Hostname: page-component-8448b6f56d-sxzjt Total loading time: 0 Render date: 2024-04-25T05:56:04.564Z Has data issue: false hasContentIssue false
  • English
  • Français

An evaluation of a person-centred care programme for long-term care facilities

Published online by Cambridge University Press:  07 November 2013

JAIME WILLIAMS ,
THOMAS HADJISTAVROPOULOS ,
OMEED O. GHANDEHARI ,
XUE YAO  and
LISA LIX
JAIME WILLIAMS
Affiliation:
Centre on Aging & Health, University of Regina, Canada.
THOMAS HADJISTAVROPOULOS*
Affiliation:
Centre on Aging & Health, University of Regina, Canada. Department of Psychology, University of Regina, Canada.
OMEED O. GHANDEHARI
Affiliation:
Centre on Aging & Health, University of Regina, Canada. Department of Psychology, University of Regina, Canada.
XUE YAO
Affiliation:
Department of Community Health Sciences, University of Manitoba, Winnipeg, Canada.
LISA LIX
Affiliation:
Department of Community Health Sciences, University of Manitoba, Winnipeg, Canada.
*
Address for correspondence: Thomas Hadjistavropoulos, Department of Psychology, University of Regina, Regina, SK, S4S 0A2, Canada. E-mail: hadjistt@uregina.ca
Get access Rights & Permissions [Opens in a new window]

Abstract

Person-centred approaches in long-term care focus on providing holistic care to residents in order to improve quality of life, enhance resident wellbeing and autonomy, and mitigate behavioural and/or other symptoms. The results of research on person-centred approaches to care are mixed, with very few high-quality empirical studies examining resident outcomes specifically. The purpose of this investigation was to examine a person-centred care programme implemented in three Canadian long-term care facilities to determine its effect on resident outcomes, approach to care and maintenance of the programme three years after implementation. Using the Resident Assessment Instrument Minimum Data Set (RAI-MDS) scale scores and quality indicators, we retrospectively examined resident outcomes before, after and six months following the initiation of the programme using three additional facilities as control. We did not find any effects on resident outcomes. Focus group interviews with facility staff revealed no systematic differences between the programme and control facilities in their approach to care. All facilities supported aspects of a person-centred philosophy. Focus group interview data from the programme facilities indicated partial maintenance in two facilities and more complete maintenance in one facility. Although staff members supported the programme, implementation and maintenance proved difficult and effectiveness on resident outcomes was not indicated in this research. Additional controlled studies are needed.

