Thesis (M.S.)--University of Michigan, 1991.

Thesis (Ph. D.)--University of Chicago, Irving B. Harris Graduate School of Public Policy Studies, December 1999. / Includes bibliographical references. Also available on the Internet.

Thesis (Ph. D.)--University of Texas at Austin, 2005. / Supervisor: Kenneth A. Lawson. Vita. Includes bibliographical references.

Thesis (M.S.)--University of Michigan, 1991.

Abstract Elderly people, because of the frail health condition and consequent problems, have in most cases substantial difficulties living at home. Despite the need for widened nursing home custody, the field of quality institutional elderly care in Slovenia in the past did not undergo comprehensive research. The purpose of this two-part study was to investigate the quality of institutional elderly care and elderly care offered in Slovenian nursing homes. Additional purpose was to evaluate nursing staff members about their willingness, knowledge, skills and importance to meet residents’ physical and psychosocial nursing care needs. Also, a part of this research was bound for recognition of maltreatment and nursing staff members’ well-being. The qualitative and quantitative research methods were used. The quality of institutional elderly care and elderly care offered were researched by interviewing the parties involved in elderly care, residents, relatives and nursing staff members (N=48). The data for quantitative research was collected by surveying nursing staff by using a structured questionnaire (N=148). All data have been collected in three public and one private nursing home located in two major cities of Ljubljana and Maribor. Collected data was examined by content analysis method and statistical analysis, to corroborate findings across data sets, reducing the impact of potential biases that can exist in a single study. Triangulation was used to approach to data analysis to synthesize data from multiple sources. Main categories of quality institutional elderly were formulated as attentive care, optimal custody and holistic approach. The most important issue of quality institutional elderly care was formulated as meeting needs on time. Nursing staff members were found to be better skilled in meeting physical than psychosocial needs of residents. Maltreatment was recognised as neglect of care due to postponed duties or hastiness in nursing interventions resulting in discomfort of residents. Factors in connection to quality of institutional elderly care were expressed as quality of nursing care, friendly relationship, meaningful activities, pleasant dwelling environment and versatile assistance. The obtained findings were presented in form of proposals to improve quality of institutional elderly care in Slovenian nursing homes, and could be used to develop institutional elderly care and improve dwelling. In addition many specific terms have been extracted during the analysis process that may contribute to development of gerontological nursing care rationale in Slovenia.

Background: Today, 160,000 people with dementia live in Sweden. With increasing age, the risk of suffering from dementia is higher. Many of those who seek hospital care and other healthcare facilities have dementia in addition to other disorders. Caring for people with dementia demands that the nurse has the knowledge and skills required to be able to provide adequate and safe care. Aim: The aim of this study is to describe nurse´s experiences in taking care of patients with dementia disease. Method: A literature-based study was performed, analyzing ten qualitative articles Results: The results consist of two main themes with four subthemes each. The first theme is nurses experience of barriers to good dementia care with four subthemes, the organization as an obstacle, lack of time, lack of knowledge, education and experience, non-adapted care environment. The second main theme was nurse's experience with conditions to good dementia care with four sub-themes, working in teams, working person-centered, knowledge of dementia diseases and caring environment. These highlight nurses experience to care for people with dementia. Conclusion: To care for patients with dementia, according to the result, time and knowledge are mainly required. Working person-centered gives the patient quality of care. Building a relationship with the patient and learning how to interpret signals takes time but is necessary for good care and good working environment. Resources are needed from management in form of time, staffing and knowledge development

