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

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A concrete example of the priority given by the facility to keeping residentsconnected was whether the facility made newspapers available to residents ornot. Many facilities had one or two newspapers delivered, some had none and afew had individual newspapers delivered to residents. The facilities which boughtindividual newspapers had an explicit ethos of enabling residents to continue tolive a normal life. There was a clear focus on keeping residents involved and staffrespondents prioritised talking to residents about the news and other events.Some staff respondents working in facilities that did not make newspapersavailable recognised this as an omission and responded by bringing newspapersin to some residents. However, in effect, this meant that most residents had noaccess to a newspaper. Relatives also brought newspapers and favourite magazinesin to residents. The choice of newspaper delivered was also an issue. Facilitieswhich bought one or two newspapers tended to buy the most popular papers.A resident who had always read a particular paper might be unlucky in not havingaccess to his or her favourite newspaper.10.3 Resident/Staff Relationships187This category explored resident/staff relationships, focusing on what residentsconsidered important for good relationships (Table 10.2). Resident respondentsdescribed staff they liked as ‘friendly’ and ‘interested in them’. They valuedopportunities to chat with staff and were particularly pleased when staff sharedpersonal information as opposed to care-related information only. This could beas trivial as what they did last night but to resident respondents this was a signthat they had forged a ‘special’ relationship. It is possible that sharing this kindof information helped equalise the relationship as it mirrors the give and take of‘normal’ interaction and friendship. Continuity of staff made it easier for residentrespondents to build a relationship with staff as it provided greater opportunityfor chatting and sharing information. Resident respondents found it difficultwhen staff, although efficient, were cold and unfriendly. Relatives also identifiedstaff relationships with residents as an important determinant of quality of life.The staff characteristics relatives identified as important closely matched thoseidentified by resident respondents: kindness, being caring and being goodhumoured. Treating residents well, being respectful and being ‘nice’ werealso valued highly by relatives.
Resident respondents indicated that staff were generally kind and helpful. Theyemphasised how hard they worked and that ‘nothing was too much trouble’for them. Not surprisingly, residents had favourite staff members but they alsoindicated that there were some staff they did not like. When staff were not liked,it appeared to relate to either their manner or general approach to their work.A clash of personalities could account for some of these differences, but in someinstances residents’ comments would suggest that to some degree they werefrightened of some staff members. A few residents described being handledroughly on occasions. Some reported that certain staff did not provide care ina caring way, making them feel a nuisance if they sought help. In such instances,residents reported not asking for help unless they had to.Table 10.2: Resident/staff relationships188Building a relationshipI’ve visited nursing homes before wecame in you know, visiting neighboursand there was nobody talking toanybody.Int: But it’s different here?It’s different here, the nurses comeup there, they just come up for a bitof slag. (LCI Resident 15, Private)I’ll always speak to them (residents),have a little chat … and we talk aboutgardens. … Sometimes the patientswill ask me ‘are you married?’, andthat’s the way I like it, as if you werevisiting them at home. That’s the wayI look at it. (YW2 Care Assistant 01,Private)Gentle and caringYou’ve no idea how good they (staff)are! It’s like your own now.Int: And they’re gentle with you noware they, when they’re handling you?Oh, you couldn’t imagine it. Theyhug you and love you, and all that.(YW1 Resident 02, Private)Relationship with residentsnot a priorityThey’re (staff) very, very busy here. Youfeel that you can’t make more friendshipwith them. (YW5 Resident 07, Private)Some people (staff) are very strict andmaybe it depends about the personalitiesand expectations. Maybe some peoplehere only treat the job as a job becausethey need money. They don’t need to buildsome relationship but anyways it’s alwayseasier to work you know … if you havegood relationship with your patients.(YW5 Registered Nurse 01, Private)They (staff) are very good at providingphysical care but they do not cater wellfor emotional side of things. … Emotionalwell-being plays second fiddle. (Relative)Rough handlingInt: Are they (staff) gentle when they’rewashing you?Ah, they are, very gentle, but someof them is tough like, you know.Int: How are they tough?Well, they wouldn’t mind throwing youaround. (GN2 Resident 06, Public)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
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Table 6.6: Ratio of RNs on the even
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Staff turnover investigates the num
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Table 6.10: Therapeutic and other s
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sector and 50 per cent in the volun
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Table 6.13: Number of facilities in
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stay units also allow ambulant, men
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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
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 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
Page 224 and 225: activities need to be dynamic and r
Page 226 and 227: Older people in residential care mu
Page 228 and 229: choice regarding the gender of a ca
Page 230 and 231: Residents and their families should
Page 232 and 233: References
Page 234 and 235: Birren, J.E. and Dieckmann, L., 199
Page 236 and 237: 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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