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Webinar with Dr. Estabrooks and TREC doctoral candidate Stephanie Chamberlain
Going it alone: Unbefriended older adults in long term care
Long term care residents are ‘unbefriended’ if they lack decision-making capacity and a family member or a friend to act as their guardian. Little is known about these residents although they are among the most vulnerable older adults generally and especially in long term care. Stephanie Chamberlain and Dr Carole Estabrooks will describe a research project examining the characteristics and potentially unmet care needs of unbefriended residents in long term care. This presentation will describe what is currently known about unbefriended residents and selected (very) preliminary results from interviews with long term care staff and public guardian representatives in Alberta.
Grants & Awards
Alzheimer Society Research Program
Multiple opportunities available:
– 2018 Grants and Awards Competition (deadline: 6 November 2017)
– Support for Scientific Meetings, Conferences and Congresses (open for 2018)
– Research recruitment (open)
Publications
KT
Health Care Administration and Organization
Health Care Innovation and Quality Assurance
Research Practice and Methodology
Aging
KT
Knowledge mobilisation for policy development: implementing systems approaches through participatory dynamic simulation modelling
Non UofA Access
BACKGROUND: Evidence-based decision-making is an important foundation for health policy and service planning decisions, yet there remain challenges in ensuring that the many forms of available evidence are considered when decisions are being made. Mobilising knowledge for policy and practice is an emergent process, and one that is highly relational, often messy and profoundly context dependent. Systems approaches, such as dynamic simulation modelling can be used to examine both complex health issues and the context in which they are embedded, and to develop decision support tools.
Toward criteria for pragmatic measurement in implementation research and practice: a stakeholder-driven approach using concept mapping
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BACKGROUND: Advancing implementation research and practice requires valid and reliable measures of implementation determinants, mechanisms, processes, strategies, and outcomes. However, researchers and implementation stakeholders are unlikely to use measures if they are not also pragmatic. The purpose of this study was to establish a stakeholder-driven conceptualization of the domains that comprise the pragmatic measure construct. It built upon a systematic review of the literature and semi-structured stakeholder interviews that generated 47 criteria for pragmatic measures, and aimed to further refine that set of criteria by identifying conceptually distinct categories of the pragmatic measure construct and providing quantitative ratings of the criteria’s clarity and importance.
Knowledge translation tools for parents on child health topics: a scoping review 
Non UofA Access
BACKGROUND: An emerging field of knowledge translation (KT) research has begun to focus on health consumers, particularly in child health. KT tools provide health consumers with research knowledge to inform health decision-making and may foster ‘effective consumers’. Thus, the purpose of this scoping review was to describe the state of the field of previously published effectiveness research on child health-related KT tools for parents/caregivers to understand the evidence-base, identify gaps, and guide future research efforts.
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Health Care Administration and Organization
Managerial attitudes and perceived barriers regarding evidence-based practice: An international survey
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Abstract: Evidence-based practice (EBP) in management is still in its infancy. Several studies suggest that managers in businesses and other organizations do not consult the scientific evidence when making decisions. To facilitate its uptake, we need to better understand practitioner attitudes and perceived barriers related to EBP. In medicine and nursing, an abundance of research exists on this subject, although such studies are rare in management. To address this gap, we surveyed 2,789 management practitioners in Belgium, the Netherlands, the United States, the United Kingdom and Australia. Our findings indicate that most managers we studied have positive attitudes towards EBP. However, lack of time and a limited understanding of scientific research are perceived as major barriers to the uptake and implementation of EBP in management. Studies in other professions where EBP is far more established also report similar barriers. We discuss the implications of our findings for practice, education and research, providing suggestions to enhance use of EBP in management practice.
Exploring nursing staff views of responsive behaviours of people with dementia in long-stay facilities
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INTRODUCTION: Caring for people with dementia and responsive behaviours can challenge nurses and little is known of their experiences.
AIM: To explore nurses views of supporting people with dementia and responsive behaviours in long-stay facilities.
Influence of leadership on implementing Dementia Care Mapping: A multiple case study
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Abstract: Dementia Care Mapping is an internationally applied method for enhancing person-centred care for people with dementia in nursing homes. Recent studies indicate that leadership is crucial for the successful implementation of Dementia Care Mapping; however, research on this topic is rare. This case study aimed to explore the influence of leadership on Dementia Care Mapping implementation in four nursing homes. Twenty-eight interviews with project coordinators, head nurses and staff nurses were analysed using qualitative content analysis. Nursing homes that failed to implement Dementia Care Mapping were characterised by a lack of leadership. The leaders of successful nursing homes promoted person-centred care and were actively involved in implementation. While overall leadership performance was positive in one of the successful nursing homes, conflicts related to leadership style occurred in the other successful nursing homes. Thus, it is important that leaders promote person-centred care in general and Dementia Care Mapping in particular. Furthermore, different types of leadership can promote successful implementation.
