Search results

The purpose of this paper is to discuss participatory action research with staff, residents and relatives contributed to the residents’ quality of life through the development of an inclusive praxis in a public nursing home in Denmark. The project addressed the residents’ reports about a lack of influence in their everyday lives.

The project used future-creating workshops as an important methodological tool. Theoretical concepts about developing a social reflexive and colletive morally obliging praxis were central to frame democratic learning and acting. The theoretical concepts of empowerment and capability were also applied. This paper will outline the methods and the results obtained.

Learning processes were initiated, enabling staff to respectfully engage in dialogue with residents and their relatives about their needs and wishes. The development of a democratic knowledge-building process was established based on the perspectives of the residents, relatives and staff. In conclusion, the project contributed to the development of a more reflective and democratic praxis focused on empowering the residents as the primary “stakeholders” in the daily life of the nursing home.

The research paper is based on the authors’ own research.

The aim of this research is to provide insight into how organizations can co-create value with family members engaged in service journeys of customers experiencing vulnerabilities, thereby paying attention to their organizational practices (i.e. recursive or routinized patterns of organizational actions and behaviors).

To investigate, this research relies upon a multiple case study in a group of nursing homes in Flanders that had the ambition to engage family members in service journeys of their loved ones while measuring their value perceptions as a performance indicator (here, satisfaction with nursing home services).

The case evidence shows that nursing homes co-create value with family members through caring practices that focus on their role as secondary customers (i.e. welcoming, connecting and embedding) and empowering practices that focus on their role as partial employees (i.e. teaming up, informing and listening practices). However, the way in which the different caring and empowering practices are enacted by the nursing home and its staff affects their value co-creation potential.

By focusing on the practices with which organizations can co-create value with family members engaged in service journeys of their loved ones, this research bridges the service literature with its attention for value co-creation practices and the literature on customers experiencing vulnerabilities with its focus on extended customer entities.

This qualitative research examines the varied reasons for relocation to old age homes (OAHs) in contemporary India. The purpose of this study investigates the acceptance of institutional living in Lucknow (a Tier II city of India) and whether migration to OAHs is a voluntary decision. This study also examines the lifeworld of the older adult in these OAHs in an attempt to find out whether OAHs are conducive to positive ageing. Derivatively, the authors study their engagement/time use pattern and social networking patterns in the OAHs. Finally, the research seeks to learn whether OAHs are slowly substituting older adult care given within the family by offering the best of the facilities and services.

This qualitative research was conducted in two private OAHs in Lucknow, India. The findings of the study are based on 28 qualitative interviews conducted with the inmates, administrative staff and caretakers. The interviews were unstructured and open-ended and were supported by observations. The observation was not only made of the social setting but also the reaction of the participants. The idea was to develop an emic view of the subject by exploring valid narratives. Pseudonyms were used to report the finding so as to maintain the confidentiality of the research subjects.

This research moves beyond the traditional wisdom that people move to OAH because of the push factors within the family. OAHs in India have evolved over the years and high-end OAHs are equipped with modern amenities to cater to the upper class in their twilight years. Residents were found to lead active lives in OAHs and their common habitus and bonding capital helped them to face the vagaries of old age more confidently. Their active life and membership in various civic organizations challenge the contention of the role theory that the aged are more prone to lose rather than gain roles.

The originality of the research lies in the fact that the authors are extending the arguments made by the role theory of social ageing. The theory proposes that aged people are more likely to lose out roles rather than gain new ones. This study finds that the elderly tend to live a very active life in OAHs and engaged various civic organizations. Although they may lose/voluntarily give up the roles like the head of the household, spouse, etc., they acquire new roles in the context of OAHs.

The emergence of Covid-19 and its epidemic features have affected many people around the world. Regardless of the physical and psychological problems caused by it, people must isolate themselves from their surroundings. This problem is more intense in urban areas where people live in crowded apartments and high-rise buildings. During the lockdown, residents of such buildings suffered from disconnection from nature, in addition to the lack of communication with others. As most multi-story apartments and residential complexes do not have separate green spaces and do not provide a safe connection to nature for occupants, it is very tough for the residents of these buildings to endure the disease, and occupants are more vulnerable to disease. Accordingly, this study proposes the biophilic design as an effective approach to provide a secure connection with nature in residential complexes and high-rise apartments.

