Living Independently: Exploring the Experiences of Visually Impaired People Living in Age-Related and Lifetime Housing Through Qualitative Synthesis

Objectives: The aim of this study is to gain a deeper understanding of the experiences of visually impaired older people living independently at home. Background: As populations are aging globally, there is now an increase in the prevalence of visual impairment. That means for ongoing and future aging-in-place strategies that seek to enable older people to remain independent for longer, more attention needs to be given to the needs of those with visual impairment. As people develop visual impairment, they use adaptive strategies including modifying long-term homes or relocating to more suitable accommodation. In the United Kingdom, aging-in-place strategies include employing statutory lifetime home standards (LTHS) in the home or relocating to sheltered housing to live independently with support available if required. Methods: To get a better understanding of the needs of the visually impaired in the home, 12 interviews with six visually impaired occupants of LTHS homes and six from sheltered accommodation were analyzed separately using interpretative phenomenological analysis. Secondly, qualitative synthesis was used to further analyze themes generated from both samples before interview results were conceptualized in two superordinate concepts, namely, “negotiating priorities” and “understanding visual impairment.” Results: Participants from both groups had similar needs and were willing to compromise by living with some negative features. Those who coped well with moving utilized various resources. Conclusions: These findings will shed more understanding on providing good quality housing for those with visual impairment wanting to live either independently or within healthcare home environments

Finding a way: long-term care homes to support dementia

An ageing demographic has increased the number of people with dementia. Although dementia is commonly associated with memory loss, other early symptoms include difficulty with wayfinding. Dementia alters visuo-spatial perception and the processes used to interpret the physical environment. The role of the design of the physical environment for people with dementia has gained increased recognition. Despite this, design for dementia is often overlooked, focusing on issues relating to physical impairment. This paper presents the results of a PhD study and aims to examine the role of the design of the physical environment in supporting wayfinding for people with dementia living in long-term care settings in Northern Ireland. Mixed methods combined the observation of wayfinding walks and conversational style interviews to elicit perspectives and experiences of residents with dementia. The findings aim to promote well-being for those with dementia living in long-term care settings

Experiencing visual impairment in a lifetime home: an interpretative phenomenological inquiry

Lifetime home standards (LTHS) are a set of standards aimed at making homes more accessible. Previous research, however, indicates that LTHS do not adequately meet the needs of those with sensory impairments. Now, with visual impairment set to increase globally and acknowledging the recognised link between quality of dwelling and wellbeing, this article aims to examine the experiences of visually impaired people living in lifetime homes. The objectives are to investigate existing lifetime homes and to identify whether LTHS meet occupants’ needs. Qualitative semi-structured interviews were carried out with six visually impaired people living in homes designed to LTHS in Northern Ireland. Collected data was analysed using interpretative phenomenological analysis identifying three super-ordinate themes: (1) living with visual impairment; (2) design considerations and (3) coping strategies. A core theme of balance between psychological and physical needs emerged through interconnection of super-ordinate themes. Although there are benefits to living in lifetime homes, negative aspects are also apparent with occupants employing several coping strategies to overcome difficulties. Whilst residents experience negative emotions following visual impairment diagnoses, results suggest that occupants still regard their homes as key places of security and comfort in addition to then highlighting the need for greater consideration of specific individual needs within general guidelines

Designing dementia nursing and residential care homes

Purpose– This study seeks to appraise the design of nursing and residential care homes for people with dementia in Northern Ireland using the design audit checklist developed by the Dementia Services Development Centre – DSDC. Design/methodology/approach– The appraisal used postal questionnaires, based on the DSDC essential design criteria, that were sent to facility managers. This was conducted in order to establish the level of compliance with these criteria to achieve a dementia-friendly home, and to ascertain whether there are any noticeable differences between nursing homes and residential care homes. Findings– The study identified the types of homes that were seen as failing to meet most of the DSDC design criteria and, in particular, which criteria are not met according to their managers. Results from this sample suggest that nursing homes align better with DSDC criteria than residential care homes. The study concludes that the majority of managers perceive their care homes to meet over 50 percent of the essential criteria, with just over 5 percent below the 50 percent mark. Research limitations/implications– Given that this study used postal questionnaires more research is needed in order to validate results. Behavioural and policy implications are crucial aspects that will be the subject of future research which will involve post-occupancy evaluation. Practical implications– More attention to dementia-friendly building design needs to be taken into consideration by residential care homes, and more improvement would still be required by nursing homes not meeting all criteria. Originality/value– The paper highlights the importance of dementia-friendly building design and the requirements for more care in designing and fitting care environments for people with dementia

