Calls for Abstracts
Grants & Awards
Publications
Events
Courses
News
Resources
Opportunities
Happy Christmas and all the best for 2018!
Announcements
New TREC newsletter
New KUSP articles
Shining a Light: Examining Similarities and Differences in the Work Psychology of Health Support Workers Employed in Long-Term Care and Home and Community Care Settings 
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Abstract: Health Support Workers (HSWs) provide up to 80% of care to residents and clients in the long-term care (LTC) and home and community care (HCC) sectors but have received little research attention compared with the regulated professions. The authors explore similarities and differences in the work psychology of HSWs employed in LTC and HCC settings. Data were collected via survey from 276 LTC and 184 HCC HSWs. Descriptive statistics and path analyses were conducted. HSWs in LTC and HCC settings have significant, positive associations between organizational citizenship behaviors directed toward the organization (OCB-Os) and psychological empowerment, as well as intention to stay (ITS) and job satisfaction. For LTC sector HSWs, there are significant relationships between OCB-Os and quality of work life (QWL), ITS and work engagement, and individual performance and both job satisfaction and QWL. For the HCC sector, OCB-Os and ITS are significantly and directly related to organizational commitment. This study has implications for organizations interested in developing targeted interventions to improve the retention of HSWs.
Improving quality of work life for care providers by fostering the emotional well-being of persons with dementia: A cluster-randomized trial of a nursing intervention in German long-term care settings
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Abstract: We tested the feasibility of a nursing intervention (DEMIAN) in routine care and its effects on care providers’ job satisfaction, motivation, and work strain. This cluster-randomized trial was conducted in 20 German long-term care facilities. We randomly assigned 20 facilities to an intervention group (84 care providers, 42 residents with dementia) or a control group (96 care providers, 42 residents with dementia). Intervention group providers received two training days on the intervention; 68 providers attended both training days. Sixty two providers completed both baseline and follow-up questionnaires. Trained providers created individualized mini-intervention plans for participating residents. Control group residents received ‘usual care’. Intervention group providers stated that the intervention was feasible and helped them improve emotional well-being of residents with dementia. We found significantly decreased time pressure and decreased job dissatisfaction for intervention group providers. DEMIAN is an effective and pragmatic contribution to implementing person-centred care in long-term care, with positive effects on providers’ working conditions.
Measuring Activity Performance of Older Adults Using the activPAL: A Rapid Review
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Abstract: Current measures of physical activity and sedentary behaviors such as questionnaires and functional assessments are insufficient to provide comprehensive data on older adults. In response, the use of activity monitors has increased. The purpose of this review was to summarize and assess the quality of observational literature on activity measuring of older adults using the activPAL activity monitor. Seventeen databases and a bibliography, compiled by the activPAL creators, were searched. Articles were included if they were in English, were peer-reviewed, included people 65 years or older, measured activity using the activPAL and reported at least one of the following outcomes: step count, hours upright, hours sitting/lying, hours stepping, or hours standing. The search revealed 404 titles; after exclusions 24 were included in the final review. Of these studies, one examined older adults from residential aged care, six from hospital in-patient clinics, nine from outpatient clinics and eight examined community-dwellers. Mean age ranged from 66.0 to 84.2 years. Not all studies reported similar outcome variables, preventing data pooling. The review found a lack of high quality articles. There may be limitations to using the activPAL among older adults but further research is required to examine its use in this population.
New articles by KUSP researchers
Compassionate care: not easy, not free, not only nurses
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No abstract available
A randomised controlled trial assessing the efficacy of an electronic discharge communication tool for preventing death or hospital readmission
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OBJECTIVE: To assess the efficacy of an electronic discharge communication tool (e-DCT) for preventing death or hospital readmission, as well as reducing patient-reported adverse events after hospital discharge. The e-DCT assessed has already been shown to yield high-quality discharge summaries with high levels of patient and physician satisfaction.
Managing diabetes in people with dementia: a realist review
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BACKGROUND: Dementia and diabetes mellitus are common long-term conditions that coexist in a large number of older people. People living with dementia and diabetes may be at increased risk of complications such as hypoglycaemic episodes because they are less able to manage their diabetes.
OBJECTIVES: To identify the key features or mechanisms of programmes that aim to improve the management of diabetes in people with dementia and to identify areas needing further research.
Calls for Abstracts
5th Global Symposium On Health Systems Research
The 5th Global Symposium on Health Systems Research (HSR2018) will be held in Liverpool from October 8-12, 2018. The theme for the symposium is “Advancing Health Systems for All in the SDG Era”. The symposium will advance conversations and collaborations on new ways of financing health; delivering services; and engaging the health workforce, new social and political alliances, and new applications of technologies to promote health for all, as reflected in goal 3 of the Sustainable Development Goals (SDG).
Key questions for this symposium include:
– How can our approach to health systems help us work across sectors to achieve shared goals of social development?
