Search

The current study aimed to test the feasibility and preliminary efficacy of the Promoting Positive Care Interactions (PPCI) intervention designed to establish positive care interactions between staff and residents in assisted living (AL) using an online approach. PPCI was implemented in one AL community using a single group pre-/posttest design; 17 care staff were recruited from the memory care unit. Delivery, receipt, and enactment of the PPCI were assessed for feasibility. Change in staff outcomes and facility outcomes were examined for preliminary efficacy. The four steps of the PPCI were implemented as intended with 100% staff exposure to education and considerable staff engagement in weekly mentoring sessions. Although there was an improvement in AL environment and policy, no significant changes were observed in staff outcomes. Future testing of the PPCI should include a longer timeline and explore a hybrid model that includes online education and in-person mentoring and coaching of staff to improve care interactions. [ Journal of Gerontological Nursing, 48 (8), 17–25.]

Care interactions are essential to understand and respond to resident needs in assisted living (AL). The factors that influence care interactions in AL have not been directly examined. In this study, we explored the factors associated with the quality of care interactions in AL. It was hypothesized that resident functional status, agitation, depression, and resistiveness to care as well as facility size and ownership would be significantly associated with the quality of care interactions in AL after controlling for resident demographics (age, gender, marital status), comorbidities, and cognition. To test the hypothesis, we utilized baseline data including 379 residents from the second and third cohorts recruited in a randomized trial titled ‘Dissemination and Implementation of Function Focused Care for Assisted Living Using the Evidence Integration Triangle’. Regression analysis was performed using a stepwise method. The care interactions were mostly positive (mean=6.3; range = 0-7). Resident agitation and facility ownership were significantly associated with care interactions and accounted for 8.2% of the variance. Increased resident agitation was associated with negative or neutral interaction while for-profit ownership was associated with positive interactions. To promote positive care interactions, staff should be educated about strategies to minimize resident agitation (e.g., calm posture and respectful listening) and encouraged to engage with residents using resident-centered care and communication approach. Findings also suggest the need to work towards optimizing care interactions in nonprofit stings. Future research could further explore the impact of facility-level factors (e.g., staffing ratios, staff longevity, and job satisfaction) on care interactions.

Nursing homes (NHs) are challenged to consistently deliver person-centered care (PCC), or care based on residents' values and preferences. NH staff associate certain resident preferences with risk. However, there are limited evidence-based person-centered risk management strategies to assist NH staff with risky resident preferences. The purpose of the current study was to explore NH staff perceptions of health and safety outcomes associated with honoring NH residents' risky preferences to inform intervention development. This descriptive, qualitative study used sequential focus groups and content analysis, revealing that nursing staff perceive negative and positive outcomes for staff and residents when seeking to honor residents' risky preferences. This finding is supported by three themes: Potential Harms to Staff , Potential Harms to Residents , and Positive Shared Outcomes . These results contribute a set of nurse-driven quality of life and quality of care outcomes for NH staff and residents associated with PCC delivery in NHs. [ Research in Gerontological Nursing, 15 (6), 271–281.]

This study examined the associations between cognition and depressive symptoms, function, and pain among hospitalized older patients with dementia. We utilized baseline data of 461 hospitalized older patients with dementia who participated in an intervention study implementing Family-centered Function-focused Care (Fam-FFC) and conducted stepwise linear regression. On average, the participants (males = 189; 41% and females = 272; 59%) were 81.64 years old (Standard Deviation, SD = 8.38). There was a statistically significant association of cognition with depressive symptoms (b = −0.184, p < .001), functional status (b = 1.324, p < .001), and pain (b = −0.045, p < .001) when controlling for covariates. This study utilized a large sample of a relatively underrepresented population, hospitalized older adults with dementia, and addressed a topic with great clinical significance. Specific focus on testing and implementing best practices or interventions to support the clinical outcomes, and the cognitive function of hospitalized older adults with dementia is warranted in both practice and research.

Background: Positive and effective staff–resident interactions are imperative to adequately assess and meet the needs of cognitively impaired residents in nursing homes and optimize their quality of life. Purpose: The purpose of this study was to quantify, describe, and analyze the interaction between staff and cognitively impaired residents in nursing homes, using the Quality of Interaction Schedule (QuIS). Specifically, the following aims were addressed— Aim 1: To quantify and describe the quality of interactions between staff and cognitively impaired residents in nursing homes. Aim 2: To analyze whether the quality of staff–resident interactions vary by resident cognitive status (moderate vs severe) and interaction characteristics (interaction location, interaction situation, interpersonal distance, type of staff, and resident level of participation). Method: This descriptive analysis utilized baseline data from the first 2 cohorts in a randomized clinical trial including 341 residents from 35 nursing homes. Results: Five hundred fifty-six staff–resident interactions were evaluated; majority were positive (n = 466, 83.8%) and the remaining were either neutral (n = 60, 10.8%) or negative (n = 30, 5.4%). The quality of interactions varied by interaction location, interpersonal distance, and resident participation. Conclusion: This study provides some current descriptive information about the quality of staff-resident interactions in nursing homes and the interaction characteristics that might impact these interactions. Future research should focus on decreasing the negative/neutral interactions and explore staff characteristics (e.g., gender, level of experience) and facility factors (e.g., size, ownership) that might influence the quality of interactions.