Factors Influencing New RNs’ Supervisory Performance in Long-Term Care Facilities
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Abstract; In long-term care facilities (LTCF), registered nurses (RNs) perform both clinical and supervisory roles as part of a team aiming to provide high-quality care to residents. The residents have several co-morbidities and complex care needs. Unfortunately, new RNs receive minimal preparation in gerontology and supervisory experience during their program, leading to low retention rates and affecting resident outcomes. This qualitative study explored factors that influence supervisory performance of new RNs in LTCF from the perspective of 24 participants from Ontario, Canada. Data were collected through individual interviews, followed by a directed content analysis. Three levels of influences were identified: personal influences, organizational influences, and external influences. Each level presented with sub-elements, further describing the factors that impact the supervisory performance of the new RN. To retain new RNs in LTC, organizations must provide additional gerontological education and mentoring for new RNs to flourish in their supervisory roles.
Influences on Decision-Making Regarding Antipsychotic Prescribing in Nursing Home Residents With Dementia: A Systematic Review and Synthesis of Qualitative Evidence
Non UofA Access
BACKGROUND: Antipsychotic prescribing is prevalent in nursing homes for the management of behavioral and psychological symptoms of dementia (BPSD), despite the known risks and limited effectiveness. Many studies have attempted to understand this continuing phenomenon, using qualitative research methods, and have generated varied and sometimes conflicting findings. To date, the totality of this qualitative evidence has not been systematically collated and synthesized.
Long-Term Care Nurse Residency Program: Evaluation of New Nurse Experiences and Lessons Learned
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Abstract: Transitioning to long-term care environments presents a significant challenge for new nurses and their directors of nursing. The complexity of this environment, instability of the workforce, and the lack of support structures frequently affect a new nurse’s decision not to apply to long-term care, but to look for positions in acute care hospitals. To address these issues, a long-term care new nurse residency program was developed, implemented, and evaluated in New Jersey through the work of the New Jersey Action Coalition. The purpose of this study was to determine the effects of the residency program on new nurses’ confidence, competence, retention, job satisfaction, and perceptions of organizational safety.
Evaluation of the association between Nursing Home Survey on Patient Safety culture (NHSOPS) measures and catheter-associated urinary tract infections: results of a national collaborative
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BACKGROUND: Recent efforts to reduce patient infection rates emphasise the importance of safety culture. However, little evidence exists linking measures of safety culture and infection rates, in part because of the difficulty of collecting both safety culture and infection data from a large number of nursing homes.
Discovery of Implementation Factors That Lead to Technology Adoption in Long-Term Care
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Abstract: The current exploratory, qualitative study discovered and clarified implementation factors that led to technology adoption in long-term care (LTC). The Integrated Technology Implementation model guided the study of an electronic health record used in three LTC settings. Thirty key stakeholders (i.e., directors of nursing, nurses, and certified nurse aides) participated in focus groups or interviews. Findings indicated experiences were more similar than different among groups and facilities. Five major implementation themes supported by a variety of minor themes were identified. Implications for nursing include that leaders must be knowledgeable and committed to the change and engage staff throughout the implementation process. In addition, various communication and education strategies are required.
International practice settings, interventions and outcomes of nurse practitioners in geriatric care: A scoping review
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OBJECTIVES: To identify and summarize the common clinical settings, interventions, and outcomes of nurse practitioner care specific to older people.
Psychosocial Predictors of Anxiety in Nursing Home Staff
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OBJECTIVES: Although research shows that nursing home staff experience significant levels of stress and burnout, studies analyzing the relationship of psychosocial variables on their feelings of anxiety are scarce. This study aims to analyze the relationship between psychosocial variables and levels of anxiety among staff.
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Health Care Innovation and Quality Assurance
Using comprehensive geriatric assessment for quality improvements in healthcare of older people in UK care homes: protocol for realist review within Proactive Healthcare of Older People in Care Homes (PEACH) study
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Introduction: Care home residents are relatively high users of healthcare resources and may have complex needs. Comprehensive geriatric assessment (CGA) may benefit care home residents and improve efficiency of care delivery. This is an approach to care in which there is a thorough multidisciplinary assessment (physical and mental health, functioning and physical and social environments) and a care plan based on this assessment, usually delivered by a multidisciplinary team. The CGA process is known to improve outcomes for community-dwelling older people and those in receipt of hospital care, but less is known about its efficacy in care home residents.
Effect of Promoting High-Quality Staff Interactions on Fall Prevention in Nursing Homes: A Cluster-Randomized Trial
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IMPORTANCE: New approaches are needed to enhance implementation of complex interventions for geriatric syndromes such as falls.
OBJECTIVE: To test whether a complexity science-based staff training intervention (CONNECT) promoting high-quality staff interactions improves the impact of an evidence-based falls quality improvement program (FALLS).
