The transition from home to a nursing home can be stressful and traumatic for both older persons and informal caregivers and is often associated with negative outcomes. Additionally, transitional care interventions often lack a comprehensive approach, possibly leading to fragmented care. To avoid this fragmentation and to optimize transitional care, a comprehensive and theory-based model is fundamental. It should include the needs of both older persons and informal caregivers. Therefore, this study, conducted within the European TRANS-SENIOR research consortium, proposes a model to optimize the transition from home to a nursing home, based on the experiences of older persons and informal caregivers. These experiences were captured by conducting a literature review with relevant literature retrieved from the databases CINAHL and PubMed. Studies were included if older persons and/or informal caregivers identified the experiences, needs, barriers, or facilitators during the transition from home to a nursing home. Subsequently, the data extracted from the included studies were mapped to the different stages of transition (pre-transition, mid-transition, and post-transition), creating the TRANSCITmodel. Finally, results were discussed with an expert panel, leading to a final proposed TRANSCIT model. The TRANSCIT model identified that older people and informal caregivers expressed an overall need for partnership during the transition from home to a nursing home. Moreover, it identified 4 key components throughout the transition trajectory (ie, pre-, mid-, and post-transition): (1) support, (2) communication, (3) information, and (4) time. The TRANSCIT model could advise policy makers, practitioners, and researchers on the development and evaluation of (future) transitional care interventions. It can be a guideline reckoning the needs of older people and their informal caregivers, emphasizing the need for a partnership, consequently reducing fragmentation in transitional care and optimizing the transition from home to a nursing home.
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BACKGROUND: Nursing home residents are mainly inactive. Nursing staff can encourage residents to perform functional activities during daily care activities. This study examines 1) the extent to which nursing staff perceive that they encourage functional activity in nursing home residents and 2) the associations between these nursing behaviors and professional characteristics, contextual factors, and information-seeking behaviors. METHODS: In this cross-sectional study, 368 registered nurses and certified nurse assistants, working in somatic and psychogeriatric wards of forty-one nursing homes throughout the Netherlands participated. Self-reported data were collected with a questionnaire, comprising the MAINtAIN-behaviors, which assesses the extent to which nursing staff encourage functional activities, including different activities of daily living (ADL), household activities, and miscellaneous encouraging activities (e.g., discouraging informal caregivers from taking over activities residents can do themselves). Additional data collected included professional characteristics (e.g., age), contextual factors (e.g., ward type), and information-seeking behaviors (e.g., reading professional journals). Descriptive statistics were used to determine the extent to which functional activities were encouraged. Hierarchical linear regression analyses were performed to determine the associations between the encouragement of functional activities and other factors. RESULTS: Nursing staff perceived that household activities (mean 4.1 (scale range 1-9), SD 1.9) were less often encouraged than ADL (mean 6.9, SD 1.2) or miscellaneous activities (mean 6.7, SD 1.5). The percentage of nursing staff stating that different household activities, ADL, or miscellaneous activities were almost always encouraged ranged from 11 to 45%, 41 to 86%, and 50 to 83% per activity, respectively. The extent to which these activities were encouraged differed for some of the professional characteristics, contextual factors, or information-seeking behaviors, but no consistent pattern in associations emerged. CONCLUSIONS: According to nursing staff, household activities are not as often encouraged as ADL or miscellaneous activities. Professional characteristics, contextual factors, and information-seeking behaviors are not consistently associated with the encouragement of functional activity. Nursing staff should also focus on improving the encouragement of household activities. Future research could examine the role of other factors in encouraging functional activity, such as experienced barriers, and assess to what extent the perception of nursing staff corresponds with their actual behavior.
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Objective: To obtain insight into (a) the prevalence of nursing staff–experienced barriers regarding the promotion of functional activity among nursing home residents, and (b) the association between these barriers and nursing staff–perceived promotion of functional activity. Method: Barriers experienced by 368 nurses from 41 nursing homes in the Netherlands were measured with the MAastrIcht Nurses Activity INventory (MAINtAIN)-barriers; perceived promotion of functional activities was measured with the MAINtAIN-behaviors. Descriptive statistics and hierarchical linear regression analyses were performed. Results: Most often experienced barriers were staffing levels, capabilities of residents, and availability of resources. Barriers that were most strongly associated with the promotion of functional activity were communication within the team, (a lack of) referral to responsibilities, and care routines. Discussion: Barriers that are most often experienced among nursing staff are not necessarily the barriers that are most strongly associated with nursing staff–perceived promotion of functional activity.
