Day 1 :
Keynote Forum
Lee Hyer
Georgia Neurosurgical Institute, USA
Keynote: New model: Holistic assessment and treatment of older adults
Time : 09:00-09:35
Biography:
Lee Hyer is a Professor at Georgia Neurosurgical Institute in the Department of Psychiatry and Health Behavior. He serves as Board of Advisors and Senior Fellow Eye Movement Desensitization and Reprocessing (EMDR) Coordinator and Special Instructor. Lee involves in several Administrative Responsibilities/Appointments and Committees. He secured many awards/honors and serves as editorial member and also a reviewer for the following journals Journal of Consulting and Clinical Psychology, Journal of Clinical Psychology, Journal of Applied Gerontology, Journal of Aging Studies, Journal of Gerontology, The Gerontologist, Journal of Traumatic Stress, Journal of Personality Disorders, Journal of Personality Assessment, Psychological Reports and Professional Practice. Lee also published many research papers in highly reputed journals.
Abstract:
In 2014 a new model of assessment and treatment for older adults was promulgated (Hyer 2014). This presentation explicates this Watch and Wait model, outlining five core domains of care, the importance of a focus on the “real world” of an older adult, the limitations of extant treatments and the overvalued focus of the nuanced differences in treatment (one antidepressant vs. another, one psychotherapy vs. another, etc.). We explicate two parts of this model; (1) A case-based and deliberative unfolding of a plan, applying psychoeducation, assessment, validation, alliance building, monitoring, and use of treatment modules; and, as noted, (2) The relevance of five areas {depression, anxiety, cognition, health (especially comorbidities, pain and sleep), and life adjustment (unmet needs in the community)}. We base this model on Primary Care Clinic data of 500 older patients.
We set the stage discussing influencing meta-trends requiring a new model of care for older adults. We then address the unfolding of the first 3-4 sessions of Watch and Wait. We elaborate on an assessment battery for each domain using set screens and a short neuropsychological battery. We explain the metric for designating whether the patient met criteria for each domain; Mild, Moderate, or Problem. This leads to a profile for each patient of the five domains. We then apply an empirically-supported plan of modules for each domain and monitor these.
This model is case-based, applies common factors/motivational interviewing, and uses evidence-based modules of treatment. It also endorses team care, family involvement, and monitoring. Importantly, we endorse and maximize lifestyle interventions, especially exercise, cognitive training, stress reduction, and diet. Health depends on good living and support.
We believe that we need a new, deliberative and thoughtful model of care for this new cohort of older adults. The current medical model is both limiting and ineffective.
Neural Enrichment & Neural Depletion
Keynote Forum
Angela Kydd
Edinburgh Napier University, UK
Keynote: Prescribing for the oldest old
Time : 09:35-10:10
Biography:
Angela Kydd has her expertise in frail older people and people with dementia. She worked as a nurse for ten years before working in academia. She is an associate professor at Edinburgh Napier University and works as a co-founder of a Pan-University Ageing Research Network. Over the years she has designed and delivered degree and masters programmes and modules in gerontology. She has undertaken research on attitudes to health care professionals working with older people, self-care beliefs of women with diabetes and her PhD thesis were on delayed discharge from a policy and patient perspective. She has also undertaken evaluations of clinical areas and projects. Her latest project was on developing the culture and care in a care home setting, which included on site work with three care homes. She is co-editor of a textbook on The Care and Well-being of Older People and has numerous publications in this field.
Abstract:
Given the global increase in people over the age of 85, there is a growing body of literature looking at treating the oldest old. However much of this work is confined to the literature, specialising in geriatrics and the more generic health care papers refer to ‘older people’ with little definition of what is meant by ‘old’. Age is not a diagnosis, but humans do have a finite lifespan and as they age, they become increasing more susceptible to disease and have decreased functional reserve. A major issue in prescribing for people over the age of 85 is that guidelines for diseases are based on trials with younger adults, outline the best practice for one disease in isolation of other diseases and take no account of the interaction of drugs used in managing several diseases. Iatrogenesis (ill health caused by doctors) is a major issue which points to the fact that nurse prescribers and general practitioners (GPs) need practical help in prescribing for the oldest old. Balancing evidenced based practice with clinical judgement means weighing up what will do good, what will cause harm and what is acceptable to the patient. This has to be carried out mostly in isolation from colleagues, within a time-limited consultation with few relevant guidelines on managing multi morbidities in the oldest old. A narrative literature review was undertaken and a literature search on iatrogenesis and the oldest old showed that all papers sourced referred to prescribing for the ‘old’ as those aged over 65, with only scant mention of the oldest old. This paper presents the findings of this review.
Keynote Forum
Stephen Jacobs
University of Auckland, New Zealand
Keynote: A systematic method for improving service quality in home support services for older people
Time : 10:10-10:45
Biography:
Stephen Jacobs is a senior lecturer in the School of Nursing, the Faculty of Medical and Health Sciences, The University of Auckland lecturing of Health Services for Older People and Leadership and Management for Quality Healthcare. He is also co-director of the Institute of Healthy Ageing coordinating five research streams: workforce, mental health, best practice, community, and rehabilitation. He researches in two key areas: community dementia services and the adaptive leadership and empowerment of nurses. His PhD was in Medicine, researched quality control of home support services for older people. From 2000 till November 2006 he was Senior Advisor in the Health of Older People in the New Zealand Ministry of Health Prior to that, he was for five years Manager, Services for Older People, Wesley Wellington Mission, managing a community service, a home care service, two rest homes, and two continuing care hospitals.
Abstract:
Health services are seeking to assist older people to stay functional and at home for as long as possible. However, community care for elderly with complex health needs raises issues about co-ordination, risk aversion and societal expectations of safety. Safety is less important to older people than a sense of control. New Zealand research uncovered older people were dissatisfied with home based services. They thought they were insufficiently involved in decision-making, cultural differences were insufficiently respected, and they had little control over their everyday lives a balanced scorecard was established to enable benchmarking of success factors critical to the successful support of older people living in the community. Benchmarking can assist learning by ‘communities of practice’ by identifying what works well. A recursive innovation, action research approach involving twenty focus groups across three District Health Boards informed the initial implementation of the INTOUCH benchmarking system with five District Health Boards. Data from performance measurement is used to triangulate the personal and social worlds of the stakeholders. Transparency helps quality improvement. The recursive dialogue encouraged by INTOUCH supports better and more sustainable service development because performance management is anchored to agreed data that has meaning to all stakeholders. Incorporating the consumer perspective within the balanced scorecard means older people are included in the service design and delivery. Implementation fidelity is a major issue in contemporary health projects so an evidence-based systematic model that engages all stakeholders into an agreed approach provides leaders with a management control mechanism that is useable in this twenty-first century world in which people work in networks and alliances.
Recent Publications:
- Jacobs SP, Rouse P, Parsons M (2014) Leading change within health services: The theory behind a systematic process for leading the implementation of new services within a network structure. Leadership in Health Services 27,2:72-86
- Senior HE, Parsons M. Kerse N, Chen M, Jacobs S, Vanderhoorn, S, Anderson C. (2014) Promoting independence in frail older people: a randomised controlled trial of a restorative care service in New Zealand. Age & Ageing 43: 418–424
- Parsons, M, Anderson C, Senior H, Chen X, Kerse N, Jorgensen D, Brown p, Jacobs S, Vanderhoorn S, Kilpatrick J. (2005) ASPIRE - Assessment of Services Promoting Independence and Recovery in Elders. Auckland: The University of Auckland.
- Sajtos, L., Rouse, P., Harrison, J., & Parsons, M. (2014). Case-mix system as a boundary object: the case of home care services. Australasian Marketing Journal (AMJ), 22 (3), 189-196.
- Breitenstein, S.M., Gross, D., Garvey, C.A., Hill, C., Fogg, L. and Resnick, B. (2010) Implementation fidelity in community-based interventions, Research in Nursing and Health, 33, 164-173.
