Voices of Seniors

Table 1. Voices of Seniors Regarding the Future

Printer Friendly...Table 1

PurposeLocation,
Sample &
Measurements
FindingsAuthors
Determine how boomer generation & 65 plus are doing in 20 social, economic and health areas
  • USA sample
  •   5 federal surveys,
  •   UCLA survey,
  •   AARP survey
  • Age group 50 to 64 years
  • Over 10 years - all 20 indicators improved;
  • most improvements in income, financial assets, pension coverage, employment rate;
  • least improvements in health insurance;
  • ability to afford needed health care;
  • spending on non-necessities
  • Age group 65 years & older
  • Over 10 years
  • primary declines: income other than SS,
  • employment rate and health status;
  • primary imrovements:
  • ability to afford health care and spending on non-necessities.
AARP Policy
and Strategy
Group,2004
Determine housing and home modification issues for older adults
  • USA sample
  • 2000 respondents, age 45+,
  • Age & gender representative sample
  • Age 55+
  •   86% own home & 89% want to live in own home as long as possible;
  • 86% made at least one simple modification
  •   e.g., installed nightlights, non-skid strips in bathtub or shower, higher wattage light bulbs.
  • 70% made major modification
  •   e.g., installed light switches in stairs, changes so can live on first floor, handrails on both sides of stairs, grab bars in bathroom.
  • Total 90% made changes
  •   48% did work themselves,
  •   75% believe changes will allow them to live in home another 10 years or more
  • Reasons no modifications made, if needed:
  •   37% cannot do themselves,
  •   29% not trusting home contractors,
  •   25% not knowing how to make changes,
  •   22% not knowing how to find a good contractor to do it
Bayer & Harper, 2000
Assess attitudes and preferences for in-home care
  • California sample, representative of state
  • 612 adults, 40 years +
  • Telephone interviews
  • 48% of sample needed in-home care
  • for self or family member in past year.
  • Of these, 55% needed 6+ months of care 51% of total sample could not afford 2 hours per day for 6 months
  • Preferences:
  •   32% family unpaid
  •   30% family paid
  •   21% private hiring of paid help
  •   21% pay home care agency for help

Extremely Important for home care service:
  •   -help not steal
  •   -adult feels safe & comfortable
  •   -help is on-time
  •   -help is educated/trained

59%: not important that help is same race
Gray & Feinberg, 2003
Examine expectations of boomers & aging adults regarding services that will help them remain independent
  • USA sample
  • 2000 respondents, age 45+
  • Telephone survey
  • 83% want to stay in own home as age
  • 82% want services in own home
  • 68% will be able to rely on family/friends
  • 35% counting on children to help when older
  • Most important features in home:
  •   Bath & bedroom on main floor,
  •   non-slip floors,
  •   covered parking,
  •   climate controls
  • Most important community features:
  •   Safe neighborhoods, hospital,
  •   MD office, worship place
  • Most important community services:
  •   door-to-door transportation
Greenwald, M. & Associates, 2003
Perspectives of persons, age 50+ with disabilities regarding what would make their lives better
  • USA sample
  • 1,102 adults age 50+ with disabilities (68% mobility, 21% vision or hearing 19 cogintive or emotional); most disabilities occurred between age 40 and 64
  • Strongly prefer independent living in own homes
  • Want more control over services received
  •   25% do not use any special equipment
  •   25% need more help with ADLs bathing, cooking
  •   33% need home modification, can not due to $
  •   50% received regular help: mostly family/friends
  •   33% use community services
  • Severe levels of disability decreasing
  •   Persons 65+
  •   In community use assistive technology, do not require human assistance increased 9% to 20%
  • What is most important for quality of life?
  •   96% spending time with family and friends
  •   82% religious/spiritual activities
  •   80% physical activities or exercise
Gibson, 2003

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Table 2. Voices of Seniors Regarding Home Care Services