The questionnaire method was used in this study to analyze the raised hypotheses. Two types of residential zones were selected for the survey and comparing the results. One is apartment units without dedicated green space, and the other is villa houses with private green space. Size of the sample population include 300 people (150 residents of an apartment block and 150 residents of villa homes).

Strict restrictions during the pandemic have prevented people from connecting with nature, especially in urban areas, owing to the lack of separated and dedicated green spaces, whereas connection with nature can be healing and lead to relieving anxiety and stress in this era based on the approved research. Accordingly, applying a biophilic approach to the design process would be helpful.

The lack of a biophilic project to observe was one of the limitations of this study. Being an available biophilic project in the surroundings could be very helpful to observe and acquire comprehensive knowledge and experiences from the handlers and users of biophilic buildings.

This study can be beneficial for patients, individuals and occupants of apartments and residential complexes in urban areas who suffer from distance from nature and green spaces during the restrictions of pandemics such as Covid-19.

This study proposes the use of biophilic architecture in the design process of residential complexes and high-rise apartments to provide isolated and dedicated green spaces for occupants, especially during the lockdown when people have been deprived of parks and public green spaces.

At the outset of the COVID-19 pandemic the United Kingdom Government implemented a policy to rapid discharge hospital patients into care homes. This study aimed to examine how the media in the United Kingdom portrayed hospital discharge to care homes during the COVID-19 pandemic.

This study was a qualitative document analysis. Four sources (Daily Mail, The Independent, The Guardian and BBC News) were selected to represent political orientations encompassing right-wing, centrist and left-wing perspectives, and were searched for mention of hospital discharge, care homes and Covid-19 pandemic between 1st January 2020 and 24th February 2022. Article text was copied verbatim into Microsoft Word documents prior to analysis. Data were thematically analysed, followed by coding the sentiment in the included articles as well as coding the sentiment of themes and sub-themes.

Of 722 identified articles, 133 were eligible for inclusion as the final corpus. Data represented a moralistic narrative consisting of four themes: (1) Government as villain, (2) care homes as antiheroes, (3) patients as ideal victims and (4) moral outcomes. Most of the corpus had a negative sentiment (78.1%). One theme, moral outcomes, had considerably more positive sentiment (32.4%) than others (range 15.1%–21.9%).

A moralistic argument for improving cross-boundary interactions between health and social care services is provided, and the media can play a role pushing cross-boundary working higher up the policy agenda. Future work should examine how direct stakeholders, including those working in healthcare and care home settings, perceived the discharge policy.

This paper aims to explore the role of frontline employees (FLEs) as mediators in transformative service processes within services targeting vulnerable users.

This paper is based on a case study of the development and implementation of a dementia village, and the data consist of documents, in-depth interviews and field observations.

The analysis identifies FLEs as mediators in six different roles. These roles highlight how FLEs perform as mediators, acting in between and for vulnerable users and thus supporting their well-being. Specifically, the roles explicate the mediating role of FLEs in the design and planning of transformative changes and in daily work practices.

The different mediating roles of FLEs presented here should inform care providers and managers of how employees can become assets for supporting vulnerable users’ well-being during the design and planning stages of transformative change and through daily service work.

This paper offers novel insights into the multifaceted roles of FLEs in transformative services. The findings add to the current debate on mediation in transformative services and contribute to the literature by extending and refining the established conceptual and empirical understandings of the role of transformative service mediators in consumers’ well-being.

Research with vulnerable groups is crucial to get their input into public policy design that will directly impact on them. However, there are many methodological and ethical challenges involved in encouraging participation from groups with a wide range of intellectual, cognitive and physical capacities while ensuring that the rights and well-being of participants are protected. Rather than exploring ethical theories, this chapter is a case study describing the practical ethical considerations that were involved in designing and holding a series of focus groups with adult health and social care service users from vulnerable cohorts. It is based on a series of focus groups which the Institute of Public Health (IPH) held with specified cohorts as part of a policy development process on adult safeguarding for the Department of Health (DOH) in Ireland. The four cohorts were people with intellectual disability, cognitive impairments, significant mental health challenges and nursing home residents. This chapter does not describe the findings of the focus groups but outlines the ethical and methodological considerations that arose in designing and conducting this research, and the practical ethical safeguards employed to mitigate risk and comply with Irish and EU General Data Protection Regulation (GDPR) legislation governing health research. It outlines the ethical issues around protecting confidentiality and using incentives to encourage participation, how individuals' capacity to give informed consent was maximized, the risk-assessment and mitigation procedures used to prevent harms arising and the measures put in place to provide follow-up emotional support to participants.