- Elderly Care | Gerontological Nursing | Geriatric Medicine | Geriatric Case Studies | Geriatric Dementia | Geriatric Mental Health | Geriatrics Palliative Care
Location: Balvenie Glenmorangie
Chair
Lee Hyer
Georgia Neurosurgical Institute | USA
Co-Chair
Stephen Jacobs
University of Auckland | New Zealand
Session Introduction
Vigdis Abrahamsen Grøndahl
Østfold University College, Norway
Title: Health care quality from the persons with dementia’s perspective: Development and testing of a questionnaire
Time : 11:10-12:50
Biography:
Vigdis Abrahamsen Grøndahl works at Østfold University College in Norway. She has experience from medical wards and intensive care units. She has worked as a nursing teacher for 25 years, including 6 years as head of bachelor in nursing, 1 year as protector and the last 9 years as both teacher and researcher. Her PhD degree concerned health care quality from the patients’ perspective, and her special interest in research concerns person centered care both in community health care and hospital, elderly care and healthcare quality from the patients’ perspective.
Abstract:
Statement of the Problem: Dementia care is one of the most rapidly growing areas in healthcare; however, relatively little is known about the experiences of care quality of persons with dementia themselves. The Quality from the Patient’s Perspective (QPP) questionnaire is based on a model of care quality from the patients’ perceptions of care, and has previously been adapted
for use in different healthcare settings. The purpose of this study was twofold: (1) to adapt the QPP for use by persons with dementia and (2) to describe perceptions of care quality among persons with dementia in special care units (SCUs) in nursing homes.
Methodology & Theoretical Orientation: A cross-sectional design was used. Structured interviews using a questionnaire were carried out. The study was conducted in SCUs in three nursing homes in Norway and included 61 persons with dementia, with a response rate of 96.8%. An exploratory factor analysis using principal axis factoring with oblique rotation was performed for psychometric evaluation. Internal consistency was assessed by Cronbach’s alpha and subgroup comparisons were performed using chi-squares and t tests.
Results: The QPP questionnaire was adapted for dementia care by selecting items from the QPP, modifying items, and constructing new items specifically for dementia care. The QPP questionnaire specifically for dementia care (QPP-DC) consists of 23 items representing seven factors with an eigenvalue ≥ 1.0. The reliability coefficients were acceptable for most factors. The quality ratings of persons with dementia showed considerable variation across the different items.
Conclusions & Significance: QPP-DC provides a meaningful tool for quality improvements of care in special care units by detecting areas of importance for the persons with dementia. Nevertheless, research is needed to further validate and test the QPP-DC in other contexts.
Recent Publications:
- Drageset J, Kirkevold M. Espehaug B. (2011). Loneliness and social support among nursing home residents without cognitive impairment: A questionnaire survey. Int J Nurs Stud, 48:611–619.
- Helgesen AK (2013). Patient participation in everyday life in special care units for persons with dementia. Faculty of Social and Life Sciences, Karlstad University Studies. (Doctoral dissertation).
- Larsson G, Wilde-Larsson B. (2001). Quality of care and service as perceived by adults with developmental disabilities, their parents and primary caregivers. Mental Retardation 39:249-258.
- Perales J, Cosco TD, Stephan BC, Haro JM, Brayne C. (2013) Health-related quality-of-life instruments for Alzheimer's disease and mixed dementia. International Psychogeriatrics, 25:691-706.
- van Baalen A, Vingerhoets Ad JJM, Sixma HJ & de Lange J (2011). How to evaluate quality of care from the perspective of people with dementia: an overview of the literature. Dementia, 10:112–37.
Ann Karin Helgesen
Østfold University College, Norway
Title: Health care quality from the persons with dementia’s perspective: Development and testing of a questionnaire
Time : 11:10-12:50
Biography:
Ann Karin Helgesen works as a teacher and researcher at the Østfold University College in Norway. She has 16 years’ experience as a registered geriatric nurse, most of them in elderly care in general and dementia care in special. Her Ph.D. degree explored patient/user participation in everyday life in special units for persons with dementia.
Abstract:
Statement of the Problem: Dementia care is one of the most rapidly growing areas in healthcare; however, relatively little is known about the experiences of care quality of persons with dementia themselves. The Quality from the Patient’s Perspective (QPP) questionnaire is based on a model of care quality from the patients’ perceptions of care, and has previously been adapted for use in different healthcare settings. The purpose of this study was twofold: (1) to adapt the QPP for use by persons with dementia and (2) to describe perceptions of care quality among persons with dementia in special care units (SCUs) in nursing homes.
Methodology & Theoretical Orientation: A cross-sectional design was used. Structured interviews using a questionnaire were carried out. The study was conducted in SCUs in three nursing homes in Norway and included 61 persons with dementia, with a response rate of 96.8%. An exploratory factor analysis using principal axis factoring with oblique rotation was performed for
psychometric evaluation. Internal consistency was assessed by Cronbach’s alpha and subgroup comparisons were performed using chi-squares and t tests.
Results: The QPP questionnaire was adapted for dementia care by selecting items from the QPP, modifying items, and constructing new items specifically for dementia care. The QPP questionnaire specifically for dementia care (QPP-DC) consists of 23 items representing seven factors with an eigenvalue ≥ 1.0. The reliability coefficients were acceptable for most factors. The quality ratings of persons with dementia showed considerable variation across the different items.
Conclusions & Significance: QPP-DC provides a meaningful tool for quality improvements of care in special care units by detecting areas of importance for the persons with dementia. Nevertheless, research is needed to further validate and test the QPP-DC in other contexts.
Recent Publications:
- Drageset J, Kirkevold M. Espehaug B. (2011). Loneliness and social support among nursing home residents without cognitive impairment: A questionnaire survey. Int J Nurs Stud, 48:611–619.
- Helgesen AK (2013). Patient participation in everyday life in special care units for persons with dementia. Faculty of Social and Life Sciences, Karlstad University Studies. (Doctoral dissertation).
- Larsson G, Wilde-Larsson B. (2001). Quality of care and service as perceived by adults with developmental disabilities, their parents and primary caregivers. Mental Retardation 39:249-258.
- Perales J, Cosco TD, Stephan BC, Haro JM, Brayne C. (2013) Health-related quality-of-life instruments for Alzheimer's disease and mixed dementia. International Psychogeriatrics, 25:691-706.
- van Baalen A, Vingerhoets Ad JJM, Sixma HJ & de Lange J (2011). How to evaluate quality of care from the perspective of people with dementia: an overview of the literature. Dementia, 10:112–37.
- Wilde Larsson, B. and Larsson, G. (2002), “Development of a short form of the Quality from the patient’s perspective (QPP) questionnaire”, Journal of Clinical Nursing, Vol. 11 No. 5, pp. 681-687.
Liv Berit Fagerli
Østfold University College, Norway
Title: The impact of person-centered care on older people’s perceptions of care quality in nursing homes: An intervention study
Time : 11:10-12:50
Biography:
Liv Berit Fagerli has worked as a teacher and researcher at Østfold University College in Norway since 1993. Her experiences and interests, concerns community health and person centered care, both in teaching and research. From 2013-2016 she has done research together with other researchers at the University College, on older people’s perceptions of care quality in nursing homes with special attention to person centered care. She has contributed in an intervention study that indicates that it is possible to design a care system where the older people are at the center of the health care offered.
Abstract:
Statement of the Problem: The quality of care offered to older people in nursing homes varies. Nursing home administrators often claim that they provide person-centered care, but research indicates that institutional goals take precedence. Personcentered care may influence the older people’s quality of life. The purpose of this study was to explore the impact of personcentered
care on older people’s perceptions of care quality.
Methodology & Theoretical Orientation: In our study, person-centered care was operationalized into one intervention: oneto-one contact (resident – carer). The intervention was systematically conducted for 12 months in one nursing home (41residents). One of the carers should spend 30 minutes twice a week alone with one resident. This form of companionship comprised activities such as talking, watching TV and going for a walk. Face-to-face interviews using the Quality from Patient’s Perspective (QPP) questionnaire were conducted both prior to intervention and immediately after the 12-month period. The
questionnaire comprises of four dimensions: caregivers’ medical-technical competence and identity-oriented approach, and care organisation’s socio-cultural approach and physical-technical conditions. Descriptive and comparative statistics were used to test for differences between care quality perceptions before and after intervention (p<.05).