Optimising mobility through the sit-to-stand activity for older people living in residential care facilities: A qualitative interview study of healthcare aide experiences
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AIMS AND OBJECTIVES:To explore the experience of HCAs encouraging residents living in residential care to complete the sit-to-stand activity and to identify the strategies HCAs used to integrate the activity into their daily work routines.
Use of communication plans by certified nursing assistants: little things mean a lot
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Background: Many residents in long-term care facilities in the United States have communication disorders that impede interactions with staff, particularly certified nursing assistants (CNAs) who provide direct care and are in a position to communicate with residents the most. Researchers in Canada have successfully used individualized communication plans to facilitate staff–resident communication in long-term care settings, but the viability of using communication plans to facilitate staff–resident communication in long-term care facilities in the United States has not been investigated. Aims: This study sought to determine the usefulness of communication plans by CNAs working in long-term care settings when providing personal care to residents with communication disorders and to explore the role support from the speech-language pathologist (SLP) might play in this process. Method & Procedures: The study used a grounded theory qualitative research design. Participants included 10 CNAs working in two long-term care facilities. Each CNA chose two residents with a communication disorder whom they felt might benefit from a communication plan. Communication plans were collaboratively developed by the SLP and the CNA for the selected residents. CNAs used the plans to facilitate communication during daily care of their residents for two weeks. Five CNAs from one facility received support from the SLP; five CNAs from a second facility did not. Following 2 weeks of communication plan use, all CNAs were interviewed. Interviews were transcribed verbatim and data were analyzed using open, axial, and selective coding per grounded theory methodology. Outcomes & Results: Findings indicated that communication plans were useful in facilitating CNA–resident communication. CNA’s negative views of certain aspects of their jobs were altered positively through use of communication plans. They gradually became more familiar with residents which made work less effortful and enriched relationships with residents. Findings also indicated that support for CNAs from a SLP may provide an incentive to use information in the communication plan to more effectively communicate with the resident while providing daily personal care and potentially improving the quality of that care. Conclusions: Communication plans are useful to CNAs in facilitating communication with residents in long-term care facilities and a minimal amount of support from the SLP enhances this process.
Associations Among Healthcare Workplace Safety, Resident Satisfaction, and Quality of Care in Long Term Care Facilities
Non UofA Access
OBJECTIVE: We performed an integrated cross-sectional analysis of relationships between long term care work environments, employee and resident satisfaction, and quality of patient care.
Environmental design for end-of-life care: An integrative review on improving quality of life and managing symptoms for patients in institutional settings
Non UofA Access
CONTEXT: The environment in which end-of-life care is delivered can support or detract from the physical, psychological, social, and spiritual needs of patients, their families, and their caretakers.
OBJECTIVES: This review aims to organize and analyze the existing evidence related to environmental design factors that improve the quality of life and total well-being of people involved in end-of-life care and to clarify directions for future research.
Effects of an Intervention to Reduce Hospitalizations From Nursing Homes: A Randomized Implementation Trial of the INTERACT Program
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OBJECTIVE:To determine whether training and support for implementation of a nursing home (NH) quality improvement program (Interventions to Reduce Acute Care Transfers [INTERACT]) reduced hospital admissions and emergency department (ED) visits.
A Typology of Interprofessional Teamwork in Acute Geriatric Care: A Study in 55 units in Belgium
Non UofA Access
OBJECTIVES: To explore the quality of interprofessional teamwork in acute geriatric care and to build a model of team types.
Life experiences of elderly people with suicide ideation at the long-term care hospitals in South Korea
Non UofA Access
OBJECTIVE: To understand the life experiences of elderly people who are living in long-term care hospitals and are afflicted with suicide ideation.
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Research Practice and Methodology
Metaphorical interpretations of the educator-student relationship: An innovation in nursing educational research
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Abstract: Previous research has shown that collecting and analysing metaphors is a useful strategy in seeking data that are difficult to collect via verbal interviews or that cannot be represented by statistics. This study explored nursing students’ perceptions of the educator-student relationship using metaphorical interpretation. A qualitative study with a personal essay approach was adopted. A total of 124 students were recruited from a nursing school in Hong Kong. A personal essay form was distributed to the participants. They were asked to give a metaphor with explanations to describe the power dynamics in the educator-student relationship, within 200 words in English or Chinese. After some thought, the participants each gave their own metaphor individually, because the aim of this study was to collect their subjective experiences. The results were presented as follows: a) The overall description of the metaphors; b) The three groups of metaphors; c) The fives natures of metaphors; d) The most significant metaphors; and e) The four thematic meanings – (i) nurturing role; (ii) guiding role; (iii) insufficient connection; and (iv) promoting development. The implications for research methods and nurse education of collecting and analyzing metaphors were discussed. Discrepancies in metaphorical interpretations are to be expected, as interpretations are dependent on the researchers’ socio-cultural background, personal experiences, professional training, languages spoken, and other factors.
