Improving Quality of Life for Older People in Long-Stay Care ...

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sector and 50 per cent in the voluntary sector. Nearly one quarter of units in district/community hospital facilities have no personal laundry arrangement which meansthat residents have to arrange for relatives to do their laundry or, in some cases,cannot choose to wear their own clothes.Table 6.12: Availability of communal facilities by facility typeAllfacilitiesPrivatenursinghomesPublichomes/hospitalsVoluntaryhomes/hospitalsDistrict/communityhospitalsWelfarehomesTelevision 320 (99.4) 203 (100.0) 38 (100.0) 34 (100.0) 31 (93.9) 14 (100.0)Newspapers 300 (93.2) 194 (95.6) 36 (94.7) 32 (94.1) 28 (84.8) 10 (71.4)Video/DVDplayers293 (91.0) 180 (88.7) 38 (100.0) 32 (94.1) 30 (90.9) 13 (92.9)Library 262 (81.4) 168 (82.8) 27 (71.1) 32 (94.1) 22 (66.7) 13 (92.9)Games 279 (86.6) 178 (87.7) 35 (92.1) 29 (85.3) 26 (78.8) 11 (78.6)Musicalinstruments163 (50.6) 101 (49.8) 18 (47.4) 24 (70.6) 11 (33.3) 9 (64.3)Shop 78 (24.2) 36 (17.7) 15 (39.5) 17 (50.0) 8 (24.2) 2 (14.3)PublictelephoneTea/coffeemakingfacilitiesPersonallaundryfacilities272 (84.5) 161 (79.3) 35 (92.1) 33 (97.1) 29 (87.9) 14 (100.0)128 (39.8) 89 (43.8) 11 (28.9) 17 (50.0) 6 (18.2) 5 (35.7)271 (84.2) 169 (83.3) 33 (86.8) 30 (88.2) 26 (78.8) 13 (92.9)N 322 203 38 34 33 141296.7 Meaningful OccupationIn recent years, there has been a growing recognition that activity programmesdesigned to fill the time should be differentiated from meaningful or purposefulactivity in long-stay facilities. Meaningful occupation is likely to incorporate dailyactivities that promote enjoyment and fulfil individual needs in relation to purpose,self-care and participation. Respondents in our survey were first asked if theypermitted residents to engage in household tasks followed by a question on thetype of activities that residents could pursue. Two thirds of all facilities offered
esidents the opportunity to participate in household tasks within the residentialsetting. Almost four fifths of private nursing homes offered residents theopportunity to engage in purposeful activity (Figure 6.8). In contrast, only one thirdof district/community hospitals allowed such participation. Generally, theopportunity for participation is higher in welfare homes than in other public facilities,reflecting the lower levels of dependency in the former compared to public geriatrichomes/hospitals and district/community hospitals.Having the opportunity to participate does not indicate actual participation.Table 6.13 shows that while residents may generally have the opportunity toengage in household tasks, participation levels are quite low. Laying tables andgardening tend to be the activities that residents do most, with gardening mostlikely to occur within private nursing home settings. The lower level of dependencyin welfare homes is reflected in the relatively high level of resident involvement inactivities such as laying tables and making beds. Resident participation in servingfood, cleaning rooms and cooking occurs in only a handful of facilities reflecting thegeneral commodification of these activities in all settings.130Figure 6.8: Percentage of facilities in which residents participatein household tasksWelfare homes(n = 14)District/Community hospitals(n = 33)Voluntary homes/hospitals(n = 34)Public homes/hospitals(n = 38)Private nursing homes(n = 198)All facilities(n = 317)0% 10% 20% 30% 40% 50% 60% 70% 80%Improving Quality of Life for Older People in Long-Stay Care Settings in Ireland
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ImprovingQuality of Lifefor Older P
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National Council on Ageing and Olde
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Authors’ AcknowledgementsThe rese
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ContentsCouncil Comments and Recomm
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6.7 Meaningful Occupation 1296.8 Ch
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CouncilComments andRecommendations
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Quality of Life DomainsThe research
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Meaningful ActivitiesThe research n
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the research revealed that, in gene
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The Council accepts that the cultur
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this regard. The Council believes t
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ExecutiveSummary
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MethodologyA mixed method research
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Long-Stay Facility Survey FindingsT
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Residents were most positive about
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Chapter OneIntroduction
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There is no single definition descr
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This chapter provides justification
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Chapter TwoQuality of Careand Quali
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2.2 Separating Quality of Care and
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2.3 Policy for Long-Stay Care in Ir
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2.4 Regulatory StructuresThere are
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Medical preparations - medication s
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inspections are mainly concerned wi
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often not designed to meet the spec
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Residents who did not want to be in
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Human resources management standard
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The Mid-West Standards for Resident
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process and outcomes of the service
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2.9 ConclusionQuality of life for o
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Chapter ThreeThe Interpretationand
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The difficulty of defining such an
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Implicit definitions use the broad
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Human needs may also provide part o
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successfully complete a self-report
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In relation to older people specifi
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The results of this particular stud
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The design of a residential care se
Page 80 and 81: Chapter FourMethodology