Results: The older people rated all four quality dimensions significantly higher after the 12-month period. At the item level significantly higher scores were given to ‘The healthcare personnel showed commitment’, ‘The healthcare personnel were respectful towards me’,‘I received the best possible medical care’ and ‘There was a pleasant atmosphere on the ward’.
Sample characteristics
Conclusion & Significance: Older people’s perceptions of care quality increase when person-centered care is operationalized and takes precedence over ward routines. The results indicate that it is possible to design a care system where the older people are at the center of the health care offered.
Recent Publications:
- Askari M, Wierenga PC, Eslami S, Medlock S, Rooij SE, Abu-Hanna A (2011) “Assessing quality of care of elderly patients using the ACOVE quality indicator set: a systematic review”, PLoS ONE, Vol. 6 No. 12, e28631.
- Backhaus R, Verbeek H, van Rossum E, Capezuti E, Hamers JPH (2014) “Nurse staffing impact on quality of care in nursing homes: a systematic review of longitudinal studies”, Journal of the American Medical Directors Association, Vol. 15 No. 6, pp. 383-93.
- Grøndahl VA, Fagerli LB Nursing home care quality: a cluster analysis. International Journal of Health Care Quality Assurance. (in press)
- Hasson H, Arnetz JE (2010) “A comparative study of nursing staff, care recipients’ and their relatives’ perceptions of quality of older people care”, International Journal of Older People Nursing, Vol. 5 No. 1, pp. 5-15.
- Hughes K, Moore S (2012) “Quality of life versus quality of care: elderly people and their experience of care in South Australian residential facilities”, Practice: Social Work in Action, Vol. 24 No. 5, pp. 275-285.
Eli-Anne Skaug
Østfold University College, Norway
Title: Male residents’ experiences of an activity program for men only in a nursing home
Time : 11:10-12:50
Biography:
Eli Anne Skaug works at the Østfold University College in Norway. She has experience as an intensive care nurse from intensive care units, medical and rehabilitation wards. She has worked as nursing teacher for about 30 years and as head of the bachelor nursing education at Østfold University College for eight years. She is a co-editor and author of a textbook in basic nursing.
Abstract:
Statement of the Problem: Research to date indicates that most nursing homes offer various kinds of activities for their residents, but that these are seldom tailored to each individual person. In respect of activities, it is reasonable to assume that male residents are at particular risk of not receiving person-centred care as they inhabit a largely ‘female domain’, where the majority of personnel and often also of residents are female. Few studies to date have focused on activities for men in nursing homes. The purpose of this study was to explore male residents’ experiences of an activity program in a nursing home.
Methodology & Theoretical Orientation: The study had an explorative Grounded Theory (GT) design. Data were collected by means of interviews with nine residents. All of the men were offered an activity at least once a week as part of a project over the preceding year. According to the basic principles of grounded theory sampling, data collection and analysis are carried out
simultaneously using constant comparison.
Findings: The core category showed that there was ‘a change in the men’s everyday lives’ after the special activity program – for men only – was offered. Their own influence on the content of the conversations and on the activity itself was described as limited. This was not important for them, as the most essential issues were ‘being together’ and ‘getting away’. Conditions relating to the men themselves, the place where the activities were held and the nursing personnel had an impact on how important the activity program was for them.
Conclusions & Significance: A more personcentred approach in future activity programs will enhance the residents’ integrity and well-being, and allow them a degree of self-determination even while resident in a nursing home.
Recent Publications:
- Bradshaw SA, Playford ED, Riazi A (2012) Living well in care homes: a systematic review of qualitative studies. Age and Ageing, 41(4), 429-440.
- den Ouden M, Bleijlevens M, Meijers JM, Zwakhalen SM, BraunSM, Tan FE, Hamers JP (2015). Daily (In) Activities of nursing home residents in their wards: an observation study. Journal of the American Medical Directors Association, 16(11), 963-968.
- Helgesen AK (2013). Patient participation in everyday life in special care units for persons with dementia. Faculty of Social and Life Sciences, Karlstad University Studies. (Doctoral dissertation).
- Helgesen AK, Skaug EA, Abrahamsen Grøndahl V (2016) Changing Men’s Everyday Lives in Nursing Homes: A Grounded Theory Study. The International Journal of Person Centered Medicine 2016 Vol 6 Issue 3 pp 185-190.
- Moss, SZ, Moss MS (2007). Being a man in long term care. Journal of Aging Studies, 21(1), 43-54.
Ann Karin Helgesen
Østfold University College, Norway
Title: User participation in everyday decision-making in special care units for persons with dementia
Time : 11:10-12:50
Biography:
Ann Karin Helgesen works as a teacher and researcher at the Østfold University College in Norway. She has 16 years’ experience as a registered geriatric nurse, most of them with elderly care in general and dementia care in special. Her Ph.D. degree explored patient/user participation in everyday life in special units for persons with dementia.
Abstract:
Statement of the Problem: Studies about how user participation appears in the context of special care units for persons with dementia are lacking. The purpose of this study was to explore user participation in everyday decision making for persons with dementia living in special care units in nursing homes.
Methodology & Theoretical Orientation: The study has an explorative design. Grounded theory was chosen as method. Data collection was carried out by means of open observations and additional conversations with residents and personnel. Simultaneously, data analysis was performed with open, axial and selective coding.
Findings: The findings showed that user participation concerned ‘A matter of presence’ as the core category. The other categories described as ‘presence of personnel’ and ‘presence of residents’, were strongly connected to the core category as well as to each other. Presence of personnel comprised three levels; being there in body, which required physical presence; being there in mind, which required presence with all senses based on knowledge and competence; and being there in morality which was understood as being fully present, as it was based on humanistic values and included the two other levels. Presence of
residents comprised ‘ability and wish’ and ‘adaptation’. Organizational conditions concerning leadership, amount of personnel and routines as well as housing conditions concerning architecture and shared accommodation could stimulate or hinder user participation.
Conclusions & Significance: The study highlighted the great impact of the personnel’s presence in body, mind and morality on the participation capacity of the residents. The great importance of the nurse leaders was stressed, as they were responsible for organizational issues and served as role models.
Recent Publications:
- Boer M, Hertogh C, Droes RM, Riphagen I, Jonker C, Eefsting J (2007) Suffering from dementia – the patient’s perspective: a review of the literature. International Psychogeriatrics 19, 1021–1039.
- Cahill J (1998) Patient participation – a review of the literature. Journal of Clinical Nursing 7, 119–128.
- Helgesen AK (2013) Patient participation in everyday life in special care units for persons with dementia. Faculty of Social and Life Sciences, Karlstad University Studies. (Doctoral dissertation).
- Menne HL, Whitlatch CJ (2007) Decision-making involvement of individuals with dementia. The Gerontologist 47, 810–819.
- Wilkinson H (2001) Empowerment and decision-making for people with dementia: the use of legal interventions in Scotland. Ageing & Mental Health, 5, 322–328.
Vigdis Abrahamsen Grøndahl
Østfold University College, Norway
Title: Older people’s involvement in activities related to meals in nursing homes
Time : 11:10-12:50
Biography:
Vigdis Abrahamsen Grøndahl works at Østfold University College in Norway. She has experience from medical wards and intensive care units. She has worked as a nursing teacher for 25 years, including 6 years as head of bachelor in nursing, 1 year as protector and the last 9 years as both teacher and researcher. Her PhD degree concerned health care quality from the patients’ perspective, and her special interest in research concerns person centered care both in community health care and hospital, elderly care and healthcare quality from the patients’ perspective.
