'It's like home' - A small-scale dementia care home and the use of technology: A qualitative study.
Alzheimer's disease
care homes
dementia
homes for the aged
nurses' attitudes
nursing
nursing home
technology
Journal
Journal of advanced nursing
ISSN: 1365-2648
Titre abrégé: J Adv Nurs
Pays: England
ID NLM: 7609811
Informations de publication
Date de publication:
Oct 2023
Oct 2023
Historique:
revised:
14
03
2023
received:
28
10
2022
accepted:
21
05
2023
medline:
14
9
2023
pubmed:
8
6
2023
entrez:
8
6
2023
Statut:
ppublish
Résumé
To explore the experiences of residents, families and staff in the establishment of a new small-scale home model of care for people living with dementia. New and innovative small-scale models of care have the potential to improve outcomes for older people, especially those with dementia, who experience high rates of cognitive impairment in traditional residential aged care homes in Australia. A qualitative descriptive study. Semi-structured interviews with 14 guests, family and staff of a new small-scale dementia home named 'Kambera House' in the Australian Capital Territory were conducted between July 2021 when the home opened and August 2022. Data were analysed using reflexive thematic analysis and reported according to the COREQ guidelines. Two guests with mild-to-moderate dementia, five family and seven staff members participated in the study. The data revealed high satisfaction with Kambera House, generating five themes. Falls detection technology in the home provided a sense of safety, enabling more time for person-centred care. Free, everyday technology connected the home with families as part of an overall community of care where staff were empowered to maximize choice and dignity of risk of guests living in the home. This contributed to the sense of community, rather than an institution, where the conditions of work supported the conditions of care, and were embedded in a culture of responsiveness, change and flexibility. Kambera House represents a successful example of a new small-scale dementia home. Technology played an important background role in improving overall safety and flexibility as part of a model of care which demonstrated positive experiences for guests and families by being responsive to their individual needs. Small-scale homes for people with dementia offer an alternative model that may provide more individualized, person-centred care compared with the traditional institutionalized care. No patient or public contribution.
Sections du résumé
AIM
OBJECTIVE
To explore the experiences of residents, families and staff in the establishment of a new small-scale home model of care for people living with dementia.
BACKGROUND
BACKGROUND
New and innovative small-scale models of care have the potential to improve outcomes for older people, especially those with dementia, who experience high rates of cognitive impairment in traditional residential aged care homes in Australia.
DESIGN
METHODS
A qualitative descriptive study.
METHODS
METHODS
Semi-structured interviews with 14 guests, family and staff of a new small-scale dementia home named 'Kambera House' in the Australian Capital Territory were conducted between July 2021 when the home opened and August 2022. Data were analysed using reflexive thematic analysis and reported according to the COREQ guidelines.
RESULTS
RESULTS
Two guests with mild-to-moderate dementia, five family and seven staff members participated in the study. The data revealed high satisfaction with Kambera House, generating five themes. Falls detection technology in the home provided a sense of safety, enabling more time for person-centred care. Free, everyday technology connected the home with families as part of an overall community of care where staff were empowered to maximize choice and dignity of risk of guests living in the home. This contributed to the sense of community, rather than an institution, where the conditions of work supported the conditions of care, and were embedded in a culture of responsiveness, change and flexibility.
CONCLUSION
CONCLUSIONS
Kambera House represents a successful example of a new small-scale dementia home. Technology played an important background role in improving overall safety and flexibility as part of a model of care which demonstrated positive experiences for guests and families by being responsive to their individual needs.
IMPACTS
CONCLUSIONS
Small-scale homes for people with dementia offer an alternative model that may provide more individualized, person-centred care compared with the traditional institutionalized care.
PATIENT OR PUBLIC CONTRIBUTION
UNASSIGNED
No patient or public contribution.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
3848-3865Informations de copyright
© 2023 The Authors. Journal of Advanced Nursing published by John Wiley & Sons Ltd.
Références
Bail, K., Gibson, D., Hind, A., Strickland, K., Paterson, C., Merrick, E., Gibson, J., Kozlovskaia, M., O'Dea, A., Smith, B., & Redley, B. (2022). 'It enables the carers to see the person first': Qualitative evaluation of point-of-care digital management system in residential aged care. Journal of Clinical Nursing., 32, 174-190. https://doi.org/10.1111/jocn.16285
Baines, D., & Armstrong, P. (2018). Promising practices in long term care: Can work organisation treat both residents and providers with dignity and respect? Social Work & Policy Studies: Social Justice, Practice and Theory, 1(1), 1-26.
