Hostname: page-component-cd9895bd7-jn8rn Total loading time: 0 Render date: 2024-12-13T05:26:33.892Z Has data issue: false hasContentIssue false

Rehabilitation in Residential Aged Care Facilities: Barriers and Facilitators in a Dementia Context

Published online by Cambridge University Press:  28 May 2013

Leander K. Mitchell*
Affiliation:
The University of Queensland, Australia
Nancy A. Pachana
Affiliation:
The University of Queensland, Australia
*
Correspondence may be sent to: Dr Leander Mitchell, School of Psychology McElwain Building, The University of Queensland, St Lucia Qld 4072. E-mail: leander.mitchell@uqconnect.edu.au
Get access

Abstract

This review of the literature sought to highlight key barriers to the implementation of rehabilitation-based interventions in an aged care facility context. It then identifies how such barriers might be actively countered with a view to facilitating rehabilitation-based strategies within such contexts. Key barriers identified included staffing issues, heterogeneity of residents, and the potential complexity behind establishing appropriate forms of rehabilitation for the residents. The most successful facilitators identified included training, the provision of appropriate support, and an open communication process. Having an awareness and an appreciation of potential barriers to the use of rehabilitation interventions in aged care facilities provides the opportunity to actively plan around them, thereby increasing and improving their use.

Type
Articles
Copyright
Copyright © The Author(s), published by Cambridge University Press on behalf of Australian Academic Press Pty Ltd 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