Abstract:
Statement of the Problem: Eating and drinking are fundamental human needs, and consequently essential parts of nursing and nursing care. Therefore and as part of nursing care encouraging older people in nursing homes to engage in different mealtime activities could be one way to increase participation in activities of daily living and more optimal nutrition status
among older people. The purpose of this study is to explore how residents in nursing homes perceive their participation in activities related to food and meals, and possible factors influencing their involvement.
Methodology & Theoretical Orientation: A cross-sectional survey design was used. A total of 204 residents (88 percent) in one Norwegian county agreed to participate and completed a face-to-face interview questionnaire about food and meal experiences. Descriptive and comparative statistics was used.
Results: Close to 30 percent of the residents were vulnerable to malnourishment. None of the residents were involved in menu planning, and more than 90 percent did not participate in food preparation or setting/clearing tables. Ten percent were able to choose where they could eat and five percent when they could eat. Older persons living in nursing homes with more than
80 residents and those younger than 65 years of age, participated the most, while older people with poor appetites were able to choose more often where they wanted to eat, compared to those with a healthy appetite.
Conclusion & Significance: The residents in this study appeared to be vulnerable to malnourishment. The results indicated that they only to a limited extent were involved in activities concerning food and meals at the nursing homes. Management and nurses should focus on residents eating and drinking which are essentials of nursing care. The residents should be asked, if they would like to participate in different mealtime activities. Further, a person-centred care approach that facilitates activities concerning food and meals should be promoted.
Table 1a. Characteristics of the residents (N=204)
Recent Publications:
- Beattie E, O’Reilly M, Strange E, Franklin S, Isenring E (2014) How much do residential aged care staff members know about the nutritional needs residents? International Journal of Older People Nursing 9, 54-64.
- Carrier N, West GE, Ouellet D (2009) Dining experience, food services and staffing are associated with quality of life in elderly nursing home residents. The Journal of Nutrition, Health & Aging 13, 565-570.
- Divert C, Laghmaoui R, Crema C, Issanchou S, Van Wymelbeke V, Sulmont-Rossé C (2015) Improving meal context in nursing homes. Impact of four strategies on food intake and meal pleasure. Appetite 84,139-147.
- Grøndahl VA, Aagaard H (2016) Older people’s involvement in activities related to meals in nursing homes. International Journal of Older People Nursing 11, 204-213.
- McCormack B, Dewing J, McCance T (2011) Developing person-centred care: Addressing contextual challenges through practice development. Online Journal of Issues in Nursing 16(2).
Bart Van Rompaey
University of Antwerp, Belgium
Title: Transmural cooperation between general practioners and nursing staff in residential care facilities
Time : 12:50-13:15
Biography:
Bart Van Rompaey is a nurse scientist with a PhD in Medical Sciences. He is the chair of the master in nursing and midwifery at the University of Antwerp. With a
workload balancing between education, management and research, he has been teaching at different levels of the nursing and midwifery education. Currently he
is responsible for several courses on the principles and practices of research. The major achievements in his research ought to be situated in the field of frail older
people, e.g. delirium and medication management. He is also the vice-president of the NuPhaC research group (Nurse and Pharmaceutical Care).
Abstract:
Statement of the Problem: In Belgium patients are free to choose their general practitioner. Moreover, this free choice remains after the transition to a residential care facility. Consequently, staffs have to corroborate with several physicians each having their procedures and habits. Since residential care facilities. Almost two third of 172 studied facilities indicate to deal with 11 to 30 general practitioners. The latter indicated the visit and care for older people in these facilities was not a priority, indicating a need for easy and accessible communication with the staff. The aim of this study was to obtain insight in the cooperation between nurses and general practitioners in residential care facilities.
Methodology & Theoretical Orientation: Since few researches were available on the topic and we focused on the perceptions of the respondent, a phenomenological design with a descriptive approach was developed. Using a semi-structured interview six head nurses and eight general practitioners in a non-metropolitan region in Flanders, Belgium, were included. The interviews were recorded and transcribed. Relevant data were coded leads to themes answering to the research questions.
Findings: Respondents indicated the collaboration being agreeable, but indicated bottle necks. The poor availability of the general practitioners, where nurses preferred standardized visits, influenced the continuity of care and caused gaps in the information process. Physicians and nurses pointed at the need to be fully informed at all times.
Population
Conclusion & Significance: Both parties have an equal assignment and responsibility in the care for older people in a residential care facility. To improve quality of care in this specific situation, the implementation of a tailored patient file system is highly recommended.
Recent Publications:
- Vanwesemael T, Van Rompaey B, Petrovic M, Boussery K, Dilles T. SelfMED: Self-Administration of Medication in hospital. A prevalence study in Flanders, Belgium, Journal of Advanced Nursing, (2016), 72,58-9
- Bogaerts A, De Baetselier E, Ameye L, Dilles T, Van Rompaey B, Devlieger R, Postpartum weight trajectories in overweight and lean women, Midwifery,2016, 1-19
- Mestdagh E, Van Rompaey B, Beeckman K, Bogaerts A, Timmermans O, A concept analysis of proactive behaviour in midwifery, J Adv Nur-2016, 72(6), 1236-1250
- Van Bogaert P, Peremans L, Diltour N, Van heusden D, Dilles T, Van Rompaey B, Sullivan Havens D, Staff nurses' perceptions and experiences about structural empowerment: a qualitative phenomenological study PLoS ONE,2016, 11 (4)
- Van Rompaey B, Van Hoof, A; Van Bogaert P; Timmerman, O; Dilles T, The patients' perception of a delirium: a qualitative research in a Belgian intensive care unit, Intensive Crit Care Nurs, 2016 Feb;32:66-74
Libba Reed McMillan
Auburn University, USA
Title: Integration of end of life care of military members and veterans into a baccalaureate nursing concepts course
Time : 14:00-14:25
Biography:
Libba Reed McMillan has been at Auburn University since 2008, and currently is an Associate Professor. She has over 33 years of diverse nursing experience.
Her research interests include program evaluation, and military/veteran health: wounded warrior competency development, and community and family transition. She has served as Co-Primary Investigator for PROJECT SERVE (Student Education Related to Veteran Experiences) developing an elective for AU School of Nursing students. This experience is located at Walter Reed National Military Medical Centre (Bethesda, MD) teaching students nursing care of wounded warriorsLibba Reed McMillan has been at Auburn University since 2008, and currently is an Associate Professor. She has over 33 years of diverse nursing experience. Her research interests include program evaluation, and military/veteran health: wounded warrior competency development, and community and family transition. She has served as Co-Primary Investigator for PROJECT SERVE (Student Education Related to Veteran Experiences) developing an elective for AU School of Nursing students. This experience is located at Walter Reed National Military Medical Centre (Bethesda, MD) teaching students nursing care of wounded warriors transitioning from acute to chronic healthcare systems. Dr. McMillan is a frequent podium and poster presenter at national and international conferences on topics related to Veteran health, critical thinking and patient safety.
Abstract:
Statement of the Problem: Military members and Veterans have a unique end-of-life issue which impact and often complicates grief and bereavement. It is imperative that nursing faculty train and develop nursing students to meet the needs facing our nation as current conflicts draw down, our nation’s Heroes return to their hometown, and ultimately faces end-of-life issues. The specific war (Vietnam, WWII, Korea, Gulf War, OEF/OIF) and perceived acknowledgement by the healthcare professional can impact the Veteran and/or
caregiver’s sense of pride and shame; impacting their sense of grief/ bereavement. The grief experience may be impacted if death is experienced as a result of injury or loss associated with Veteran military service. Health care providers and nursing students need to have a fundamental understanding about nursing care of these military members/ Veterans and family members/ caregivers, to effectively recognize emotional, physical and spiritual conditions and develop nursing interventions that positively impact end-of-life outcomes.
The purpose is to describe the infusion of unique Veteran-specific end-of-life concepts in addition to existing grief, loss and bereavement content in a baccalaureate nursing program. The need to incorporate a specific Veteran focus stems from a high percentage of Veterans living in the surrounding area(s) of our State land-grant university.