– How best should the movement for universal health coverage consider the role of the private sector in delivering and financing health care?
– How can health systems be mobilized to form the backbone of social protection for vulnerable groups?
– How should health systems engage communities to achieve universal coverage?
The Conference on Advancing Implementation and Quality Improvement Science for Children’s Health Care (APA QI) is held each year the day before the Pediatric Academic Societies’ (PAS) meeting. In 2018, the conference will focus on methodological and technical issues of major importance for those performing Implementation Science and Quality Improvement (QI) research related to pediatric health care.
This conference aims to engage clinicians, physicians, hospitalists, nurses, nurse practitioners, epidemiologists, educators, public health practitioners, researchers, administrators, active pediatric investigators involved in implementation science and quality improvement research, and quality improvement professionals who are seeking to develop additional expertise in implementation science and quality improvement research methods to improve health care and outcomes for children – infants through adolescents.
Some of the topics that will be explored at the meeting this year include:
– Gerontology, robotics and domestics
– Concepts of and approaches to care in gerontology
– Information, communications, technologies and older adults
– Geriatric and interdisciplinary assessments
– Health system, care pathways and geriatric patients
– Primary and secondary prevention in geriatrics
Abstracts should discuss and report on recent discoveries and innovations related to promoting healthy brain aging and delaying or preventing dementia, including research findings, technologies, and translational tools and services. We welcome submissions on the following topics:
Theme 1: New frontiers of biomarker research, early detection and precision health application
Theme 2: Markers of the pathophysiology and progression of neurodegenerative and vascular cognitive disorders
Theme 3: Cutting-edge rodent models and the path to diagnostics/ therapeutics
Theme 4: Exercise and cognitive interventions for healthy brain aging and prevention of dementia
Theme 5: Applied research in dementia
Theme 6: All other research and translation approaches to dementia, healthy brain and cognitive aging or other neurodegenerative diseases (eg. FTD, PD/LBD) not covered within themes 1-5
Grants & Awards
Active and Assisted Living Smart Ageing Prize
The AAL Programme launched the 2nd edition of the Smart Ageing Prize, which is a competition that aims to identify the most promising solutions using ICT for active ageing. This year’s theme is: Products and services that use innovative digital technologies to support older people to participate fully in social life.
The Smart Ageing Prize will be awarded for innovative and inspiring products and services using digital technologies that facilitate real world interactions to engage older people in social and stimulating activities, promoting active and connected ageing.
Evidence from global research suggests that supporting older people to participate fully in social life will help them to remain active and healthy for longer into later life. At the same time, reducing social isolation requires meaningful engagements and social experiences. A key value proposition of ICT is its ability to connect people and communities. Digital technologies can therefore act as a broker for stimulating social experiences that improve wellbeing. That is why digital innovation to meet older people’s requirements and wishes is at the heart of this challenge prize.
Publications
KT
Health Care Administration and Organization
Health Care Innovation and Quality Assurance
Organizational Change
Research Practice and Methodology
Aging
KT
A multi-institutional study of the perceived barriers and facilitators to implementing evidence-based practice
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AIMS AND OBJECTIVES: The study aims were to examine perceived barriers and facilitators to implementing evidence-based practice among nurses working in psychiatric, geriatric, hospital and community settings in The Bahamas.
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Health Care Administration and Organization
Certified nursing assistants’ perspectives of the CARES® activities of daily living dementia care program
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Abstract: Background There has been a proliferation of online training programs for nursing home direct care staff related to dementia care, yet little is known about the effectiveness of the training. Some evidence exists that online training is effective in addressing problem behaviors of nursing home residents with dementia by enhancing self-efficacy, improving attitudes, and increasing knowledge of nursing home staff. Study aim The current study aim was to evaluate the implementation of an online training program consisting of ten, one-hour modules which applies the CARES® concepts and learning framework to activities of daily living (ADL) care for persons with dementia. Methods Responses from Likert-type items, and open-ended questions were analyzed in a sample of 48 certified nursing assistants (CNAs) from 10 nursing homes in six states (ME, MT, ND, WI, MN, MO) that were part of a National Institute of Aging funded intervention study (Grant #AG026210). Results The mixed-method study findings indicated that CNAs gained a better understanding, more knowledge, and more confidence in caring for persons with dementia. Recommendations were made regarding training length and technical issues, and some questioned the practicality of providing person-centered care when resident assignment was very high. CNAs expressed satisfaction with the online training, found it easy to use, and many said they would recommend the training. CARES® ADL Dementia Care online training appears to be a viable way of helping CNAs address the personal care needs of long-term care residents. Future CARES® ADL Dementia Care program research should include more racially diverse CNAs.
