Perspectives on activities in nursing homes

Abstract Introduction: Access to meaningful activities is an indicator of quality of nursing homes, and contributes to wellbeing and dignity. Lack of activities can lead to boredom, apathy, disruptive behaviour or lack of confidence or meaning. Recent inspections undertaken by the authorities in nursing homes in Norway show lack of activity provision, which is in line with research. This indicates that the government’s policy and new regulations to increase the level of activities in nursing homes has not succeeded, probably related to challenges in developing care practices. However, nursing homes should strive to incorporate meaningful activities for residents to occupy their time and provide a sense of purpose. Few studies have discussed the meaning of activities as well as the challenges in developing a practice focused on activities. Therefore, we want to point out some important perspectives which policy makers, researchers and practitioners can reflect on. Aims: A scoping study was undertaken to discuss what constitutes meaningful activities as well as the opportunities to develop a person-centred practice focused on activities. Conclusions and implications for practice development: The understanding of activities in a residential nursing home setting needs to be reconsidered, broadened and further developed. For example, what most people might recognize to be passive activity, may be interpreted by nursing home residents as an activity. Activities must be person-centred recognising and accepting individuals wishes. The goal is to transform practice cultures to enable person-centred ways of working

Ageing Intensifies the Care Needs of Adults Living with Parkinson ’s Disease and their Carers

Parkinson’s disease (PD) is the second most common neurological disorder in Australia typically affecting people over the age of 65. Few studies of people living with Parkinson’s disease have estimated current hours of home support and unmet needs. In addition no studies have been found that estimate hours of unmet need in terms of functioning or care arrangements or examined whether these estimates differ depending on the viewpoints of carers and the people living with PD whom they care for. In 2007, we surveyed the home care support needs of adults diagnosed with Parkinson’s disease in Western Australia (WA). The survey revealed that adults living with Parkinson’s disease prefer, and can be supported with, home care support services in lieu of residential care placement. As expected, required services increased as functioning decreased. In addition, unmet needs were found to be greater for those with carers irrespective of their level of functional dependency. Unmet needs for weekly services, for people that require home support services, are estimated at 38, 33, 55 and 47 min for personal care, cleaning, social support, and gardening and home maintenance, respectively. The survey also found that most carers and people living with PD agreed that current levels of different types of home care support including nursing were either adequate or insufficient; some carers preferred more services even if the people living with PD were satisfied and some people living with PD wanted more services even if their carers reported needing no extra help. Respite was used by 29 % of people living with PD with carers with two thirds wanting more opportunities for respite. Of the 71 % of people living with PD with carers who had not used respite, less than half stated that they would like to use respite. The 2007 survey was followed by interviews with a sample of survey respondents at different stages of their disorder. In the interviews, most of the people living with Parkinson’s disease commented that continuing to remain at home depended on the rate of degeneration of their disorder as well as the ability of their carers to continue to care. Most of these people and their careers were living day-to-day with a hope that enough support would be made available if and when they need it. As vocal Baby Boomers age, policymakers would do well to acknowledge the diversity of care needs for people with Parkinson’s disease and address the quantum and type of support to meet these needs

"You feel dirty a lot of the time" : policing 'dirty work', contamination and purification rituals

Following the controversial adoption of spit-hoods by some UK police forces, most recently by the London Metropolitan Police in February 2019, this article contributes to and extends debates on physical and symbolic contamination by drawing on established considerations of ‘dirty work’. The article argues that, for police officers, cleansing rituals are personal and subjective. As a relatively high-prestige occupation, police officers occupy a unique position in that they are protected by a status shield. Reflections from this ethnographic study suggest that the police uniform can be used as a vehicle for contamination and staff employ purification rituals and methods of taint management

Teacher Response Process to Bureaucratic Control: Individual and Group Dynamics Influencing Teacher Responses

Educational organizations can be characterized by the institution’s bureaucratic controls and the varied ways teachers respond to these controls. Although different controls and responses are studied in disparate theories and empirical research, the process of how teachers respond is not often studied and integrated in a singular theoretical framework. In this conceptual article, I argue that the teacher response process is characterized by three distinct, nonlinear phases of individual cognition, social formation, and response execution. Within these phases are dynamics and tensions, which are mediated and appropriated by the relationship between the educational institution and teachers

New quality regulations versus established nursing home practice: a qualitative study

<p>Abstract</p> <p>Background</p> <p>Western governments have initiated reforms to improve the quality of care for nursing home residents. Most of these reforms encompass the use of regulations and national quality indicators. In the Norwegian context, these regulations comprise two pages of text that are easy to read and understand. They focus particularly on residents’ rights to plan their day-to-day life in nursing homes. However, the research literature indicates that the implementation of the new regulations, particularly if they aim to change nursing practice, is extremely challenging. The aim of this study was to further explore and describe nursing practice to gain a deeper understanding of why it is so hard to implement the new regulations.</p> <p>Methods</p> <p>For this qualitative study, an ethnographic design was chosen to explore and describe nursing practice. Fieldwork was conducted in two nursing homes. In total, 45 nurses and nursing aides were included in participant observation, and 10 were interviewed at the end of the field study.</p> <p>Results</p> <p>Findings indicate that the staff knew little about the new quality regulations, and that the quality of their work was guided by other factors rooted in their nursing practice. Further analyses revealed that the staff appeared to be committed to daily routines and also that they always seemed to know what to do. Having routines and always knowing what to do mutually strengthen and enhance each other, and together they form a powerful force that makes daily nursing care a taken-for-granted activity.</p> <p>Conclusion</p> <p>New regulations are challenging to implement because nursing practices are so strongly embedded. Improving practice requires systematic and deeply rooted practical change in everyday action and thinking.</p