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Purpose The purpose of this paper is to describe whether and how groups of nursing home residents respond to the interactive device “the CRDL”. The CRDL can translate touches between people into sounds. It recognises the type of touch and adjusts the produced sound accordingly. Design/methodology/approach This was as an observational explorative study. Responses were coded and analysed using an existing theoretical framework. Findings – The CRDL creates an atmosphere of playfulness and curiosity. It lowers the threshold to touch, provides an incentive to touch and encourages to experiment with different types of touches on arms and hands. The sounds the CRDL produces sometimes trigger memories and provide themes to start and support conversation. Involving a (large) group of nursing home residents to interact with the CRDL is challenging. Research limitations/implications In order to more fully understand the potential of the CRDL, its use should be studied in different group and individual sessions and the effects of tailored content, adjusted to individual preferences and/or stages of cognition should be explored. Finally, the effects of using the CRDL on the general wellbeing of nursing home residents should be studied. Practical implications The CRDL can help caregivers to use touch to make contact with (groups of their) residents. A session should be guided by an experienced caregiver. Some familiarisation and practice with the CRDL are recommended and a quiet environment is advised. Originality/value This paper demonstrates the potential of interactive objects, such as the CRDL, in the nursing home.
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Purpose. To provide an overview of factors influencing the sense of home of older adults residing in the nursing home. Methods. A systematic review was conducted. Inclusion criteria were (1) original and peer-reviewed research, (2) qualitative, quantitative, or mixed methods research, (3) research about nursing home residents (or similar type of housing), and (4) research on the sense of home, meaning of home, at-homeness, or homelikeness. Results. Seventeen mainly qualitative articles were included. The sense of home of nursing home residents is influenced by 15 factors, divided into three themes: (1) psychological factors (sense of acknowledgement, preservation of one's habits and values, autonomy and control, and coping); (2) social factors (interaction and relationship with staff, residents, family and friends, and pets) and activities; and (3) the built environment (private space and (quasi-)public space, personal belongings, technology, look and feel, and the outdoors and location). Conclusions. The sense of home is influenced by numerous factors related to the psychology of the residents and the social and built environmental contexts. Further research is needed to determine if and how the identified factors are interrelated, if perspectives of various stakeholders involved differ, and how the factors can be improved in practice.
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Abstract Background: To address the lack of social interaction and meaningful activities for persons with dementia (PWD) in nursing homes an artistic Photo-Activity was designed. The present study aims to develop a digital version of the Photo-Activity and to investigate its implementation and impact on nursing home residents with advanced dementia, and their (in)formal carers. Methods: First, within a user-participatory design, a digital-app version of the Photo-Activity will be developed and pilot-tested, in co-creation with (in)formal carers and PWD. Next, the feasibility and effectiveness of the Photo-Activity versus a control activity will be explored in a randomized controlled trial with nursing home residents (N=90), and their (in)formal carers. Residents will be offered the Photo- Activity or the control activity by (in)formal carers during one month. Measurements will be conducted by independent assessors at baseline (T0), after one month (T1) and at follow up, two weeks after T1 (T2). Qualitative and quantitative methods will be used to investigate the effects of the intervention on mood, social interaction and quality of life of the PWD, sense of competence of informal carers, empathy and personal attitude of the formal carers, and quality of the relationship between the PWD, and their (in)formal carers. In addition, a process evaluation will be carried out by means of semi-structured interviews with the participating residents and (in)formal carers. Finally, an implementation package based on the process evaluation will be developed, allowing the scaling up of the intervention to other care institutions. Discussion: Results of the trial will be available for dissemination by Spring 2023. The digital Photo-Activity is expected to promote meaningful connections between the resident with dementia, and their (in)formal carers through the facilitation of person-centered conversations. Trial registration: Netherlands Trial Register: NL9219; registered (21 January 2021); NTR (trialregister.nl)