This systematic review paper aims to investigate seasonal ambient change’s impact on the incidence of falls among older adults.

The population, exposure, outcome (PEO) structured framework was used to frame the research question prior to using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis framework. Three databases were searched, and a total of 12 studies were found for inclusion, and quality appraisal was carried out. Data extraction was performed, and narrative analysis was carried out.

Of the 12 studies, 2 found no link between seasonality and fall incidence. One study found fall rates increased during warmer months, and 9 of the 12 studies found that winter months and their associated seasonal changes led to an increase in the incidence in falls. The overall result was that cooler temperatures typically seen during winter months carried an increased risk of falling for older adults.

Additional research is needed, most likely examining the climate one lives in. However, the findings are relevant and can be used to inform health-care providers and older adults of the increased risk of falling during the winter.

Older people living in nursing homes have complex care needs and frequently need specialists’ advice and support that can be challenging to deliver in a rural setting. The aim of this paper is to describe a model of integrated care in a rural area supported by a nurse case manager.

A real-world evidence study of people living in Ribes de Freser nursing home, was conducted between specific timeframes in 2019 and 2022, comparing the casemix and outcomes of a traditional care model with the integrated interdisciplinary model.

The integrated care model led to a significant reduction in transfers to the emergency department, hospitalisations, outpatient medical visits and a reduction in the number of medicines. In addition, the number of residents receiving end-of-life care at the nursing home showed a substantial increase.

This case study contributes valuable evidence supporting the implementation of an integrated model of nurse case manager support in nursing homes, particularly in the rural contexts, where access to specialist medical staff may be limited. The findings highlight the potential benefits of person-centred integrated care for older adults, addressing their complex needs and improving end-of-life care in nursing home settings.

High-quality nursing home (NH) care has long been a challenge within the United States. For decades, policymakers at the state and federal levels have adopted and implemented regulations to target critical components of NH care outcomes. Simultaneously, our delivery system continues to change the role of NHs in patient care. For example, more acute patients are cared for in NHs, and the Center for Medicare and Medicaid Services (CMS) has implemented value payment programs targeting NH settings. As a part of these growing pressures from the broader healthcare delivery system, the culture-change movement has emerged among NHs over the past two decades, prompting NHs to embody more person-centered care as well as promote settings which resemble someone's home, as opposed to institutionalized healthcare settings.

Researchers have linked culture change to high-quality outcomes and the ability to adapt and respond to the ever-changing pressures brought on by changes in our regulatory and delivery system. Making enduring culture change within organizations has long been a challenge and focus in NHs. Despite research suggesting that culture-change initiatives that promote greater resident-centered care are associated with several desirable patient outcomes, their adoption and implementation by NHs are resource intensive, and research has shown that NHs with high percentages of low-income residents are especially challenged to adopt these initiatives.

This chapter takes a novel approach to examine factors that impact the adoption of culture-change initiatives by assessing knowledge management and the role of knowledge management activities in promoting the adoption of innovative care delivery models among under-resourced NHs throughout the United States. Using primary data from a survey of NH administrators, we conducted logistic regression models to assess the relationship between knowledge management and the adoption of a culture-change initiative as well as whether these relationships were moderated by leadership and staffing stability. Our study found that NHs were more likely to adopt a culture-change initiative when they had more robust knowledge management activities. Moreover, knowledge management activities were particularly effective at promoting adoption in NHs that struggle with leadership and nursing staff instability. Our findings support the notion that knowledge management activities can help NHs acquire and mobilize informational resources to support the adoption of care delivery innovations, thus highlighting opportunities to more effectively target efforts to stimulate the adoption and spread of these initiatives.