Meeting the needs of visually impaired people living in lifetime homes

This article explores perceptions on the suitability and effectiveness of Lifetime Homes standards (LTHS) for those with visual impairment in Northern Ireland. LTHS are a series of mandatory United Kingdom public-sector housing design interventions, providing a model for ensuring accessible and adaptable homes throughout an occupant\u27s life span. An aging demographic with increasing incidence of diabetes has led to rising numbers of elderly, visually impaired people wanting to remain in their homes for longer. Qualitative semi-structured interviews were conducted with 13 key stakeholders and thematically analyzed. Although findings show that employing LTHS offers benefits to visually impaired residents, shortcomings were also identified. Evidence indicates a need for policy makers, health-care professionals, and housing associations to modify practices to better meet the housing needs of visually impaired people. Findingsmay also be applicable to those with other impairments and disabilities in relation to housing for elderly residents

Telecare Service Use in Northern Ireland: Exploratory Retrospective Cohort Study

BACKGROUND: Telecare is a health service that involves the home installation of a number of information technology support systems for individuals with complex needs, such as people with reduced mobility or disabilities and the elderly. It involves the use of sensors in patients’ homes to detect events, such as smoke in the kitchen, a front door left open, or a patient fall. In Northern Ireland (NI), outputs from these sensors are monitored remotely by the telecare team, who can provide assistance as required by telephone or through the emergency services. The facilitation of such rapid responses has the aim of promoting early intervention and therefore maintaining patient well-being. OBJECTIVE: The aims of this study were to construct a descriptive summary of the telecare program in NI and evaluate hospital-based service use by telecare patients before and after the installation of telecare equipment. METHODS: An exploratory retrospective cohort study was conducted involving more than 2000 patients. Data analysis included the evaluation of health care use before and after the telecare service was initiated for individual participants. Individuals with data for a minimum of 6 months before and after the installation of the telecare service were included in this analysis. RESULTS: A total of 2387 patients were enrolled in the telecare service during the observation period (February 26, 2010-February 22, 2016). The mean age was 78 years (median 81 years). More women (1623/2387, 68%) were enrolled in the service. Falls detectors were the most commonly deployed detectors in the study cohort (824/1883, 43.8% of cases). The average number of communications (calls and/or alarms) between participants and the coordinating center was the highest for patients aged ≥85 years (mean 86 calls per year). These contacts were similarly distributed by gender. The mortality rate over the study period was higher in men than women (98/770, 14.4% in men compared to 107/1617, 6.6% in women). The number of nonelective hospital admissions, emergency room visits, and outpatient clinic visits and the length of hospital stays per year were significantly higher (P<.001) after the installation of the telecare equipment than during the period before installation. CONCLUSIONS: Despite the likely benefits of the telecare service in providing peace of mind for patients and their relatives, hospital-based health care use significantly increased after enrollment in the service. This likely reflects the increasing health care needs over time in an aging population

Exploring the work of nurses who administer chemotherapy to children and young people

PURPOSE OF THE RESEARCH: To explore the knowledge, attitudes and beliefs of nurses who administer chemotherapy to children and young people. METHODS AND SAMPLE: A national postal survey of nurses working within the 21 cancer centres in the United Kingdom and Ireland. The questionnaire included 25-items addressing the attitudes, beliefs and concerns regarding nurses' roles, support mechanisms and educational preparation related to administration of chemotherapy. RESULTS: In total 286/507 (56%) questionnaires were returned. The majority of nurses worked in inpatient +/-outpatient (78%) settings and most gave chemotherapy on a daily basis (61%). The median time working in oncology was 10 [range 0.5-32] years and time administering chemotherapy was 8 [0.1-32] years. Aspects of administration that caused the most worry included treatment side-effects, extravasation, dealing with allergic/anaphylactic reactions and knowledge deficits in colleagues. There was no significant difference in worry according to level of nurse education but those with an oncology qualification had less Knowledge-related worry (p = 0.05). There was no difference in attitude according to level of education or having an oncology qualification. There were significant correlations between time qualified, time working in oncology and the number of years administering chemotherapy and the worry domains (ranging from r = -0.14 to r = -0.24, p < 0.05); and attitude to chemotherapy (ranging from r = 0.12 to r = 0.26, p < 0.001). CONCLUSION: As anticipated nurses new to chemotherapy administration were initially anxious about the role and they worried about making a drug error. Education and support from colleagues appears to have a positive effect on reducing worry and increasing competence