Norway. Descriptive analysis was used. Results: According to the leaders, home care services had less voluntary work than nursing homes. Respondents from home care scored “poor flow of information” and “low interest in the municipality” as major hinderances, more so than respondents from nursing homes did. Discussion: Nursing homes typically have many residents under one roof following a similar schedule. Thus, volunteer-run activities are held more easily at set times and incorporated into the daily life of the institutions. On the other hand, home dwellers in home care stay in a more individualised setting with more autonomy and can opt out of activities that nursing home residents would normally join. Skill acquisition, networking and socializing are common motivations for volunteering, and a nursing home setting may be an easier context to obtain this. The governmental endeavour for increased voluntary work in LTC can be seen as an effort to meet expected rises in public expenditure. However, the realism can be debated due to substantial challenges on the future potential of volunteerism in LTC, especially in the home care context.

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Estrada, Leah, Andrew Dick, Patricia Stone, and Jordan Harrison. "Racial Differences in Infection Management and Palliative Care at End-of-Life in Nursing Homes Nationwide." Antimicrobial Stewardship & Healthcare Epidemiology 1, S1 (July 2021): s69. http://dx.doi.org/10.1017/ash.2021.133.

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Background: Infections are common at end-of-life in older nursing-home residents. This often leads to the overuse of antibiotics and burdensome treatments. Improving infection management through palliative care at the end of life has been proposed as a key strategy to reducing inappropriate antibiotic use. Black nursing-home residents tend to reside in poorly performing nursing homes. We examined palliative care services in nursing homes with varying proportions of black residents. Methods: Cross-sectional, nationally representative nursing-home survey data (2017–2018) was combined with the Minimum Data Set 3.0 (nursing-home resident characteristics), the Certification and Survey Provider Enhanced Reporting data (nursing-home facility characteristics), and the Multidimensional Deprivation Index (county-level poverty estimates). The survey included 24 validated items on nursing-home palliative care services, as well as the nursing home’s infection control program and integration of infection management and palliative care (summative score, 0–100). We used nursing-home facility-level multivariate regression to estimate the relationship between proportion of black residents and palliative care scores, before and after controlling for county-level poverty estimates, facility characteristics, and resident characteristics. We categorized proportion of black residents using methods reported in the literature (25%). Results: The mean weighted palliative-care score in our sample of 869 nursing homes (weighted n = 15,020) was 47.7 (SE, 0.70). In unadjusted analyses, nursing homes with higher proportions of black residents provided significantly fewer palliative care services than nursing homes with no black residents, with the greatest differences (P = .027) observed between nursing homes with >25% black residents (mean palliative care score, 43.82; SE, 2.31) versus nursing homes with no black residents (mean palliative care score, 49.47; SE, 1.08). These disparities persisted after adjustment for urbanicity and county-level poverty rates (p < 0.01) but were attenuated after further adjustment for resident and facility level characteristics (p=0.138). Conclusions: Our findings demonstrate that wide variations in nursing-home palliative-care services exist with increased proportions of black residents, even after accounting for community characteristics. Further research is needed to identify and understand the specific community characteristics that play a role in the provision of palliative care services. Palliative care is a method to reduce inappropriate antimicrobial use at the end of life and should be expanded with a focus on nursing homes with higher proportions of black residents.Funding: NoDisclosures: None

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Lord, Justin, Ganisher Davlyatov, Kali S. Thomas, Kathryn Hyer, and Robert Weech-Maldonado. "The Role of Assisted Living Capacity on Nursing Home Financial Performance." INQUIRY: The Journal of Health Care Organization, Provision, and Financing 55 (January 2018): 004695801879328. http://dx.doi.org/10.1177/0046958018793285.