Methodology & Theoretical Orientation: A mixed method research design, comprised of pre- and post -test survey results, assessing student perspective of the holistic impact of end-of-life care (emotional, social, and spiritual injuries) sustained by Veterans will be used. A video by Deborah Grassman entitled “Wounded Warriors: Their Last Battle” will be also be utilized to solicit qualitative perspectives and spearhead dialogue from the student perspectives.
Findings: Qualitative and quantitative findings will be shared with the 91 students participating in the concepts course.
Conclusion & Significance: End-of-life care as applied to nursing education will be discussed.
Recent Publications:
- Boss, P. (1999). Ambiguous loss--Learning to live with unresolved grief. Harvard University Press, Cambridge, MA.
- Breen, L. (2012). The effect of caring on post-bereavement outcome: research gaps and practice priorities. Progress in palliative care, 20(1), 27-30.
- Burke, L., Clark, K., Ali, K., Gibson, B., Smigelsky, A. & Neimeyer, R. (2015). Risk factors for anticipatory grief in family members of terminally ill Veterans receiving palliative care services. Journal of social work in end-of-life and palliative care. 11:244-266.
- Grassman, D. “Wounded warriors: Their last Battle”, Home healthcare Nurse. 25 (5): 299-304, May 2007
- Hynes, C. & Thomas, M. (2016). What does the literature say about the needs of veterans in the areas of Health? Nurse Education Today, 47, 81-88.
Tinne Dilles
University of Antwerp, Belgium
Title: Self-administration of medication in hospital: A mixed-method study on the perspectives of patients and health care providers
Time : 14:25-14:50
Biography:
Tinne Dilles is nurse researcher and lecturer at the University of Antwerp and the Thomas More University College. In 2011, her PhD project entitled ‘Pharmacotherapeutic Care in Nursing Homes: Nurses’ contribution to drug monitoring’ was successfully presented. Her research focuses on nursing and pharmaceutical care, especially in older persons. In different national and international courses Tinne specialized in research methodology and statistics. She teaches research methodology, statistics and pharmacotherapy for nurses and midwives at bachelors’ and masters’ level. She is a member of Sigma Theta Tau International Honor Society in Nursing, het National Verbond voor Katholieke Vlaamse Verpleegkundigen en Vroedvrouwen (NVKVV) and the Belgian Society for Pharmacoepidemiology. She is president of NuPhaC (Nurse and Pharmaceutical Care) and vice-president of the division of Nursing and Midwifery of the Faculty of Medicine and Health Care Sciences of the University of Antwerp.
Abstract:
Background & Aim: Self-administration of medications relates to the process where hospitalized patients prepare and consume medications themselves rather than a health professional taking over this role. Literatures suggest possible advantages such as increased patient satisfaction, adherence to pharmacotherapy, and self-care competences. The aim of this study was to explore health care providers’ and patients’ perspectives concerning self-administration of medication whilst in hospital, and to describe which adaptations are required for implementation.
Design & Methods: Mixed-method study; qualitative study in one regional and two university hospitals using semi-structured interviews with nurses, physicians, hospital pharmacists and patients, and a cross-sectional observational study on all hospitalized patients of 14 randomly selected wards in 3 Belgian hospitals.
Findings: Self-administration of medication was perceived as beneficial for patients, nurses and inter- professional collaboration. Nevertheless, also disadvantages for patients, nurses and physicians were mentioned. A clear overview of barriers to overcome in order to increase the prevalence and the quality of self-administration resulted from the interviews. Important conditions to be fulfilled before allowing patients to self-administer medication were related to the patient, the type of medication and the organizational structure. Most of the 124 patients who completed the questionnaire had a positive opinion on the implementation of self-administration, 84% was willing to self-administer their medication whilst in hospital. Patients believed that it would result in feeling more autonomous (75%) and it would increase medication knowledge (73%). The majority was convinced it would not jeopardize the safety of other patients (75%).
Willingness of patients to self-administer medication whilst in hospital
Conclusion: The study extends our knowledge of the perspectives of all health care providers and patients in the process of selfadministration of medication. General perceptions on self-administration were very positive and the conditions for implementation can facilitate adaptations to take the step between evidence and practice.
Recent Publications:
- Vanwesemael, T., Van Rompaey, B., Petrovic, M., Boussery, K., & Dilles, T. (2017). SelfMED: Self-Administration of Medication in Hospital: A Prevalence Study in Flanders, Belgium. J Nurs Scholarsh. 2017 May;49(3):277-285.
- Willemse E., Anthierens S., Farfan-Portet MI., Schmitz O., Macq J., Bastiaens H., Dilles T., Remmen R. (2016) Do informal caregivers for elderly in the community use support measures? A qualitative study in five European countries. BMC Health Serv Res. 2016 Jul 16;16:270.
- Paque K, Goossens K, Elseviers M, Van Bogaert P, Dilles T. (2016) Autonomy and social functioning of recently admitted nursing home residents. Aging Ment Health. 2016 May 13:1-7.
- Dilles T, Van Rompaey B, Van Bogaert P, Elseviers MM. (2015) Resident and nurse reports of potential adverse drug reactions. Eur J Clin Pharmacol. 2015 Jun;71(6):741-9
- Van Bogaert P, Tolson D, Eerlingen R, Carvers D, Wouters K, Paque K, Timmermans O, Dilles T, Engelborghs S. (2016) J Psychiatr Ment Health Nurs. 2016 Nov;23(9-10):568-575.
Chanel Burke
University of Technology Sydney, Australia
Title: Improving quality of life for people with dementia: The Person-Centred Environment and Care Assessment Tool
Time : 14:50-15:15
Biography:
Chanel Burke has over 40 years’ experience working with children, families and in the aged care industry as a practitioner, manager and researcher. Chanel’s PhD thesis was the development of the Person-Centre Environment and Care Assessment Tool (PCECAT) and Guidelines based on Tom Kitwood’s person-centred principles and the Australian Residential Care Accreditation Standards. The PCECAT aims to assist aged care organisations to improve the quality of life for people living with dementia. Chanel regularly provides consultancies in aged care organisations to assist in the development of person-centred cultures, environments and practices, and the establishment of continuous improvement strategies. She provides education to staff to enhance their knowledge and skills in applying person-centred principles into their practice. As a certified aged care quality assessor, Chanel has undertaken multiple audits of aged care homes for the Aged Care Standards and Accreditation Agency. Chanel is also a registered nurse and holds a Master of Studies in Psychology and a Master in Management.
Abstract:
Background and Purpose: A person-centred care approach to service delivery can improve the quality of life of people living in residential aged care homes. Such an approach also meets many of the requirements of the Australian Aged Care Residential Standards. The Person-Centred Environment and Care Assessment Tool (PCECAT) was developed as an evaluation measure for residential aged care services, linking Kitwood’s person-centred principles and the requirements of the Australian Standards. The PCECAT assesses specific areas for improvement, according to person-centred principles and the Australian Standards. Opportunities for improvement are identified, strategies developed and their effects for residents may be evaluated.
Methodology: A mixed method approach was used to develop and validate the PCECAT in five sequential stages. The domains and items of the PCECAT were theoretically derived and confirmed for content and face validity by an expert Delphi panel. The Delphiconfirmed versions were piloted resulting in amendment to content and layout. Testing and re-testing of the amended PCECAT occurred, inter-rater reliability was established, and factor analysis and other validity tests confirmed the final version of the PCECAT.
Outcomes and Significance: The PCECAT has been used by various aged care organisations across Australia and New Zealand to assist in the development of strategies to improve the quality of life for people living with dementia in residential aged care homes. One such organisation, a large provider of residential aged care services, utilised the PCECAT to identify gaps in organisational culture, care, activities and environment necessary to support person-centred care. The subsequent introduction of quality improvement
strategies has resulted in a demonstrated improvement in the provision of person-centred care within that organisation over a three year period.