Graphs, Tables, and Scientific Illustrations: Visualisation as the Science of Seeing Gerontology
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Abstract: Visual inscriptions (e.g., graphs, illustrations) are a defining feature of scientific discovery to aid in data analysis, interpretation, and communication (e.g., Latour, 1990; Lynch, 1985). Our purpose was to examine how visual inscriptions are used to present data in gerontology journals. We compared 357 articles sampled from 24 peer-reviewed gerontology journals published between 1995 and 2009. Approximately 11 per cent of page space was dedicated to data presentation with more page space occupied by tables (9.13%) than graphs (2.32%). Graph use in gerontology was lower than in psychology (6.6% of page space) and higher than in criminology and criminal justice (1.7% of page space). Following Latour (1990), we argue that visualisations provide an understandable summary of complex data by effectively presenting multifaceted results. When inscriptions are used in dissemination, researchers become less reliant on complex statistical jargon and can communicate easily with a diverse audience (researchers, health care practitioners, clients).
Organizational participatory research: a systematic mixed studies review exposing its extra benefits and the key factors associated with them
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BACKGROUND: In health, organizational participatory research (OPR) refers to health organization members participating in research decisions, with university researchers, throughout a study. This non-academic partner contribution to the research may take the form of consultation or co-construction. A drawback of OPR is that it requires more time from all those involved, compared to non-participatory research approaches; thus, understanding the added value of OPR, if any, is important. Thus, we sought to assess whether the OPR approach leads to benefits beyond what could be achieved through traditional research.
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Aging
A prospective observational study to investigate utility of the Delirium Observational Screening Scale (DOSS) to detect delirium in care home residents
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Background: Care home residents are particularly at risk of delirium due to high prevalence of dementia. The Delirium Observation Screening Scale (DOSS) identifies behavioural changes associated delirium onset that nursing staff are uniquely placed to recognise. We tested the psychometric properties of the DOSS in UK care homes compared with the Confusion Assessment Method (CAM).
Factors affecting residents transition from long term care facilities to the community: a scoping review
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BACKGROUND: Long-term care facilities (LTCFs) are often places where persons with complex health needs that cannot be met in a community setting, reside and are cared for until death. However, not all persons experience continuous declines in health and functioning. For some residents who experience improvement in personal abilities and increased independence, transition from the LTCF to the community may be an option. This scoping review aimed to synthetize the existing evidence regarding the transition process from discharge planning to intervention and evaluation of outcomes for residents transitioning from LTCFs to the community.
Dying comfortably in very old age with or without dementia in different care settings – a representative “older old” population study
Non UofA Access
BACKGROUND: Comfort is frequently ranked important for a good death. Although rising numbers of people are dying in very old age, many with dementia, little is known about symptom control for “older old” people or whether care in different settings enables them to die comfortably. This study aims to examine, in a population-representative sample, associations between factors potentially related to reported comfort during very old people’s final illness: physical and cognitive disability, place of care and transitions in their final illness, and place of death.
Association between Antidepressants and Fall-Related Injuries among Long-Term Care Residents
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OBJECTIVES: Antidepressants are associated with an increased risk of falls although little is known of the comparative risks of different types of antidepressants or individuals who are at greatest risk for falls. We examined the association between new use of antidepressants and fall-related injuries among older adults in long-term care (LTC).
Sex Differences in the Circumstances Leading to Falls: Evidence From Real-Life Falls Captured on Video in Long-Term Care
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OBJECTIVES: Falls are a major health concern for older adults. Understanding sex differences in fall circumstances may guide the design of fall management plans specifically to men and women. In this study, analyzed real-life falls captured on video to compare scenarios leading to falls between men and women in 2 long-term care (LTC) facilities.
Social Engagement and Antipsychotic Use in Addressing the Behavioral and Psychological Symptoms of Dementia in Long-Term Care Facilities
Non UofA Access
Abstract: The use of antipsychotics, mainly to address the behavioral and psychological symptoms of dementia (BPSD), remains a common and frequent practice in long-term care facilities (LTCFs) despite their associated risks. The objective of this study was to explore the association between social engagement (SE) and the use of antipsychotics in addressing the BPSD in newly admitted residents to LTCFs. Methods A cross-sectional study was undertaken using administrative data, primarily the Resident Assessment Instrument Minimum Data Set (Version 2.0) that collected between 2008 and 2011 (Fraser Health region, British Columbia, Canada). The data analysis conducted on a sample of 2,639 newly admitted residents aged 65 or older with a diagnosis of Alzheimer’s disease or other dementias as of their first full or first quarterly assessment. Multivariate logistic regression analyses were undertaken to predict antipsychotic use based on SE. Results SE was found to be a statistically significant predictor of antipsychotic use when controlling for sociodemographic variables (odds ratio ( OR) = .86, p < .0001, confidence interval (CI) [0.82, 0.90]). However, the association disappeared when controlling for health variables ( OR = .97, p = .21, CI [0.97, 1.0]). Conclusion The prediction of antipsychotic use in newly admitted residents to LTCFs by SE is complex. Further research is warranted for further examination of the association of antipsychotic use in newly admitted residents to LTCFs.
