Global ETD Search

1	The Decision Making Process of Informal Caregivers of Dementia Family Members Regarding Nursing Home Placement Merritt, Rebecca 29 November 2010 (has links) The purpose of this study was to understand the decision making process of caregivers placing their elderly family members in a nursing home facility. Experiential Learning Theory (ELT) was used, as well as the Critical Incident Technique (CIT). ELT was utilized in an effort to understand the learning that took place during the caregiving experiences, and CIT was used to better understand the critical incidents that led the caregivers to seek nursing home placement. A sample of twelve former informal dementia caregivers between the ages of fifty-seven and eighty-seven was drawn from the metropolitan Richmond, Virginia area. In-depth interviews were audiotaped and provided the primary source of data for this study. An interview protocol consisting of eleven open-ended questions derived from current dementia caregiving literature guided the conversation between the researcher and the caregivers in the sample. A constant comparison method was used in this study. The findings revealed that there are a variety of reasons why informal dementia caregivers seek nursing home placement for their family members. Themes related to the decision making process to seek nursing home placement include (1) dementia related behaviors, (2) safety concerns, (3) emotional and psychological burden, and (4) unexpected medical intervention. Indicators of each theme found in this study suggest that providing informal care for an individual with dementia can be very overwhelming and challenging. Although there were some positive aspects associated with this form of caregiving, such as feelings of pride and self-worth, the overall consensus from this study was that dementia caregiving is a very difficult experience in which the primary caregiver had to ultimately seek formal placement in a nursing home for their family member for a variety of reasons. dementia caregiving decision to seek nursing home placement Education Educational Leadership
2	Factors Affecting the Utilization and Quality of Long-Term Care Temple, April 25 June 2009 (has links) The aging of the nation in the coming decades will contribute to an increased demand for long-term care. Given this trend, it is becoming increasingly important to understand utilization of services along the continuum of care and to determine factors that influence the provision of quality care. These insights are needed to reduce national expenditures on long-term care and to maximize independence and well-being among older adults. The purpose of the present dissertation was to explore factors that influence the utilization and quality of long-term care by conducting three separate studies. The first study examined risk of nursing home (NH) placement in a frail sample of older adults receiving publicly-funded long-term care in two settings: home and community-based services (HCBS) or assisted living (AL). Specifically, it explored whether these settings of care modify the relationship between dementia and NH placement. The second study examined NH organizational characteristics and job characteristics of staff in relation to turnover of nursing assistants (NAs) in a nationally representative sample of NHs. Using the same sample, the final study examined the presence of employment-based benefits of NAs and explored the relationship between NH organizational characteristics and the availability of staff benefits. Findings from this dissertation can contribute to a greater understanding of the use of long-term care services and the retention of staff to provide quality care. In the first study, AL was associated with longer time to NH placement for individuals with dementia when compared to HCBS. In the second study, the provision of competitive wages and benefits, involvement of NAs in resident care planning, and high levels of nurse staffing were associated with lower NA turnover, which may be important for quality of NH care. In the final study, for-profit ownership and high Medicaid occupancy were negatively associated with NA benefits whereas facility size, chain membership, occupancy level, union involvement, and education of the NH administrator were positively associated with benefits offered to these staff. Collectively, the findings from this dissertation may have important implications for policy makers, providers, and consumers of long-term care. Nursing home placement Dementia Nursing assistants Turnover Benefits American Studies Arts and Humanities
3	Individual and Geographic Predictors of Formal and Informal Care Patterns and Nursing Home Placement Risk among Rural Appalachian Elders Bivens, Laura R. 01 July 2016 (has links) A variety of individual and geographic factors influence the mix of formal and informal services utilized by older adults and their families along the continuum of care. This study focuses on a specific rural population in the United States - Central and South Central Appalachia, which experiences the triple jeopardy of vulnerable people (older adults) in vulnerable places (rural Appalachia), with cultural views and beliefs that may negatively impact the care they receive. Using Andersen’s behavioral model of service utilization, Soldo’s supplementation model of care, and Bronfenbrenner’s ecological theory as the theoretical frameworks, data from the Older Families in Rural Communities: Personal and Social Influences on Service Use project and the United States 2000 Census were used to examine the utilization of informal and formal care services and nursing home placement risk in a rural Appalachian population. The main goals of this research were to (a) examine the relationships among individual and geographic characteristics and determine how those relationships affect the utilization of informal-formal care-mix, and (b) determine how the informal-formal care-mix is associated with nursing home placement risk in older adults living in rural southwest Virginia. Two separate analyses were completed in order to address the research objectives. First, a multinomial regression model, including both individual and geographic data, was used to predict care-mix. Second, after calculating the outcome variable “nursing home placement risk” via a derived logistic regression equation, a log-linear analysis with a 3×4 contingency table was computed in order to understand the association between care-mix and nursing home placement risk. Results indicate that disparities in sex and poverty level in an area that already suffers from healthcare disparities significantly affect the type of care an older adult receives. When formal care was utilized, it was more often added to existing informal care systems, supplementing them, rather than replacing them. The type of care-mix individuals received was also associated with nursing home placement risk. Specifically, when informal support was the only source of care, nursing home placement risk was significantly higher than when informal-formal care-mix was received. Research and policy implications for disparity-ridden areas are discussed. / Ph. D. Appalachia Nursing Home Placement Risk Informal Care Formal Care Older Adults Rural Care Patterns