Anglicare – PCECAT results
Conclusion: The PCECAT is a means for assisting residential services to identify, address and improve service delivery and resident outcomes accordingly to Australian Residential Care Accreditation Standards and the person-centred model, and benchmark services against international best practice.
References:
- Edvardsson et al. (2008). Person-centred care of people with severe Alzheimer’s disease: current status and ways forward. Lancet Neurology, 7(4), 362-367.
- Commonwealth Department of Health and Family Services (1998). Standards and Guidelines for Residential Aged Care Services Manual. Commonwealth Department of Health and Family Services, Aged and Community Care Division, Canberra.
- Kitwood T. (1997) Dementia Reconsidered: The person comes first. Open University Press, Buckingham.
- Burke C, Stein-Parbury J, Luscombe G, Chenoweth L. (2016) Development and Testing of the Person- Centre Environment and Care Assessment Tool (PCECAT). Clinical Gerontologist Vol 39, ISS. 4.
Fernando Pereira
Institute Polytechnic of Braganca, Portugal
Title: Gerontologist skills and client satisfaction in long-term residential care for older persons
Time : 15:15-15:40
Biography:
Fernando Pereira completed his Ph.D. in Social Sciences from the University of Trs-os-Montes and Alto Douro, 2004. He acts as Researcher collaborator of the Center for Research and Educational Intervention Faculty of Psychology and Educational Sciences of the University of Porto, since 2008. Researcher collaborator Research Center Mountain CIMO, the College of Agriculture of Bragança since 2008. He was an effective investigator of this center since 2003. Coordinator of Nucleus of Research and Intervention of the Elderly / IPB, from 2009-2015. Founding Member and Investigator Group ASPTI Research (Social Analysis Technical Working Intellectual) since 2002. ASPTI is an informal group that involves researchers from several national higher education institutions is engaged among other activities of organizing seminars scientific research projects, monitoring of academic research evidence. Principal Investigator of the project "BeHome BeHappy"-EIP-AHA (European Innovation Partnership and Healthy Active-Ageing), European Commission, 2013-2015. In the scope of this pedagogical and scientific activity he published several books, chapters of books, articles on the subject of the elderly and aging, highlighting the book "Theory and Practice of Gerontology: A Guide
for Caregivers of the Elderly", PsicoSoma 2012 and 2017 (second edition).
Abstract:
In contemporary Western societies the population aging poses new challenges both to the policies and to the support systems for the older persons. In Portugal, where the phenomena have a major impact, it has emerged a new professional profile, the gerontologist. From the beginning the gerontologist (Licenciate’s Diploma in Gerontology) has emerged as a new professional exclusively devoted to providing care for the older persons and shares the labor market with other professionals who are usually leaders in LTCRs for the older persons, namely: managers, psychologists, nurses, sociologists, social educators and other social workers.
Recent studies (Pereira & Antão, 2014; Pereira & Caria, 2014) show a clear evidence of technical, organizational and communicative skills, which can be considered specific to this professional group (gerontologists) and which are distinctive from those shown by other professional caregivers. The focus goes to the sensibility of the gerontologists to detect in advance symptoms of a pathological aging, and to a personal contact with the older person and their families. It is still very valuable their ability to organize and develop innovative services and activities. The internalization of the concept of interdisciplinary and the ability to integrate and streamline interdisciplinary technical teams is also mentioned as a feature of this professional group. These profile skills have been considered by employers the main reasons to hire gerontologists rather than other professionals (Pereira, Mata & Pimentel, 2012).
In this study 160 older persons living in Portuguese LRTC are questioned about their satisfaction in regard to the effectiveness of organization. The older persons from LTRCs managed by a gerontologist are more likely to be “more satisfied” with provided care. This association was not explained by residents’ characteristics or by the older person’s circumstances as residents. These findings highlight the appropriateness of gerontologist skills in managing LTRCs.
Gerontologist skills and client satisfaction in long-term residential care for older persons
Recent Publications:
- Falcão, A., Pereira, F., Pimentel, H., Teixeira, C., & Rodrigues, V. (2016). The academic background of gerontologists and client satisfaction in long-term residential care for older persons. Educational Gerontology, 1–11.
- Caria, Telmo H., & Pereira, Fernando (2016). Social work like as a bureaucratic professional labour: An empirical analysis in non-profit organizations in Northern Portugal. European Journal of Social Work, 19(1), 120-139.
- Fernando Pereira e Telmo Caria (2014). “Travail professionnel des gérontologues: une approche méthodologique”. Revista Le Sociographe. Champ Social Éditions. pp 306-330.
- Fernando Pereira (Coordinator) (2017) "Theory and Practice of Gerontology: A Guide for Caregivers of Elderly". Second Edition. Ed. Psicosoma, Viseu.
- Fernando Pereira and Celeste Antão (2013) "Concept of Gerontological Care Professionals Provided by gerontologists". International Journal of Development and Educational Psycology INFAD Journal of Psychology. Year XXV, No. 2-2013. p. 51-58.
Yannic van Gils
University of Antwerp, Belgium
Title: Drinking motives of community dwelling older adults and its associated factors
Time : 15:40-16:05
Biography:
Yannic van Gils is a clinical psychologist and a psychotherapist with years of experience in education and clinical fields. The focus of her PhD research is to describe the biopsychosocial factors that discriminate older adults at risk for alcohol related problems. Prevention and interventions are efficient strategies for older adults, but still under recognized.
Abstract:
Statement of the Problem: Although a decrease in alcohol consumption by older adults has been demonstrated, the number of older adults using alcohol is growing. Due to the ageing processes, older adults are more vulnerable to the adverse consequences of alcohol use. There is little knowledge about the reasons why older adults are using alcohol despite the fact that drinking motives are an important factor in predicting alcohol use and alcohol problems. Recent studies in older populations reported the association between drinking for social reasons and binge drinking. Drinking to cope has been linked to alcohol related problems. The purpose of this study is to describe the drinking motives of older adults and its associations with alcohol use and alcohol related problems.
Methodology & Theoretical Orientation: In a retrospective cross sectional research the alcohol use and drinking motives of community dwelling older adults were studied. The study sample consisted of 1093 adult’s aged 65 years and older using alcohol at the time of the interview. The participants were questioned about their alcohol use with the extended version of the AUDIT. The Drinking Motives Questionnaire and the geriatric version of the Michigan Alcohol Screening Test were used for the registration of the drinking motives and the alcohol related problems respectively.
Findings: The most frequent cited drinking motive for men and women are the social motives, followed by the enhancement and the coping motives. The most relevant associations are moderate to strong positive associations between the enhancement motive and the quantity of alcohol, between the coping and enhancement motives and binge drinking and between coping and enhancement motives and self-reported alcohol related problems.
Conclusion & Significance: Drinking motives can be associated with alcohol use and alcohol related problems in older adults. Awareness among health care givers about this topic is necessary.
Recent Publications:
- Cooper ML, Russell M, Skinner JB, Windle M (1992) Development and validation of a Three-Dimensional Measure of Drinking Motives Psychological Assessment 4:123-132
- Gilson KM, Bryant C, Bei B, Komiti A, Jackson H, Judd F (2013) Validation of the Drinking Motives Questionnaire (DMQ) in older adults Addict Behav 38:2196-2202 doi:10.1016/j.addbeh.2013.01.
- Hoeck S, Van Hal G (2013) Unhealthy drinking in the Belgian elderly population: prevalence and associated characteristics European Journal of Public Health 23:1069-1075 doi:10.1093/eurpub/cks152.
