Shifting Gears: From Coercion to Respect in Residential Care

ERIC Educational Resources Information Center

Dunn, Leslie T.

2010-01-01

Charles Hall Youth Services (CHYS), a residential foster-care provider in Bismarck, North Dakota, desired to move from an adult-centered, punitive program model to a strength-based model with an emphasis on teaching critical life skills and behaviors to young clients. Through a partnership with the Teel Institute of Kansas City, Missouri, the…

Fresh Thinking about Families: A View from Residential Care

ERIC Educational Resources Information Center

Garfat, Thom

2011-01-01

Historically there has been a huge gulf between families and residential programs serving their children. This contradicted classic studies showing that family involvement is the cornerstone for successful outcomes with children in out-of-home care. But in spite of frequent early calls for such inclusion, the family was historically considered to…

Predicting the Academic Functioning of Youth Involved in Residential Care

ERIC Educational Resources Information Center

Griffith, Annette K.; Trout, Alexandra L.; Epstein, Michael H.; Garbin, Calvin P.; Pick, Robert; Wright, Tanya

2010-01-01

Youth involved in residential care programs present with significant difficulties across behavioral and mental health domains. Although this is a group that is also at considerable risk for academic failure, very little research has been done to understand the academic functioning of this population. The current study sought to expand what is…

Comparison of Four Probabilistic Models (CARES, Calendex, ConsEspo, SHEDS) to Estimate Aggregate Residential Exposures to Pesticides

EPA Science Inventory

Two deterministic models (US EPA’s Office of Pesticide Programs Residential Standard Operating Procedures (OPP Residential SOPs) and Draft Protocol for Measuring Children’s Non-Occupational Exposure to Pesticides by all Relevant Pathways (Draft Protocol)) and four probabilistic mo...

Older adult stereotypes among care providers in residential care facilities: examining the relationship between contact, eduaction, and ageism.

PubMed

Reyna, Christine; Goodwin, Eric J; Ferrari, Joseph R

2007-02-01

One barrier to quality elder care is ageism among care providers. In the present study, two models of stereotype reduction were tested with care providers at residential homes for older adults--the effects of contact and the effects of education on prejudice. Caregivers at five residential programs in Australia completed a survey assessing education, training, contact with older clients, prior experience, and stereotypes toward older adults. Results revealed that contact was not associated with fewer stereotypes but education (both specific and general) was associated with fewer stereotypes. Implications are discussed in terms of possible interventions and increasing optimal contact with older clients.

Medicaid-financed residential care for persons with mental retardation.

PubMed

Lakin, K C; Hall, M J

1990-12-01

Two sources of Medicaid support for persons with mental retardation and related conditions (MR/RC) are examined, the intermediate care facility for the mentally retarded (ICF/MR) program and the home and community-based services (HCBS) waiver. Results indicate that Medicaid support through the ICF/MR program has shown little recent growth in terms of number of persons served, although expenditures continue to increase. Medicaid's HCBS waiver is being used increasingly by States to support residential placement because of its greater flexibility and more individualized approach relative to ICF/MR care. Use of Medicaid to finance care for persons with MR/RC varies considerably across States.

Medicaid-financed residential care for persons with mental retardation

PubMed Central

Lakin, K. Charlie; Hall, Margaret Jean

1990-01-01

Two sources of Medicaid support for persons with mental retardation and related conditions (MRIRC) are examined, the intermediate care facility for the mentally retarded (ICF/MR) program and the home and community-based services (HCBS) waiver. Results indicate that Medicaid support through the ICF/MR program has shown little recent growth in terms of number of persons served, although expenditures continue to increase. Medicaid's HCBS waiver is being used increasingly by States to support residential placement because of its greater flexibility and more individualized approach relative to ICF/MR care. Use of Medicaid to finance care for persons with MR/RC varies considerably across States. PMID:10113489

What follows newborn screening? An evaluation of a residential education program for parents of infants with newly diagnosed cystic fibrosis.