Printer Friendly...Table 2

PurposeLocation,
Sample &
Measurements
FindingsAuthors
Examine experiences & outcomes of saniors using home care services
  • California, low income Medicaid home care consumers
  • 511 consumer directed model family/clients
  • 584 professional agency model family/clients
  • Telephone interviews
  • Consumer directed models more positive in all outcomes and
  • -unmet IADL needs
  • -service satisfaction
  • Family of consumer models more positive with safety & service satisfaction
Benjamin, et al., 2000
Determine relationship of client choice and satisfaction
  • Michigan, Maryland, & Texas
  • 879 seniors receiving personal assistant home care through Medicaid
  • Telephone survey
  • Greater choice in hiring, firing, scheduling, supervising, and paying attendants associated with higher satisfaction areas
  • More than 90% given choice in selecting assistant reported high levels of satisfaction compared to 59% of those without choice of assistant.
Commonwealth Fund, 1991
  • Identify dimensions of care associated with excellence versus satisfaction
  • Identify dimensions of care separating satisfaction from dissatisfaction
  • Midwestern rural/urban areas
  • 696 clients recently discharged from 13 home care agencies
  • Mail survey with 46 items, Likert responses
  • Excellence/Satisfaction Discriminators
  •   1 Staff unhurried
  •   2 Staff helped manage illness better
  •   3 How to reach on call explained
  •   4 Staff were clean
  •   5 Staff on time
  • Satisfaction/
    Dissatisfaction Discriminators
  •   1 Staff help me feel better
  •   2 Early discharge instructions
  •   3 Explained medicine instructions
  •   4 Nurse communicated with family
  •   5 Staff were unhurried
Dansky & Brannon, 1996
  • Rank importance clients ascribe to their values
  • Determines differences in values between new and ongoing clients
  • One urban/rural Midwestern site and one urban Western site
  • 790 clients, 2 1/2 hour semi -structured interviews
  • Two questionnaires with open and closed ended questions
  • Values ranked by importance:
  •   1 Freedom/safety
  •   2 Home surroundings & atmosphere
  •   3 Helper traits & competence
  •   4 Involvement of family
  •   5 Activities
  •   6 Privacy - general, body, social, $
Very important values
  Clients 
 NewOn-
going
 
  Freedom/
safety
71%79% *
(p≤.05)
  Home85%76% 
  Helper77%75% 
  Involve
  Family
73% 64%*
(p≤.05)
  Activities  52%56% **
(p≤.001)
Degenhotz, Kane, & Kivnick, 1997
Explore worker-
client relationships
  • Minnesota
  • 54 home care clients with at least 2 visits per week
  • In-depth interviews with open and closed questions
  • The majority of clients expresses satisfaction with their worker
  • 66% describe worker as friend or "like family"
  • 66% report worker does "extras"
  • 75% discuss personal problems with workers
  • 25% claim workers work beyond paid hours
Eustis & Fischer, 1991
Identify dimensions of general satisfaction with home care
  • Alberta, Canada
  • 10 senior clients
  • -from home care scenarios, seniors identified importance of various dimensions
  • Dimensions of client satisfaction are:
  • availability of care,
  • continuity of care,
  • provider competence &
  • personal qualities of the provider
  • Most important qualities for provider satisfaction:
  • sensitivity to clients'needs
  • and interpersonal skills of the home care workers
Forbes, 1996
  • Determine client interest in greater autonomy
  • Determine satisfaction with worker and case manager
  • Massachusetts
  • 883 home care clients
  • Telephone interviews with 55 closed-ended questions
  • 78% preferred some overall control
  • 18% wanted more control
  • Most clients would accept less case manager attention,
  • only small percentage wanted less contact
  • Willing to accept responsibility:
  •   39% for scheduling
  •   37% for supervising
  •   29% for hiring
  •   26% for paying worker
  •   24% for firing
Glickman, et al., 1997