Braun, V., & Clarke, V. (2019). Reflecting on reflexive thematic analysis. Qualitative Research in Sport, Exercise and Health, 11(4), 589-597. https://doi.org/10.1080/2159676X.2019.1628806
Brennan, S., & Doan, T. (2022). Small-scale living Environments' impact on positive behaviors and quality of life for residents with dementia. Journal of Aging and Environment, 1-21, 181-201. https://doi.org/10.1080/26892618.2022.2030845
D'Cunha, N. M., Isbel, S., McKune, A. J., Kellett, J., & Naumovski, N. (2020). Activities outside of the care setting for people with dementia: A systematic review. BMJ Open, 10, e040753. https://doi.org/10.1136/bmjopen-2020-040753
Dementia Australia. (2022). Key facts and statistics. https://www.dementia.org.au/statistics
de Boer, B., Beerens, H. C., Katterbach, M. A., Viduka, M., Willemse, B. M., & Verbeek, H. (2018). The physical environment of nursing homes for people with dementia: Traditional nursing homes, small-scale living facilities, and green care farms. Healthcare (Basel), 6(4), 137. https://doi.org/10.3390/healthcare6040137
Dyer, S., Berg, M., Barnett, K., Brown, A., Johnstone, G., Laver, K., Lowthian, J., Maeder, A., Meyer, C., Moores, C., Ogrin, R., Parella, A., Ross, T., Shulver, W., Winsall, M., & Crotty, M. (2019). Review of innovative models of aged care (research paper 3). Royal Commission into Aged Care Quality and Safety. https://agedcare.royalcommission.gov.au/sites/default/files/2020-01/research-paper-3-review-innovative-models-of-aged-care.pdf
Dyer, S. M., Liu, E., Gnanamanickam, E. S., Milte, R., Easton, T., Harrison, S. L., Bradley, C. E., Ratcliffe, J., & Crotty, M. (2018). Clustered domestic residential aged care in Australia: Fewer hospitalisations and better quality of life. Medical Journal of Australia, 208(10), 433-438. https://doi.org/10.5694/mja17.00861
Gibson, D. (2022). Aged care employment and the productivity commission: Fixing the data gaps may be the most useful thing it can do. Australasian Journal on Ageing., 41, 573-578. https://doi.org/10.1111/ajag.13113
Harrison, S. L., Dyer, S. M., Laver, K. E., Milte, R. K., Fleming, R., & Crotty, M. (2022). Physical environmental designs in residential care to improve quality of life of older people. Cochrane Database of Systematic Reviews, 3, CD012892. https://doi.org/10.1002/14651858.CD012892.pub2
Howcroft, J., Kofman, J., & Lemaire, E. D. (2017). Prospective fall-risk prediction models for older adults based on wearable sensors. IEEE Transactions on Neural Systems and Rehabilitation Engineering, 25(10), 1812-1820. https://doi.org/10.1109/tnsre.2017.2687100
Ibrahim, J. E., & Davis, M. C. (2013). Impediments to applying the 'dignity of risk' principle in residential aged care services. Australasian Journal on Ageing, 32(3), 188-193. https://doi.org/10.1111/ajag.12014
Ko, M., Wagner, L., & Spetz, J. (2018). Nursing home implementation of health information technology: Review of the literature finds inadequate Investment in Preparation, infrastructure, and training. Inquiry, 55, 46958018778902.
Leading Aged Services Australia. (2021). Comparing aged care and NDIS support: A funding analysis. Canberra. https://lasa.asn.au/wp-content/uploads/2021/04/LASA0873_Comp-Aged-Care-and-NDIS-Support_public.pdf
Lee, S., Hung, L., Chaudhury, H., & Morelli, A. (2021). Effects of physical environment on quality of life among residents with dementia in long-term care facilities in Canada and Sweden: A longitudinal study in a large-scale institutional setting versus a small-scale homelike setting. Architectural Research., 23(2), 18-28. https://doi.org/10.5659/AIKAR.2021.23.2.19
Lincoln, S. Y., & Guba, E. G. (1985). Naturalistic inquiry. In Naturalistic inquiry. Sage.
Low, L.-F., & Purwaningrum, F. (2020). Negative stereotypes, fear and social distance: A systematic review of depictions of dementia in popular culture in the context of stigma. BMC Geriatrics, 20(1), 477. https://doi.org/10.1186/s12877-020-01754-x
Moyle, W., Murfield, J., & Lion, K. (2021). The effectiveness of smart home technologies to support the health outcomes of community-dwelling older adults living with dementia: A scoping review. International Journal of Medical Informatics, 153, 104513. https://doi.org/10.1016/j.ijmedinf.2021.104513
Pappadà, A., Chattat, R., Chirico, I., Valente, M., & Ottoboni, G. (2021). Assistive Technologies in Dementia Care: An updated analysis of the literature [systematic review]. Frontiers in Psychology, 12:644587. https://doi.org/10.3389/fpsyg.2021.644587
Rayner, J.-A., Fetherstonhaugh, D., & Cowen, S. (2020). Research priorities in residential aged care services: A statewide survey. Australasian Journal on Ageing, 39(1), 40-47. https://doi.org/10.1111/ajag.12653
Royal Commission into Aged Care Quality and Safety. (2021). Final Report - Executive Summary. https://agedcare.royalcommission.gov.au/publications/final-report-executive-summary
Shu, S., & Woo, B. (2021). Use of technology and social media in dementia care: Current and future directions. World Journal of Psychology, 11(4), 109-123.
Sun, R., & Sosnoff, J. J. (2018). Novel sensing technology in fall risk assessment in older adults: A systematic review. BMC Geriatrics, 18(1), 14. https://doi.org/10.1186/s12877-018-0706-6
Tierney, L., Doherty, K., Breen, J., & Courtney-Pratt, H. (2022). Community expectations of a village for people living with dementia. Health & Social Care in the Community., 30, e5875-e5884. https://doi.org/10.1111/hsc.14018
Tong, A., Sainsbury, P., & Craig, J. (2007). Consolidated criteria for reporting qualitative research (COREQ): A 32-item checklist for interviews and focus groups. International Journal for Quality in Health Care, 19(6), 349-357. https://doi.org/10.1093/intqhc/mzm042
Verbeek, H., van Rossum, E., Zwakhalen, S. M., Ambergen, T., Kempen, G. I., & Hamers, J. P. (2009). The effects of small-scale, homelike facilities for older people with dementia on residents, family caregivers and staff: Design of a longitudinal, quasi-experimental study. BMC Geriatrics, 9, 3. https://doi.org/10.1186/1471-2318-9-3
Zwakhalen, S. M., Hamers, J. P., van Rossum, E., Ambergen, T., Kempen, G. I., & Verbeek, H. (2018). Working in small-scale, homelike dementia care: Effects on staff burnout symptoms and job characteristics. A quasi-experimental, longitudinal study. Journal of Research in Nursing, 23(2-3), 109-122. https://doi.org/10.1177/1744987118757838