PubMed

Sawyer, Susan M; Glazner, Judith A

2004-08-01

The diagnosis of a severe life-limiting condition, such as cystic fibrosis (CF), is generally followed by assessment and treatment of the child and education and counseling for parents. The introduction of newborn screening for CF provides an opportunity for standardized assessment and education. The aim of this study was to evaluate a 5-day residential assessment and education program for parents of infants who receive a diagnosis of CF after newborn screening. Eligible parents had a 6- to 30-month-old infant with CF diagnosed by newborn screening. Parents were interviewed by telephone using a structured questionnaire that addressed 3 main themes: 1) initial communication of the diagnosis of CF, 2) the perceived value of the 5-day assessment and education program, and 3) the perceived advantages and disadvantages of the residential component (Care-By-Parent unit) of the program. Fifteen of 17 eligible families took part in the 5-day assessment and education program, 12 of whom used the residential Care-By-Parent unit. At the end of the program, parents believed that they had the knowledge and skills required to manage their child's CF at home. One hundred percent endorsed the timing of the assessment and education program immediately after the child's diagnosis and would recommend it to other families in the same situation. Perceived advantages of the residential program were not having to travel (89%), being able to concentrate on CF (50%), and the benefit of a "home base" at the hospital (39%). Twenty-two percent reported that financial costs related to participation (paternal time off work) were a disadvantage, 17% reported additional strain on family members caring for siblings, and 17% mentioned lack of comfort within the unit. This time-intensive residential program was evaluated positively by parents of children with newly diagnosed CF. It provides a model for education programs after the diagnosis of CF by newborn screening, as well as for other pediatric conditions that require intensive parent education.

Aquatic exercise for residential aged care adults with dementia: benefits and barriers to participation.

PubMed

Henwood, Timothy; Neville, Christine; Baguley, Chantelle; Beattie, Elizabeth

2017-09-01

Pilot work by our group has demonstrated that aquatic exercise has valuable functional and psychosocial benefits for adults living in the residential aged care setting with dementia. The aim of the currents study was to advance this work by delivering the Watermemories Swimming Club aquatic exercise program to a more representative population of older, institutionalized adults with dementia. The benefits of 12 weeks of twice weekly participation in the Watermemories Swimming Club aquatic exercise program were assessed among an exercise and usual care control group of residential aged care adults with advanced dementia. A battery of physical and psychosocial measures were collected before and after the intervention period, and program implementation was also investigated. Seven residential aged care facilities of 24 approached, agreed to participate and 56 residents were purposefully allocated to exercise or control. Twenty-three participants per group were included in the final analysis. Both groups experienced decreases in skeletal muscle index and lean mass (p < 0.001), but exercise stifled losses in muscle strength and transition into sarcopenic. Behavioral and psychological symptoms of dementia and activities of daily living approached significance (p = 0.06) with positive trends observed across other psychosocial measures. This study demonstrates the value of exercise participation, and specifically aquatic exercise in comparison to usual care for older, institutionalized adults with advanced dementia. However, it also highlights a number of barriers to participation. To overcome these barriers and ensure opportunity to residents increased provider and sector support is required.

Maintaining Basic Skills through Summer Thematic Tutoring with Exceptional Students in Residential Foster Care.

ERIC Educational Resources Information Center

Colombey, Hanna

A thematic teaching program and portfolio assessment were used to maintain basic academic language arts and mathematics skills during the summer for 21 elementary students placed in residential foster care settings as victims of physical and/or sexual abuse. All activities were designed around the selected theme of a safari. Students listened to…

25 CFR 20.502 - Can Child Assistance funds be used to place Indian children in residential care facilities?

Code of Federal Regulations, 2010 CFR

2010-04-01

... 25 Indians 1 2010-04-01 2010-04-01 false Can Child Assistance funds be used to place Indian children in residential care facilities? 20.502 Section 20.502 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR HUMAN SERVICES FINANCIAL ASSISTANCE AND SOCIAL SERVICES PROGRAMS Child Assistance How...

Differences between Adopted and Nonadopted Adolescents in Wilderness and Residential Treatment

ERIC Educational Resources Information Center

Bettmann, Joanna E.; Freeman, Pamela Clarkson; Parry, Kimber J.

