The lucidity in dementia experience: perspectives from family and professional caregivers.

Background: Family and professional caregivers of individuals with dementia often witness care-receiver's lucidity events.

Objective: A qualitative data analysis was performed of documented family and professional caregivers' experiences and their respective appraisals of lucidity events.

Research Design And Methods: Using a reduction method of selection, data from 10 in-home family caregivers and 20 professional caregivers to long-term care residents was content-coded and analysed.

Estimated Prevalence of Resident-to-Resident Aggression in Assisted Living.

Importance: Resident-to-resident aggression in assisted living facilities can result in physical and psychological harm, but its prevalence is unknown.

Objective: To estimate the prevalence of resident-to-resident aggression, including physical, verbal, and sexual, among residents in assisted living facilities.

Design, Setting, And Participants: This study used cross-sectional, observational data from a clinical trial, in which residents of assisted living facilities were monitored for events over a 1-month period.

Unexpected lucidity in dementia: application of qualitative methods to develop an informant-reported lucidity measure.

Objectives: Unexpected lucidity is a phenomenon of scientific, clinical, and psychological relevance to health professionals, to those who experience it, and their relatives. This paper describes qualitative methods used to develop an informant-based measure of lucidity episodes.

Methods: The approach was refinement of the operationalization of the construct; review of seminal items, modification, and purification; and confirmation of the feasibility of reporting methodology.

Reports About Paradoxical Lucidity from Health Care Professionals: A Pilot Study.

Although clinicians caring for persons at the end of life recognize the phenomenon of paradoxical/terminal lucidity, systematic evidence is scant. The current pilot study aimed to develop a structured interview instrument for health care professionals to report lucidity. A questionnaire measuring lucidity length, degree, content, coinciding circumstances, and time from episode to death was expanded to include time of day, expressive and receptive communication, and speech during the month prior to and during the event.

Factors associated with resident-to-resident elder mistreatment in nursing homes.

Background: Resident-to-resident elder mistreatment (RREM) in nursing homes has serious physical and psychological consequences, but factors related to RREM occurrence remain unclear. This study identifies individual and environmental characteristics associated with involvement in RREM episodes.

Methods: The design was an observational study carried out in five urban and five suburban New York state nursing homes randomly selected on the basis of size and location.

Resident-to-resident elder mistreatment (R-REM) intervention for direct care staff in assisted living residences: study protocol for a cluster randomized controlled trial.

Background: Resident-to-resident elder mistreatment (R-REM) is defined as negative and aggressive physical, sexual, or verbal interactions between (long-term care) residents that in a community setting would likely be construed as unwelcome and have high potential to cause physical and/or psychological harm and distress. R-REM has been established as a serious problem that has a negative impact on the safety, physical well-being, and quality-of-life of residents living in nursing homes. Although there are no in-depth studies, there is evidence that it is prevalent in assisted living residences and associated with a variety of person, environmental, and facility characteristics.

Resident-to-Resident Mistreatment: Evaluation of a Staff Training Program in the Reduction of Falls and Injuries.

Resident-to-resident elder mistreatment (R-REM) occurs frequently in long-term services and support settings. The purpose of the current study was to evaluate the effect of a R-REM training program for nursing and other frontline staff on resident falls and injuries in a cluster randomized trial of units within four nursing homes. Interview and observational data from a sample of 1,201 residents (n = 600 and n = 601 in the usual care and intervention groups, respectively) and staff were collected at baseline and 6 and 12 months.

The Prevalence of Resident-to-Resident Elder Mistreatment in Nursing Homes.

Background: Resident-to-resident elder mistreatment (R-REM) in nursing homes can cause physical and psychological injury and death, yet its prevalence remains unknown.

Objective: To estimate the prevalence of physical, verbal, and sexual R-REM in nursing home residents and subgroups.

Design: 1-month observational prevalence study.

Managing resident-to-resident elder mistreatment in nursing homes: the SEARCH approach.

This article describes an educational program to inform nursing and care staff of the management of resident-to-resident elder mistreatment (R-REM) in nursing homes, using the SEARCH (Support, Evaluate, Act, Report, Care plan, and Help to avoid) approach. Although relatively little research has been conducted on this form of abuse, there is mounting interest in R-REM because such aggression has been found to be extensive and can have both physical and psychological consequences for residents and staff. The goal of the SEARCH approach is to support staff in the identification and recognition of R-REM as well as to suggest recommendations for management.

A staff intervention targeting resident-to-resident elder mistreatment (R-REM) in long-term care increased staff knowledge, recognition and reporting: results from a cluster randomized trial.

Background: Elder abuse in long-term care has received considerable attention; however, resident-to-resident elder mistreatment (R-REM) has not been well researched. Preliminary findings from studies of R-REM suggest that it is sufficiently widespread to merit concern, and is likely to have serious detrimental outcomes for residents. However, no evidence-based training, intervention and implementation strategies exist that address this issue.

Comparative effectiveness of implementing evidence-based education and best practices in nursing homes: effects on falls, quality-of-life and societal costs.

Objectives: The aim was to conduct a comparative effectiveness research study to estimate the effects on falls, negative affect and behavior, and the associated societal costs of implementing evidence-based education and best practice programs in nursing homes (NHs).

Design: A quasi-experimental design, a variant of a cluster randomized trial of implementation research examining transfer of research findings into practice, was used to compare outcomes among three groups of residents in 15 nursing homes per group.

Methods: Forty-five NHs participated in one of three conditions: (1) standard training, (2) training and implementation modules provided to facility staff, or (3) staff training and implementation modules augmented by surveyor training.

Effects of electronic health information technology implementation on nursing home resident outcomes.

Objective: To examine the effects of electronic health information technology (HIT) on nursing home residents.

Methods: The study evaluated the impact of implementing a comprehensive HIT system on resident clinical, functional, and quality of care outcome indicators as well as measures of resident awareness of and satisfaction with the technology. The study used a prospective, quasi-experimental design, directly assessing 761 nursing home residents in 10 urban and suburban nursing homes in the greater New York City area.

Disseminating QI interventions.

Background: Partnerships contributed to the success of three diverse health care quality improvement (QI) projects. The Partnerships for Quality (PFQ) Dissemination Planning Tool was used to identify the most appropriate partners to disseminate the QI interventions for three projects, that is, partners most likely to reach and influence the target user(s)-(1) the Catholic Healthcare Partners Heart Failure Partnership, a multisite demonstration of the efficacy of a collaborative approach in the management of heart failure, (2) the Center for Value Purchasing, a collaborative study of the effects of quality incentives on the delivery of chronic disease care, and (3) the New York State Information Dissemination project, a collaborative partnership that targeted dissemination of evidence-based practices in the long term care setting.

Results: The RE-AIM model, a construct to aid planning, implementation, and evaluation of health behavior interventions, was used as a framework to examine the impact of partnerships on the three collaborative projects.