Background The sense of home of nursing home residents is a multifactorial phenomenon which is important for the quality of living. This purpose of this study is to investigate the factors influencing the sense of home of older adults residing in the nursing home from the perspective of residents, relatives and care professionals. Methods A total of 78 participants (n = 24 residents, n = 18 relatives and n = 26 care professionals) from 4 nursing homes in the Netherlands engaged in a qualitative study, in which photography was as a supportive tool for subsequent interviews and focus groups. The data were analyzed based on open ended coding, axial coding and selective coding. Results The sense of home of nursing home residents is influenced by a number of jointly identified factors, including the building and interior design; eating and drinking; autonomy and control; involvement of relatives; engagement with others and activities; quality of care are shared themes. Residents and relatives stressed the importance of having a connection with nature and the outdoors, as well as coping strategies. Relatives and care professionals emphasized the role the organization of facilitation of care played, as well as making residents feel like they still matter. Conclusions The sense of home of nursing home residents is influenced by a multitude of factors related to the psychology of the residents, and the social and built environmental contexts. A holistic understanding of which factors influence the sense of home of residents can lead to strategies to optimize this sense of home. This study also indicated that the nursing home has a dual nature as a place of residence and a place where people are supported through numerous care strategies.
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Abstract Purpose Knowledge of clinical pharmacotherapy is essential for all who prescribe medication. The aims of this study were to investigate differences in the pharmacotherapy and polypharmacy knowledge of medical and surgical residents and consultants and whether this knowledge can be improved by following an online course. Methods Design: A before-and-after-measurement. Setting: An online course available for Dutch residents and consultants working in hospitals. Study population: Dutch residents and consultants from different disciplines who voluntarily followed an online course on geriatric care. Intervention An online 6-week course on geriatric care, with 1 week dedicated to clinical pharmacotherapy and polypharmacy. Variables, such as medical vs surgical specialty, consultant vs resident, age, and sex, that could predict the level of knowledge. The effects of the online course were studied using repeated measures ANOVA. The study was approved by the National Ethics Review Board of Medical Education (NERB dossier number 996). Results A total of 394 residents and 270 consultants, 220 from surgical and 444 from medical specialties, completed the online course in 2016 and 2017. Residents had higher test scores than consultants for pharmacotherapy (73% vs 70%, p<0.02) and polypharmacy (75% vs 72%, p<0.02). The learning effect did not differ. Medical residents/consultants had a better knowledge of pharmacotherapy (74% vs 68%, p<0.001) and polypharmacy (77% vs 66%, p<0.001) than surgical residents/consultants, but the learning effect was the same. Conclusions Residents and consultants had a similar learning curve for acquiring knowledge, but residents outperformed consultants on all measures. In addition, surgical and medical residents/consultants had similar learning curves, but medical residents/consultants had higher test scores on all measures.
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Post-war urban neighbourhoods in industrialised countries have been shown to negatively affect the lifestyles of their residents due to their design. This study aims at developing an empirical procedure to select locations to be redesigned and the determinants of health at stake in these locations, with involvement of residents’ perspectives as core issue. We addressed a post-war neighbourhood in the city of Groningen, the Netherlands. We collected data from three perspectives: spatial analyses by urban designers, interviews with experts in local health and social care (n = 11) and online questionnaires filled in by residents (n = 99). These data provided input for the selection of locations to be redesigned by a multidisciplinary team (n = 16). The procedure yielded the following types of locations (and determinants): An area adjacent to a central shopping mall (social interaction, traffic safety, physical activity), a park (experiencing green, physical activity, social safety, social interaction) and a block of low-rise row houses around a public square (social safety, social interaction, traffic safety). We developed an empirical procedure for the selection of locations and determinants to be addressed, with addressing residents’ perspectives. This procedure is potentially applicable to similar neighbourhoods internationally.