Personhood, dementia policy and the Irish National Dementia Strategy
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Abstract: Personhood and its realisation in person-centred care is part of the narrative, if not always the reality, of care for people with dementia. This paper examines how personhood is conceptualised and actualised in Ireland through a content analysis of organisational and individual submissions from stakeholders in the development of the Irish National Dementia Strategy, followed by an examination of the Strategy itself. The organisational submissions are further categorised into dementia care models. A structural analysis of the Strategy examines its principles, actions and outcomes in relation to personhood. Of the 72 organisational and individual submissions received in the formulation of the Strategy, 61% contained references to personhood and its synonyms. Of the 35 organisational submissions, 40% fit a biomedical model, 31% a social model and 29% a biopsychosocial model. The Strategy contains one direct reference to personhood and 33 to personhood synonyms. Half of these references were contained within its key principles and objectives; none were associated with priority actions or outcomes. While stakeholders value personhood and the Strategy identifies personhood as an overarching principle, clearer direction on how personhood and person-centred care can be supported in practice and through regulation is necessary in Ireland. The challenge, therefore, is to provide the information, knowledge, incentives and resources for personhood to take hold in dementia care in Ireland.
Clinical characteristics and patterns of health deficits of centenarians receiving home care and long-term care services
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Abstract: Centenarians (persons aged 100 years and older) are one of the fastest growing cohorts in countries across the world. With the increasing prevalence of centenarians and growing amount of clinical information in large administrative health databases, it is now possible to more fully characterize the health of this unique and heterogeneous population. This study described patterns of health deficits in the centenarian population receiving care from community-based home care services and long-term care facilities (LTCFs) in Ontario, Canada. All centenarians who received home care and were assessed using the interRAI-Home Care Assessment instrument between 2007 and 2011 (n=1163) and all centenarians who resided in LTCFs between 2005 and 2011 who were assessed using the interRAI Minimum Data Set (MDS 2.0) (n=2228) were included in this study. Bivariate analyses described the centenarian population while K-means clustering analyses were utilized to identify relatively homogeneous subgroups within this heterogeneous population. The 3391 centenarians were aged 100 to 114 (mean age 101.5years ±1.9 SD) and the majority were women (84.7%). Commonly reported deficits included cognitive impairment, physical impairment, and bladder problems. Centenarians residing in LTCFs were significantly more likely than centenarians receiving home care services to report cognitive or functional impairment, or to exhibit symptoms of depression. The commonalities and uniqueness of four clusters of centenarians are described. Although there is great variability, there is also commonality within the centenarian population. Recognizing patterns within the heterogeneity of centenarians is key to providing high-quality person-centered care and to targeting health promotion and intervention strategies.
Prevalence of Long-Term Opioid Use in Long-Stay Nursing Home Residents
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BACKGROUND/OBJECTIVES: Overall and long-term opioid use among older adults have increased since 1999. Less is known about opioid use in older adults in nursing homes (NHs).
Template for an Antibiotic Stewardship Policy for Post-Acute and Long-Term Care Settings
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Abstract: In response to a rising concern for multidrug resistance and Clostridium difficile infections, the Centers for Medicare and Medicaid services (CMS) will require all long-term care (LTC) facilities to establish an antibiotic stewardship program by November 2017. Thus far, limited evidence describes implementation of antibiotic stewardship in LTC facilities, mostly in academic- or hospital-affiliated settings. To support compliance with CMS requirements and aid facilities in establishing a stewardship program, the Infection Advisory Committee at AMDA-The Society for Post-Acute and Long-Term Care Medicine, has developed an antibiotic stewardship policy template tailored to the LTC setting. The intent of this policy, which can be adapted by individual facilities, is to help LTC facilities implement an antibiotic stewardship policy that will meet or exceed CMS requirements. We also briefly discuss implementation of an antibiotic stewardship program in LTC settings, including a list of free resources to support those efforts.
Pushing the Boundaries: A Physical Activity Intervention Extends Sensor-Assessed Life-Space in Nursing Home Residents
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BACKGROUND AND OBJECTIVES: To determine whether a multicomponent, individually tailored intervention to promote physical activity (PA) enhances life-space (LS) utilization in nursing home (NH) residents and whether intervention effects can be sustained at follow-up after continuation of the program as part of institutional daily routines.
Fall Risk, Supports and Services, and Falls Following a Nursing Home Discharge
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BACKGROUND AND OBJECTIVES: Falls are a major source of morbidity and mortality among older adults; however, little is known regarding fall occurrence during a nursing home (NH) to community transition. This study sought to examine whether the presence of supports and services impacts the relationship between fall-related risk factors and fall occurrence post NH discharge.
