Does nurses' vulnerability affect their ability to care?

Recent reports from the Department of Health (2008), the Parliamentary and Health Service Ombudsman (2011) and the Commission on Dignity in Care for Older People (2012) have been highly critical regarding the care that some patients have experienced. They have highlighted that fundamental aspects of care are missing resulting in a lack of high quality individualised nursing care, which is in contrast with holistic nursing philosophy. We have to ask ourselves what is happening within nursing, as many enter the profession owing to a desire to 'make a difference'. Drawing on focus group data exploring perceptions of caring for residents with dementia in a care home setting, the authors found that nurses and healthcare assistants experience a mutual vulnerability with patients. This paper explores whether this mutual vulnerability could lead to nurses focusing on the clinical aspects of their role to the detriment of the compassionate, caring components of nursing

A brief report on an action learning group exploration of how older people adapt to change in later life

In collaboration with Age Concern UK, older people were invited to participate in action learning groups to explore how they adapt to change. Themes for discussion were initially identified using a nominal focus method. Discussions identified actual and desired methods of coping with changes in later life. A series of weekly meetings with three cohorts of urban, rural and sheltered accommodation participants with an average age of 81 years revealed that they were concerned with having to cope with and adapt to a wide range of experiences. These included the loss of sharing and reduced sociability, reduced mobility, bereavement, physical changes, having to move house order to cope with these experiences, participants engaged in a range of activities that centred on aspects of communication and social networking. Participants talked to each other socially and informally, exchanging information and advice. When able, they also participated in more structured but non-specific social events during which time they also had the opportunity more formal social networking and information exchange opportunities

Pain and agitation in dementia: a review of the literature

Between 30-60% of residents of nursing homes with late stage dementia suffer with pain daily and this is thought to be due to the inability to communicate their needs. The purpose of this literature review is to analyse research to identify if there are links between pain and agitation. Three themes emerged when analysing the papers in relation to links with pain and agitation: - behavioural change that could be associated with pain, undertreating of pain and pain assessment tools. Drawing upon the findings it can be suggested that pain could be a factor that is associated with agitated behaviour, however, there needs to be further research that determines cause and effect

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

Better Together – A Day Hospital’s move towards Integrated care

Abstract - Background/Aims: This article will present how an interdisciplinary team working within a day hospital in an acute NHS Foundation Trust embraced the opportunities of practice development to work ‘better together’ to meet the complex needs of individuals using the service. Methods: By working closely with key stakeholders, the team developed an integrated service intersecting both primary and secondary care boundaries. Results: The principles of practice development, including shared vision and focus, ensured changes made to the service were patient centred. These changes included a 360-degree assessment by professional staff with extended skills beyond their own professional role, and a virtual ward round, where individual patients are reviewed by an interdisciplinary team in the community with a focus on avoiding hospital admission, with quicker access to the day hospital. The team worked closely with their local university towards achieving practice development unit status, demonstrating a rigorous approach to the development of services provided by the day hospital. Conclusions: The article highlights both the value of practice development and significantly the value of an interdisciplinary team working within a day hospital setting

Exploring the meaning of home for six baby boomers.

Baby boomers (those born c. 1945 to c. 1965) are entering later life. As a result, by 2035, almost a quarter of the UK population will be over 65. Current policy and practice in the UK is that people should, wherever possible, age at home, but there is no research into what home means to baby boomers. Therefore, this researcher asks two questions. Firstly, how can the meaning of home for baby boomers be explored? Secondly, what influence does the life course have on the meaning of home for six baby boomers? Existing literature informed the research. For example, some literature suggests methodology for researching issues similar to the meaning of home; other research explores meanings of home amongst groups other than baby boomers; and research into the life course of baby boomers has attributed to them characteristics which could influence their meaning of home. As a result, this researcher adopts a qualitative methodology which participant generated images, photo elicitation interviews and reflective review panels. This enabled the meaning of home for six participants to emerge from stories and photographs of their own homes and their individual life course. The six stories are published as a separate volume. Although based on only six baby boomers, the research suggests important conclusions. The first research question produced unique methodology for revealing deep layers of understanding of the meaning of home for these baby boomers. The second research question showed that, despite what one might expect from reading other research, the unique life course of six baby boomers has not created a meaning of home which is markedly different from earlier cohorts. However, what is acknowledge is that choice which is a key concept for the meaning of home, is influenced by the broader social context of demographic changes and changes in living arrangements. Further investigation of the meaning of home for baby boomers is necessary to help influence policy and practice; this research proposes important ideas about the methodology for that work, also suggestions for further research based on the findings from this study

What is an older husband’s experience of caring for his wife who has dementia?

There are a significant number of informal carers looking after people who have dementia. Women’s caregiving experiences are well documented. However, there is a substantially smaller amount of research specifically investigating the male carer perspective. This literature review considers older husbands’ perceptions of supporting their wives who have dementia. The findings suggest that husbands are committed to their caregiving role but can feel socially isolated. The caregiving role of older men has altered the dynamic within the marriage. Husbands continue to show commitment towards their spouses but feel that male-only support groups could offer some respite from their responsibilities. Nurses need to take time to listen to husband’s experiences, offering emotional support and signposting them to other services that can offer assistance. Further research on the long-term effects and support needs of older male carers is needed