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

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how important it was that residents’ clothes were appropriate and matched.Staff respondents described how they personally bought clothes or toiletries forresidents who had little.Table 9.4: Clothes and washing and groomingClothes and laundryThe girls brings allmy clothes home andwashes them andbrings me in whateverI want. I just tell themand they get it for me.(GN2 Resident 02,Public)Int: And whatabout your clothesand things?They’re washed.They’ve a washeteriahere and I have to sortout my clothes becauseI don’t like letting mygood things go.Int: So sometimesthey lose the clothes,do they?No, they shrink them.(YW5 Resident 02,Private)They have nice clothesand if they haven’t wekind of all, you know,if we have the oddpatient that justwouldn’t have thatmuch clothes, wepersonally bring inthings to them, likeblouses and tops andthat. (YW4 RegisteredNurse 02, Private)Washing and groomingOh yeah, the hairdresser comes in, hairdresser comes inwhenever I want you know, get a perm whenever I wantit. It would want to be done again. I like a good shape onmy hair; that’s the way I like it. (PK3 Resident 11, Public)I love my bath.Int: You love your bath?Yes, I love my bath, yes, look forward to it.Int: Is that once a day, or once a week?Fortnight, but I think we could have it weekly.Int: That would be your preference.Yes, weekly. (PK3 Resident 02, Public)Int: Are there enough bathrooms?We need more. … Most people who want to do theirshowers, that is, in the mornings, and you see queues,actually for the bathrooms. We have two shower roomsand a bathroom. That is all, it’s not enough. … And weare rushing in and out and you might stay a little bit butbefore you go someone else is there (laugh). Sometimesit’s upsetting. You get so upset. (GN1 Registered Nurse01, Public)When I came in here, the second day, no, the second dayI was here, I was in me room … and this young fella wasstanding in the corner and, and eh, and the nurse camein and she says ‘take off your’, she says ‘you have a showertoday’. … I said ‘I’m not taking off my clothes, he has toleave’. She said, ‘you don’t have to bother about him’,she says ‘you have got to take off your clothes and getwashed, get your shower’. So I done it and I threw allthe clothes up in the corner. (YW5 Resident 03, Private)A funny little man was in here a while ago and I had a sorebottom … (the sister recommended some cream). … Nextday the cream came and the funny little man who lookedafter me, about five foot nothing, bald, just a funny littleman, he said ‘what was it’, so I showed it to him … and hesaid … ‘you bring your bum and put it on the bed there andI will use it (the cream) for you’. Well now, I felt mortified,but on the other hand, how mortified does he feel?(YW2 Resident 01, Private)173
Opportunities to have a wash differed across sites. In private nursing homes,resident respondents usually had a room with an en suite. Consequently, they couldhave a bath or shower when they liked if they were able to wash independently,or when staff were available if they needed help. In contrast, the lack of bathroomsin public facilities meant that resident respondents were frequently on a rota fora bath. Many respondents in public facilities expressed a desire for more frequentbaths. This reinforces the data from the survey reported in Chapter Six, whichshowed a much greater availability of washing facilities in private nursing homes.One issue raised by residents was who assisted them with washing. Some femaleresident respondents were shocked when a male carer helped them with washingor other intimate care. It would appear that on occasions, women’s preferencefor a same-sex carer could not be accommodated. The female respondents whodescribed this experience were clearly upset by the experience but ‘got on withit’. However, most respondents shared that it was how kind and caring someonewas that was more important than gender. None of the men interviewed raiseda similar concern.1749.4 IndividualityThe extent to which long-term care facilities met or responded to residentrespondents’ individual preferences and needs varied greatly (Table 9.5). At one endof the spectrum, respondents were able to live their life as normal and did not feelconstrained by rules or regulations. They could ‘be themselves’ and felt they hadthe freedom to come and go as they pleased. At the other end of the spectrum, theroutine dominated to such an extent that respondents felt they had little autonomy.There was a sense that they had to fit their lives around the routine and obey the‘rules’. What the rules were was not always clear, but they reported mirroring whatthe other residents did. They described their life as monotonous and unchanging.One resident respondent likened it to ‘living in a prison’, another to ‘being in school.Respondents coped with this in different ways. The majority spoke about ‘puttingup with it’ or ‘getting on with it’. A few actively rebelled and did what they wantedirrespective of the consequences. Others worried about being viewed as atroublemaker or getting on the ‘wrong side’ of the staff.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
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Chapter FourMethodology
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each method used at the same point
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4.3.3 Data AnalysisThe transcripts
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Table 4.2: Distribution of question
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4.4.4 Quantitative Data AnalysisThe
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Anonymity and confidentiality are i
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from stakeholders who attended the
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4.7 Ethical ClearanceEthical cleara
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Chapter FiveQuality of Lifein Long-
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All participants reported that ther
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Staffing and skill mix: comments fr
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Recruiting and retaining staff: com
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Impact of physical environment on r
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5.6.2 Social EnvironmentParticipant
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They believed that this problem was
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Participants also discussed at leng
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Chapter SixQuality of Lifein Long-S
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Table 6.1: Type of facilityN %Priva
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Figure 6.2: Age profile of long-sta
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Figure 6.5 shows the percentages of
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Figure 6.7: Long-stay residents’
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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 130 and 131: sector and 50 per cent in the volun
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 176 and 177: Table 9.5: Freedom and constraintsA
Page 178 and 179: 9.5 PrivacyThe degree of privacy en
Page 180 and 181: 9.6 Self-RespectAcknowledging resid
Page 182 and 183: 9.7 ConclusionsThe findings suggest
Page 184 and 185: Chapter TenConnectedness,Social Rel
Page 186 and 187: 10.2 Connectedness, Involvement and
Page 188 and 189: A concrete example of the priority
Page 190 and 191: Cultural differencesnot an issueI f
Page 192 and 193: esidents but reserved the title of
Page 194 and 195: Table 10.3: Relationships among res
Page 196 and 197: it feel more like visiting somebody
Page 198 and 199: Near home(I) was living up the road
Page 200 and 201: Chapter ElevenActivitiesand Therapi
Page 202 and 203: had a special activities/therapies
Page 204 and 205: 11.3 Therapeutic ActivityThis categ
Page 206 and 207: A few facilities had incorporated o
Page 208 and 209: Some facilities organised special t
Page 210 and 211: For residents, what appeared to be
Page 212 and 213: Chapter TwelveConclusions andRecomm
Page 214 and 215: The prevalence of quality deficits
Page 216 and 217: attitude to their institutionalisat
Page 218 and 219: higher the proportion of care given
Page 220 and 221: was that they had a choice. In some
Page 222 and 223: 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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