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The rapid growth of the assisted living industry has coincided with decreased levels of nursing home occupancy and financial performance. The purpose of this article is to examine the relationships among assisted living capacity, nursing home occupancy, and nursing home financial performance. In addition, we explore whether the relationship between assisted living capacity and nursing home financial performance is mediated by nursing home occupancy. This research utilized publicly available secondary data, for the state of Florida from 2003 through 2015. General descriptive statistics were used to assess the relationships among financial performance, assisted living capacity, and occupancy. To explore the relationships among financial performance, assisted living capacity and occupancy, and test potential mediation of occupancy, we followed Baron and Kenny’s approach and estimated 3 models examining the relationships between (1) assisted living capacity and nursing home financial performance, (2) assisted living capacity and nursing home occupancy, and (3) nursing home occupancy and financial performance after assisted living capacity is included in the model. We used generalized estimating equations, to adjust for repeated measures and to model the above relationships. Year fixed effects control for time trend. The independent variable, assisted living beds, was lagged for 1 year to account for the potential influence on financial performance. The final analytic sample consisted of 7688 nursing home-year observations from 657 unique nursing homes. Our findings suggest that assisted living capacity does have a negative impact on nursing homes’ financial performance. Even though, assisted living capacity seems not to significantly decrease nursing home occupancy. The relationship between assisted living capacity and financial performance was not mediated through occupancy. These findings suggest that assisted living communities may not be able to significantly reduce nursing home occupancy; however, the presence of assisted living communities may create additional financial/competitive pressures that result in decreased nursing home financial performance.

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Xiao, Huimin, and Binbin Yong. "Stress and Nursing Home Adjustment: Mediation by Resourcefulness and Self-Efficacy." Innovation in Aging 4, Supplement_1 (December 1, 2020): 184. http://dx.doi.org/10.1093/geroni/igaa057.596.

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Abstract Relocation to a nursing home is often assumed to be associated with stress for older adults. This study aimed to explore how stress affect psychological adjustment of nursing home residents. A cross-sectional survey was conducted. A sample of 386 nursing home residents was recruited from 11 nursing homes in Fujian Province, Southeast China. The Nursing Home Adjustment Scale, Perceived Stress Scale, Resourceful Scale, and General Self-Efficacy Scale were adopted to collect data. The path analysis was used to analyze the relationship of stress, nursing home adjustment, resourcefulness, and self-efficacy. The results indicated that stress directly caused poor nursing home adjustment. It also indirectly affected nursing home adjustment through the mediators of resourcefulness and self-efficacy, respectively. Furthermore, chained mediation was found from stress to nursing home adjustment through resourcefulness, and then through self-efficacy to cope with the negative affect. The current study contributes to the understanding of the mechanism of stress on nursing home adjustment in older adults. To improve their psychological adjustment, additional focus should be placed on enhancing resourcefulness and self-efficacy in nursing home residents.

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Weeks, Lori, Stephanie Chamberlain, and Janice Keefe. "What makes a nursing home a home? Insights from family members and friends." Housing, Care and Support 20, no. 4 (December 18, 2017): 152–63. http://dx.doi.org/10.1108/hcs-05-2017-0013.

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Purpose The purpose of this paper is to explore the concept of homelikeness from the perspective of family members and friends of nursing home residents across different models of nursing homes. Design/methodology/approach This mixed-methods study examined survey data collected from 397 family members and friends of residents living in 23 nursing homes representing three models of care (traditional, new augmented, and full scope). Participants completed a homelikeness scale and a measure of the importance of nursing home spaces to family members and friends. This study also involved conducting three focus groups with 20 family members and friends to provide further insights into the findings. Findings Analysis of survey data indicated quite high levels of homelikeness overall. Significant differences did emerge between traditional model nursing homes compared to new full-scope and new augmented models for all items in the homelikeness scale and for many items about nursing home spaces. Qualitative results provided insights into how homelikeness can be fostered through public and private spaces and through care and relationships. Research limitations/implications As this study was conducted in one Canadian province, the results may not be applicable to other geographic areas. In addition, there are limitations in survey response rate. Practical implications Homelikeness can be supported across models of care by fostering relationships between residents and staff, ensuring that that family and friends feel welcome, and creating public and private physical spaces that are conducive to new and ongoing relationships. Originality/value The results provide evidence to nursing home decision makers about how to foster a homelike environment in various models of nursing homes.