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Purpose In the Netherlands, the prevalence of visual impairments is the highest among the subgroup of nursing home residents. Over 40 percent are estimated to have visual impairments1. Older adults experience visual problems due to biological aging or eye disease2. These problems can affect several visual functions as well as daily functions in general3,4. Providing appropriate lighting of sufficient intensity and color temperature (CT), and making use of capabilities of the visual environment in the nursing home4 is one of the tasks for professional carers.Light conditions were measured in order to find out to what extent older adults live with the proper lighting conditions. With these data, we wanted to enhance the awareness among care professionals of how light conditions affect the daily lives of the nursing home residents. Moreover, care professionals and technical staff could make the right improvements to the nursing home environment based on the outcomes. Method We assessed light conditions (Konica Minolta chromameter CL-200) in seven nursing homes in the Netherlands. Light conditions were measured in places where residents spend most of their time during the day. In total, 59 living rooms and corridors were assessed in this study. Horizontal and vertical illuminances as well as CT were measured and compared to the values given in a guideline by the Dutch Society for Illumination5. The study was performed between October 2009 and the end of March 2010 at daytime between 10:00 and 15:00 hours. By measuring in autumn, winter and early spring, the contribution of daylight to the indoor illuminance levels was kept at a minimum. Results & Discussion In general lighting conditions encountered in the nursing homes were poor. Four-fifths of the measured illuminances in the common rooms were below the 1,000 lx threshold. Illuminances in the corridors fell below the 200 lx threshold in at least three quarters of the measurements. This means that nursing home residents may have difficulty carrying out tasks and could fall during transfers. The CT of light to which nursing home residents were exposed, fell below the reference value for daylight of 5,000 K with median scores of 3,400 to 4,500 K. High CT of light, in combination with higher illuminances, may positively affect the biological clock, resulting in better sleep quantity and quality.Nursing home staff should be aware of these data in order to arrange better light conditions. Technical staff should be aware that lighting guidelines are not specifically developed for older adults. Special attention should be paid to the fact that older adults need more light than younger persons to perform Activities of Daily Living (ADL).
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Successfully introducing care innovations depends on the type of care setting, the intervention and specific circumstances. In this study the factors influencing the introduction of an evidence based nursing guideline on depression in psychogeriatric nursing home residents were studied.
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Purpose: This study examined the effects of a giant (4×3 m) exercising board game intervention on ambulatory physical activity (PA) and a broader array of physical and psychological outcomes among nursing home residents. Materials and methods: A quasi-experimental longitudinal study was carried out in two comparable nursing homes. Ten participants (aged 82.5±6.3 and comprising 6 women) meeting the inclusion criteria took part in the 1-month intervention in one nursing home, whereas 11 participants (aged 89.9±3.1 with 8 women) were assigned to the control group in the other nursing home. The giant exercising board game required participants to per-form strength, flexibility, balance and endurance activities. The assistance provided by an exercising specialist decreased gradually during the intervention in an autonomy-oriented approach based on the self-determination theory. The following were assessed at baseline, after the intervention and after a follow-up period of 3 months: PA (steps/day and energy expenditure/day with ActiGraph), cognitive status (mini mental state examination), quality of life (EuroQol 5-dimensions), motivation for PA (Behavioral Regulation in Exercise Questionnaire-2), gait and balance (Tinetti and Short Physical Performance Battery), functional mobility (timed up and go), and the muscular isometric strength of the lower limb muscles. Results and conclusion: In the intervention group, PA increased from 2,921 steps/day at baseline to 3,358 steps/day after the intervention (+14.9%, P=0.04) and 4,083 steps/day (+39.8%, P=0.03) after 3 months. Energy expenditure/day also increased after the intervention (+110 kcal/day, +6.3%, P=0.01) and after 3 months (+219 kcal/day, +12.3%, P=0.02). Quality of life (P<0.05), balance and gait (P<0.05), and strength of the ankle (P<0.05) were also improved after 3 months. Such improvements were not observed in the control group. The preliminary results are promising but further investigation is required to confirm and evaluate the long-term effectiveness of PA interventions in nursing homes.
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Purpose For most people, nursing homes are a place they reside for the rest of their lives. Therefore, a nursing home, apart from providing good care, has to provide for a sense of home (1). Mostly professionals are responsible for this sense of home. The aim of this study was to explore how professionals (both care professionals, managers, suppliers of nursing home equipment and architects experience 'sense of home' in a nursing home. Method Over 70 persons (±20-65 years old, 2/3 women) having varying professional involvement in nursing homes participated. The Lego serious play method was used to engage participants in a personal and authentic manner (2). After building their model of 'sense of home', participants recorded their main issues on a sticky note. The models represented the personal stories of the participants, who shared the meaning of their model. Results & Discussion The findings revealed that a range of themes were considered important by the participants (table 1). The main themes involved privacy, space, mobility and freedom, for instance, to open doors, social engagement, being recognised as the person used to before, and nature or the presence of plants and animals. These results are compared with results of a recently performed literature review and photography supported research in residents, family and staff in four nursing homes (3).
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