The dementia environment in care home

A new addition to Social Care TV (from the UK's Social Care Institute for Excellence), this film shows how simple changes to create a more dementia friendly care home environment can have a positive impact on a person living with dementia's emotional well being and independence.

http://www.scie.org.uk/socialcaretv/video-player.asp?v=dementiaenvironmentinacarehome

Long Term Care Family Experience Survey

Published in November, 2011 by the Health Quality Council of Alberta. Using the CAHPS Nursing Home Survey: Family Member Instrument, the 2010/2011 Survey repeated a survey done in 2007/8, the first long term care experience survey done at the provincial level. The survey sought to:

•  identify areas of excellence and opportunities for improvement
• compare information across the province
• provide an opportunity for facilities to compare results from the previous survey

The questionnaire collected the following information:

• resident and respondent characteristics
• family experience and perceptions
• family member ratings
• willingness to recommend the home
• suggestions for improvement

http://www.hqca.ca/assets/files/HQCA%20LTC%20Family%20Experience%20Survey%20Final%202010-11.pdf

Complaints in for-profit, non-profit and public nursing homes in two Canadian provinces

"Background: Nursing homes provide long-term housing, support and nursing care to frail elders who are no longer able to function independently. Although studies conducted in the United States have demonstrated an association between for-profit ownership and inferior quality, relatively few Canadian studies have made performance comparisons with reference to type of ownership. Complaints are one proxy measure of performance in the nursing home setting.  The goal  of the study is to determine whether there is an association between facility ownership and the frequency of nursing home complaints.

Methods: Publicly available data on complaints, regulatory measures, facility ownership and size for 604 facilities in Ontario over 1 year (2007/08) and 62 facilities in British Columbia (Fraser Health region) over 4 years (2004–2008) was analyzed. All analyses were carried out at the facility level.

Interpretation: Compared with for-profit chain facilities, non-profit, charitable and public facilities had significantly lower rates of complaints in Ontario. Likewise, in British Columbia’s Fraser Health region, non-profit owned facilities had significantly lower rates of complaints compared with for-profit owned facilities."

 Click here to read the full article

Young People in Nursing Homes

Published by Monash University in August, 2011, the objective of this white paper is to summarize the research and policy context related to the issue of young people in nursing homes in Australia.

This discussion paper aims to:
• summarize research regarding the social inclusion of young people in nursing homes
• provide background on the policy and practical challenges regarding young people in
nursing homes

http://www.summerfoundation.org.au/attachments/151_White%20Paper%20Young%20People%20in%20Nursing%20Homes-lo.pdf

Nurse Competencies for Nursing Home Culture Change

In 2008 Hartford Institute for Geriatric Nursing (HIGN) collaborated with the Coalition of Geriatric Nursing Organizations (CGNO) and Pioneer Network (PN) to convene a panel of 31 nursing and other experts to explore opportunities and barriers for nursing and culture change.

The panel worked to answer the question, "what is the role for nurses in achieving and sustaining this change?" The decision was made by a core group of nurses and clinical nurse leaders involved in cultural transformation to concentrate on those competencies that are unique to culture change nursing, building on the work already done to identify specific clinical competencies for geriatric nursing (see www.aacn.nche.edu/Education/gercomp.htm) and Position Descriptions and Related Competencies for Long Term Care Nursing Positions (www.ltcnursing.org).

"Nursing Competencies for Nursing Home Culture Change", release May 27th, 2010, is a result of that collaboration.

http://pioneernetwork.org/Data/Documents/TenCompetenciesReport0510.pdf

From the Pioneer Network press release.

Nursing Home Week Planning Guide

The American Health Care Association's Nursing Home Week Planning Guide is now available for download.

Natinal Nursing Home Week, beginning May 9 - May 15, 2010,  spotlights nursing home residents and staff and encourages all to celebrate those that make a positive difference in their lives every day. The week also provides an opportunity to honor all those who contribute to our nation’s nursing homes – residents, family members, employees and volunteers.


http://ow.ly/1efsv

Advancing Excellence in America’s Nursing Homes Campaign Implementation Guides

The Mission of the Advancing Excellence in America’s Nursing Homes Campaign is to help nursing homes achieve excellence in the quality of care and quality of life for residents of America’s nursing homes by:

Establishing and supporting an infrastructure of

• Local Area Networks of Excellence (LANEs),
• Strengthening the workforce
• Improving clinical and organizational outcomes.