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Chen, M. Keith, Judith A. Chevalier, and Elisa F. Long. "Nursing home staff networks and COVID-19." Proceedings of the National Academy of Sciences 118, no. 1 (December 15, 2020): e2015455118. http://dx.doi.org/10.1073/pnas.2015455118.

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Nursing homes and other long-term care facilities account for a disproportionate share of COVID-19 cases and fatalities worldwide. Outbreaks in US nursing homes have persisted despite nationwide visitor restrictions beginning in mid-March. An early report issued by the Centers for Disease Control and Prevention identified staff members working in multiple nursing homes as a likely source of spread from the Life Care Center in Kirkland, WA, to other skilled nursing facilities. The full extent of staff connections between nursing homes—and the role these connections serve in spreading a highly contagious respiratory infection—is currently unknown given the lack of centralized data on cross-facility employment. We perform a large-scale analysis of nursing home connections via shared staff and contractors using device-level geolocation data from 50 million smartphones, and find that 5.1% of smartphone users who visited a nursing home for at least 1 h also visited another facility during our 11-wk study period—even after visitor restrictions were imposed. We construct network measures of connectedness and estimate that nursing homes, on average, share connections with 7.1 other facilities. Traditional federal regulatory metrics of nursing home quality are unimportant in predicting outbreaks, consistent with recent research. Controlling for demographic and other factors, a home’s staff network connections and its centrality within the greater network strongly predict COVID-19 cases.

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VAN GAALEN, R. D., H. A. HOPMAN, A. HAENEN, and C. VAN DEN DOOL. "Staff exchange within and between nursing homes in The Netherlands and potential implications for MRSA transmission." Epidemiology and Infection 145, no. 4 (December 5, 2016): 739–45. http://dx.doi.org/10.1017/s0950268816002831.

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SUMMARYA recent countrywide MRSA spa-type 1081 outbreak in The Netherlands predominantly affected nursing homes, generating questions on how infection spreads within and between nursing homes despite a low national prevalence. Since the transfer of residents between nursing homes is uncommon in The Netherlands, we hypothesized that staff exchange plays an important role in transmission. This exploratory study investigated the extent of former (last 2 years) and current staff exchange within and between nursing homes in The Netherlands. We relied on a questionnaire that was targeted towards nursing-home staff members who had contact with residents. We found that 17·9% and 12·4% of the nursing-home staff formerly (last 2 years) or currently worked in other healthcare institutes besides their job in the nursing home through which they were selected to participate in this study. Moreover, 39·7% of study participants worked on more than one ward. Our study shows that, in The Netherlands, nursing-home staff form a substantial number of links between wards within nursing homes and nursing homes are linked to a large network of healthcare institutes through their staff members potentially providing a pathway for MRSA transmission between nursing homes and throughout the country.

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Cater, Diana, Serena Hasworth, Diana White, Ozcan Tunalilar, and Jaclyn Winfree. "WHAT MAKES A NURSING HOME FEEL LIKE HOME? RESIDENT PERSPECTIVES." Innovation in Aging 3, Supplement_1 (November 2019): S928—S929. http://dx.doi.org/10.1093/geroni/igz038.3380.

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Abstract Providing an environment that feels like home is increasingly a programmatic goal in nursing homes (NH), yet few NH studies have explored “home” as a concept through a large number of residents’ voices. In the current study, 294 residents living in 32 randomly selected NH in Oregon were asked if it felt like home. We followed up with “what makes it feel like home?” or “what would make it feel more like home?” Open-ended responses were classified via open coding. Six major themes emerged: relationships, meaningful possessions, quality of care, personal autonomy, physical environment, and the impossibility of it feeling like home. Overall, 26% percent of residents found that their current setting felt like home. Among residents who perceived their current setting as feeling like home, the most prominent theme was relationships with people at the nursing home (45% of responses). Residents also emphasized the importance of having family or other meaningful relationships from outside the nursing home (22% of all responses) for an environment that was home. Among those who responded that the nursing home did not feel like home, 32% reported that nothing could replace their home. Results indicate that NH can become home environments for their residents and provides additional evidence that relationship building, personal autonomy, and physical environment are likely critical pillars for creating and sustaining feelings of home. Future research will examine variations in responses described here, including resident or facility characteristics, and length of stay.