- Immonen S, Valvanne J, Pitkala KH (2011) Older adults' own reasoning for their alcohol consumption International journal of geriatric psychiatry 26:1169-1176 doi:10.1002/gps.2657
- Rehm J., Gmel G., Gmel G., Hasan O., Imtiaz S., Popova S., Probst C., Roerecke M., Room R., Samokhvavlov A., Shield K & Shuper P. (2017) The relationship between different dimensions of use and the burden of disease – an update. Addiction. 1:1-34
Alba Malara
National Association of Third Age Residences (ANASTE), Italy
Title: Profiles of ICF disability in Alzheimer and vascular dementia
Time : 16:25-16:50
Biography:
Alba Malara specialized in Geriatrics and Gerontology. Since 2004 she had worked as Medical Director in a Residential Centre and Extensive Rehabilitation Continuous Cycle as well as in several other nursing homes in Calabria. Since 2007 she has worked as Scientific Coordinator of the "Scientific Committee of National Association of Third Age Residences (ANASTE)". Since 2011 she has been a scientific consultant for the European Confederation Home Care Organization (ECHO), Brussels, Belgium. Since January 2015 she is Chairwoman of Italian Society Geriatrics and Gerontology (SIGG) Calabria. Dr. Malara has set up a research methodology based on daily utilization of multidimensional geriatric assessment tests used in clinical practice in a network of nursing homes in Italy. In particular Dr. Malara’s research is primarily focused on geriatric multidimensional assessment, dementia, behavioural problems, pain and pharmacological and non-pharmacological strategies, care of end of life, care quality and patients' quality of life.
Abstract:
The International Classification of Functioning, Disability and Health (ICF) is a suitable tool to standardize the status of health and disability. A previous study, carried out on 546 subjects included in the database ANASTE (National Association of Nursing Home for Third Age) Calabria, showed that 78.43% of the patients suffered from cognitive impairment whereas 52% had a severe
degree of dementia. 65% of them were suffering from Alzheimer’s disease (AD), whereas 23% from vascular dementia (VD).
Aim: Aim of this study was to analyse the prevalence of functional impairments, activity limitations and participation restrictions of patients affected by AD and VD.
Design: Observational descriptive study.
Setting: Nursing Homes ANASTE Calabria.
Participants: 10 patients with probable AD (ADPr) and 10 patients affected by probable VD (VDPr). All patients were underwent multidimensional geriatric assessment. The profiles of disability ICF, were expressed in terms of Capacity and Performance, and coded according to mild, medium, severe and complete disability. Environmental factors were skilled in facilitator or no facilitator.
Results: The patients with ADPr displayed a severe impairment of functional status, and advanced clinical stage requiring the higher care burden compared with VDPr patients. The ICF assessment showed that the global and specific Mental Functions, Communication and Interpersonal Relationships were more reduced in patients with ADPr respect those with VDPr. The identification of an ICF checklist of various forms of dementia might provide a more detailed description of the profiles of disability and improving therapeutic, rehabilitative interventions and psico-social care.
Recent Publications:
- World Health Organization.: International Classification of Functioning, Disability and Health : ICF. Geneva, World Health Organization; 2001.
- Ustun B: The international classification of functioning, disa- bility and health-a common framework for describing health states. 2002. http:// whqlibdoc.who.int/publications/2002/9241545518_Chap7.3.pdf.
- Mueller M, Lohmann S, Strobl R, Boldt C, Grill E. Patients’ functioning as predictor of nursing workload in acute hospital units providing rehabilitation care: a multi-centre cohort study. BMC Health Services Research 2010; 10:295- 307
- Okochi J, Utsunomiya S, Takahashi T. Health measurement using the ICF: Test-retest reliability study of ICF codes and qualifiers in geriatric care. Health and Quality of Life Outcomes 2005; 3:46-59
- Mueller M, Boldt C, Grill E, Strobl R, Stucki G: Identification of ICF categories relevant for nursing in the situation of acute and early post- acute rehabilitation. BMC Nurs 2008; 7:3.
Lisa PL Low
Caritas Institute of Higher Education, Hong Kong
Title: Opting out of own homes for residential care homes: Decision-making experiences of family members of older adults with moderate dementia
Time : 16:50-17:15
Biography:
Lisa PL Low works as an Associate Professor. Her research interests are gerontology and long-term care, with emphasis on the organization of gerontological care and practices, discharge planning for older patients and family members. Her Ph.D. thesis adopts a constructivist grounded theory approach to explore decisionmaking in residential care homes from the perspectives of older residents, family members and care providers. This work has now been extended to explore family decision-making of older people with mild-moderate dementia and for clients with intellectual disability using predominately qualitative research approaches. As part of her post-doctoral development her intentions are to continue to develop qualitative research approaches and methodologies in her academic and research career.
Abstract:
Statement of the Problem: Residential care home services play an important role in supporting Chinese older adults with dementia and their family members. However, it is still the intention of the Hong Kong Government to promote ageing in place so that older people can remain in their own homes and supported by community care services for as long as possible. Indeed, there is a dearth of knowledge about the decision-making experiences of family members particularly at what point they reconsider their own roles and
responsibilities of caring for their community-dwelling older relatives with moderate dementia and consider residential care homes instead.
Methodology: As part of a main grounded theory study that explores decision-making experiences of family members caring for older people with dementia, this paper presents the data of around 50 family caregivers who described their decision-making experiences of caring for their older relatives with moderate dementia at home and in residential care homes. Purposive sampling was used to recruit the immediate family caregivers who provided physical and psychosocial care. They were matched against their older relatives who were diagnosed with dementia, had an MMSE score of 11 to 20, or an AMT score of < 7. Interviews lasted 40-45 minute, and data were content-analyzed.
Results: In-depth experiences of family caregivers who underwent a range of memorable circumstances and incidents of caring for their older relatives with moderate dementia at home that catalyzed the affirmative decision to move them into four residential care homes in Hong Kong will be described. Once the older persons became residents, family members were asked about the decisionmaking experiences they were now engaged in so that a comparison could be made about their changing roles and responsibilities before entry and after entry into residential care homes.
Conclusion: Findings can provide an understanding of the preliminary processes that family members went through as they begun taking care of the older family member with dementia at home. For various changing circumstances and incidents that have been described, the process of how family members then considered opting out of caring in their own homes for residential care homes can be delineated. The need to further support family caregivers of older relatives with dementia is highlighted.
Recent Publications:
- Low LPL, Lam LW, Fan KP (2017) Decision-making experiences of family members of older adults with moderate dementia towards community and residential care home services: A grounded theory study protocol. BMC Geriatrics (accepted).
- Low LPL, Fan KP (2016) Sampling issues using the grounded theory methodology: Applicability to family caregiving research of clients with dementia and intellectual disability. 15th Qualitative Methods Conference 3-5 May: 24.
- Low LPL, Fan KP (2015) Contested provocation: Reflected experiences of the lives of family caregivers before the admission of older residents with dementia. 22nd Annual Congress of Hong Kong Association of Gerontology 21 Nov: 43.
- Low LPL, Lam LW (2013) Decision-making role, potential and challenges faced by family members when making decisions for residential care home residents with mild to moderate dementia. 16th Asia Pacific Regional Conference of Alzheimer’s Disease International 11-13 Dec: 24.
Beyhan Cengiz Ozyurt
Ege University, Turkey
Title: Assessment of risk of falls in the elderly and associated factors with falls
Time : 17:15-17:25
Biography:
Beyhan Cengiz Özyurt is currently a PhD student in Health of the Elderly Program at Ege University under the department of Internal Medicine and concurrently working in Celal Bayar University under the department of Public Health. She has published more than 15 papers in reputed journals.
Abstract:
Statement of the Problem: Falls are the most common cause of domestic accidents among the elderly. One of every three elderly age 65 and over who lives in the community falls once in every year. Main approach of falls management is to find out and to treat the underlying reason. The study aims to determine the history of falling in the last year and the factors associated with falls in patients aged 65 or older.
Methodology & Theoretical Orientation: The population of this cross-sectional study was 3163 elderly individuals who were living at the region of two randomly selected primary medical services (one at rural area, other at urban area) in April 2015. The sample size was calculated using the software of Epi info 7.0; thereby, 480 elderly individuals were enrolled. Each individual was randomly selected from his/her registration at the Manisa Public Health Department. All data were collected by face-to-face interview and a standardized questionnaire form that involved sociodemographic characteristics, health and social status, Katz index was used. The
rate of participation was 88.9% (n=427). All data were evaluated using descriptive analysis and chi square test. Logistic regression was used for multivariate analysis.