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Explore domains of satisfaction with home health care nursing
  • Vermont
  • 73 clients, both active and discharged
  • Client Satisfaction Survey by Reeder and Chen
  • Overall high satisfaction with nurses
  • Most satisfaction with nurses in:
  • -not too busy to spend time talking
  • -efficient in doing work
  • -patience with client
  • Less satisfaction with nurse in:
  • -teach how to stay healthy
  • -discuss changes since last visit
  • -tells about tests & procedures
  • -want involvement with decision making
Laferrier, 1993
Identify problems following discharge from hospital
  • Amsterdam, Netherlands
  • 145 seniors 1 week after hospital discharge
  • 1/2 mail survey & 1/2 interviewed at home; closed & open ended questions
  • Most frequent problems:
  • -feeling ill informed
  • -questions regarding illness & recovery
  • Other needs & problems:
  • -questions rearding prescriptions/life rules
  • -difficulty with housekeeping
  • Most seniors relied on relatives for support:
  • 37% had unmet needs
Mistiaen, et al., 1997
Determine key drivers of home care client satisfaction
  • All regions of US
  • 160,000 clients from 183 agencies
  • Mail survey, closed ended questions
  • Key Drivers of Client Satisfaction:
  • Care Process-strongest driver
  •   Staff show concern for patient as a person,
  •   enough time spent with patient
  •   staff are dependable & timely
  • Client Involvement/Education
  •   Involved in care decisions;
  •   family involved
  •   staff encourage questions;
  •   clear explanations of care & procedures
  • Orientation to Home Care:
  •   Know whom to call for questions & how to voice a complaint;
  •   good staff explanations
  • Perceived medical outcome - weakest driver
  •   Condition improved as much as expected &
  •   patient gained better understanding of condition
Seibert, 1996
Determine client preferences of nurse caring behaviors
  • Michigan
  • 28 recently discharged home care clients
  • Interviews with Caring Assessment Instrument (CARE-Q); respondents sorted 50 nurse behavior cards into order of importance
  • Top caring behaviors:
  •   1 Know when to call the doctor
  •   2 Listens to the patient
  •   3 Talks to the patient
  •   4 Gives tx and meds on time
  •   5 Puts patient first
  •   6 Knows how to do techniques
  •   7 Quick response to calls
  •   8 Good physical care
  •   9 Honest about medical condition
  •   10 Uses understandable language
Smit and Spoelstra, 1991
Identify consumer concerns and preferences
  • Cleveland, Ohio
  • 200 recently discharged home care clients or caregivers in 20 focus groups
  • Core concerns:
  •   1 Pre-discharge preparation & instruction
  •   2 Orientation of patient to services
  •   3 "Style of Care"
  •   4 Scheduling of visits
  •   5 Continuity of direct care staff
  •   6 Staff Attire
  •   7 Concern, listening, attention
  •   8 Teaching appropriate to learning readiness
  •   9 Preserving patient dignity & privacy
  •   10 Perceptions of Outcome
Stricklin, 1993
Identify recommendations for improving home care services post hospitalization
  • Chicago suburb
  • 44 discharged patients
  • 21 caregivers of patients
  • In home interviews, open ended questions & satisfaction scales with Likert scales
  • General satisfaction=
  • 4.75 from 5 point scale.
  • Client who received medication info more satisfied than those who did not.
Weaver, et al., 1998
Identify dimensions of quality home care workers
  • 78 home care clients
  • Two telephone surveys:
  • 1st survey asked clients to evaluate characteristics of workers
  • 2nd survey asked open ended questions
  • The top three job related skills were:
  •   punctuality,
  •   safety awareness,
  •   organizational skills
  • (None focused on technical competence)
Woerner & Philips, 1989

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Table 3. Voices of Seniors Regarding
Independent - or Assisted-Living Facilities

Printer Friendly...Table 3

PurposeLocation,
Sample &
Measurements
FindingsAuthors
  • Determine areas of dissatisfaction
  • Determine preferred nursing assistants' characteristics
  • Midwest metropolitan area
  • 3 Assisted Living Facilities
  • 87 residents
  • 113 family members
  • Residents were interviewed; family members received a mail survey.
  • Surveys included closed and open ended questions.
  • Areas of dissatisfaction:
  •   Meal time - food, hours & seating arrangement
  •   Nursing Assistants - turnover, training, lack of patience and compassion
  •   Recreational Activities - more & different activities
  • Preferred characteristics of NAs:
  •   Genuine concern, kindness & patience
  •   Respectfulness
  •   Consistent attentiveness
  •   Pleasant disposition
Buelow & Fee, 1999
Describe residents using ALF with highest level of services
  • Nationally representative of high service;
  • privacy ALFs
  • 300 Assisted Living Facilities
  • 184,558 residents
  • In-person interviews
  • Amount of control over selection of ALF:
  •   52% Complete
  •   23% Some Control
  •   25% Little/no control
  • Need more help
  •   12% Dressing
  •   12% Locomotion
  •   26% Toileting
  • Staff
  •   80% treated with dignity
  •   61% show affection
  •   52% take time to listen
  •   52% training/good supervision
  • Activities:
  •   45% do most or all time
  •   35% not outside ALF in last 2 weeks
  •   51% enjoy most/always
  • Staff ask preference:
  •   23% never
  •   35% sometimes
  • Meals:
  •   54% always choice
  •   26% always tasty
  • Extra services purchased:
  •   61% grooming hair
  •   26% foot care
  • Information Shared
  •   67% aware of monthly charge
  •   30% aware of discharge policy
Hawes & Phillips, 2000
Describe death related planning and preferences for place of death among well elders in CCRCs
  • North Carolina
  • Independent living apartment in 1 CCRC
  • 219 residents
  • Questionnaire survey, returned to researchers anonymously
  • 40% issues re death played a role in decision to move to CCRC
  • 5 themes/reasons:
  • - need for terminal illness care
  • - fear re: family burden
  • - fear re: isolation
  • - want to be near spouse
  • - far from family
  • 66% preferred to die on CCRC campus
  •   36% apartment
  •   18% in CCRC SNF
Hays, et al., 2001
Examine the amenity preferences of potential private pay nursing home residents presuming basic services are provided.
  • Dayton, Ohio
  • 2 independent living facilities
  • 262 residents
  • Mail survey with rating questions from most to least important
  • Preferred amenities:
  •   1-Mental & physical services
  •   2-comfort & security
  •   3-Personal services
  • Top preferred single amenities:
  •   1-Security system
  •   2-Home-like environment
  •   3-Private rooms
  •   4-Post office services
  •   5-Transportation provided
  • Least Important Ratings:
  •   Financial consultation, fresh flowers, hospital-like environment, gardens and educational opportunities
MacDowell & Clawson, 1992-3
Determine the relative importance of services, amenities & activities in the initial selection of an ALF
  • Arkansas communities with populations of 5,000 or more
  • 279 heads of households, age range from 23-83 years
  • Mail survey asked importance of 43 services, facility amenities & activities in selection of an ALF for an adult parent
  • Top Services Preferences:
  • - personal security
  • - financial affordability
  • - available medical facilities
  • - meals available
  • - personal care available
  • - near adult child
  • Facility amenities
  • - chapel/spiritual center
  • - full kitchen
  • - washer & dryer in apt
O'Bryan, et al., 1996