Oral medicine modification for older adults: a qualitative study of nurses
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Objective: Oral medicines are frequently modified (eg, tablets crushed) for older adults. However, these modifications can have clinical, legal and/or ethical implications. Nurses bear responsibility for medicine administration and hence, perform these modifications. The aim of this study was to investigate the knowledge, attitudes and beliefs of nurses about oral medicine modification for older adults.
Accurate identification of hospital admissions from care homes; development and validation of an automated algorithm
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Background: measuring the complex needs of care home residents is crucial for resource allocation. Hospital patient administration systems (PAS) may not accurately identify admissions from care homes.
Objective: to develop and validate an accurate, practical method of identifying care home resident hospital admission using routinely collected PAS data.
Barriers to Optimal Pain Management in Aged Care Facilities: An Australian Qualitative Study
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Abstract: Up to 80% of residents in aged care facilities (ACFs) experience pain, which is often suboptimally managed. To characterize pain management in ACFs and identify the barriers to optimal pain management. An exploratory descriptive qualitative study using semistructured interviews. Five Southern Tasmania, Australian ACFs. 23 staff members (18 nurses and 5 facility managers). Interviews were conducted from September to November 2015. Interviews included questions about how pain was measured or assessed, what happened if pain was identified, barriers to pain management, and potential ways to overcome these barriers. Interviewees noted that there were no formal requirements regarding pain assessment at the ACFs reviewed; however, pain was often informally assessed. Staff noted the importance of adequate pain management for the residents’ quality of life and employed both nonpharmacologic and pharmacologic techniques to reduce pain when identified. The barriers to optimal pain management included difficulty identifying and assessing pain, residents’ resistance to reporting pain and/or taking medications, and communication barriers between the nursing staff and GPs. Staff interviewed were dedicated to managing residents’ pain effectively; however, actions in a number of areas could improve resident outcomes. These include a more consistent approach to documenting pain in residents’ progress notes and improving nurse-GP communications to ensure that new or escalating pain is identified and expedient changes can be made to the resident’s management. Additionally, resident, family, nurse, and carer education, conducted within the facilities on a regular basis, could help improve the pain management of residents.
Case management for people with dementia and its translations: A discussion paper
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Abstract: Case management is generally seen as a way to provide efficient, cost-saving person-centred care for people with dementia by connecting together fragmented services, but the available evidence in favour of its merits is often considered inconclusive, unclear and sketchy. This discussion paper investigates the evidence of the benefit of case management for people with dementia and explores the complexity of the concept and the experiences of its implementation. It offers a comprehensive framework for conceptualising various types of case management and asks the question: who can be a case manager? Building on examples from three European countries it addresses the problem of the expansion and adoption of the case management method. It compares the conventional model of diffusion of innovation with the ideas of interessement and co-constitution and envisions a successful model of case management as a fluid technology that is both friendly and flexible, allowing it to adapt to different settings and systems.
Preventing elder abuse and neglect in geriatric institutions: Solutions from nursing care providers
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Abstract: This study explores how and why abuse and neglect occurs in geriatric institutions and presents practical prevention measures. Exploratory qualitative interviews were carried out with purposive sample of 23 nursing staff members. They were recruited from different institutions caring for older patients in the north-western region of Switzerland. These interviews were analyzed using thematic analysis. Participating nursing staff members reported several factors pertaining to the care provider, the older patient, and the institution that precipitated abuse and neglect. They mentioned different solutions that could help them address their responsibilities in a reasonable manner. The solutions included, for example, ensuring proper education and training, better management nursing care provider’s responsibilities and timely intervention to address abuse and neglect, as well as rotating care provider. Implementing these suggestions will allow geriatric institutions, its managers, and nursing care providers to improve quality of care and reduce such negative occurrences in these settings.
Integrated Working for Enhanced Health Care in English Nursing Homes
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BACKGROUND: The increasingly complex nature of care home residents’ health status means that this population requires significant multidisciplinary team input from health services. To address this, a multisector and multiprofessional enhanced healthcare programme was implemented in nursing homes across Gateshead Council in Northern England.
Variation Across U.S. Assisted Living Facilities: Admissions, Resident Care Needs, and Staffing
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PURPOSE: Though more people in the United States currently reside in assisted living facilities (ALFs) than nursing homes, little is known about ALF admission policies, resident care needs, and staffing characteristics. We therefore conducted this study using a nationwide sample of ALFs to examine these factors, along with comparison of ALFs by size.