Keywords

nursing homesdementiaolder adults
Type
Articles
Information
Ageing & Society , Volume 35 , Issue 3 , March 2015 , pp. 457 - 488
Copyright
Copyright © Cambridge University Press 2013 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Aestima Research 2003. The ‘Putting the P.I.E.C.E.S. Together’ 2002 Learning Initiative. Evaluation Report February 2003. Aestima Research, London, Ontario.Google Scholar
Alzheimer Society of Canada 2011. Guidelines for Care: Person-centred Care of People with Dementia Living in Care Homes. Available online at http://www.alzheimer.ca/en/About-dementia/For-health-care-professionals/~/media/Files/national/Culture-change/culture_change_framework_e.ashx [Accessed 13 January 2012].Google Scholar
Bellchambers, H. and Penning, C. 2007. Person-centred approach to care (PCA): a philosophy of care and management for carers. Contemporary Nurse, 26, 2, 196–7.Google Scholar
Berta, W., Teare, G. F., Gilbart, E., Ginsburg, L. S., Lemieux-Charles, L., Davis, D. and Rappolt, S. 2005. The contingencies of organizational learning in long-term care: factors that affect innovation adoption. Health Care Management Review, 30, 4, 282–92.Google Scholar
Bockerman, P., Johansson, E. and Saarni, S. I. 2012. Institutionalisation and subjective wellbeing for old-age individuals: is life really miserable in care homes? Ageing & Society, 32, 7, 1176–92.Google Scholar
Boyatzis, R. E. 1998. Transforming Qualitative Information: Thematic Analysis and Code Development. Sage, Thousand Oaks, California.Google Scholar
Brownie, S. and Nancarrow, S. 2013. Effects of person-centered care on residents and staff in aged-care facilities: a systematic review. Clinical Interventions in Aging, 8, 1, 1–10.Google Scholar
Brune, K. 2011. Culture change in long term care services: Eden-Greenhouse-Aging in the community. Educational Gerontology, 37, 6, 506–25.CrossRefGoogle Scholar
Chenoweth, L., King, M. T., Jeon, Y. H., Brodaty, H., Stein-Parbury, J., Norman, R., Haas, M. and Luscombe, G. 2009. Caring for Aged Dementia Care Resident Study (CADRES) of person-centred care, dementia-care mapping, and usual care in dementia: a cluster-randomised trial. The Lancet Neurology, 8, 4, 317–25.CrossRefGoogle ScholarPubMed
Cohen-Mansfield, J. 1986. Agitated behaviors in the elderly II. Preliminary results in the cognitively deteriorated. Journal of the American Gerontological Society, 34, 10, 722–7.Google Scholar
Coleman, M. T., Looney, S., O'Brien, J., Ziegler, C., Pastorino, C. A. and Turner, C. 2002. The Eden Alternative findings after 1 year of implementation. Journals of Gerontology: Biological Sciences and Medical Sciences, 57A, 7, M422–7.Google Scholar
Crabtree, B. F. and Miller, W. L. (eds) 1999. Doing Qualitative Research. Second edition, Sage, Thousand Oaks, California.Google Scholar
Crandall, L. G., Wite, D. L., Schuldheis, S. and Talerico, K. A. 2007. Initiating person-centered care practices in long term care facilities. Journal of Gerontological Nursing, 33, 11, 47–56.Google Scholar
Creswell, J. W. and Miller, D. L. 2000. Determining validity in qualitative inquiry. Theory into Practice, 39, 3, 124–30.CrossRefGoogle Scholar
Desai, A. K. and Grossberg, G. T. 2001. Recognition and management of behavioral disturbances in dementia. Primary Care Companion to the Journal of Clinical Psychiatry, 3, 3, 93–109.Google Scholar
Dixon-Woods, M., Agarwal, S., Jones, D., Young, B. and Sutton, A. 2005. Synthesising qualitative and quantitative evidence: a review of possible methods. Journal of Health Services Research and Policy, 10, 1, 45–53B.Google Scholar
Dow, B., Fearn, M., Haralambous, B., Tinney, J., Hill, K. and Gibson, S. 2013. Development and initial testing of the Person-Centred Health Care for Older Adults Survey. International Psychogeriatrics, 25, 7, 1065–76.Google Scholar
Eden Alternative 2009. Eden Alternative. Available online at http://www.edenalt.org/ [Accessed 19 June 2013].Google Scholar
Finnema, E., Dröes, R. M., Ettema, T., Ooms, M., Adèr, H., Ribbe, M. and Tilburg, W. V. 2005. The effect of integrated emotion-oriented care versus usual care on elderly persons with dementia in the nursing home and on unregulated care providers: a randomized clinical trial. International Journal of Geriatric Psychiatry, 20, 4, 330–43.Google Scholar
Gagnon, M. M., Hadjistavropoulos, T. and Williams, J.Development and mixed methods evaluation of a pain assessment video training program for long-term care staff. Pain Research and Management, in press.Google Scholar
Graneheim, U. H. and Lundman, B. 2004. Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness. Nurse Education Today, 24, 2, 105–12.CrossRefGoogle ScholarPubMed