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Discover why residents leave Assisted Living Facilities (ALFs)
  • Nationally representative of American ALFs
  • 278 ALFs
  • 1,483 in person resident interview
  • 7 months later, telephone interview with 248 residents discharged
  • Location of residents who left ALF
  •   59% nursing home
  •   28% other ALF
  • Reasons for leaving
  •   78% need more care
  •   14% closer to family
  •   12% dissatisfied with care
  • Decision maker:
  •   75% family/resident
  •   25% facility decision
  • Factors impacting departures:
  • - Cognitive impairment
  • - Need ADL assistance
  • - For profit facilities
Phillips, C. et al., 2003
Determine preferred characteristics of congregate care facilities by family members
  • Southeastern city
  • 42 adult children who recently selected a congregate care facility for parents
  • Interviews rank ordered in terms of desirability
  • Attributes & importance ratings:
  •   1 = Staff Attitudes
  •   2 = Location near family
  •   3 = Nursing Care
  •   4 = Cost
Shemwell & Yavas, 1997
Understand consumers' satisfaction with their selection of independent-living facilities
  • Long Island, New York & Florida (affluent areas)
  • Independent Living Facilities
  • 204 seniors
  • Interviews, with rating scales
  • Reason for selecting facility
  •   53% to be near family
  •   25% to be near needed services
  •   15% to be near my friends
  • Factors considered important:
  •   94% security on grounds
  •   85% have emergency call system, access to RNs & MDs, have social activities
  • Evaluated as below expectations:
  •   56% emergency call system
  •   43% cleanliness
  •   35% caring
  • Evaluated as exceeded expectations:
  •   29% quietness
  •   25% design of unit
  •   25% caring
Sherman et al., 1992
Determine the relationships between resident satisfaction and organizational factors of Assisted Living Facilities
  • Maryland
  • 13 Assisted Living Facilities
  • small to large size
  • 119 residents interviews
  • Variables - MEAP's facility amenities, costs to residents, resident characteristics, and participation in decision concerning relocation
  • Resident characteristics together explained most of satisfaction
  • Significant characteristics:
  • - personal happiness
  • - high functional independence
  • - participated in relocation decision
  • Organizational factors added only 7% to the satisfaction
  • Moderate physical amenities and personal space were the two significant variables
Sikorska, 1999
Examine decision making abilities of residents in assisted living regarding abuse and neglect
  • USA
  • unknown area
  • 3 ALFs
  • 27 residents
  • Interviews & watched video scenarios of common types of abuse, then re-interviewed regarding abuse & strategy if it happened to them
  • Identified about 54% of inappropriate behaviors:
  • Most identified = physical, fiduciary & medication issues
  • Least identified = verbal abuse, neglect and environmental hazards
  • Asked how would leave if unhappy
  •   51% couldn't answer
  •   26% rely on family
  •   22% acceptable plan without family
Wood & Stephens, 2003