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Hege, Adam, Sandi Lane, Trent Spaulding, Margaret Sugg, and Lakshmi S. Iyer. "County-Level Social Determinants of Health and COVID-19 in Nursing Homes, United States, June 1, 2020–January 31, 2021." Public Health Reports 137, no. 1 (November 17, 2021): 137–48. http://dx.doi.org/10.1177/00333549211053666.

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Objectives: Nursing homes are a primary setting of COVID-19 transmission and death, but research has primarily focused only on factors within nursing homes. We investigated the relationship between US nursing home–associated COVID-19 infection rates and county-level and nursing home attributes. Methods: We constructed panel data from the Centers for Medicare & Medicaid Services (CMS) minimum dataset, CMS nursing home data, 2010 US Census data, 5-year (2012-2016) American Community Survey estimates, and county COVID-19 infection rates. We analyzed COVID-19 data from June 1, 2020, through January 31, 2021, during 7 five-week periods. We used a maximum likelihood estimator, including an autoregressive term, to estimate effects and changes over time. We performed 3 model forms (basic, partial, and full) for analysis. Results: Nursing homes with nursing (0.005) and staff (0.002) shortages had high COVID-19 infection rates, and locally owned (−0.007) or state-owned (−0.025) and nonprofit (–0.011) agencies had lower COVID-19 infection rates than privately owned agencies. County-level COVID-19 infection rates corresponded with COVID-19 infection rates in nursing homes. Racial and ethnic minority groups had high nursing home–associated COVID-19 infection rates early in the study. High median annual personal income (−0.002) at the county level correlated with lower nursing home–associated COVID-19 infection rates. Conclusions: Communities with low rates of nursing home infections had access to more resources (eg, financial resources, staffing) and likely had better mitigation efforts in place earlier in the pandemic than nursing homes that had access to few resources and poor mitigation efforts. Future research should address the social and structural determinants of health that are leaving racial and ethnic minority populations and institutions such as nursing homes vulnerable during times of crises.

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Kang, Sehwon, and Changhee Kim. "Effect of Shortages of Personal Protective Equipment and Staff on COVID-19 Infection in Nursing Homes: The Moderating Role of Quality." Korean Production and Operations Management Society 33, no. 2 (May 31, 2022): 325–44. http://dx.doi.org/10.32956/kopoms.2022.33.2.325.

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During the COVID-19 pandemic, more than twenty percent of the total COVID-19 fatalities in the United States originated in nursing homes. While previous studies underline the shortages of personal protective equipment and staff as potential causes that led to the COVID-19 infection, the generalizability of their findings is limited because they focus on certain states or cross- sectional data. This study empirically investigates these effects using nationwide data spanning 29 weeks. Using longitudinal nursing home-level data and panel regression analyses with fixed effects, this study shows that both shortages led to rise in cases in nursing home residents and staff in the United States. In addition, nursing home quality intensifies the unfavorable effect of staff shortage on staff infection. The results imply that there is a trade-off between improving nursing home quality and preventing staff infection in nursing homes. This study contributes to the literature on the healthcare industry and provides practical implications for stakeholders on how they can mitigate the spread of COVID-19 in nursing homes. First, it suggests nursing home administrators develop contingency plans for personal protective equipment. Second, the study proposes amending the laws on nursing homes’ minimum staffing levels.

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Balode, Aija, Anda Stolarova, Anita Villerusa, and Janis Vetra. "Well-being and functional abilities in nursing home and home living seniors in Latvia." SHS Web of Conferences 51 (2018): 02002. http://dx.doi.org/10.1051/shsconf/20185102002.

