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

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Table 4.2: Distribution of questionnaires to pilot sitesGeriatrichomes/hospitalsWelfarehomesDistrict/communityhospitalsVoluntarygeriatrichomes/hospitalsPrivatenursinghomes% of total beds 24 4 12 12 48 100RegionNumber of facilitiesERHA 1 – – 2 3 6Midland 1 – – – 1 2Mid-West 1 – 1 1 1 4North-East 1 – – – 2 3North-West 1 – 1 – 1 3South-East 1 1 – 1 2 5South 1 – 1 – 2 4West 1 – – – 2 3Total 8 1 3 4 14 30TotalEach pilot site was allocated a code and data was entered into SPSS using this code.In addition, feedback was gathered from respondents by telephone with respectto question clarity, time to complete and any other issues. Non-responders werecontacted by telephone to encourage them to complete the questionnaire. Thefinal response rate to the pilot questionnaire was 60 per cent (18 questionnaires).85Having analysed the returned pilot questionnaires and respondents’ comments,the basic structure of the questionnaire remained the same but some minorchanges were made to the wording of questions and to the layout of somequestions. The topics covered in the final questionnaire were as follows: profileof the long-stay facility, including beds, residents and dependency; staff resources,including nursing and other staff and information on shifts; services and facilities,covering therapeutic services, activities and communal provision; care process,measuring choice and autonomy for residents within the facility; and physicalresources, detailing the nature of the physical care environment.Originally, it was proposed that the main survey could be run as a census exercise.It was proposed that a date for return of all data be set and a mechanism forcollection of questionnaires put in place, including the physical collection ofquestionnaires from respondents. It was evident from the pilot work that thiswould not be possible for two reasons. Firstly, the resources required to physicallycollect questionnaires from all long-stay facilities in the country were not available
to the research team; secondly, it was evident from the pilot study that a singledate for return would impact negatively on overall response rate as the manager/proprietor would not necessarily be on duty on the specified date. It was decided,therefore, that the questionnaire should be collected by post only and that a longertime span for return be given.4.4.3 Main SurveyA questionnaire was sent to all facilities (n = 526). Responses were tracked andthose who had not returned the questionnaire by a specified date were followedup and telephoned individually. The purpose of this was to encourage participants toreturn the questionnaire and to clarify with participants any issues they had in fillingin the questionnaire. The questionnaire was reissued to all participants who had notreturned the questionnaire by a specified date. These strategies helped maximisethe response rate. The final response rate was 332 (62 per cent), which is excellentfor a postal questionnaire of this type. The response rate varied across facility type;the highest rate was achieved in welfare homes (95 per cent) and lowest in privatenursing homes (56 per cent).86An examination of non-response was undertaken to identify if there was anypattern underlying non-response. None was evident; there were responses fromall types of facilities and locations. Table 4.3 below outlines the response rate byfacility type.Table 4.3: Questionnaires returned by category of facilityNumber ofquestionnairessentNumber ofquestionnairesreturnedGeriatrichomes/hospitalsWelfarehomesDistrict/communityhospitalsVoluntarygeriatrichomes/hospitalsPrivatenursinghomesTotal53 19 48 61 345 52637 18 34 43 193 325Response rate 6 70% 95% 71% 70% 56% 62%6 The response rate identified above refers to the classification of facilities used at the start of thestudy. Some survey respondents had recategorised themselves when the survey was returned.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
Page 36 and 37: There is no single definition descr
Page 38 and 39: This chapter provides justification
Page 40 and 41: Chapter TwoQuality of Careand Quali
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 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 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
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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
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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
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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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