The Implementation Guides are organized by campaign goal. Each guide includes the campaign goal; Flow Diagram; Process Framework; Process Review Tool; and Resources. These guides are designed to assist all nursing homes in meeting their selected campaign goals.

Goal 1 - Staff Turnover: Nursing homes will take steps to minimize staff
turnover in order to maintain a stable workforce to care for residents.

Goal 2 - Consistent Assignment: Being regularly cared for by the same caregiveris essential to quality of care and quality of life. To maximize quality, as well as resident and staff relationships, the majority of Nursing Homes will employ “consistent assignment” of CNAs.

Goal 3 - Restraints: Nursing home residents are independent to the best of their ability and rarely experience daily physical restraints.

Goal 4 - Pressure Ulcers: Nursing home residents receive appropriate care toprevent and appropriately treat pressure ulcers when they develop.

Goal 5 - Pain: Nursing home residents will receive appropriate care to prevent and minimize episodes of moderate or severe pain. Objectives for long stay and short stay are slightly different.

Goal 6 - Advance Care Planning: Following admission and prior to completing or updating the plan of care, all NH residents will have the opportunity to discuss their goals for care including their preferences for advance care planning with an appropriate member of the healthcare team. Those preferences should be recorded in their medical record and used in the development of their plan of care.

Goal 7 - Resident/Family Satisfaction: Almost all Nursing Homes will assess resident and family experience of care and incorporate this information into their quality improvement activities.

Goal 8 - Staff Satisfaction: Almost all nursing homes will assess staff satisfaction with their work environment at least annually and upon separation and incorporate this information into their quality improvement activities.

American Healthcare Association 2009 Quality Report: A Comprehensive Report on the Quality of Care in America's Nursing and Rehabilitation Facilities

The goal of this report is to provide an objective and representative overview of the state of nursing and rehabilitative care in America by highlighting key quality trends, improvements and areas that require more attention in the future.

The report relies primarily on available government data and findings from leading researchers in long term care. Evidence exists that quality initiatives such as Quality First have improved quality of care and quality of life for residents and patients in key areas such as reducing use
of restraints and improvements in wound care.

The report presents a wide range of strategies designed to improve staff satisfaction among long-term care workers, including direct-care staff, in nursing homes. Strategies including everything from maintaining a timely performance-review schedule to keeping the nursing home facility clean and clutter-free, and many the role of respect in the workplace.

Finally, the authors suggest that nursing home leaders create a comfortable, home-like environment for their workers; praise and publicly recognize their hardest-working staff members, particularly those who go above and beyond their job descriptions; and be as transparent as possible, sharing any relevant evaluative, clinical, and financial data with their staff.

http://www.ahcancal.org/research_data/quality/Documents/2009AnnualQualityReport.pdf

My Home Life DVD

My Home Life DVD is a series of online films designed to showcase the new phase of the My Home Life initiative.

Each film is split into two parts: a case study and a question about the film answered by a series of experts.

My Home Life is supported by the recently merged Age Concern and Help the Aged, City University London and the Joseph Rowntree Foundation

My Home Life aims at improving the quality of life of those who are living, dying, visiting and working in care homes for older people.

The eight films on the site are based on the themes of the program:

• Managing transitions
  
• Maintaining identity
• Creating community
• Sharing decision-making
• Improving health & healthcare
• Supporting good end-of-life
• Keeping workforce fit for purpose
• Promoting a positive culture

http://www.myhomelifedvd.org.uk/

Enhancing Informal Adult Learning for Older People in Care Settings

“Enhancing informal adult learning for older people in care settings” is putting into practice the commitments of The Learning Revolution White Paper, which reported that ‘learning can improve the health and quality of life for older people in care, but too often it’s missing’.

Funded by the UK Department for Business, Innovation and Skills (BIS), the report draws on feedback from organizations and individuals and highlights 10 examples of existing practice, setting out the challenges in providing more learning opportunities for older people in care settings.