Pilot Testing a Coaching Intervention to Improve Certified Nursing Assistants’ Dressing of Nursing Home Residents
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Abstract: The purpose of the current study was to identify initial effects of a coaching training intervention using Level of Assistance (LoA) strategies compared with traditional lecture techniques on the appropriateness of LoA use by certified nursing assistants (CNAs) and independence of dressing of nursing home residents with dementia. Seventeen CNA-resident dyads participated in this pilot randomized controlled trial (RCT). Control and experimental group CNAs received a 25-minute traditional lecture. Experimental group CNAs also underwent three coaching sessions over 4 weeks. There were significant between-group differences in the percentage of dyads who had improved scores for appropriateness of LoA use and dressing independence from pretest to posttest (experimental: n = 9, 100%; control: n = 8, 50%; p = 0.029). However, there were no statistically significant median differences between groups in appropriateness of LoA use by CNAs and resident dressing independence scores. There were significant within-group median improvements in appropriateness of LoA use (p = 0.004) and independence of dressing scores (p = 0.004) between pretest and posttest in the experimental group, but not in the control group. This initial pilot RCT supports coach training as a method to improve appropriate use of LoA strategies by CNAs and independence of resident dressing.
Substitution of Formal and Informal Home Care Service Use and Nursing Home Service Use: Health Outcomes, Decision-Making Preferences, and Implications for a Public Health Policy
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OBJECTIVES: The purposes of this study are: (1) to empirically identify decision-making preferences of long-term health-care use, especially informal and formal home care (FHC) service use; (2) to evaluate outcomes vs. costs based on substitutability of informal and FHC service use; and (3) to investigate health outcome disparity based on substitutability.
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Health Care Innovation and Quality Assurance
“Leisurely Dining”: Exploring How Work Organization, Informal Care, and Dining Spaces Shape Residents’ Experiences of Eating in Long-Term Residential Care
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Abstract: Mealtimes are among the busiest times in nursing homes. Austerity measures resulting in insufficient staff with heavy workloads limit the amount of time available to assist residents with eating. Within a feminist political economy framework, rapid team-based ethnography was used for an international study involving six countries exploring promising practices and also for a study conducted in one Canadian province in which interrelationships between formal and informal care were investigated. Data collection methods included interviews and observations. In addition, dining maps were completed providing a cross-jurisdictional comparison of mealtime work organization, and illustrating the time spent assisting residents with meals. Dining maps highlight the reliance on unpaid care as well as how low staffing levels leave care providers rushing around, preventing a pleasurable resident dining experience, which is central to overall health and well-being.
Palliative Care Eligibility, Symptom Burden, and Quality-of-Life Ratings in Nursing Home Residents
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No abstract available
Involving institutionalized people with dementia in their care-planning meetings: Impact on their quality of life measured by a proxy method
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Abstract: The objective of the study was to assess the impact of an intervention in which people with dementia attended meetings to discuss their individual care plans on their quality of life. Fifty-two older people ( M = 86.7 years, SD = 7.3) diagnosed with moderate-to-severe dementia living in four nursing homes in Spain participated in the study. The intervention was implemented with 27 residents at two of the nursing homes; the other 25 cases at the other two homes acted as controls. A proxy measure of quality of life was used. Improvements were found in quality of life as assessed by staff members, in both within and between-group comparisons, which suggests that including older people with dementia in care-planning meetings may improve their quality of life. However, further controlled studies are needed to confirm these preliminary results.
Analyses of Complaints, Investigations of Allegations, and Deficiency Citations in United States Nursing Homes
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Abstract: Quality of care in nursing homes has been evaluated from varying perspectives, but few studies analyze complaints made to surveyors. This study analyzed complaints, investigations, and citations for nursing homes nationwide. Using the complaint and survey data sets, analyses match nursing home complaints with findings of investigations conducted. Results showed the average complaint rate was 13.3 complaints per 100 residents and that 43.2% of complaint allegations were substantiated, with complaints about care and services provided being the most prevalent. Variability was noted among the Centers for Medicare and Medicaid Services regions and, on average, 47.5% of facilities had five or more complaints in a given year. While additional research could evaluate the effect of complaint investigations on nursing home quality, results indicated that complaints and subsequent investigations provide further information regarding quality for residents. Results also suggest improvements in the training for surveyors and more consistency across Centers for Medicare and Medicaid Services survey regions.
The relationships between the combination of person- and organization-related conditions and patients’ perceptions of palliative care quality
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BACKGROUND: Little is known about the combination of person- and organization- related conditions and the relationships with patients’ perspectives of care quality. Such a combination could contribute knowledge reflecting the complexity of clinical practice, and enhance individualized care. The aim was to investigate the relationships between the combination of person- and organization-related conditions and patients’ perceptions of palliative care quality.
Music Intervention With Reminiscence Therapy and Reality Orientation for Elderly People With Alzheimer Disease Living in a Nursing Home: A Pilot Study
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Abstract: The purpose of this study was to investigate the effect of an 8-week nursing intervention consisting of 2 weekly sessions of music and reminiscence therapy together with the application of reality orientation techniques. Our expectation at the onset of the study was that listening to music that was familiar and connected with the memory of past events would, due to the music’s emotional impact, stimulate memory associations, leading, in turn, to a positive effect on depression and anxiety in people living with dementia. We carried out a pre-/posttest intervention design with a sample of 19 patients divided into 2 groups-a 10-patient control group and a 9-patient intervention group-in a nursing home in Spain. Goldberg tests for depression and anxiety have been assessed at baseline and postintervention in both groups. Our results confirm the valuable effect of music therapy and reminiscence therapy together with reality orientation techniques on depression in patients with mild Alzheimer disease. Our study may constitute an important starting point for further research on nursing interventions based on the provision of music and/or reminiscence therapy together with reality orientation techniques that is implemented on a daily basis in nursing homes.