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Bed-ridden nursing home residents are in need of environments which are homelike and facilitate the provision of care. Design guidance for this group of older people is limited. This study concerned the exploration and generation of innovative environmental enrichment scenarios for bed-ridden residents. This exploration was conducted through a combination of participatory action research with user-centred design involving 56 professional stakeholders in interactive work sessions. This study identified numerous design solutions, both concepts and products that are available on the marketplace and that on a higher level relate to improvements in resident autonomy and the supply of technological items and architectural features. The methodology chosen can be used to explore the creative potential of stakeholders from the domain of healthcare in product innovation.
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This paper reports the responses of nursing home residents who live in a psychogeriatric ward to the abstract interactive art installation ‘Morgendauw’, which was specifically designed for this study. All stakeholders were involved in designing and implementing Morgendauw. The artwork seems able to evoke responses in both the residents and their caregivers, but the amount and duration of the responses observed during the study were limited. 15 interactions over the course of 14 h were noted and almost all of them were initiated by the nursing home staff, physiotherapy students or visitors (n = 12). Interactions lasted for about 3 min on average. Although the nursing home residents initially did not seem to notice the artwork, the threshold of acknowledging and approaching the artwork was quickly overcome when staff nudged or directed the residents’ attention towards the artwork. Beyond this point, nursing home residents generally needed little explanation of the interface to interact with the artwork. The location in which Morgendauw was placed during the study or the characteristics of the installation seemed to create a threshold. Further research should focus on the importance and the effects of context when designing and implementing an interactive art installation in a nursing home environment.
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In the context of public budget cuts and rural areas facing depopulation and aging, local governments increasingly encourage citizen engagement in addressing local livability issues. This paper examines the non-engagement of mid-aged and elderly residents (45+ years old) in civic initiatives that intend to improve the livability of their community. We focus on residents of depopulating rural areas in the North Netherlands. We compare their engagement with the behavior of residents in other, not depopulating, rural areas, and urban areas. Using logistic statistical analyses, we found that the majority of the aging residents did not engage in civic livability initiatives during the past two years, and one-third of this group had no intention to do so in the future. In all areas, the main reasons for non-engagement were that residents had other priorities, felt not capable of engaging, or felt that the responsibility for local livability belonged to the local government. Furthermore, it appeared that non-engagement was predominantly explained by the unwillingness to engage, rather than by specific motivations or lacking abilities.
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Background The experiences of residents who have communication difficulties such as dysphasia are largely absent from the literature. Aim To illuminate the everyday experiences of four residents with severe communication difficulties living in a residential care setting in the Netherlands. Methodology & Methods A collective case study methodology was used. Seventy-five hours of observation, interview and documentary data was gathered over six weeks. Alternative strategies of communication were developed to enable the co-creation of dialogue between participants and researcher. For example, a participant who could not talk used intentionally created artwork to share her ideas with the researcher. Findings Participants' daily experiences were characterised by struggling against the constraints of the residential setting: having to wait, having unmet needs, experiencing vulnerability and uncertainty. Participants' communication difficulties exacerbated these constraints. Their experiences of struggling were sometimes ameliorated by significant social contact with family or particular staff members, and engaging in enjoyable activities. Occasionally the experiences of enjoying the here-and-now, and being 'seen' as a person by the other, would create beautiful moments in which truly person centred engagement would occur. These moments were neither articulated nor recorded, and were thus invisible after they had occurred. Similarly, the experiences of struggling against the constraints were neither acknowledged nor recorded. Significant experiences in the lives of these four residents were therefore invisible to others. The unifying theme representing the participants' daily experiences was: That which goes unsaid. Discussion It was necessary to develop communication strategies which would by-pass the researcher's assumptions and enable participants to introduce their own ideas and opinions. This ongoing process of co-creation of dialogue required work from, and trust between, participants and researcher. What is new? Expressly seeking the views of residents with communication difficulties Successfully using process consent with participants in this situation Using intentionally created artwork during data gathering in this context What has regional, national or international relevance? The findings indicate that people with communication difficulties may not receive optimal care in residential settings in the Netherlands. Methods are described which could be used by practitioners in their everyday work, and which show facilitators or practice developers how they can help carers to engage in more effective communication with this kind of resident. Additionally, this research contributes to the international discussion about ethical participation of vulnerable people in research.