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Table 4. Voices of Seniors Using Nursing Homes

Printer Friendly...Table 4

Describe what makes nursing homes dehumanizing
  • Washington D.C., Massachusetts, and Arizona
  • Examined diaries of 3 Nursing Home Residents
  • Dehumanizing characteristics:
  • Lack of control, privacy relationships
  •   control: admission to home, food, ADLs, and care preferences
  •   privacy: family visits, possessions, bodily functions, birthdays and death
  •   relationships: roommates, staff, religious and social activities and other residents
Berdes, 1988
Explore residents' definition of quality care & dimensions of daily life
  • Madison, Wisconsin
  • 3 nursing facilities
  • 26 residents
  • 2 In-depth interviews with each resident, ground dimensional analysis of data
  • Definitions of quality varied by type of resident
  •   1. For higher income residents, quality = care as a purchased service; poor quality meant having to wait, poor outcomes, etc.
  •   2. For frail residents, quality = care which provided physical comfort (a pillow, drink, etc.)
  •   3. Largest % residents, quality = relationship with staff, degrees of closeness experienced
Bowers, Fibich, & Jacobson, 2001
Examine factors which differentiate men and women's adjustment to nursing homes
  • Rural middle West
  • 4 nursing homes,
  • 114 residents
  • Resident interviews regarding personal histories and experiences
  • Social workers completed Staff Rating Index for adjustment scores on each resident
  • Women were perceived as significantly less well adjusted to nursing home life than were men.
  • For women, significant factors related to adjustment were voluntary placement in home and previous living arrangements
  • For men, no one variable predicted adjustment
Joiner & Freudiger, 1993
Compare three interview methods to assess nursing home residents' needs in the ADL area 3 floors of 1 SNF

  • 70 residents interviewed for 7 ADL needs in 3 ways:
  •   a) Direct satisfaction ratings
  •   b) Discrepancy questions (e.g., do you want more or less mobility care?
  •   c) open ended questions (what type of change would you want?)
  • Open ended questions produced most useful answers.
  • Unmet needs were significantly highest for discrepancy and open ended measures compared to direct satisfaction questions.
% dissat.ABC
Dressing43632
In/out of bed124133
Mealtime44018
Pad changes33732
Showering73631
Toileting64314
Walking247635
Levy- Storms, et al., 2002
Determine most important values of residents
  • Texas
  • 1 nursing home
  • 134 residents
  • Forced ranking of 10 values
  • Values were paired and respondents chose most important value.
All values seemed very important to resident as they ranked values very close (standard deviation = 2.86)