Long-term success of oral health intervention among care-dependent institutionalized seniors: Findings from a controlled clinical trial
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OBJECTIVES: The purpose of this work was to investigate the long-term effectiveness of oral health education of caregivers in nursing homes with care-dependent and cognitively impaired residents.
Exercise or Social Intervention for Nursing Home Residents with Dementia: A Pilot Randomized, Controlled Trial
Non UofA Access
OBJECTIVES: To compare the effects of exercise with those of a structured nonphysical intervention on ability to perform activities of daily living (ADLs) and physical and cognitive function of persons with dementia (PWDs) living in nursing homes (NH).
Prevalence of inappropriate medication use in residential long-term care facilities for the elderly: A systematic review
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BACKGROUND: Multi-morbidity and polypharmacy of the elderly population enhances the probability of elderly in residential long-term care facilities experiencing inappropriate medication use.
OBJECTIVES: The aim is to systematically review literature to assess the prevalence of inappropriate medication use in residential long-term care facilities for the elderly.
Assessment of Depression in Elderly. Is Perceived Social Support Related? A Nursing Home Study: Depression and Social Support in Elderly
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Abstract: Geriatric depression is more common in nursing homes and social support is a mechanism that mitigates the stressors of life factors and simultaneously promotes wellness and health. The purpose of the study was to assess the levels of depression and social support among elderly in nursing homes. During the period February 2016-March 2016 170 elderly residents in nursing homes completed the Geriatric Depression Scale-15 (GDS-15) and the Multidimensional Scale of Perceived Social Support (MSPSS). Statistical analysis was conducted with IBM SPSS Statistics 23. 37, 1% of the sample had depressive symptoms. Depression is statistically correlated with age and it is affected by the years of education (p = 0.003), the number of the children (p = 0.006), whether the elderly person is bedridden or not (p < 0.001), the frequency of visits by family members (p < 0.001) and whether the elderly performs activities outside the nursing home (0.001). Higher GDS score had those who were illiterate (6.41), those with one or no children (6.82 and 6.59 respectively), the bedridden (6.70), people without visits from relatives (7.69) and without activities outside (5.64). Also, social support is affected by the family status (p < 0.001), the number of children (p < 0.001), the frequency of visits by relatives (p < 0.001) and whether the elderly performs activities outside the foundation (p < 0.008). Higher MSPSS score had those who were married (61.60), those who had four children (63.50), people who accept visits from relatives every day (64.58) and people who do activities outside the institution (58.07). The appearance of this increased rate of depression symptoms in this elderly population leads to the need for more aid social support.
Polypharmacy and use of potentially inappropriate medications in long-term care facilities: does coordinated primary care make a difference?
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OBJECTIVES: Polypharmacy is both common and harmful for frail residents of long-term care facilities (LTCF). We aimed to study rates of polypharmacy and potentially inappropriate medications (PIMs) before and after the implementation of a new model of coordinated primary care in LTCF, ‘Care by Design (CBD)’.
Positive and negative outcomes of informal caregiving at home and in institutionalised long-term care: a cross-sectional study
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BACKGROUND: Our ageing society is putting tremendous strain on public health and welfare programs to meet the needs of ageing individuals. Promoting informal caregiving is one way for policymakers to reduce this burden. However, caregiving may be experienced as stressful and is associated with adverse health consequences. While quite a lot of research focuses on caregiving for community-dwelling older adults, little is known about informal care in institutionalised long-term care (ILTC). Therefore, the objectives of this study were: 1) to compare characteristics of informal caregivers and care receivers and caregiver outcomes – at home and in ILTC; 2) to study the association between these characteristics and positive and negative caregiver outcomes; 3) to investigate the moderating effect of the setting (at home vs. ILTC) on these associations.
Readily Identifiable Risk Factors of Nursing Home Residents’ Oral Hygiene: Dementia, Hospice, and Length of Stay
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BACKGROUND/OBJECTIVES: The poor oral hygiene of nursing home (NH) residents is a matter of increasing concern, especially because of its relationship with pneumonia and other health events. Because details and related risk factors in this area are scant and providers need to be able to easily identify those residents at most risk, this study comprehensively examined the plaque, gingival, and denture status of NH residents, as well as readily available correlates of those indicators of oral hygiene, including items from the Minimum Data Set (MDS).
Change in psychotropic drug use in Norwegian nursing homes between 2004 and 2011
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BACKGROUND: We aimed to assess whether there were any changes in the use of psychotropic drugs in Norwegian nursing homes between 2004 and 2011. Also, we investigated whether the predictors of use of specific psychotropic drug groups have changed.
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Events
UofA
META Moving Evidence to Action Pragmatic Workshop Series
META provides a tailored, individualized learning experience. You have the flexibility to register for workshops that best meet your learning needs and interests. These are ‘how to’ workshops – bring your current or planned project to work on. META workshops will take place on the University of Alberta campus. Please see link for specific workshop details.
