How Do We Achieve Person-Centered Care across Health Care Settings? Expanding Ideological Perspectives into Practice to Advance Person-Centered Care.

Person or patient-centered care (PCC) is touted as the gold standard in geriatric medical care across care settings. However, despite more than 3 decades of research and practice initiatives, it remains a challenge to consistently implement PCC that fully places the individual at the center of care planning and the delivery process. The lack of universal implementation of PCC, we argue, may be in large part due to the use of multiple terms and ideologies leading to an inability to coordinate efforts across medical settings.

Preferences and Quality of Life in Nursing Home Residents: A Mixed Methods Study.

Purpose: Delivery of person-centered care (PCC) is the standard in nursing homes (NHs) and demonstrates a positive impact on resident quality of life (QOL). PCC inherently recognizes and prioritizes resident preferences; however, preferences, and their degree of importance among residents, demonstrate a variable relationship with QOL that remains underexplored. Therefore, the current study examined the association between preferences and QOL among NH residents.

Implementation of STAR-VA for behavioral symptoms of dementia in acute care: Lessons learned.

As the population grows, the incidence of dementia will increase. A common occurrence in people with dementia is behavioral and psychological symptoms of dementia (BPSD). BPSD can include apathy, aggression, resistance to care, and agitation.

Nurse-led supportive Coordinated Transitional Care (CTraC) program improves care for veterans with serious illness.

Background: The Coordinated Transitional Care (CTraC) program is a telephone-based, nurse-driven program shown to decrease readmissions. The aim of this project was to implement and evaluate an adapted version of CTraC, Supportive CTraC, to improve the quality of transitional and end-of-life care for veterans with serious illness.

Methods: We used the Replicating Effective Programs framework to guide adaptation and implementation.

"It's Not a Sprint, It's a Marathon": Stages of Managing a Nursing Home Throughout the Pandemic.

Objectives: To qualitatively examine the impact of COVID-19 on nursing homes over the course of the pandemic from the perspective of nursing home administrators.

Design: In-depth, semi-structured interviews with nursing home administrators, repeated 3 months apart for a total of 4 each from July 2020 through December 2021.

Settings And Participants: Administrators from a total of 40 nursing homes from 8 health care markets across the United States.

COVID-19 Vaccination Among Skilled Nursing Facility Staff: Challenges and Strategies Identified by Administrators.

COVID-19 vaccinations are critical for mitigating outbreaks and reducing mortality for skilled nursing facility (SNF) residents and staff, yet uptake among SNF staff varies widely and remains suboptimal. Understanding which strategies are successful for promoting staff vaccination, and examining the relationship between vaccination policies and staff retention/turnover is key for identifying best practices. We conducted repeated interviews with SNF administrators at 3-month intervals between July 2020 and December 2021 ( = 156 interviews).

Organizational and Resident Characteristics of Nursing Homes Associated With Partial and Complete Implementation of the Preferences for Everyday Living Inventory.

Background And Objectives: Person-centered care practices are essential to providing high-quality care for nursing home (NH) residents. A key component of implementing person-centered care is the assessment and fulfillment of residents' preferences. However, few NHs consistently assess and implement residents' preferences into care.

Assessment of Nursing Staff Learning Needs Around Person-Centered Risk Management in Nursing Homes.

The purpose of the current study was to describe nursing home (NH) staff's perceived learning and practice competency needs to facilitate effective delivery of person-centered care (PCC) when older adult residents' care preferences involve perceived risks. This needs assessment included a survey of NH staff and leaders ( = 87) and two focus groups (FGs) ( = 14). Results indicated staff were most confident handling preferences related to medication refusal (mean item rating = 4.

Effects of Nurse Staffing on Resident Outcomes in Nursing Homes: A Systematic Review.

Objectives: To evaluate the evidence on effects of nurse staffing in nursing homes on resident outcomes.

Design: Systematic review.

Setting And Participants: Studies evaluating the effects of nurse staffing levels, total staffing, or skill mix on pressure ulcers, nursing home associated infections, and pain outcomes for adult residents in US nursing homes.

Testing the Reliability and Validity of the Revised Care Plan Checklist for Evidence of Person-Centered Care Approaches for Behavioral and Psychological Symptoms of Distress in Persons With Dementia.

The Checklist for Evidence of Person-Centered Care Approaches for Behavioral and Psychological Symptoms of Distress (BPSD) in Care Plans was developed to assess the person-centeredness of care plans for nursing home residents living with behavioral and psychological symptoms associated with dementia. The purpose of the current study was to evaluate the reliability and validity of a revised version of the Checklist. Data from a larger randomized clinical trial testing the implementation of the Evidence of Integration Triangle for BPSD were used.

Comparing Resident, Proxy, and Staff Respondents for Nursing Home Residents' Preferences for Everyday Living.

To encourage person-centered care, the Centers for Medicare and Medicaid require nursing homes to measure resident preferences using the Preferences Assessment Tool (PAT). No known research has examined the implications of respondent type (i.e.

A Spotlight on Adaptation: Preimplementation of Montessori-Based Activity Programming in Long-Term Care Using the Framework for Reporting Adaptations and Modifications-Enhanced (FRAME).

