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

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Chapter TwoQuality of Careand Quality of Lifefor Older People
Chapter TwoQuality of Careand Quality of Lifefor Older People2.1 Introduction40Concerns surrounding the quality of long-stay care are not unique to Ireland.Evidence has emerged in many Organisation for Economic Co-operation andDevelopment (OECD) countries of quality shortfalls in nursing homes, ranging frominappropriate and substandard care to the more serious problem of neglect andabuse of residents (OECD, 2005). Problems contributing to unsatisfactory care innursing homes tend to be similar across OECD countries. These problems includeinsufficient numbers of trained staff, substandard buildings and facilities, inadequatequality assessment and poor monitoring systems. Lack of consumer satisfactionwith institutional care is often contrasted with the higher levels of satisfactionexpressed by recipients of home care services. This has resulted in a demandfor more comprehensive quality regulations for residential care across Europe,including in Ireland. Reform, where it has occurred, has, however, concentratedmore on quality of care than on quality of life, which continues to be seen assecondary to concerns about care. This chapter examines both quality of care andquality of life issues for older people in residential care in Ireland, beginning withan attempt to distinguish between the two.Improving Quality of Life for Older People in Long-Stay Care Settings in Ireland
Page 1 and 2: ImprovingQuality of Lifefor Older P
Page 3: National Council on Ageing and Olde
Page 6 and 7: Authors’ AcknowledgementsThe rese
Page 8 and 9: ContentsCouncil Comments and Recomm
Page 10: 6.7 Meaningful Occupation 1296.8 Ch
Page 14 and 15: CouncilComments andRecommendations
Page 16 and 17: Quality of Life DomainsThe research
Page 18 and 19: Meaningful ActivitiesThe research n
Page 20 and 21: the research revealed that, in gene
Page 22 and 23: The Council accepts that the cultur
Page 24 and 25: this regard. The Council believes t
Page 26 and 27: ExecutiveSummary
Page 28 and 29: MethodologyA mixed method research
Page 30 and 31: Long-Stay Facility Survey FindingsT
Page 32 and 33: Residents were most positive about
Page 34 and 35: Chapter OneIntroduction
Page 36 and 37: There is no single definition descr
Page 38 and 39: This chapter provides justification
Page 42 and 43: 2.2 Separating Quality of Care and
Page 44 and 45: 2.3 Policy for Long-Stay Care in Ir
Page 46 and 47: 2.4 Regulatory StructuresThere are
Page 48 and 49: Medical preparations - medication s
Page 50 and 51: inspections are mainly concerned wi
Page 52 and 53: often not designed to meet the spec
Page 54 and 55: Residents who did not want to be in
Page 56 and 57: Human resources management standard
Page 58 and 59: The Mid-West Standards for Resident
Page 60 and 61: process and outcomes of the service
Page 62 and 63: 2.9 ConclusionQuality of life for o
Page 64 and 65: Chapter ThreeThe Interpretationand
Page 66 and 67: The difficulty of defining such an
Page 68 and 69: Implicit definitions use the broad
Page 70 and 71: Human needs may also provide part o
Page 72 and 73: successfully complete a self-report
Page 74 and 75: In relation to older people specifi
Page 76 and 77: The results of this particular stud
Page 78 and 79: 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
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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
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Table 6.17: Call bell facilities by
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Chapter SevenDescription ofStudy Si
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others were open and residents’ b
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7.2.2 StaffingRegistered nurses and
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Some residents were able to leave t
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the day by their bed. In addition,
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equired full assistance with dressi
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Chapter EightCare Environmentand Et
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8.2 Promoting AutonomyThis category
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Table 8.1: Involvement of residents
Page 158 and 159:
Table 8.2: Maintaining independence
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Focus group participants reported t
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Staff respondents also highlighted
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Therefore, the practice of rosterin
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8.7 ConclusionThis chapter presente
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Chapter NinePersonal Identity
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Table 9.1: Identity and personalise
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The real meI’m there in a photogr
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how important it was that residents
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Table 9.5: Freedom and constraintsA
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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
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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
Page 234 and 235:
Birren, J.E. and Dieckmann, L., 199
Page 236 and 237:
Collin, C., Wade, D.T., Davies, S.,
Page 238 and 239:
Hubbard, G., Downs, M.G. and Tester
Page 240 and 241:
McCormack, B., 2003. ‘A conceptua
Page 242 and 243:
Redfern, S., Hannan, S., Norman, I.
Page 244 and 245:
Appendices
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Profile of your long-stay facility1
Page 248 and 249:
6a. Are there any reasons why you w
Page 250 and 251:
Staff resources10. How many whole-t
Page 252 and 253:
Services and facilities17. Are any
Page 254 and 255:
Care process24a. Can long-stay resi
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32b. If Yes, when can residents smo
Page 258 and 259:
38a. Was this facility purpose-buil
Page 260 and 261:
45. Are any of the following provid
Page 262 and 263:
General atmosphereComment on the ge
Page 264 and 265:
DomainFeeling caredfor/feelingsecur
Page 266 and 267:
DomainFeeling caredfor/feelingsecur
Page 268 and 269:
DomainGeneralCue question/promptsHa
Page 270 and 271:
DomainCompanionship/relationshipCon
Page 272 and 273:
DomainRelationship tofamily/friends
Page 274 and 275:
Terms ofReference
Page 276 and 277:
c) providing information and advice
Page 278:
National Council on Ageingand Older
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