No description available.

The following was a research practicum instituted as an actual project for the State of Montana Welfare Department between June, 1970, and May, 1971. The project had a two-fold purpose in being conceived: one purpose was to fulfill a graduate school academic requirement; and the second purpose was to fulfill a responsibility to the people of Montana who would eventually gain some benefits from this project. The series of written documents that follow are the description of that project's conception and actualization in six Montana counties. The first part is the project idea and theory; the next two parts consist of the means by which the project was implemented; and the final two parts constitute the interim and final reports and evaluations of the project.

Originally, the focus of this project was to be a policy analysis and survey of the new procedures and regulations established by the state of Oregon for the protection and management of nursing home residents' Personal Incidental Funds (PIF). The analysis was to be divided into four phases, according to a pre-planned timetable. The last phase was to be a field survey of the policy's impact upon nursing homes and adult service workers. The timetable was synchronized with that of the Congregate Care Consultant from the Public Welfare Division's (PWD) Adult Services Unit, whose responsibility it was to develop and write a new policy for the state. Although the PIF is a miniscule segment of the total policy which the state of Oregon has developed for nursing facilities, it is submitted here as representative of public policy formulation in that area.

Introduction Older people in care homes are at increased risk of medication errors and adverse drug events. The effect of formulation on administration errors is not known, that is whether the medicine is a tablet or capsule, liquid or device such as an inhaler. Also, the impact on administration errors of monitored dosage systems (MDS), commonly used in UK care homes to dispense tablets and capsules, is not known. This study investigated the influence of formulation and MDS on administration errors. Methods Administration errors were identified by pharmacists (using validated definitions) observing two drug rounds of residents randomly selected from a purposive sample of UK nursing and residential homes. Errors were classified and analysed by formulation and medicine delivery system. Results The odds of administration errors by formulation, when compared with tablets and capsules in MDS, were: liquids 4.31 (95% CI 2.02 to 9.21; p=0.0002); topicals/transdermals/injections 19.61 (95% CI 6.90 to 55.73; p<0.0001); inhalers 33.58 (95% CI 12.51 to 90.19; p<0.0001). The odds of administration errors for tablets and capsules not in MDS were double those that were dispensed in MDS (adjusted OR 2.14, 95% CI 1.02 to 4.51; p=0.04). Conclusions Inhalers and liquid medicines were associated with significantly increased odds of administration errors. Training of staff in safe administration of these formulations needs implementing. Although there was some evidence that MDS reduced the odds of an administration error, the use of MDS impacts on other aspects of medicines management. Because of this, and as the primary topic of our study was not MDS, a prospective trial specifically designed to evaluate the overall impact of MDS on medicine management in care homes is needed.

published_or_final_version / Social Work / Master / Master of Social Work

Structural equation modeling was utilized in studying the voluntariness of the assumption of caregiving status. A model hypothesizing the stress flow that occurs when assuming a new life schema was presented. Utilizing three groups of caregiving populations, Home Caregivers, Intermediate Care Facility Aides, and Intensive Care Units and Emergency Room Nurses (N = 66), measures were administered to determine the voluntariness of the assumption of the role of caregiver. Path analysis and causal interpretation were utilized to determine outcomes. The involuntary assumption of the role of caretaker was shown to significantly affect depression and burnout rates negatively when perceived feelings of burden were high. When caretaker age was greater upon assumption of the role, self-esteem was low and family support was perceived to be lacking. When the role of caretaker is assumed on a voluntary basis and support from outside sources is perceived as helpful (i.e., social or financial support from the family), job stress and the subjective manageability of the symptoms were viewed as manageable. Implications for those assuming the role of caretaker with the elderly were examined, and recommendations for further training and interventions within the caretaker population were offered.

University of Macau / Faculty of Social Sciences and Humanities / Department of Government and Public Administration

published_or_final_version / Housing Management / Master / Master of Housing Management

No description available.

Aim: This study explored and described residential care for the elderly in eThekwini Municipality in terms of the organizational structure, staff and residents, and determined how those factors influenced elder care. This was aimed to make recommendations for residential care in eThekwini Metropolitan Municipality. Methodology: A descriptive explorative case study design, using both quantitative and qualitative approaches was adopted for this study. The study participants included eight administrators, twenty elderly residents and thirty nursing staff from four residential care facilities (RCFs) in eThekwini Municipality, Durban. Data were collected through interviews, questionnaires, record review and observation based on the structure, process and outcome of the study's conceptual framework. Qualitative data were gathered from administrators and elderly residents. The data were transcribed and analyzed manually using Framework Analysis (Ritchi & Spencer, 1994). Quantitative data was obtained from nursing staff using questionnaires, and analyzed using SPSS. Findings: Administrative fmdings followed the structure, process and outcome of the study. The structural findings were focused on facility philosophy and human-material resources, as well as on emerging themes from the data. The emerging themes from facility philosophy were assisting vulnerable people across age groups, document review, quality indicators, admission criteria and reasons for admission to each facility. Emerging themes from human-material resources were fmancial sustainability, staff-resident ratio and material resources. The process findings were focused on care and service delivery to the elderly and the emerging themes were one big family, incidence of abuse, methods of elder care and service delivery, knowledge about elder care, relationship of control, being there, gentle restraint, setting boundaries with the residents, medication safety, common religious belief and resident satisfaction. Findings from the outcome were focused on success and challenges of elder care, experiences of the elderly and nursing staff care experiences. Thus, emerging themes from success and challenges were strong bond, retaining staff, maintenance of physical structure, location of care centre; success and its dependence and challenges of procuring basic medical equipment. Findings from experiences of the elderly were reasons for admission, relationship, experiences of the elderly, response shift, psychosocial support and satisfaction with care, cultural belief and well respected. Emerging themes from nursing staffs experiences of caring for the elderly was mainly focused on their professional knowledge about elder care. Details of these findings are written down in Chapters Four and discussed in relation to literature in Chapter Five. Conclusion: The study concluded by making recommendations for the care of the elderly in -RCFs in eThekwini Municipality in line with the findings of the study. The recommendations have implications for the government, policy makers, nursing education and nursing research. Moreover, those concerned are encouraged to adopt and use the recommendations where applicable to promote residential care quality for the elderly in eThekwini Metropolitan Municipality. / Thesis (Ph.D.)-University of KwaZulu-Natal, Durban, 2010.