An on-line forum has been created on the Learning Revolution discussion-site to capture thoughts and ideas. These contributions will be included in the production of a toolkit of best practice to be published next year. To contribute, visit http://thelearningrevolution.ning.com/group/olderpeople

Visit the website of the project to read more about the project; to view a video of Tansley House Care Home, an example of a learning program in a care home, and to read some comments about the effectiveness of this program: http://www.niace.org.uk/niace-project-helps-older-people-in-care

Better Care Every Step of the Way: Report on the Quality of Palliative and End of Life Care

Published by the Scottish Commission for the Regulation of Care in April 2009, this report details what the Healthcare Regulation Care Commission found out about palliative and end of life care from their inspections; and what they learned from complaints about palliative and end of life care in care homes.

http://www.carecommission.com/images/stories/documents/publications/reviewsofqualitycare/better_care_every_step_of_the_way_-_april_2009.pdf

Remember, I'm Still Me: Care for People with Dementia Living in Care Homes

This joint report by Scotland's Care Commission and the Mental Welfare Commission aimed to answser the following questions about the care of people with dementia living in care homes in Scotland:

• What is it like to have dementia and be living in a care home?
• Do people get the care and respect they need and deserve?
• Do care home staff know enough about the people in their care?

Ten key areas were examined:

• Care that respects the individual
• Activities and being part of the community
• The environment in which people live
• Managing money
• Health assessment
• Managing medication
• Managing challenging behaviour and the use of medication
• Legal protections and safeguards
• Consent to treatment
• Staff knowledge and training

These finding will be of interest to anyone interested in quality dementia care.

http://www.carecommission.com/images/stories/documents/publications/reviewsofqualitycare/remember_im_still_me_-_may_09.pdf

Models for Providing Improved Care in Residential Nursing Homes: a thematic literature review

This extensive bibliography from the Warwick Medical School (England) covers reports, journal article, web documents, and books on care models in nursing homes.

http://wrap.warwick.ac.uk/438/2/WRAP_Szczepura_0370507_130209_Master_Bibliography_JRF_Literature_Review-print.pdf

Current Perspectives Update: Easing the Transition to Long Term Care

“Easing the Transition to Long Term Care” in the "Current Perspectives Series" has been newly updated. The "Current Perspectives Series" from the J. W. Crane Memorial Library, highlights current articles, books and Internet resources on specific topics of interest to long-term care professionals. To access "Easing the Transition” and other topics in the series, go to: http://umanitoba.ca/libraries/units/health/links/aging.html

Improving Care in Residential Care Homes: A Literature Review

This review by a team from the University of Warwick and University of the West of England, with support from the University of York examines the research evidence available to provide improved care for older people in residential homes.

http://www.jrf.org.uk/knowledge/findings/socialcare/pdf/2326.pdf

CBC News I-Team Series: Questionable Care in Manitoba Nursing Homes

Visit the CBC I-Team website for a special series on Manitoba nursing homes. The series airs on CBC News at 6 p.m. CST weekdays.

http://www.cbc.ca/manitoba/features/nursinghomes/

Thinking About Improving Practice

From the UK Relatives and Residents Association, this series of handouts were developed for direct care staff to emphasize that there are many small things that can make a big difference to the daily lives of older people living in care homes.

The four topics in the series are:

• Scene setting
• Privacy
• Mealtimes
• Continence Care

http://www.relres.org/thinking-about-improving-practice.html

What We Heard: Long-Term Care Quality Consultation, 2008

The Ministry of Health and Long-Term Care (MOHLTC) and the Seniors Health Research Transfer Network (SHRTN) hosted a consultation process to develop a common vision of quality in long-term care (LTC) homes that reflects all aspects of the resident’s LTC experience. The consultation was organized by a planning committee with representation from LTC homes across the province, provincial LTC associations, Family Councils, Residents’ Councils, government, SHRTN and Local Health Integration Networks (LHINs) as well as quality improvement leaders, researchers and data experts.

The consultation took place in five sessions between February 12 and April 10, 2008 in Toronto, Hamilton, Ottawa, London and Sudbury. In total there were over 600 participants with up to 60 per cent representing LTC homes and approximately 40 per cent representing the remaining stakeholder groups.

The purpose of this report is to synthesize the themes from the five sessions to reveal a common vision of quality in LTC homes. While the dialogues varied in their emphases, there was significant consensus on how participants describe quality, what the priorities are and how to move forward.

http://www.health.gov.on.ca/english/public/pub/ministry_reports/quality_consultation_08/quality_consultation_08.pdf

What to look for in a long-term care facility

A CBC In depth report on choosing a long term care facility for a parent or family member.
http://www.cbc.ca/health/story/2008/07/16/f-longtermcare.html?ref=rss

Supporting Older People in Care Homes at Night

This report from the Joseph Rowntree Foundation, (University of Edinburgh) 2008 sought to explore night time care in nursing homes at night. A review of the literature revealed that this was an understudied, and less well understood aspect of care in the nursing home.

http://www.jrf.org.uk/bookshop/eBooks/2192-night-care-older-people.pdf