Greene, J. C. 2008. Is mixed methods social inquiry a distinctive methodology? Journal of Mixed Methods Research, 2, 1, 7–22.Google Scholar
Hadjistavropoulos, T., Marchildon, G., Fine, P., Herr, K., Palley, H., Kaasalainen, S. and Beland, F. 2009. Transforming long-term care pain management in North America: the policy clinical interface. Pain Medicine, 10, 3, 506–20.Google Scholar
Hamilton, P., Harris, D., Le Clair, J. K. and Collins, J. 2008. ‘Putting the P.I.E.C.E.S. Together’. A Learning Resource for Providers Caring for Older Adults with Complex Physical and Cognitive/Mental Health Needs and Behavioural Changes. Sixth edition, Shop for Learning Publishing Services, Canada.Google Scholar
Hawes, C. H., Morris, J. N., Phillips, C. D., Fries, B. E., Murphy, K. and Mor, V. 1997. Development of the nursing home Resident Assessment Instrument in the USA. Age and Ageing, 26, supplement 2, 19–25.CrossRefGoogle ScholarPubMed
Hawes, C., Morris, J. N., Phillips, C. D., Mor, V., Fries, B. and Nonemaker, S. 1995. Reliability estimates for the Minimum Data Set Nursing Facility Resident Assessment and Care Screening (MDS). The Gerontologist, 35, supplement 2, 172–78.CrossRefGoogle ScholarPubMed
Hedeker, D. and Gibbons, R. D. 2006. Longitudinal Data Analysis. Wiley and Sons, Hoboken, New Jersey.Google Scholar
Hutchinson, A. M., Milke, D. L., Maisey, S., Johnson, C., Squires, J. E., Teare, G. and Estabrooks, C. A. 2010. The Resident Assessment Instrument-Minimum Data Set 2.0 quality indicators: a systematic review. BMC Health Services Research, 10, 1, 1–14.Google Scholar
Johnson, R. B. and Onwuegbuzie, A. J. 2004. Mixed methods research: a research paradigm whose time has come. Educational Researcher, 33, 7, 14–26.CrossRefGoogle Scholar
Jones, S. L., Hadjistavropoulos, H. D., Janzen, J. A. and Hadjistavropoulos, T. 2011. The relation of pain and caregiver burden in informal adult caregivers. Pain Medicine, 12, 1, 51–58.Google Scholar
Kaasalainen, S., Coker, E., Dolovich, L., Papaioannou, A., Hadjistavropoulos, T., Emili, A. and Ploeg, J. 2007. Pain management decision-making among long-term care physicians and nurses. Western Journal of Nursing Research, 29, 5, 561–80.Google Scholar
Kaasalainen, S., Williams, J., Hadjistavropoulos, T., Thorpe, L., Whiting, S., Neville, S. and Tremeer, J. 2010. Creating bridges between researchers and long-term care homes to promote quality of life for residents. Qualitative Health Research, 20, 12, 1689–704.Google Scholar
Koopmans, R. T., Zuidema, S. U., Leontjevas, R. and Gerritsen, D. L. 2010. Comprehensive assessment of depression and behavioral problems in long-term care. International Psychogeriatrics, 22, 7, 1054–62.Google Scholar
Koren, M. J. 2010. Person-centered care for nursing home residents: the culture-change movement. Health Affairs, 29, 2, 312–7.Google Scholar
Krueger, R. A. and Casey, M. A. 2009. A Practical Guide for Applied Research. Sage, Thousand Oaks, California.Google Scholar
Landers, M. G. and McCarthy, G. M. 2007. Person-centered nursing practice with older people in Ireland. Nursing Science Quarterly, 20, 1, 78–84.Google Scholar
Larsen, K., Petersen, J. H., Budtz-Jørgensen, E. and Endahl, L. 2000. Interpreting parameters in the logistic regression model with random effects. Biometrics, 56, 3, 909–14.Google Scholar
Law, M., Baptiste, S. and Mills, J. 1995. Client centred practice: what does it mean and does it make a difference? Canadian Journal of Occupational Therapy, 62, 5, 250–7.Google Scholar
Leutz, W., Bishop, C. E. and Dodson, L. 2010. Role for a labor–management partnership in nursing home person-centered care. The Gerontologist, 50, 3, 340–51.Google Scholar
Logsdon, R. G., McCurry, S. M. and Teri, L. 2007. Evidence-based psychological treatments for disruptive behaviors in individuals with dementia. Psychology and Aging, 22, 1, 28–36.Google Scholar
Lopez, S. H. 2006. Culture change management in long-term care: a shop-floor view. Politics and Society, 34, 1, 55–80.CrossRefGoogle Scholar
Marshall, M. N. 1996. Sampling for qualitative research. Family Practice, 13, 6, 522–6.CrossRefGoogle ScholarPubMed
McAiney, C. A. 2004 a. Survey of Long-term Care Facilities: Feedback on the P.I.E.C.E.S. Initiative 2003. Part of Initiative #1: Staff Education and Training Ontario's Strategy for Alzheimer Disease and Related Dementias. Available online at http://www.akeresourcecentre.org/Alzheimer-Strategy#1 [Accessed 29 October 2012].Google Scholar