Person-centered care in Norwegian nursing homes and its relation to organizational factors and staff characteristics: a cross-sectional survey
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BACKGROUND: Person-centered care (PCC) is regarded as good quality care for persons with dementia. This study aimed to explore and understand the association between PCC and organizational, staff and unit characteristics in nursing homes (NHs).
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Organizational Change
What Happens to a Nursing Home Chain When Private Equity Takes Over? A Longitudinal Case Study
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Abstract: We analyzed what happens to a nursing home chain when private equity takes over, with regard to strategy, financial performance, and resident well-being. We conducted a longitudinal (2000-2012) case study of a large nursing home chain that triangulated qualitative and quantitative data from 5 different data sources. Results show that private equity owners continued and reinforced several strategies that were already put in place before the takeover, including a focus on keeping staffing levels low; the new owners added restructuring, rebranding, and investment strategies such as establishing new companies, where the nursing home chain served as an essential “launch customer.”
Nursing Home Regulations Redefined: Implications for Providers
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Abstract: The Centers for Medicare and Medicaid Services (CMS) finalized a comprehensive update to nursing home requirements of participation in October 2016. Nearly 10,000 public comments were received regarding the proposed rule, and CMS made multiple modifications based on comments from providers, advocacy organizations, and others before issuing the final rule. The final rule describing nursing home requirements of participation modernizes nursing home regulation. It is being implemented in three phases-beginning in November 2016, November 2017, and November 2019. There are multiple provisions that have implications for clinicians caring for nursing home residents, particularly in terms of management of infections, medication prescribing and monitoring, and delegation of medical orders.
Nursing Home Response to Nursing Home Compare: The Provider Perspective
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Abstract: 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.
Evaluation of an integrated primary care-led dementia shared care program in Singapore: An effectiveness and cost-effectiveness study
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AIM: With an aging Singapore population, there is an increasing demand for dementia care. The present study aimed to evaluate the effectiveness and cost-effectiveness of the Primary Care Dementia Clinic (PCDC) in comparison with the Memory Clinic (MC; hospital-based) and other polyclinics.
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Research Practice and Methodology
Methods for Involving Older People in Health Research-A Review of the Literature
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Abstract: Demographic change has increased the need for research on healthcare for older people. Recently there has been a growing awareness that research might benefit from actively involving patients and the public in study design and conduct. Besides empowering patients and democratizing research, involvement enhances the quality of research and the development of equitable healthcare solutions. Little is known about how to involve older people. This review aims to support scientists intending to involve older people in health research by systematically identifying and describing studies involving older people and analyzing associated facilitators and challenges. Old people were operationalized as people living with old-age-related conditions. We conducted a systematic search in PubMed, CINAHL (Cumulative Index to Nursing and Allied Health Literature), and Cochrane library for the period 2007 to July 2017 and also manually searched reference lists of the nine retrieved articles and other relevant sources. While involvement of older people in research is feasible, specific challenges related to this group need be taken into account. Strategies to enhance effective involvement comprise a thoughtful choice of location, use of visualization and accessible communication, building good relationships and flexible approaches. Further research is needed on the involvement of people in care homes or with vision, hearing or mobility limitations.
Working in a Storied Way – Narrative based approaches to person-centred care and practice development in older adult residential care settings
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AIMS AND OBJECTIVES: To evaluate the effects of the implementation of a methodological framework for a narrative based approach to practice development and person-centred care in residential aged care settings.
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Aging
Likelihood that expectations of informal care will be met at onset of caregiving need: a retrospective study of older adults in the USA
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Background: Ageing adults are likely to expect informal caregiving assistance from a friend or family member, reflecting the reality that most long-term care (LTC) is provided by family and friends. The purpose of the study was to determine the likelihood that expectations of care will be unmet at the onset of functional disability, and the factors that impact that likelihood.
A greater risk of premature death in residential respite care: a national cohort study
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Background: the demand for residential respite care for older persons is high yet little is known about the occurrence of harm, including death in this care setting.
Objective: to compare the prevalence and nature of deaths among residential respite to permanent nursing home residents.
Obesity and Nursing Home Care in the United States: A Systematic Review
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Background and Objectives: Obesity is increasing among people residing in nursing homes, and resident obesity substantially affects services needed, equipment and facilities provided, and morbidity in this setting. The purpose of this article is to describe the scope and depth of evidence regarding the impact of obesity among nursing home residents in the United States.