Background And Objectives: Effectively adapting evidence-based interventions for nursing home (NH) implementation is a critical, yet underexamined, component of improving care quality. Montessori-based activity programming (MAP) is an evidence-based intervention that promotes person-centered care, engages persons living with dementia, and mitigates distress behaviors. Currently, there is sparse evidence of MAP in Department of Veterans Affairs NHs (i.

Exploring the Criterion Validity of Pragmatic Person-Centered Care/Culture Change Measures.

Background: Nursing homes (NHs) are required to provide person-centered care, efforts often folded into broader culture change initiatives. Despite the known benefits of culture change, it is difficult to measure. This study aims to assess the criterion validity of the Preferences for Everyday Living Inventory (PELI) Implementation Indicator with other culture change measures.

Applying Agile Methodology to Reengineer the Delivery of Person-Centered Care in a Nursing Home: A Case Study.

Nursing home (NH) providers would benefit from adopting evidence-based measures for gathering and utilizing resident preference information in their daily care activities. However, providers face barriers when implementing assessment tools used to promote person-centered care (PCC). Although Agile methodology is not commonly used in NH settings, this case study shows how it can be used to achieve the goal of delivering preference-based, PCC, within a large NH.

Nursing Leadership - Transforming the Work Environment in Nursing Homes.

The work environment is a modifiable construct associated with the quality of nursing home care. This article describes and explains variables known to be associated with the work environment of nurses in nursing homes, including the history and characteristics of nursing homes; the nature of nursing work; the nursing skill mix, and care delivery. Nursing leadership has the potential to transform the nursing home work environment and improve quality of care through education, research, advocacy, and implementation of evidence-based practices.

Age Discrepancies Across Two Decades: Desiring to be Younger Is Associated with Daily Negative Affect Over Three Waves of Assessment.

Negative perceptions of aging and older adulthood, including the idealization of youth, are common in the United States. Past work has found that holding negative perceptions of aging is closely associated with poor mental and physical health consequences, yet few studies have examined how these perceptions impact day-to-day experiences. The current study had two objectives: (1) investigate whether age discrepancy (specifically desiring to be younger than one's chronological age) was related to daily negative affect and (2) examine whether this relationship changed as participants aged over time.

Community Goal Setting and Attainment: Organizational Characteristics and Indicators of Staff Adoption.

In residential care communities (CCs), implementation strategies can improve the use of person-centered approaches for residents' behavioral symptoms of distress. We examined staff perceptions of how well their organizational goals for achieving person-centered care (PCC) were met following implementation of the strategy, Evidence Integration Triangle for Behavioral and Psychological Symptoms of Distress. We also identified organizational characteristics and indicators of staff adoption associated with perceived goal attainment.

The Stability of Nursing Home Residents' Ratings of Importance of Recreation Preferences Over One Year.

Long-term stability of nursing home (NH) residents' everyday preference remains unknown. We examined 1-year stability in reports of importance of 34-recreational activity preferences (8-MDS 3.0 Section F items; 26- items) by NH residents ( = 161).

The Association Between Preference Satisfaction and Satisfaction with Overall Care for Nursing Home Residents.

The Centers for Medicare and Medicaid Services mandate the provision of person-centered care (PCC), but there is limited evidence on how PCC impacts nursing home (NH) residents' care experiences. This study examined the relationship between n = 163 NH residents' ratings of satisfaction with care related to their preferences and their satisfaction with overall care. Residents with higher preference satisfaction ratings reported significantly higher levels of satisfaction with overall care.

Factors that influence the emotional impact of memory problems in older adults: A qualitative descriptive study.

Background: Associations among psychological health and memory concerns in older adults are well-established, but much of this research is quantitative.

Objectives: This study examined how memory problems influence emotional well-being in older adults without dementia, and whether this differs by cognitive status and current depressive or anxiety symptoms.

Methods: A qualitative descriptive design was used to examine our research questions.

Outcomes in heart failure patients discharged to skilled nursing facilities with delirium.

Aim: Heart failure (HF) outcomes are disproportionately worse in patients discharged to skilled nursing facilities (SNF) as opposed to home. We hypothesized that dementia and delirium were key factors influencing these differences. Our aim was to explore the associations of dementia and delirium with risk of hospital readmission and mortality in HF patients discharged to SNF.

New Antipsychotic Prescribing Continued into Skilled Nursing Facilities Following a Heart Failure Hospitalization: a Retrospective Cohort Study.

Background: Multimorbidity and polypharmacy are common among individuals hospitalized for heart failure (HF). Initiating high-risk medications such as antipsychotics may increase the risk of poor clinical outcomes, especially if these medications are continued unnecessarily into skilled nursing facilities (SNFs) after hospital discharge.

Objective: Examine how often older adults hospitalized with HF were initiated on antipsychotics and characteristics associated with antipsychotic continuation into SNFs after hospital discharge.

Assessing Social Functioning During COVID-19 and Beyond: Tools and Considerations for Nursing Home Staff.

Social functioning is defined as how a person operates in their unique social environment (ie, engagement in activities, connectedness with others, and contributions to social roles). Healthy social functioning is important for nursing home residents as they are at increased risk for loneliness and isolation. Social functioning has long been an underacknowledged aspect of nursing home residents' health, but now, with the COVID-19 pandemic, residents' risk for decreased social functioning is increased.