META pragmatic workshops are organized into two broad streams:
– knowledge synthesis
– knowledge translation
Knowledge Translation Canada in collaboration with the Knowledge Translation Platform and the Career Development Platform is hosting a speaker session for anyone with an interest in improving healthcare.
Available as a webinar through KT Canada.
Non UofA
9th Canadian Conference on Dementia
The Canadian Conference on Dementia is a biennial national conference dedicated to advance knowledge on dementia in scientific research and clinical care.
26th Annual Scientific Meeting of the Canadian Academy of Geriatric Psychiatry
Evidence Live 2018 will focus on three initiatives:
– Dissemination Initiative: transform the ability to disseminate evidence; maximize research impact and join the debate on the evidence that matters to practice.
– Translation Initiative: analyze, debate and exchange opinions on how evidence should be translated into usable, accessible information.
– Innovation Initiative: foster innovative approaches to the dissemination and translation of evidence that advance health for all.
Online
Peer-to-Peer Webinar Series: Success Stories in EIDM
Introduction to Patient Engagement & Integrated Knowledge Translation
Learning Objectives:
Explain patient-oriented research(POR) in your own words
Compare patient engagement to integrated knowledge translation
Explain why patients and knowledge users should be engaged in patient-oriented research
Introduction to Knowledge Translation
Learning Objectives:
Explain Knowledge Translation (KT) in your own words.
Explain when to use integrated KT and end-of-grant KT.
Describe to Knowledge-to-Action (KTA) process model.
Introduction to Knowledge Translation Evaluation
Learning Objectives:
Define basic evaluation terms (e.g., activity, output, outcome, impact; process and outcome evaluation).
Discuss how evaluation can be used across the KT project lifecycle (from planning to impact).
Identify barriers and enablers of KT evaluation.
Introduction to Knowledge Synthesis
Learning Objectives:
Relate why evidence syntheses are important in evidence-based research
Summarize the steps involved in a systematic or scoping review
Explain the role of quality assessment
Outline possible analysis methods
Knowledge Translation Outcome Measurement
This virtual online conference is designed to address major strategies in the planning and implementation of effective and efficient KT measurement approaches. Participants will be able to register, view, and ask questions through the event’s virtual conference platform, Adobe Connect. Participants will listen using their computer speakers and will interact by way of a chat box (CART and accessible options will be available). Each day will include live polls as well as interactive discussions.
Topics include:
Oct. 30: Overcoming Barriers to Outreach
Nov. 1: Tools for Tracking Implementation
Nov. 3: Strategies for Measuring Impact
Equity and Methods in Campbell Collaboration Systematic Reviews
The Center on KTDRR is pleased to present this webcast series on equity considerations and methodological standards of the Campbell Collaboration. The Campbell Collaboration is an international research network that promotes positive social and economic change through the production and use of systematic reviews and other evidence synthesis for evidence-based policy and practice.
In this three-part webcast series participants will learn how to incorporate people with disabilities into systematic review planning as well as Campbell’s standards, methods, and guidelines for conducting systematic reviews
These webcasts are intended to provide a brief (7-10 minute) introduction into the topics of the presentation.
Topics:
– How to fairly and equitably incorporate people with disabilities into systematic review planning
– MECCIR Standards: Methodological Expectations for Campbell Collaboration Intervention Reviews
– A Short Primer on Power Calculations for Meta-analysis
Courses
Online
Introductory course on Systematic Reviews and Meta-Analyses
This is an introductory course on systematic reviews and meta-analyses. It is co-taught by Andrea Tricco (MSc, PhD) and Sharon Straus (MD, MSc). The overall course objective is to teach about systematic reviews in general, as well as how to go about doing a systematic review. This information will be used by the students to prepare a protocol for a systematic review on the topic of their choice, with guidance from the course instructors.
News
‘A sad, frustrating maze’: Her 90-year-old mother waited 6 months for a care home bed
When Denise Marshall’s 90-year-old mother went into hospital with pneumonia in early 2015, she didn’t think it would kick off a months-long ordeal sorting through a “sad, confusing, frustrating maze” to find long-term care.
POLITICO’s new special report, The Agenda: Aging in America, takes a comprehensive deep dive into the biggest barriers to improving the care of older adults, from transportation challenges to the stress experienced by family caregivers to regulatory red tape hindering hospice. Presented by The John A. Hartford Foundation, the series illustrates how older people in America continue to experience a health care system that does not always meet their needs or support vibrancy. It also explores innovations such as Medicare reforms to use tiered payments rather than one-size-fits-all daily payments, telemedicine to expand physician reach, and refining end-of-life quality markers.
Michener Institute to lead development of provincial personal support worker registry
The Michener Institute of Education at UHN has been asked by Ontario’s Ministry of Health and Long-Term Care to partner on the development of a new registry for personal support workers.