Page 82 and 83: each method used at the same point
Page 84 and 85: 4.3.3 Data AnalysisThe transcripts
Page 86 and 87: Table 4.2: Distribution of question
Page 88 and 89: 4.4.4 Quantitative Data AnalysisThe
Page 90 and 91: Anonymity and confidentiality are i
Page 92 and 93: from stakeholders who attended the
Page 94 and 95: 4.7 Ethical ClearanceEthical cleara
Page 96 and 97: Chapter FiveQuality of Lifein Long-
Page 98 and 99: All participants reported that ther
Page 100 and 101: Staffing and skill mix: comments fr
Page 102 and 103: Recruiting and retaining staff: com
Page 104 and 105: Impact of physical environment on r
Page 106 and 107: 5.6.2 Social EnvironmentParticipant
Page 108 and 109: They believed that this problem was
Page 110 and 111: Participants also discussed at leng
Page 112 and 113: Chapter SixQuality of Lifein Long-S
Page 114 and 115: Table 6.1: Type of facilityN %Priva
Page 116 and 117: Figure 6.2: Age profile of long-sta
Page 118 and 119: Figure 6.5 shows the percentages of
Page 120 and 121: Figure 6.7: Long-stay residents’
Page 122 and 123: In private and voluntary facilities
Page 124 and 125: Table 6.6: Ratio of RNs on the even
Page 126 and 127: Staff turnover investigates the num
Page 128 and 129: Table 6.10: Therapeutic and other s
Page 132 and 133: Table 6.13: Number of facilities in
Page 134 and 135: stay units also allow ambulant, men
Page 136 and 137: The majority of private and volunta
Page 138 and 139: Table 6.17: Call bell facilities by
Page 140 and 141: Chapter SevenDescription ofStudy Si
Page 142 and 143: others were open and residents’ b
Page 144 and 145: 7.2.2 StaffingRegistered nurses and
Page 146 and 147: Some residents were able to leave t
Page 148 and 149: the day by their bed. In addition,
Page 150 and 151: equired full assistance with dressi
Page 152 and 153: Chapter EightCare Environmentand Et
Page 154 and 155: 8.2 Promoting AutonomyThis category
Page 156 and 157: Table 8.1: Involvement of residents
Page 158 and 159: Table 8.2: Maintaining independence
Page 160 and 161: Focus group participants reported t
Page 162 and 163: Staff respondents also highlighted
Page 164 and 165: Therefore, the practice of rosterin
Page 166 and 167: 8.7 ConclusionThis chapter presente
Page 168 and 169: Chapter NinePersonal Identity
Page 170 and 171: Table 9.1: Identity and personalise
Page 172 and 173: The real meI’m there in a photogr
Page 174 and 175: how important it was that residents
Page 176 and 177: Table 9.5: Freedom and constraintsA
Page 178 and 179: 9.5 PrivacyThe degree of privacy en
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9.6 Self-RespectAcknowledging resid
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9.7 ConclusionsThe findings suggest
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Chapter TenConnectedness,Social Rel
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10.2 Connectedness, Involvement and
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A concrete example of the priority
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Cultural differencesnot an issueI f
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esidents but reserved the title of
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Table 10.3: Relationships among res
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it feel more like visiting somebody
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Near home(I) was living up the road
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Chapter ElevenActivitiesand Therapi
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had a special activities/therapies
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11.3 Therapeutic ActivityThis categ
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A few facilities had incorporated o
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Some facilities organised special t
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For residents, what appeared to be
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Chapter TwelveConclusions andRecomm
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The prevalence of quality deficits
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attitude to their institutionalisat
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higher the proportion of care given
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was that they had a choice. In some
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The physical environment in some fa
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activities need to be dynamic and r
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Older people in residential care mu
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choice regarding the gender of a ca
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Residents and their families should
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References
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Birren, J.E. and Dieckmann, L., 199
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Collin, C., Wade, D.T., Davies, S.,
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Hubbard, G., Downs, M.G. and Tester
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McCormack, B., 2003. ‘A conceptua
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Redfern, S., Hannan, S., Norman, I.
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Appendices
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Profile of your long-stay facility1
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6a. Are there any reasons why you w
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Staff resources10. How many whole-t
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Services and facilities17. Are any
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Care process24a. Can long-stay resi
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32b. If Yes, when can residents smo
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38a. Was this facility purpose-buil
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45. Are any of the following provid
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General atmosphereComment on the ge
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DomainFeeling caredfor/feelingsecur
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DomainFeeling caredfor/feelingsecur
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DomainGeneralCue question/promptsHa
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DomainCompanionship/relationshipCon
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DomainRelationship tofamily/friends
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Terms ofReference
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c) providing information and advice
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National Council on Ageingand Older
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