The purpose of this study was to investigate the relationship between nursing staffing and quality of life (QOL) in nursing homes (NHs). The relationships between nursing staff hours per resident day, nursing staffing skill mix, turnover of nursing staff, and the answers given to QOL questions by 231 residents in Iowa NHs were investigated. Unexpectedly, only part of staffing variables were statistically significantly correlated with QOL of residents and nurse staffing variables seemed to have little influence on predicting QOL of residents in this study. The major differences between this study and previous studies are that previous research focused on quality of care (QOC) and this study measured QOL by measuring residents' outcomes. Previous studies found that nurse staffing is an important factor in improving QOC (and by implication, QOL) of NH residents. Based on the statistically significant relationships, RNs' unique contributions were supported by the findings that NHs with more RNs, compared with LPNs/LVNs and CNAs, had residents with higher scores in the functional competence domain and overall QOL summary items. This study found that nurse staffing turnover is positively correlated with QOL, especially in the individuality domain. However, the whole study takes place in one state, Iowa. Iowa has a homogeneous population with limited racial diversity. Only Iowa NHs were selected and it is questionable whether the findings may be generalizable to the rest of the United States. Further research is required to confirm the relationship and provide policy guidelines, including nurse staffing recommendations, to guarantee optimal QOL for NH residents.

Indiana University-Purdue University Indianapolis (IUPUI) / Pain prevalence in nursing home (NH) residents is high. Studies report up to 85.0% of NH residents experience pain and up to 58.0% experience persistent pain. Pain in NH residents can lead to decreased happiness, quality of life, and life satisfaction. Traditionally, pain has been studied in relation to specific comorbid conditions or pain subtypes (nociceptive, neuropathic) with little consideration for the dynamic (temporal) nature of pain. Current pain subtypes are clinically linked to recommended pain treatments and provide insight into underlying mechanisms. However, current pain subtypes are limited by their focus on pain origin, do not include severity or duration of the pain experience, and do not illustrate how the course or trajectory of pain changes over time. Understanding the trajectory of pain experience can provide opportunities to alter the course of pain experience, improve residents’ quality of life and prevent adverse outcomes. This dissertation provides the first evidence of four distinct pain trajectories among NH residents including persistent pain which was associated with several resident characteristics and clinically relevant diagnosis. Using residents’ characteristics associated with persistent pain, such as a history of fracture or contracture, may improve care planning based on early identification or risk stratification and can improve mitigation of persistent pain. To identify and characterize pain trajectories in NH residents, the following activities were completed (1) systematic review of the literature related to prevalence of pain and associated factors in NH residents, (2) cross-sectional analysis of secondary data to examine prevalence of pain, persistent pain, and factors associated with pain in NH residents, and (3) a longitudinal retrospective analysis of secondary data using group-based trajectory modeling to identify, quantify, and characterize NH pain trajectories. The findings from this study highlight the prevalence and complexity of pain in NH residents.

Touch--both touching another and being touched--is a primary form of communication. By old age, both the need and the desire for specific amounts and kinds of touching are well established for the individual. The present study was designed to obtain information about what elderly women in nursing and retirement homes report to be liked and disliked types of touching. Participants who volunteered for this study were 32 ambulatory females 65 years of age or older who were living in nursing or retirement homes. Each participant was shown a set of 20 photos and sketches depicting a staff person touching an elderly woman in various ways, and asked to rate their liking for the particular type of touching on a one to five scale ranging from "like very much" to "dislike very much." The set of photos and sketches included ten comparable scenes with one-half showing a male staff member and the other half showing a female staff member touching an elderly woman. Scenes included: foot massage, helping to stand, back rub, brushing hair, arm around shoulder, holding hand, helping to dress, stroking cheek, helping with toileting, and helping with a shower.

The National Organization for Women use assertion training as a part of its strategy to overcome the oppression of women in our society. Certainly another group of people who suffer from oppression are the elderly. When a person in our society reaches age 65, he or she may suddenly be perceived as of decreased worth and may face forced retirement and quite often may have to adjust to a lifestyle of poverty. If an elderly person's physical health begins to wane, a nursing home may suddenly become the day to day environment he or she must accept. The therapists in the Residential Care Program, which offers mental health services to residents of nursing homes, at Elahan Mental Health Clinic and Center for Family Living in Vancouver, Washington realized that assertion training might be one way to help their elderly clients gain more control over their live and thus implemented an assertion training program. The following is an evaluation of that module which was introduced as part of the Elderly Day Treatment Program in 1977.