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Aim: To scope and explore hydration practices in care homes. Background: Older residents do not regularly consume adequate fluids to support health. Achieving this is difficult with residents who have coexisting health, sensory and functional problems, as well as challenging hydration habits. Design: This project used a sequential exploratory mixed method design to scope and explore existing hydration practices. Methods: Data were collected via two stages. First was a survey of hydration practices. Twenty‐nine responses were received from 81 care homes (response rate: 35.8%). Second was the exploration of practitioners' experiences and perceptions of hydration practice via semi‐structured interviews (54 staff: 43 interviews). Descriptive statistics summarised the survey findings. Open coding and thematic analysis were applied to the qualitative data, and details of the methods are reported in adherence to COREQ criteria. Results: It is important to provide hydration support in addition to regularly offering drinks to residents. Hydration practices include the following: use of social interaction to encourage drinking; verbal and nonverbal prompts to drink; giving fluids with routine practices and social activities; providing drinks‐related activity, use of aids and equipment to support drinking; and creating a drink‐friendly environment. Practices are implemented in care homes; however, no one care home implements all these hydration strategies at any one time. Conclusions: Older care home residents need support and encouragement to drink adequate fluids which can be difficult to achieve with residents who have complex needs and challenging drinking habits. In addition to the routine offer of drinks, hydration support should be used to facilitate residents to drink sufficient amounts of fluid. Relevance to clinical practice: Staff working in care homes have an important role in assessing the hydration needs of residents and using multiple hydration practices to support residents to achieve their hydration requirements. [ABSTRACT FROM AUTHOR]

Aims and objectives: To explore nursing home nurses' experiences and views of work identity. Background: Nursing home nurses are in a unique position as they work at the interface of health and social care. Little is known about nursing home nurses' perceptions and experiences of working within this context. Evidence suggests that using the concept of work identity can support understanding of how workers make sense of their work. Design: Hermeneutic phenomenological study. Methods: The study was carried out in seven nursing homes in North East England. Findings are based upon literary analysis of multiple episodic interviews with 13 nursing home nurses. Results: Participants' responses suggested that nursing “residents” is different to nursing “patients,” and nursing home nurses are required to modify their care activities to account for these differences. Participants also proposed that they are isolated and excluded from the rest of the healthcare workforce group. These issues led participants to feel uncertain about work identity. Many participants attempted to strengthen their work identity by aligning their role with what they perceived the “nurse identity” to be. Conclusion: Nurses' work activities and professional group identity influence their work identity. When work activities and professional group identity do not align with role expectations, as can be the case for nursing home nurses, work identity may be compromised. These nurses may attempt to change work practices to strengthen their work identity. Relevance to clinical practice: Health‐ and social care providers need to account for work identity factors in the organisation of care, and planning and implementation of integrated health‐ and social care initiatives. [ABSTRACT FROM AUTHOR]

Aims and objectives. This paper considers the impact of aphasia on health and well-being and provides suggestions for appropriate nursing interventions. Background. Effective communication is essential to holistic care and positive outcomes for individuals affected by aphasia. When verbal communication is absent, nurses fail to adequately use alternative strategies so that the standard of nurse/patient communication is frequently poor. Design. This is a discursive paper which reviews relevant literature and uses the Theory of Human Scale Development as a framework for discussion. Method. The Theory of Human Scale Development is introduced. This theory emphasises that quality of life depends as much upon self-actualisation and relation building as on physical health. The theory is used within the discussion to highlight the significance of communication to quality of life and how its loss has profound psychological and social consequences. Results. Aphasia results in 'loss of self'. The situation is exacerbated by inadequate healthcare communication strategies. Suggestions are offered regarding more appropriate strategies. Efficacy of family input is considered; nursing competence regarding language practice therapies is discussed, and the 'quest approach' is explored. Aphasia has a negative impact on relationships by denying access to support networks, which results in isolation. The individual's predicament is worsened by negative nursing responses. Positive nursing strategies, which alleviate effects of aphasia on individuals' social health, are investigated. Concept analysis and self-awareness exercises as methods of enhancing compassion skills are explored. The social model of disability is discussed to highlight the benefits to individuals of environmental adaptations. The social benefits of aphasia-group affiliation are discussed. Conclusion. The paper concludes by emphasising that fundamental human needs involve social and psychological as well as physical aspects. Relevance to clinical practice. Nursing interventions must address all needs to provide holistic care in its fullest sense. [ABSTRACT FROM AUTHOR]