Drug Burden and its Association with Falls Among Older Adults in New Zealand: A National Population Cross-Sectional Study
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BACKGROUND: Adverse outcomes associated with advanced diseases are often exacerbated by polypharmacy.
OBJECTIVES: The current study investigated an association between exposure to anticholinergic and sedative medicines and falls in community-dwelling older people, after controlling for potential confounders.
Determinants of late-life depression in residents of long-term care facility
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Abstract: Mental disorders, such as dementia and depression, are beside chronic somatic diseases, the most common problem in residents of longterm care facilities (LTCF). Late-life depression refers to depressive symptoms that arise in adults older than 65 years. According to literature review, older people tend to differ from middle-aged adults in presentation of depression.
Individualized support for informal caregivers of people with dementia – effectiveness of the German adaptation of REACH II
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BACKGROUND: Individualized, outreach and structured multicomponent interventions are a promising intervention approach to relieve the burden of informal caregivers of people with dementia. In this study, we adapted and evaluated a multicomponent intervention (Resources for Enhancing Alzheimer’s Caregiver Health II, REACH II), which was developed in the USA, to the German health-care system. Therefore the project is called the German adaptation of REACH II (in German: Deutsche Adaptation der REACH II, DE-REACH).
Compassionate collaborative care: an integrative review of quality indicators in end-of-life care
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BACKGROUND: Compassion and collaborative practice are individually associated with high quality healthcare. When combined in a compassionate collaborative care (CCC) practice framework, they are reported to improve health, strengthen care provision, and control health costs. Little is known about how to integrate and measure CCC, yet it is fundamentally applied in palliative and end-of-life care settings. This study aimed to identify quality indicators of CCC by systematically reviewing and synthesizing the current state of the palliative and end-of-life care literature.
Scaffolding and working together: a qualitative exploration of strategies for everyday life with dementia
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Background: living with dementia has been described as a process of continual change and adjustment, with people with dementia and their families adopting informal strategies to help manage everyday life. As dementia progresses, families increasingly rely on help from the wider community and formal support.
Interventions to Improve Medicines Management for People with Dementia: A Systematic Review
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BACKGROUND: The importance of optimising medicines management for people with dementia has been emphasised through research and policy. However, evidence is currently lacking regarding how to achieve this in this patient population.
From home to ‘home’: Mapping the caregiver journey in the transition from home care into residential care
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Abstract: Family caregivers play a pivotal role in supporting the functional independence and quality of life of older relatives, often taking on a wide variety of care-related activities over the course of their caregiving journey. These activities help family members to remain in the community and age-in-place for as long as possible. However, when needs exceed family capacities to provide care, the older family member may need to transition from one care environment to another (e.g., home care to nursing home care), or one level of care to another (from less intense to more intensive services). Drawing upon qualitative interview data collected in a populous health region in British Columbia, Canada, this study explores the roles and responsibilities of family caregivers for family members making the care transition from home care to residential care. A thematic analysis of the interview transcripts resulted in the development of a conceptual framework to characterize the “Caregiver Journey” as a process that could be divided into at least three phases: 1) Precursors to transition – recognizing frailty in family members and caregivers prior to transition; 2) Preparing to transition into residential nursing home care (RC) and 3) Post-transition: Finding a new balance – where caregivers adjust and adapt to new caregiving responsibilities. Our analyses revealed that the second phase is the most complex involving a consideration of the various activities, and roles that family caregivers take on to prepare for the care transition including: information gathering, advocacy and system navigation. We conclude that there is a need for family caregivers to be better supported during care transitions; notably through ongoing and enhanced investments in strategies to support caregiver communication and education.
Predicting hospital transfers among nursing home residents in the last months of life
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BACKGROUND: Concerns have been raised over the practice of transferring nursing home residents to hospital at their end of life.
Health determinants and survival in nursing home residents in Europe: Results from the SHELTER study
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OBJECTIVE: The care processes directed towards institutionalized older people needs to be tailored on goals and priorities that are relevant for this specific population. The aim of the present study was (a) to describe the distribution of selected health determinants in a sample of institutionalized older adults, and (b) to investigate the impact on survival of such measures.
Prevalence of key care indicators of pressure injuries, incontinence, malnutrition, and falls among older adults living in nursing homes in New Zealand
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Abstract: Pressure injuries, incontinence, malnutrition, and falls are important indicators of the quality of care in healthcare settings, particularly among older people, but there is limited information on their prevalence in New Zealand (NZ). The aim of this study was to establish the prevalence of these four problems among older people in nursing home facilities. The cross-sectional study was an analysis of data collected on a single day for the 2016 National Care Indicators Programme-New Zealand (NCIP-NZ). The sample included 276 people ages 65 and older who were residents in 13 nursing home facilities in a geographically diverse area of central NZ. Data were analyzed with descriptive statistics. Prevalence rates in these nursing home settings was pressure injuries 8%; urinary incontinence 57%; fecal incontinence 26%; malnutrition 20%, and falls 13%, of which half resulted in injuries. As people age, complex health issues can lead to increasing care dependency and more debilitating and costly health problems. Measuring the prevalence of basic care problems in NZ healthcare organizations and contributing to a NZ database can enable monitoring of the effectiveness of national and international guidelines.