Baltes, M. (1995). Dependency in old age: Gains and losses. Current Directions in Psychological Science, 4 (1), 1419. doi: 10.1111/1467-8721.ep10770949CrossRefGoogle Scholar
Baltes, M.M., Neumann, E., & Zank, S. (1994). Maintenance and rehabilitation of independence in old age: An intervention program for staff. Psychology and Aging, 9 (2), 179188. doi: 10.1037/0882-7974.9.2.179CrossRefGoogle ScholarPubMed
Bird, M. (2003). Dementia and suffering in nursing homes. Journal of Religious Gerontology, 13, 4968. doi: 10.1300/J078v13n03_04CrossRefGoogle Scholar
Blackford, J., Strickland, E., & Morris, B. (2007). Advance care planning in residential aged care facilities. Contemporary Nurse, 27, 141151. Retrieved from http://www.bradford.nhs.uk/CrossRefGoogle ScholarPubMed
Bland, R. (1999). Independence, privacy and risk: Two contrasting approaches to residential care for older people. Ageing & Society, 19, 539560. doi: 10.1017/S0144686X99007497CrossRefGoogle Scholar
Bowers, B.J., Esmond, S., & Jacobson, N. (2000). The relationship between staffing and quality in long-term care facilities: Exploring the views of nurse aides. Journal of Nursing Care Quality, 14, 5564. Retrieved from http://journals.lww.com/jncqjournal/CrossRefGoogle ScholarPubMed
Brennan, L., Giovannetti, T., Libon, D.J., Bettcher, B.M., & Duey, K. (2009). The impact of goal cues on everyday action performance in dementia. Neuropsychological Rehabilitation, 19 (4), 562582. doi: 10.1080/09602010802405623CrossRefGoogle ScholarPubMed
Bytheway, B. (1995). Ageism. Buckingham, UK: Open University Press.Google Scholar
Charness, N., & Holley, P. (2001). Human factors and environmental support in Alzheimer's disease. Aging & Mental Health, 5, S65S73. doi: 10.1080/13607860120044837CrossRefGoogle ScholarPubMed
Cheek, J., Ballantyne, A., Jones, J., Roder-Allen, G., & Kitto, S. (2003). Ensuring excellence: An investigation of the issues that impact on the registered nurse providing residential care to older Australians. International Journal of Nursing Practice, 9, 103111. doi: 10.1046/j.1322-7114.2003.00408.xCrossRefGoogle ScholarPubMed
Clare, L., Wilson, B.A., Carter, G., Breen, K., Gosses, A., & Hodges, J.R. (2000). Intervening with everyday memory problems in dementia of Alzheimer type: An errorless learning approach. Journal of Clinical and Experimental Neuropsychology, 22, 132146. doi: 10.1076/1380-3395(200002)22:1;1-8;FT132CrossRefGoogle ScholarPubMed
Cohen-Mansfield, J., Werner, P., Culpepper, W., & Barkley, D. (1997). Evaluation of an in-service training program on dementia and wandering. Journal of Gerontological Nursing, 23, 4047.CrossRefGoogle ScholarPubMed
Coyne, M.L., & Hoskins, L. (1997). Improving eating behaviors in dementia using behavioral strategies. Clinical Nursing Research, 6, 275290. doi: 10.1177/105477389700600307Google ScholarPubMed
Doyle, C., & Ward, S. (1998). Education and training in residential dementia care in Australia: Needs, provision and directions. Australia New Zealand Journal of Public Health, 22, 589597. doi: 10.1111/j.1467-842X.1998.tb01444.xCrossRefGoogle ScholarPubMed
Edwards, D., & Burnard, P. (2003). A systematic review of stress and stress management interventions for mental health nurses. Journal of Advanced Nursing, 42 (2), 169200. doi: 10.1046/j.1365-2648.2003.02600.xCrossRefGoogle ScholarPubMed
Engelman, K.K., Mathews, R.M., & Altus, D.E. (2002). Restoring dressing independence in persons with Alzheimer's disease: A pilot study. American Journal of Alzheimer's Disease and Other Dementias, 17, 3743. doi: 10.1177/153331750201700102CrossRefGoogle ScholarPubMed
Fisk, M.J. (1986). Independence and the Elderly. London: Croom-Helm.Google Scholar
Janes, N., Sidani, S., Cott, C., & Rappolt, S. (2008). Figuring it out in the moment: A theory of unregulated care providers’ knowledge utilization in dementia care settings. Worldviews on Evidence-Based Nursing, 5 (1), 1324. doi: 10.1111/j.1741-6787.2008.00114.xCrossRefGoogle Scholar
Kolanowski, A., Buettner, L., & Moeller, J. (2006). Treatment fidelity plan for an activity intervention designed for persons with dementia. American Journal of Alzheimer's Disease and Other Dementias, 21 (5), 326332. doi: 10.1177/1533317506291074CrossRefGoogle ScholarPubMed
Martin, B., & King, D. (2008). Who cares for older Australians? A picture of the residential and community based aged care workforce 2007. Flinders University, South Australia: National Institute of Labour Studies.Google Scholar
Maas, M.L., Kelley, L.S., Park, M., & Specht, J.P. (2002). Issues in conducting research in nursing homes. Western Journal of Nursing Research, 24, 373389. doi: 10.1177/01945902024004006CrossRefGoogle ScholarPubMed
Mentes, J.C., & Tripp-Reimer, T. (2002). Barriers and facilitators in nursing home intervention research. Western Journal of Nursing Research, 24 (8), 918936. doi: 10.1177/019394502237702CrossRefGoogle ScholarPubMed
Nomura, M., Makimoto, K., Kato, M., Shiba, T., Matsuura, C., Shigenobu, K., . . . Ikeda, M. (2009). Empowering older people with early dementia and family caregivers: A participatory action research study. International Journal of Nursing Studies, 46, 431441. doi: 10.1016/j.ijnurstu.2007.09.009CrossRefGoogle ScholarPubMed
Phillips, L.R., & Van Ort, S. (1995). Issues in conducting intervention research in long-term care settings. Nursing Outlook, 43, 249253. doi: 10.1016/S0029-6554(95)80089-1CrossRefGoogle ScholarPubMed
Resnick, B., & Remsburg, R.E. (2004). Overview of restorative care. In Resnick, B. (ed.) Restorative Care Nursing for Older Adults: A Guide for all Care Settings (pp. 112). New York: Springer Publishing Company.Google Scholar
Rogers, J.C., Holm, M.B., Burgio, L.D., Hsu, C., Hardin, J.M., & McDowell, B.J. (2000). Excess disability during morning care in nursing home residents with dementia. International Psychogeriatrics, 12 (2), 267282. doi: 10.1017/S1041610200006372CrossRefGoogle ScholarPubMed
Secker, J., Hill, R., Villeneau, L., & Parkman, S. (2003). Promoting independence: But promoting what and how? Ageing & Society, 23, 375391. doi: 10.1017/S0144686X03001193CrossRefGoogle Scholar
Simmons, S.F., & Schnelle, J.F. (2004). Individualised feeding assistance care for nursing home residents: Staffing requirements to implement two interventions. Journal of Gerontology: Medical Sciences, 59A (9), 966973.Google Scholar
Tilly, J., & Reed, P. (2008). Intervention research on caring for people with demenita in assisted living and nursing homes. Alzheimer's Care Today, 9 (1), 2432.Google Scholar
Train, G.H., Nurock, S.A., Manela, M., Kitchen, G., & Livingston, G.A. (2005). A qualitative study of the experiences of long-term care for residents with dementia, their relatives and staff. Aging & Mental Health, 9 (2), 119128.CrossRefGoogle ScholarPubMed
Woods, B. (1999). Promoting well-being and independence for people with dementia. International Journal of Geriatric Psychiatry, 14, 97109. doi: 10.1002/(SICI)1099-1166(199902)14:2<97::AID-GPS941>3.0.CO;2-X3.0.CO;2-X>CrossRefGoogle ScholarPubMed
Younger, D., & Martin, G.W. (2000). Dementia care mapping: An approach to quality audit of services for people with dementia in two health districts. Journal of Advanced Nursing, 32 (5), 12061212. doi: 10.1046/j.1365-2648.2000.01591.xCrossRefGoogle ScholarPubMed
Zimmerman, S., Williams, C.S., Reed, P.S., Boustani, M., Preisser, J. S., Heck, E., & Sloane, P.D. (2005). Attitudes, stress, and satisfaction of staff who care for residents with dementia. The Gerontologist, 45, 96105.CrossRefGoogle ScholarPubMed