  • Order of rankings for residents
  •   1 Family & Visitors
  •   2 Clean & comfortable surroundings
  •   3 Good food
  •   4 Caring Staff
  •   5 Feeling useful
  •   6 Affection
  •   7 Religious Activities
  •   8 Social Activities
  •   9 Flexibility in daily schedule
  •   10 Privacy
Knox & Upchurch, 1992
Determine most important qualities of nursing homes
  • 15 cities in USA
  • Groups of nursing home residents participated in a series of three focus groups each
  • (450 residents, 135 discussion groups)
  • Discussions with open ended questions
  • Most important components of quality care in:
  •   1-Staff with good attitudes & feelings
  •   2-Homelike environment
  •   3-Food variety, choices, preparation & service
  •   4-Activities
  •   5-Medical care
  •   6-Cleanliness
  •   7-Administration
  •   8-Religious participation
  •   9-Resident council and rights
  •   10-Community activities
National Citizens' Coalition for Nursing Home Reform, 1985
Understand how the decision to enter a nursing home was made and feelings about it
  • New South Wales
  • 5 nursing homes
  • 19 seniors
  • In-depth interviews
  • Themes emerged:
  •   1 there was no choice
  •   2 lost everything to go to the home
  •   3 felt self was devalued
  •   4 believe it was their end of life
Nay, 1995
Investigate the experiences of older people as they move from a hospital into a nursing home
  • Northern & Yorkshire Region, England
  • 20 seniors, 17 family members - after discharge from hospital to a nursing home
  • open ended interviews with one month in home
  • Move had profound change in their lives
  •   -move was distressing, lifestyle uncomfortable
  •   -move was relief from the anxiety and uncertainty
  •   -life unexpectedly pleasant
  • Seniors did not view themselves as in control or with choices, just accepted move into home; asked family to select one
Reed & Morgan, 1999
Compare objective data regarding incontinence and mobility care quality with resident surveys
  • 3 nursing homes,
  • 99 incontinent residents interviewed;
  • Satisfaction measurements:
  •   1) Direct scaled satisfaction questions
  •   2) Indirect satisfaction = preference questions, e.g., do you want (more or less) mobility care?
  •   3) Objective
    Discrepancy = observed - preferred number of times want care
  •   4) perceived discrepancy = preferred - perceived times care wanted
  • Average pad change / day = 0.57
  • Assists to the toilet / day = 0.37
  • Assists to walk / day = 0.23
  • 52%, 64% & 78%
  • residents had accurate memory of pad changes, assists & walks (respectively)
  • Residents' reported preferences were an average of 2 more pad changes, 1.5 more toilet assists, and 2 more walk assists than normally received.
  • Direct satisfaction questions, are consistently higher than other questions. The objective and perceived discrepancy questions gave the most dissatisfaction.
Simmons & Schnelle, 1999;
Simmon, Schnelle, and Rahman, 1998
Assess whether nursing homes could utilize SERVQUAL questionnaire to determine service quality
  • Wisconsin
  • 41 nursing homes
  • 416 family members of residents
  • Questionnaire had 21 questions.
  • Each question used 7 point response scale.
Family members scores aggregated by nursing home to determine means/ nursing home
The number of deficiencies and complaints correlated to mean satisfaction scores (scale = 1-7)
Mean satisfaction
Responsiveness4.99
Reliability6.13
Assurance6.11
Empathy5.89
Tangibles6.12
All correlations statistically significant, except -0.16.
Steffen & Nystrom, 1997
Determine residents' perceptions of nursing staff and their relationship to independent judgments of nursing home quality
  • Miami, Florida
  • 10 nursing homes
  • 239 residents
  • Residents completed two questionnaires evaluating nursing staff. First scale had 6 items with a 5 point response set. Second instrument had brief situation and residents stated what they thought their nursing staff would do.
  • Three external health professionals rated nursing home quality on 4 point scale.
  • In poorer quality homes, residents perceived nurses had less respect, communication, and concern. The response to call lights was slower and residents believed staff members did not like their work.
  • For the second questionnaire, residents in poorer quality homes less often selected favorable behaviors.
Stein, et al., 1986
Determine if residents' ratings of the social climate is significantly associated with independent judgments of nursing home quality
  • Miami, Florida
  • 10 nursing homes, and 301 residents completed the Sheltered Care Environment Scale.
  • Social workers independently rated the quality of care in these homes as good, fair   poor.
Resident ratings of social climate (highest possible score = 100):
 Good HomesPoor Homes
Cohesion66.241.1**
Conflict33.540.7
Independence38.730.6*
Self-explorations27.9 32.4*
Organization72.453.9***
Resident influence 62.540.3***
Physical comfort77.065.2*
* = statistically significant differences
Stein, et al., 1987
Explore how family members perceive their roles and their perceptions of the quality of care provided their relative.
  • Minneapolis
  • 3 nursing homes
  • 25 family members
  • 1-2 hour semi structured interviews were conducted
  • Family members Interviews were audiotaped & two independent researchers identifying emerging themes
  • Roles and involvement included:
  •   maintaining family connectedness
  •   maintaining resident's dignity
  •   maintaining control over room
  •   serving as an advocate for relative & other residents
  •   maintaining & improving health of relative
  • Majority of family members were satisfied with overall quality of life and care.
  • Identified Quality Concerns:
  •   1-Lack of communication among staff, residents, & family members
  •   2-Don't trust consistent good care given
  •   3-Fail to maintain residents' dignity
  •   4-Discourage families' involvement
Stum and Schmitz, 1990
Classify personal care complaints against nursing homes
  • Texas
  • All complaint records for 49 nursing homes in Texas reviewed for 2 years (340 complaints)
  • 40% of all complaints were personal care complaints
    (340) complaints categorized:
  •   27% bathing & personal hygiene
  •   19% respect and consideration
  •   12% supervision & safety
  •   9% feeding care
  •   8% incontinence care
  •   7% comfort and assistance
  •   6% response to call lights
  •   5% decubitus care
  •   3.5% water and fluid intake
  •   3.5 rehab and preventive care
Wagnild, 1986

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References for Tables

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