Non-Pharmacological Approaches to Pain Management in Residential Aged Care: a Pre-Post-Test Study
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OBJECTIVES: The project aimed to evaluate a pain management program (PMP) using non-pharmacological approaches at five residential aged care facilities (RACFs) in Australia.
Antipsychotic treatment of community-dwelling and institutionalised patients with dementia in Germany
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OBJECTIVE: A restrictive use of antipsychotic drugs in patients with Alzheimer’s disease (AD) is recommended due to an increased risk of cerebrovascular events and mortality. We hypothesise that the prescription of antipsychotics is associated with the patients’ socio-demographic and clinical status (e.g., dementia severity).
A cross-sectional examination of the prevalence of psychotropic medications for people living with dementia in Australian long-term care facilities: issues of concern
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BACKGROUND: Behavioral and psychological symptoms of dementia (BPSD) are a common problem in long-term care facilities (LTC). Clinical guidelines dictate that first-line treatments for BPSD are psychosocial and behavioral interventions; if these are unsuccessful, psychotropic medications may be trialed at low doses and their effects can be monitored.
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Events
Non UofA
eHealth: Technology and Innovation Supporting the Health of Older Adults
This unique, interactive training program will run from May 28 – June 1, 2018 and will be held in Harrison Hot Springs, BC. Graduate students and post-doctoral fellows working in, or interested in learning about, research related to the area of eHealth and aging are encouraged to apply.
Trainees will have the opportunity to participate in advanced training that crosses disciplines and brings together trainees, researchers, and members of the public and private sector from Canada and abroad.
Networking opportunities will be offered throughout the week.
The program will be launched in January 2018 on the CIHR ResearchNet. More information will follow in the coming weeks.
Online
Learning objectives:
1. Audience will be able to outline opportunities for using social media for improved knowledge translation
2. Audience will be able to describe the development, implementation, and evaluation of the #ItDoesntHaveToHurt social media initiative
3. Audience will be able to explore barriers and facilitators to using social media for improved knowledge translation
All registration requests should be sent to Meghan Storey: storeym@smh.ca by Wednesday, Jan. 10th at 12:00pm EST.
Courses
KT Canada Summer Institute 2018
The 2018 KT Canada Summer Institute is being held on June 27th-29th in Toronto, Canada. The theme will be “Knowledge Translation Interventions”. Applications will open in January.
For questions please contact Meghan Storey: storeym@smh.ca
Practicing Knowledge Translation
Practicing Knowledge Translation (PKT): Implementing evidence. Achieving outcomes is a 5-day course with a pre and post workshop webinar that focuses on applying KT science to inform implementation. The course presents a method of using evidence-based implementation strategies to produce behavior and practice changes and achieve desired outcomes. PKT is a 5-day course that includes:
– Develop an Evidence-informed, Theory-Driven program
– Map barriers and facilitators to change using theories and frameworks
– Systematically select and operationalize implementation strategies
– Plan for implementation, evaluation and sustainability
Applications for this workshop are now open.
Using Implementation Science In Practice
The Using Implementation Science in Practice seminar will be hosted by the University of Surrey in Guildford, England. The seminar includes lectures, practice examples and facilitated small group work to support participants to use implementation science more effectively in practice. The seminar is structured around four themes:
– Introduction to implementation science
– Pre-implementation planning
– Implementing your project
– Post implementation; adoption, spread and sustainability
The intended audience for this seminar is healthcare professionals, managers, commissioners, researchers and policy makers in both the public and private sector who want to make effective use of evidence based treatment and care. Participants will be asked to describe an implementation project which they would like to develop when they register.
The seminar is led by international experts in the field of implementation science including Dr Brian Mittman, Senior Research Scientist at the Kaiser Permanente Southern California Department of Research, US, Professor Sharon Straus, Chair in Knowledge Translation and Quality of Care, Department of Medicine, University of Toronto, Carl May, Professor of Healthcare Innovation, University of Southampton and Dr Siw Calfjord, Linköping University, Sweden.
Online
As more emphasis is placed on the importance of supporting the use of evidence to strengthen health systems globally, it is important to understand and learn from the innovative approaches taken in different regions around the world. Dong (Roman) Xu (executive deputy director of the Sun Yat-sen Global Health Institute of the Sun Yat-sen University), Yalong Chen (founding director of Chinese GRADE Center and co-director of WHO Collaborating Centre for Guideline Implementation and Knowledge Translation), and Qi Wang (PhD Student in the Health Policy PhD program at McMaster University) will share insights from the experiences of the Chevidence working group.