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Senior co-housing communities offer an in-between solution for older people who do not want to live in an institutional setting but prefer the company of their age peers. Residents of co-housing communities live in their own apartments but undertake activities together and support one another. This paper adds to the literature by scrutinizing the benefits and drawbacks of senior co-housing, with special focus on the forms and limits of social support and the implications for the experience of loneliness. Qualitative fieldwork was conducted in eight co-housing communities in the Netherlands, consisting of document analysis, interviews, focus groups, and observations. The research shows that co-housing communities offer social contacts, social control, and instrumental and emotional support. Residents set boundaries regarding the frequency and intensity of support. The provided support partly relieves residents’ adult children from caregiving duties but does not substitute formal and informal care. Due to their access to contacts and support, few residents experience social loneliness. Co-housing communities can potentially also alleviate emotional loneliness, but currently, this happens to a limited degree. The paper concludes with practical recommendations for enhancing the benefits and reducing the drawbacks of senior co-housing. Original article at MDPI; DOI: https://doi.org/10.3390/ijerph16193776
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Within Facility Management (FM) the connection between organisation and space is a well-established topic. This study was made in the context of discovery and explored to what extent changes in organisation and space can contribute to the quality of life of intellectually disabled residents with a severe behavioural disorder (hereafter called residents) and a need for low stimulus intensity.In scientific literature the influence of the spatial environment on well-being of this specific group of residents has been described extensively by scholars in psychology. However, the joint optimisation of organisation and space is relatively new in FM and relates to studies on evidence based design and healing environments.This current study explores the relationship between different configurations in organisation and space in real life on one side and aggressive behaviour of two residents on the other. The research design was a longitudinal comparative case study and combined retrospective analysis with analysis of the current situation. The applied methods included document analysis, interview, photography, and walkthrough.Residents were exposed to different degrees of stimulus intensity in different periods. In periods where residents were exposed to a low stimulus intensity in organisation and space a relatively low number of incidents was reported. To be more precise: in periods where residents were exposed to few peer-residents, a custom-made team, a stable team composition, a standard team approach, and many personal spaces less incidents were reported than in periods where residents were often exposed to peer-residents, a group-based team, changes in team composition, no standard team approach, and many group spaces. These preliminary results suggest that a fit between the needs of residents with organisational and spatial designs can improve the well-being of residents. Further research among a larger population of residents should reveal if the current results have more general validity and whether these current findings would also be valid for other care institutes.
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The goal of this study was (1) to determine whether and how nursing home residents with dementia respond to the interactive art installation in general and (2) to identify whether responses change when the content type and, therefore, the nature of the interaction with the artwork changes. The interactive art installation ‘VENSTER’ evokes responses in nursing home residents with dementia, illustrating the potential of interactive artworks in the nursing home environment. Frequently observed responses were naming, recognizing or asking questions about depicted content and how the installation worked, physically gesturing towards or tapping on the screen and tapping or singing along to the music. It seemed content matters a lot. When VENSTER is to be used in routine care, the choice of a type of content is critical to the intended experience/usage in practice. In this study, recognition seemed to trigger memory and (in most cases) a verbal reaction, while indistinctness led to asking for more information. When (initially) coached by a care provider, residents actively engaged physically with the screen. Responses differed between content types, which makes it important to further explore different types of content and content as an interface to provide meaningful experiences for nursing home residents. •Implications for rehabilitation •VENSTER can facilitate different types of responses ranging from verbal reactions to active physical engagement. The choice of a type of content is critical to the intended experience/usage in practice. •Activating content seems suitable for use as a meaningful experience during the spare time in between existing activities or therapy. •Sessions with interactive content are short (avg. 30 mins) and intense and can therefore potentially be used as an activating therapy, activity or exercise. •In order to actively engage residents with dementia, the role of the care provider seems very important.
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