Eli Lilly’s Experimental Alzheimer’s Drug Fails in Large Trial
An experimental Alzheimer’s drug that had previously appeared to show promise in slowing the deterioration of thinking and memory has failed in a large Eli Lilly clinical trial, dealing a significant disappointment to patients hoping for a treatment that would alleviate their symptoms.
The unloved Canadian Common CV is in for an overhaul
The Canadian Common CV, or CCV for short, sounds simple enough: it’s a standardized tool that researchers use to upload their curriculum vitae for major funding applications. But after 15 years, the anything-but-simple CCV seems slated for a massive transformation, if not a death knell.
‘Why is it taking you so long to die?’: Long-term care home treatment horrifies family
A year ago, Diana Pepin installed a video camera in her disabled mother’s room after she said she had a bad feeling about the long-term care facility. Her 85-year-old mother can’t walk and can’t talk, so Pepin felt after witnessing incidents she said put her mother at risk, she needed to be her protection. Pepin’s instincts culminated Thursday when the City of Ottawa fired three workers at the municipally run Peter D. Clark Long Term Care Centre over incidents of verbal abuse described as “disturbing and offensive” were captured on video.
Dementia is a terrible word. Why do people still use it?
Dementia is a word with a horrific impact. I’m talking about the word and its origins, not the disease. I have observed people living well with dementia and this antiquated and negative term belittles the contribution to society that they can make.
US Department of Veterans Affairs Health Services Research and Development Service’s Center for Evaluation and Implementation Resources (CEIR) will be launched in FY2018 to provide ongoing support for the QUERI Implementation Research Group, as well as to provide additional resources and support on evaluation and implementation best practices for QUERI stakeholders. Goals of the CEIR are to offer ongoing continuing education and training in evaluation and implementation science techniques – and a forum for sharing best practices and lessons learned in evaluation and implementation science.
Difficulty In Finding Reviewers Taints Editorial Decisions
Finding willing academics to review a manuscript is getting more difficult for some journals. Unfortunately, this difficulty may also be negatively affecting the judgement of journal editors, a new study reports
Resources
Online EIDM Skills Assessment Tool
This tool was developed to test knowledge and skills required for evidence-informed decision making and provide resources to help fill identified gaps. Topics covered by the tool include critical appraisal of evidence, interpreting research results and strategies for knowledge translation. The examples included are directly relevant to public health.
The state of health care and adult social care in England 2016/17
State of Care is our annual assessment of health and social care in England. The report looks at the trends, highlights examples of good and outstanding care, and identifies factors that maintain high-quality care.
Quality Improvement – training for better outcomes
Abstract not available. Report from March 2016.
Rapid Reviews to Strengthen Health Policy and Systems: A Practical Guide
Governments worldwide increasingly recognize the need for knowledge synthesis to inform health policymaking and health systems decision-making in routine, as well as emergency contexts. Rapid reviews are an efficient solution to support health policy and systems decision-making by providing high-quality evidence in a timely and cost-effective manner.
This hands-on guide, published by the World Health Organization, explores different approaches and methods for the expedited synthesis of health policy and systems research, and provides guidance on how to plan, conduct, and promote the use of rapid reviews, while highlighting key challenges including their application in low- and middle-income countries.
This review reports on three themes relating to the care of older people in care homes: Living well – maintaining good health and quality of life, ageing well – managing long term conditions associated with ageing, and dying well – ensuring a good quality end of life.
Newsletters
CIHR Institute of Aging Newsletter
October 2017
Meeting Point Between Knowledge and Practice
October 2017
Opportunities
As a member of the CABHI Innovation Office team, this individual will be responsible for facilitating the application of knowledge mobilization (KM) tools/strategies by project teams, assisting in the development of project-specific KM plans, and supporting ongoing knowledge translation and implementation efforts that that can assist CABHI projects in their implementation/ adoption efforts. In addition, this individual will be responsible for building capacity within the adoption user group by increasing the knowledge, skills, motivation, and attitudes of potential users to achieve their implementation/adoption goals and includes attention to all types of capacity (psychological, behavioral and structural) at all levels of the system (individual, organization, network, and system).
Call for Editor-in-Chief – Journal of the American Association of Nurse Practitioners
The Editor-in-Chief selects and develops journal content, including original research articles, systematic reviews, and occasional special issues or supplements; manages the peer review process; appoints and directs the activities of the Editorial Board. The work schedule can be flexible aside from scheduled conference calls and will require approximately 20-30 hours per week, with variability depending on the time of year.
The School of Healthcare Sciences, Bangor University, wish to appoint an experienced researcher to lead a synthesis of evidence around de-implementation in health and care services.
The successful candidate appointed to this study will be expected, with the support of the Co-Chief Investigators, to take a leadership role in all aspects of the management, analysis and reporting of this evidence synthesis. Realist enquiry will be used, and so it is essential that candidates have experience of this or theory-led approaches to the synthesis of mixed types of evidence.