End of Grant Knowledge Translation (KT) Course
A training opportunity to provide researchers, trainees and others with the knowledge and skills to design an end of grant KT plan.
This online course will be delivered across 3 webinars and interactive discussion sessions. Participants will develop an end of grant KT plan, and will receive feedback on their plans from KT experts.
Key Speakers:
• Sharon Straus, MSc, MD (Director and Principal Investigator, Knowledge Translation Program, Li Ka Shing Knowledge Institute, St. Michael’s Hospital; Professor, Dept of Medicine, University of Toronto)
• Kim Barnhardt (Communications and Partnerships Strategist, Canadian Medical Association Journal)
• Jessie McGowan, PhD (Adjunct professor, Dept of Medicine, University of Ottawa; Associate Editor, Journal of Clinical Epidemiology).
Who should participate?
• Professionals in any health-related discipline who are interested in learning the basics of end-of-grant KT. Course attendees can use their own grants to develop an end-of-grant KT plan.
We have several free spaces available for trainees who are affiliated with the SPOR Evidence Alliance. For more information about this course, please contact Meghan Storey (storeym@smh.ca)
News
When Nursing Homes Push Out Poor And Disabled Patients
Anita Willis says the social worker offered her a painful choice: She could either leave the San Jose, Calif., nursing home where she’d spent a month recovering from a stroke — or come up with $336 a day to stay on. She had until midnight to decide.
Are You Old? Infirm? Then Kindly Disappear
Nancy Root remembers when she vanished. Not the exact date, but the occasion: She went shopping for a mattress. This was a few years ago. Because the mall was so big and her legs were so weak, she used a wheelchair, which was new to her, and had a friend push her. Their wait for service was unusually long, and later, as she used the wheelchair more and more, she understood why. In the chair she became invisible. In the chair she turned radioactive.
In Focus: Spreading Innovative Approaches to Dementia Care
In parts of the country that lack specialized care centers for patients with Alzheimer’s disease and other forms of dementia, newly diagnosed patients and their loved ones struggle to manage what can be a long, progressive decline. Several innovative dementia care models show how, in the absence of a cure, providers can help patients and family caregivers cope with the physical symptoms of dementia, monitor its effects on other chronic conditions, and offer strategies for behavioral and psychosocial problems. Recently added Medicare billing codes for dementia care planning and for an annual wellness visit that requires clinicians to offer cognitive screening may encourage more clinicians to identify dementia and help patients and families with next steps after a positive diagnosis.
Infection Lapses Rampant In Nursing Homes But Punishment Is Rare
A Kaiser Health News analysis of federal inspection records shows that nursing home inspectors labeled mistakes in infection control as serious for only 161 of the 12,056 homes they have cited since 2014.
Resources
The McMaster Optimal Aging Portal is excited to offer citizens and stakeholders with a more comprehensive evidence source through the addition of evidence-based content about the social aspects of aging. This new content (featuring topics such as civic engagement, consumer protection, and transportation) complements the high-quality information already provided about the health aspects of aging. The broader range of content on the McMaster Optimal Aging Portal will better support citizens in making informed decisions as they age.
Just Ask: Seniors tell us what it’s really like to live in long-term care
A recent Canadian study found that 44 percent of seniors living in residential are depressed. Given that the transition to long-term care or a nursing home is one of the most difficult any of us will face, that may not be surprising. The Ontario Long-Term-Care Association (OLTCA) estimates that 90 per cent of long-term-care residents have some type of cognitive impairment. Yet another statistic that paints a bleak picture of aging. But if you want to really understand what’s behind these figures you have to talk to the real experts: the people who live in long-term care homes. They are the faces and stories behind the stats.
Nursing and residential care facilities (provisional estimates), 2015
Rural and Remote Age-friendly Communities
During this [pre-recorded] webinar, Dr Menec examined the difference between rural and remote environments, explaining that many people live in rural communities, including 42% of Canadians 60 years or older. Dr Menec also explored the reasons why it is necessary to make sure that these environments are adapted to the needs of older people, and enable older people to live independently.
Newsletters
Opportunities
The Department of Psychiatry and Behavioral Sciences at Northwestern University Feinberg School of Medicine seeks a full-time, non-tenure eligible Team Scientist at the rank of Assistant Professor. The candidate will join a rich, collaborative environment with other clinicians and scientists in the Feinberg School of Medicine and throughout the University and will be affiliated with the Center for Prevention Implementation Methodology (Ce-PIM). Responsibilities include developing collaborations to integrate implementation science into all stages of health research, developing a specialty area of research in implementation science and methodology, and advancing the knowledge of implementation science both locally and nationally.
