Models for providing improved care in residential care homes: A thematic literature review ANNOTATED BIBLIOGRAPHY (original) (raw)
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Models for providing improved care in residential care homes: a thematic literature review
2008
This Annotated Bibliography is one output from a review of the available research evidence to support improved care in residential care homes as the needs of older people intensify. Key findings The review identified extremely little published evidence on residential care homes; the research base is almost exclusively related to provision of care in nursing homes. Much of this research is from the US or other non-UK sources. Although it could be argued that some findings are generalisable to the UK residential care context, a systematic process is required to identify which. The literature often makes no distinction between nursing and residential homes; use of generic terms such as ‘care home’ should be avoided. There is considerable international debate in the quality improvement literature about the relationship between quality of care and quality of life in nursing and residential homes. Measures of social care, as well as clinical care, are needed. The centrality of the residen...
Providing nursing support within residential care homes
2009
This study examines a joint NHS-Local Authority initiative providing a dedicated nursing and physiotherapy team to three residential care homes in Bath and North East Somerset. The initiative aims to meet the nursing needs of residents where they live and to train care home staff in basic nursing. * Hospital admissions and nursing home transfers were prevented. Care home staff and managers preferred residents to be able to stay in their home when they were ill, as did residents themselves. * Enhancing health-orientated education and training of care home staff was challenging at first but relationships improved, and the confidence and professionalism of care staff grew. * Residents’ nursing needs cannot simply be equated with their level of dependency. For example, a resident with dementia can be functionally independent yet have major, often un-communicated health needs. * The early detection of illness and resulting opportunity for early intervention was a major part of the team’s...
Quality of life of older people in residential care home: a literature review
Journal of Nursing and Healthcare of Chronic Illness, 2009
Aim. To integrate the research evidence on quality of life of older people living in a residential care home setting.Background. Residential care is provided for older people who are unable to live in their own home due to various health and social reasons. A number of studies have been published that have focused on diverse quality of life issues of residential care home elders. Consolidating the evidence from these studies may provide insights into enhancing quality of life of this particular group of older people.Design. A literature review of research evidence on quality of life issues among residential care home elders.Method. A systematic search of the literature published between 1994–January 2008 was undertaken to identify research evidence on quality of life of older people living in residential care home. Information about the study design, research objectives, study setting, sample characteristics, and key findings were extracted for comparison and integration. Three aspects about quality of life of the residential care home elders were identified: views of residential care home elders on quality of life, factors affecting quality of life of residential care home elders and methods to improve quality of life in residential care home elders.Results. Eighteen publications were identified. Older people perceived their ability to maintain independence, autonomy and individuality as the most important criteria for determining quality of life. Interventions designed to improve quality of life of older people living in residential facilities corresponded to these criteria. A range of interventions including a walking program, mental stimulation and environmental modification were proposed and evaluated to improve quality of life of residential care home elders. Among these interventions, environmental modification that targeted at improving the residential care homes and quality of services appears to be promising.Conclusion. Quality of life in residential care home elders is a complex issue that may be determined by the elders’ independence, individuality and autonomy, and influenced by quality of residential care and facilities. Environmental modification appears to be a way to improve the quality of life of residential care home elders.Relevance to clinical practice. The knowledge of understanding quality of life of residential care home elders provides insights into the implementation of appropriate residential care services. Programs that aim to de-institutionalise the residential care home settings are important to the enhancement of residential care services.
Medical Care in the Nursing Home
American Journal of Nursing, 1998
Recommendation 1. Effective leadership structures are established, that where possible, include an expert physician (medical director), and an expert registered nurse (nursing director) and skilled administrator.
European Geriatric Medicine
Aim To review quality improvement in care homes and identify quality improvement approach, process evaluation and resident outcomes. Findings Seventy five articles were included which described a variety of quality improvement approaches and various methods of process evaluation addressing various clinical problems. Some studies showed benefits to health outcomes, but it was not possible to synthesise due to diversity of data. Message Future quality improvement should apply structured reporting of quality improvement initiatives and resident-level interventions in order that findings can by synthesised and implemented.
Resident perspectives of the determinants of quality of life in residential care in Ireland
Journal of Advanced Nursing, 2009
Title. Resident perspectives of the determinants of quality of life in residential care in Ireland. Aim. This paper is a report of a study conducted to identify the determinants of quality of life for older people living in residential care, including exploration of mediating factors at personal and institutional levels and to construct a model of these. Background. The quality of life of older people living in residential care is an underresearched area. The focus in the gerontology literature has been on quality of care rather than quality of life for these people. There is emerging consensus, however, that quality of life for older people is a complex, multidimensional concept, incorporating both subjective and objective elements, whether people live at home or in residential care. Method. A grounded theory study was conducted in 2005-2006. A total of 101 interviews were undertaken with older people across 12 sites, representing different types of residential care in Northern Ireland. The constant comparative technique was used to analyse data. Findings. Four themes having an impact on the quality of life of residents were identified: ethos of care; sense of self and identity; connectedness; and activities and therapies. Mediating and facilitating and/or constraining factors for quality of life were also identified. The core category was conceptualized as 'maximizing potential'. Conclusion. Achieving optimal quality of life for older people in residential care will remain elusive unless all the factors which affect on it are taken into account by practitioners and policy-makers. Improving the quality of life of older people in residential care will require action in respect of all of the domains identified in this paper.