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The society in developed countries is aging. 1.5% of seniors live in nursing homes in Latvia. Aim: to compare functional abilities and well-being between nursing home and home living Latvian seniors. Methods: 280 home living seniors and 285 from nursing homes, age ≥ 65 years able to respond to questions and stand up were included in the study based on availability. They were asked to describe their well-being from very bad to very good. The functional abilities were assessed by hand grip strength, the ability to stand up without assistance, the dependence on caregivers (1 – independent, 2 – partly dependent, 3 – fully dependent), the use of walking device assistance devices. Results:The home living seniors could stand up without assistance of hands more often than nursing home residents (60.4% vs. 38.2%, p < 0.001). The handgrip strength was higher in the elderly community-dwelling women (0.3 (0.2–0.3) vs. 0.2 (0.15–0.2) Ba), p < 0.001. The nursing home residents were less often independent (62.8% vs. 83.9%, p < 0.001), more often partly dependent (30.2% vs. 14.6%, p < 0.001) and independent (7.0% vs. 1.4%, p = 0,001) while performing activities of daily living. The nursing home residents had higher walking device assistance needs (mean rank 345.7 vs. 219.2, p < 0.001) and described their well-being as “good” more often (28.4% vs. 16.8%, p = 0.001) and less often as “bad” or “very bad” (18.9% vs. 26.8%, p = 0.048). Conclusion. The subjective well-being of elderly nurse home residents is better than of home living seniors despite having less functional abilities.

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Landes, Scott D., and Nikita Lillaney. "Trend Change in the Intellectual Disability Nursing Home Census From 1977 to 2004." American Journal on Intellectual and Developmental Disabilities 124, no. 5 (September 1, 2019): 427–37. http://dx.doi.org/10.1352/1944-7558-124.5.427.

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Abstract The Omnibus Budget Reconciliation Act (OBRA) of 1987 was expected to reduce inappropriate residential placements of persons with intellectual disability (ID) in nursing homes. Utilizing the nationally representative 1977, 1985, 1995, and 2004 National Nursing Home Surveys (NNHS), we estimate trend change in the ID nursing home census pre- and post-OBRA. We find a marked decrease in number and percentage, and a shift in the age distribution of the ID nursing home census, most pronounced between 1985 and 1995. We contend that these trend changes, concurrent with growth in the overall nursing home population, provide empirical evidence that policy changes that occurred during the OBRA enactment period were successful in reducing inappropriate residential placements of persons with ID in nursing homes.

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Shah, Kaushal, Paul Cook, Tae Lee, Muhammad Salman Ashraf, John Christie, and Xiangming Fang. "151Is Nursing Home Specific Antibiogram Necessary for All Nursing Homes?" Open Forum Infectious Diseases 1, suppl_1 (2014): S74—S75. http://dx.doi.org/10.1093/ofid/ofu052.17.

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Mukamel, D. B., W. D. Spector, J. S. Zinn, L. Huang, D. L. Weimer, and A. Dozier. "Nursing Homes' Response to the Nursing Home Compare Report Card." Journals of Gerontology Series B: Psychological Sciences and Social Sciences 62, no. 4 (July 1, 2007): S218—S225. http://dx.doi.org/10.1093/geronb/62.4.s218.

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Brauner, Daniel, Rachel M. Werner, Tetyana P. Shippee, John Cursio, Hari Sharma, and R. Tamara Konetzka. "Does Nursing Home Compare Reflect Patient Safety In Nursing Homes?" Health Affairs 37, no. 11 (November 2018): 1770–78. http://dx.doi.org/10.1377/hlthaff.2018.0721.

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Alexander, Gregory L., Kimberly Powell, Chelsea B. Deroche, Lori Popejoy, Abu Saleh Mohammad Mosa, Richelle Koopman, Lorren Pettit, and Michelle Dougherty. "Building consensus toward a national nursing home information technology maturity model." Journal of the American Medical Informatics Association 26, no. 6 (March 19, 2019): 495–505. http://dx.doi.org/10.1093/jamia/ocz006.