McAiney, C. A. 2004 b. Survey of Long-term Care Facilities: Feedback on PRC Role 2003. Part of Initiative #8: Psychogeriatric Resource Consultants Ontario's Strategy for Alzheimer Disease and Related Dementias. Available online at http://www.akeresourcecentre.org/Alzheimer-Strategy#1 [Accessed 29 October 2012].Google Scholar
McAiney, C. A., Stolee, P., Hillier, L. M., Harris, D., Hamilton, P., Kessler, L., Madsen, V. and Le Clair, J. K. 2007. Evaluation of the sustained implementation of a mental health learning initiative in long-term care. International Psychogeriatrics, 19, 5, 842–58.CrossRefGoogle ScholarPubMed
McAiney, C. A. and Stolee, P. 2003. ‘Putting the P.I.E.C.E.S. Together’ Training Initiative 2001. Final Evaluation Report. Available online at http://www.akeresourcecentre.org/Alzheimer-Strategy#1 [Accessed 29 October 2012].Google Scholar
McCallion, P., Toseland, R. W., Lacey, D. and Banks, S. 1999. Educating unregulated care providers to communicate more effectively with nursing home residents with dementia. The Gerontologist, 39, 1, 546–58.Google Scholar
Morris, J. N., Hawes, C., Fries, B. E., Phillips, C. D., Mor, V., Katz, S., Drugovich, M. L. and Friedlob, A. S. 1990. Designing the national resident assessment instrument for nursing homes. The Gerontologist, 30, 3, 293–307.Google Scholar
Morris, J. N., Nonemaker, S., Murphy, K., Hawes, C., Fries, B. E., Mor, V. and Phillips, C. 1997. A commitment to change: revision of HCFA's RAI. Journal of the American Geriatrics Society, 45, 8, 1011–6.Google Scholar
Narevic, E., Giles, G. M., Rajadhyax, R., Managuelod, E., Monis, F. and Diamond, F. 2011. The effects of enhanced program review and staff training on the management of aggression among clients in a long-term neurobehavioral rehabilitation program. Aging and Mental Health, 15, 1, 103–12.Google Scholar
O'Neil, M. E. and Freeman, M. 2011. A Systematic Evidence Review of Non-pharmacological Interventions for Behavioral Symptoms of Dementia. Department of Veterans Affairs, Washington, D.C.Google ScholarPubMed
Patton, M. Q. 2002. Qualitative Research and Evaluation Methods. Third edition, Sage, Thousand Oaks, California.Google Scholar
P.I.E.C.E.S. Canada 2013 a. Dementia Observation System. Available online at http://www.piecescanada.com/pdf/Resources%20-%20DOS.pdf [Accessed 22 January 2013].Google Scholar
P.I.E.C.E.S. Canada 2013 b. Putting the P.I.E.C.E.S.™ Together. Available online at http://www.piecescanada.com/ [Accessed 21 June 2013].Google Scholar
Rahman, A. N. and Schnelle, J. F. 2008. The nursing home culture-change movement: recent past, present, and future directions for research. The Gerontologist, 48, 2, 142–8.Google Scholar
Rosemond, C. A., Hanson, L. C., Ennett, S. T., Schenck, A. P. and Weiner, B. J. 2012. Implementing person-centered care in nursing homes. Health Care Management Review, 37, 3, 257–66.Google Scholar
RTI International 2012. MDS 3.0 Quality Measures User's Manual. Available online at www.ltc-solutions.info/Documents/MDS3-UsersManual.pdf [Accessed 5 March 2012].Google Scholar
Sandelowski, M. 2000. Combining qualitative and quantitative sampling, data collection, and analysis techniques in mixed-method studies. Research in Nursing and Health, 23, 3, 246–55.Google Scholar
Schrijnemaekers, V., van Rossum, E., Candel, M., Frederiks, C., Derix, M., Sielhorst, H. and van den Brandt, P. 2002. Effects of emotion-oriented care on elderly people with cognitive impairment and behavioral problems. International Journal of Geriatric Psychiatry, 17, 10, 926–37.Google Scholar
Speziale, J., Black, E., Coatsworth-Puspoky, R., Ross, T. and O'Regan, T. 2009. Moving forward: evaluating a curriculum for managing responsive behaviors in a geriatric psychiatry inpatient population. The Gerontologist, 49, 4, 570–6.CrossRefGoogle Scholar
Stolee, P., Mcainey, C. A., Hillier, L. M., Harris, D., Hamilton, P., Kessler, L., Madsen, V. and Le Clair, J. K. 2009. Sustained transfer of knowledge to practice in long-term care: facilitators and barriers of a mental health learning initiative. Gerontology and Geriatrics Education, 30, 1, 1–20.Google Scholar
Stones, M. J., Hadjistavropoulos, T., Tuuko, H. and Kozma, A. 1995. Happiness has traitlike and statelike properties: a reply to Veenhoven. Social Indicators Research, 36, 2, 129–44.Google Scholar
Teri, L., Huda, P., Gibbons, L., Young, H. and Van Leynseele, J. 2005. STAR: a dementia-specific training program for staff in assisted living residences. The Gerontologist, 45, 5, 686–93.Google Scholar
Verbeek, H., van Rossum, E., Zwakhalen, S. M., Kempen, G. I. and Hamers, J. P. 2009. Small, homelike care environments for older people with dementia: a literature review. International Psychogeriatrics, 21, 2, 252–64.Google Scholar