4	Anhörigskapets utmaningar : En kvalitativ studie om hur anhöriga upplever sitt anhörigskap under en äldre närståendes flyttprocess till ett särskilt boende / The challenges of being next of kin : A qualitative study of how next of kin experience an elderly’s relocation process to a nursing home Riolo Dahlsson, Daniela January 2022 (has links) Syftet med denna studie är att få ökad kunskap om hur anhöriga till en närstående äldre som beviljats särskilt boende upplever sitt anhörigskap under flyttprocessen. Studiens material består av tio kvalitativa semistrukturerade intervjuer med anhöriga makar och döttrar. Materialet har analyserats med hjälp av Bronfenbrenners utvecklingsekologi och med hjälp av det teoretiskt laddade begreppet livsbrott som framkommit i tidigare forskning. Studien visar att flyttprocessen upplevs som en känslomässig och omvälvande tid i de anhörigas liv och medför både förändringar, förluster och livsbrott då de anhöriga möter flera utmaningar under sitt anhörigskap. Känslor som skam, skuld och sorg är vanligt förekommande och anhöriga upplever ofta sin tillvaro som att vara i en väntesorg. Studien visar att anhörigskapet ofta upplevs som ensamt och osynligt och ger upphov till frustration, inte minst i relation till socialtjänstens olika representanter de kommer i kontakt med. Studien visar att de anhöriga tar på sig olika roller under flyttprocessen och att den sorts hjälp och omsorg som de ger till sin närstående äldre oftast ändras när sammanhanget för anhörigskapet skiftar från hemmet till det särskilda boendet. Studien visar också att relationen mellan anhörig och närstående förändras under och av flyttprocessen. Vidare framkommer att det är värdefullt att ha tillgång till stöttande nätverk under flyttprocessen, både privata och professionella. Att sakna stöttande nätverk visar sig påverka anhörigskapet på ett negativt sätt. / The purpose of this study is to gain increased knowledge about experiences and attitudes of next of kin towards the relocation process of an elderly family member to a nursing home. The material consists of ten qualitative semi-structured interviews with spouses and daughters. The material has been analyzed with the help of Bronfenbrenner's ecological systems theory and with the help of the theoretically charged concept of life breaking point that has emerged in previous research. The study shows that the relocation process is experienced as an emotional and transformative time by next of kin and entails both changes, losses, and life breaking points as they face several challenges during the process. Emotions such as shame, guilt and sadness are common, and next of kin often experience this time as being in a state of anticipatory grief. The study shows that next of kin often feel lonely, frustrated, and invisible during the relocation process, not least in contact with the social services' various representatives. The study shows that next of kin take on different roles over the different phases of the process and that the help and care they give to the elderly often changes when the context shifts from the home to the nursing home. The study also shows that the relationship between next of kin and elderly changes. Furthermore, the study illustrates the importance of supportive networks during the relocation process, both private and professional. Lack of supportive networks proves to affect the next of kin in a negative way. Family caregivers Next of kin experiences Relocation process Nursing home placement Anhörigskap Anhörigas upplevelser Äldres flyttprocess Särskilt boende Social Work Socialt arbete
5	Ontario’s Home First Approach, Care Transitions, and the Provision of Care: The Perspectives of Home First Clients and Their Family Caregivers English, Christine 23 May 2013 (has links) Home First is an Ontario transition management approach that attempts to reduce the pressure on hospital and Long Term Care (LTC) beds through early discharge planning, the provision of timely and appropriate home care, and the delay of LTC placement. The purpose of this qualitative descriptive study was to obtain descriptions from South Eastern Ontario Home First clients and their family caregivers of their experiences with and thoughts about care transitions, the provision of care, and the Home First approach. The goal was to enable insight into the Home First approach, care transitions, and the provision of care through access to the perspectives of study participants. Nine semi structured interviews (and one or more follow-up calls for each interview) with Home First clients discharged from hospitals in South East Ontario and their family caregivers were conducted and their content analyzed. All participating Home First clients were pleased to be home from hospital and did not consider LTC placement a positive option. All had family involved with their care and used a mix of formal and informal services to meet their care needs. Four general themes were identified: (a) maintaining independence while responding (or not) to risks, (b) constraints on care provision, (c) communication is key, and (d) relationship matters. Although all Home First clients participating in the study were discharged home successfully, a sense of partnership between health care providers, families, and clients was often lacking. The Home First approach may be successfully addressing hospital alternative level of care issues and getting people home where they want to be, but it is also putting increasing demands on formal and informal community caregivers. There is room for improvement in how well their needs and those of care recipients are being met. Health professionals and policy makers must ask caregivers and recipients about their concerns and provide them with appropriate resources and information if they want them to become true partners on the care team. / Thesis (Master, Rehabilitation Science) -- Queen's University, 2013-05-23 16:10:53.323 home support workers home health care community care older home support clients elder care discharge planning relationships family relationships nursing home Ontario health care Canadian health care placement Home First transition management care transitions aging in place maintaining independence caregiving community health and support services community long-term care family carers frail seniors client satisfaction hospital discharge health care older people aged frail elderly aging elderly supportive home care client perspectives long-term care quality of care evaluation of services care planning risk decisions case management communication independence home care constraints on care provision maintaining independence qualitative research family caregivers nursing home placement qualitative description program evaluation alternative level of care patient discharge self-care formal care aged care informal care post-discharge care home support community support services health services research

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