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Abstract Objectives We describe the development of a nursing home information technology (IT) maturity model designed to capture stages of IT maturity. Materials and Methods This study had 2 phases. The purpose of phase I was to develop a preliminary nursing home IT maturity model. Phase II involved 3 rounds of questionnaires administered to a Delphi panel of expert nursing home administrators to evaluate the validity of the nursing home IT maturity model proposed in phase I. Results All participants (n = 31) completed Delphi rounds 1-3. Over the 3 Delphi rounds, the nursing home IT maturity staging model evolved from a preliminary, 5-stage model (stages 1-5) to a 7-stage model (stages 0-6). Discussion Using innovative IT to improve patient outcomes has become a broad goal across healthcare settings, including nursing homes. Understanding the relationship between IT sophistication and quality performance in nursing homes relies on recognizing the spectrum of nursing home IT maturity that exists and how IT matures over time. Currently, no universally accepted nursing home IT maturity model exists to trend IT adoption and determine the impact of increasing IT maturity on quality. Conclusions A 7-stage nursing home IT maturity staging model was successfully developed with input from a nationally representative sample of U.S. based nursing home experts. The model incorporates 7-stages of IT maturity ranging from stage 0 (nonexistent IT solutions or electronic medical record) to stage 6 (use of data by resident or resident representative to generate clinical data and drive self-management).

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Schwab, Timothy C., Kwan-Moon Leung, Eve Gelb, Ying-Ying Meng, and Jodi Cohn. "Home- and Community-Based Alternatives to Nursing Homes:." Journal of Aging and Health 15, no. 2 (May 2003): 353–70. http://dx.doi.org/10.1177/0898264303015002002.

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Huang, Hsiu-Li, Yea-Ing Lotus Shyu, Li-Chueh Weng, Kang-Hua Chen, and Wen-Chuin Hsu. "Predictors of advance directives among nursing home residents with dementia." International Psychogeriatrics 30, no. 3 (August 29, 2017): 341–53. http://dx.doi.org/10.1017/s1041610217001661.

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ABSTRACTBackground:Advance directives are important for nursing home residents with dementia; for those with advanced dementia, surrogates determine medical decisions. However, in Taiwan, little is known about what influences the completion of these advance directives. The purpose of this study was to identify factors, which influence the presence of advance directives for nursing home residents with dementia in Taiwan.Method:Our cross-sectional study analyzed a convenience sample of 143 nursing home dyads comprised of residents with dementia and family surrogates. Documentation of residents’ advance directives, physical and cognitive status was obtained from medical charts. Surrogates completed the stress of end-of-life care decision scale and a questionnaire regarding their demographic characteristics. Nursing home characteristics were obtained from each chief administrator.Results:Less than half of the nursing home residents (39.2%) had advance directives and most (96.4%) had been completed by family surrogates. The following were predictors of an advance directive: surrogates had previously signed a do-not-resuscitate as a proxy and had been informed of advance directives by a healthcare provider; nursing homes had policies for advance directives and a religious affiliation.Conclusions:Advance directives were uncommon for nursing home residents with dementia. Presence of an advance directive was associated with surrogate characteristics and the nursing home facilities; there was no association with characteristics of the nursing home resident. Our findings emphasize the need to develop policies and strategies, which ensure that all residents of nursing homes and their surrogates are aware of their right to an advance directive.

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Ribbe, M. W. "Care for the Elderly: The Role of the Nursing Home in the Dutch Health Care System." International Psychogeriatrics 5, no. 2 (September 1993): 213–22. http://dx.doi.org/10.1017/s1041610293001541.

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Nursing homes, or verpleeghuizen, play an important role in the health care system in the Netherlands. These multifunctional institutions provide clinical and ambulatory (day hospital) care for somatic and psychogeriatric elderly with multiple pathology, disabilities, and handicaps. Quantitative data on morbidity, admission, and discharge of (psychogeriatric) nursing home patients are presented. The data on the nursing home institutions—number of residents, costs, and staff ratios—are placed in the context of the whole health care system. A new trend is to organize nursing home care in homes for the aged via substitution projects and dependences.

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