Findings: The mean age of the study group was 72.9±6.7. The majority of individuals (86.4%) had a chronic disease for which continuous drug administration was required, 49.6% was women, 35.1% was graduated from elementary school and 23.4% was living alone. More than 79.4 of elderly could have done, daily living activities easily, less than 5% were depend in one or more basic activities of their daily life. When patients’ fall experiences were questioned, it was determined that 30.4% of them had fallen in the last one year. Average number of falling of the study sample was 1.73±1.06. It was found that 43.1% of older people who reported falling history fell outside home, 36.3% fell by stumbling and 28.3% fell due to dizziness and 20.0% received medical treatment for falling at a hospital. Multivariate analysis demonstrated that the risk of falls are significantly higher in individuals who were living alone, being 75 years of age and over, having worse perceived health status, social isolation, insufficient income, lack of accessibility in health care, need of support during daily activities and had 2 and over chronic disease for which continuous drug administration was required.
Conclusion & Significance: These findings reveal that fall prevalence and risk factors that increase risk for falls are high in the individuals aged 65 or older. In order to prevent falls in the elderly, it is vital to perform assessments about risk factors for falls in elderly; and take preventive measures.
Recent Publications:
- Deandrea S, Lucenteforte E, Bravi F, et all (2010) Risk Factors for Falls in Community-dwelling Older People: "A Systematic Review and Meta-analysis, Epidemiology 21(5):658-668
- Laurence Z. Rubenstein (2006) Falls in older people: epidemiology, risk factors and strategies for prevention, Age and Ageing; 35-S2
- Moylan KC, Binder EF,Falls in Older Adults: Risk Assessment, Management and Prevention (2007) The American Journal of Medicine 120(6):493.e1–493.e6
- Chang T, Morton S, Rubenstein L, (2004) Interventions for the prevention of falls in older adults: systematic review and meta-analysis of randomised clinical trials BMJ (328):1-7
- Lord, SR Sherrington C, Menz HB (2007), Falls in older people: risk factors and strategies for prevention, Cambridge University Press
Guillaume Souesme
Francois Rabelais University, France
Title: What is an autonomy supportive environment in geriatric care services for healthcare professionals?
Time : 17:25-17:35
Biography:
Guillaume Souesme is in the second year of a doctoral program in psychology at François-Rabelais University in Tours (FRANCE). It is attached to the EA 2114– Research Team of Psychology of Ages of Life, under the direction of Professor Claude Ferrand. His subject of study concerns the "satisfaction of basic needs
of autonomy, competence, and relatedness, motivation, well-being and ageing on the “Région Centre-Val de Loire". The field of study of this research focuses on
French geriatric care services, also called SSR present in the hospitals structure or being autonomous, public and / or private. Finally, he uses the theory of Self-
Determination Theory (SDT) as a theoretical basis.
Abstract:
Statement of the Problem: Based on Self-Determination Theory (SDT; Deci & Ryan, 1985), autonomy support appears to be a key factor for patients in geriatric care services (GCS) for the satisfaction of the three basic psychological needs of autonomy, competence, and relatedness (Souesme et al., 2016). However, none studies have been conducted with healthcare professionals about “what elements might compose an autonomy-supportive environment?” That is why; it looked interesting to clarify the behaviors
underlying an autonomy-supportive motivational style in GCS.
Methodology & Theoretical Orientation: Four focus groups were used with a semi-structured guide (Patton, 2002) to explore the point of view of healthcare professionals about an autonomy-supportive environment. Twenty-six (n=26) professionals representing all professions working on GCS were recruited. Content qualitative analyses were performed using a software analysis (NVivo 10- QSR International).
Findings: Unlike Reeve (1998), our results based on queries for text analysis highlighted three categories defining the notion of autonomy support in health context. Those categories point out well the importance of the social link between medical staff and patient through the “promotion of progress”, the importance of “establish a relationship of trust”, and the necessity to “encourage them to express themselves”.
Conclusion & Significance: Our results demonstrate that the welcome are crucial to make the stay in GCS positive. Developing a partnership between patients and healthcare professionals could be a successful way to improve the stay in GCS, bring positive psychological and physical outcomes for elderly patients like a better adherence to treatment (Williams et al., 1998), and reduce rehospitalization. We need now to further define the patient’s point of view of an autonomy-supportive environment in order to compare it with healthcare professional’s definition, underlying common and diverging points. This will allow us to make recommendations and propose a training session for professionals to adopt an autonomy-supportive motivational style.
Recent Publications:
- Deci EL, & Ryan RM (1985) Intrinsic motivation and self-determination on human behavior. New-York: Plenum Press.
- Patton MQ (2002) Qualitative research and evaluation methods. Thousand Oaks, CA: Sage Publications Inc.
- Reeve J (1998) Autonomy support as an interpersonal motivating style. Is it teachable? Contemporary Educational Psychology 23:312-330.
- Souesme G, Martinent G, & Ferrand C (2016) Perceived autonomy support, psychological needs satisfaction, depressive symptoms and apathy in French hospitalized older people. Archives of Gerontology and Geriatrics 65:70-78.
- Williams GC, Rodin GC, Ryan RM, Grolnick WS, & Deci EL (1998) Autonomous regulation and long-term medication adherence in adult outpatients. Health Psychology 17(3):269-276.
Varsha Reddy Jayar
MGM Institute of Health Sciences, India
Title: Heat and spice in later years of life
Time : 17:35-17:45
Biography:
Varsha Reddy (International Healthcare Management), a Post graduate student of M.D Geriatric Medicine has been associated with Geriatric healthcare delivery across United Kingdom and India. She has managerial experience in NHS in Heartlands Hospital Birmingham, George Elliot Hospital Nuneaton and Whippscross Hospital London, where she contributed voluntary services in holistic healing promoting wellness. While pursuing MD Geriatric Medicine in M.G.M Institute of Health Sciences, Navi Mumbai ; she pioneered the “Helping Hands” program which focuses on senior citizen self support groups which deliver peer assistance within the community providing philanthropic services. She has initiated efforts in Tele-medicine, Polypharmacy and contingency management approaches for Geriatric care with special interest in sexuality in elderly, communication skills with elderly and Geriatric cosmetology. She is the recipient of the Ministry of Health Award for Volunteer work in Earthquake Relief, in addition to the many accolades for sports and educational achievement.
Abstract:
Background: Society tends to hold the idea that older people simply do not participate in or enjoy sex as much as younger people. Sexual function and activity in old age have been inadequately studied the world over. It is important to know that aging processes are not confined to persons beyond the age of 60 years; many changes in the elderly have their antecedents in the middle age. One study even showed that a significant amount of the elderly has pronounced their sex lives over at around age 50 to 60. Although sex might
not be as taboo as it used to be, the idea of sex as one gets older is still clouded with myths and uncertainty.
Aims: This study determines the patterns of sexual activity and function in individuals over 60 years of age. It also discusses the barriers such as chronic illness, cultural barriers and myths that may interfere with sexual function.
Materials and Methods: A study of subjects above the age of 60 years from a senior citizens group in the outpatient department of Geriatric Medicine (OPD) of MGM a teaching hospital in Mumbai, by interviewing 200 individuals who attended the OPDs, after taking their informed consent. Socio-demographic and other information on their sexual function and activities were obtained. Data was analyzed using statistical package for social sciences v15.
Results: 72% individuals above 60 were sexually active, while only 57% above 70 were active. Others had become completely abstinent at some time in their lives. Statistical analysis revealed significant gender, health and educational status based differences in the sample.
Conclusion: Many factors support the myth that older people are asexual: limited access to information from their youth to the present day, the physiological changes connected to aging itself, religious precepts and family oppression. However, further studies and actions directed at this population are important to promote the health of the elderly. Our study showed significant presence of sexual desire, activity and function even after the age of 60 years; a decline by the age of 70 and above was a finding that reflected more in women. Chronic illness did affect sexual function and desire.