2015-01-01

Adopted children are disproportionately represented in residential treatment programs in the United States. Adopted children in the United States constitute only 2% to 3% of the U.S population. Nevertheless, they comprise approximately 16.5% of the population in residential care. This descriptive study evaluated a sample of 473 psychological…

Special Milk Program

ERIC Educational Resources Information Center

US Department of Agriculture, 2009

2009-01-01

The Special Milk Program provides milk to children in schools, child care institutions and eligible camps that do not participate in other Federal child nutrition meal service programs. The program reimburses schools and institutions for the milk they serve. In 2008, 4,676 schools and residential child care institutions participated, along with…

Cost effectiveness analysis of a smoke alarm giveaway program in Oklahoma City, Oklahoma.

PubMed

Haddix, A C; Mallonee, S; Waxweiler, R; Douglas, M R

2001-12-01

To estimate the cost effectiveness of the Lifesavers Residential Fire and Injury Prevention Program (LRFIPP), a smoke alarm giveaway program. In 1990, the LRFIPP distributed over 10,000 smoke alarms in an area of Oklahoma City at high risk for residential fire injuries. The program also included fire prevention education and battery replacement components. A cost effectiveness analysis was conducted from the societal and health care systems perspectives. The study compared program costs with the total costs of medical treatment and productivity losses averted over a five year period. Fatal and non-fatal residential fire related injuries prevented were estimated from surveillance data. Medical costs were obtained from chart reviews of patients with fire related injuries that occurred during the pre-intervention period. During the five years post-intervention, it is estimated that the LRFIPP prevented 20 fatal and 24 non-fatal injuries. From the societal perspective, the total discounted cost of the program was $531,000. Total discounted net savings exceeded $15 million. From the health care system perspective, the total discounted net savings were almost $1 million and would have a net saving even if program effectiveness was reduced by 64%. The program was effective in reducing fatal and non-fatal residential fire related injuries and was cost saving. Similar programs in other high risk areas would be good investments even if program effectiveness was lower than that achieved by the LRFIPP.

Mindfulness-based cognitive therapy for anxiety symptoms in older adults in residential care.

PubMed

Helmes, Edward; Ward, Bradley G

2017-03-01

Anxiety in older people is under-diagnosed and poorly treated despite significant impairments that arise from anxiety. Mindfulness-based cognitive therapy (MBCT) has been shown to be a promising treatment for anxiety. The aim of this study was to determine the effect of an MBCT program on anxiety symptoms in older people living in residential care. Fifty-two participants (34 females) were randomly allocated into therapy and control groups using a 2 × 3 mixed design. The average age of participants was 83 years. The group effect showed significant improvements on all measures at the end of the seven-week program in the therapy group, while the control group did not show significant changes. This study represents one of the first studies of the effectiveness of an MBCT program on anxiety symptoms for older people using a randomized controlled trial. The study has implications for future research that include the effectiveness of MBCT for the treatment of anxiety symptoms in older people, the utility of group therapy programs in residential care and the benefits of using specialized instruments for older populations.

The Design of an Effective Family Reintegration and Aftercare Program for Youth Successfully Leaving Residential Care.

ERIC Educational Resources Information Center

Roley, Jeffrey H.

The lack of support services following the release of adolescent youths from a residential treatment center back to their families is examined in this practicum. Consequently, the development of a family reintegration program for the treatment center is focused on the concept that effective aftercare begins at intake. Understandably, families…

Costs of day hospital and community residential chemical dependency treatment.

PubMed

Kaskutas, Lee Ann; Zavala, Silvana K; Parthasarathy, Sujaya; Witbrodt, Jane

2008-03-01

Patient placement criteria developed by the American Society of Addiction Medicine (ASAM) have identified a need for low-intensity residential treatment as an alternative to day hospital for patients with higher levels of severity. A recent clinical trial found similar outcomes at social model residential treatment and clinically-oriented day hospital programs, but did not report on costs. This paper addresses whether the similar outcomes in the recent trial were delivered with comparable costs, overall and within gender and ethnicity stratum. This paper reports on clients not at environmental risk who participated in a randomized trial conducted in three metropolitan areas served by a large pre-paid health plan. Cost data were collected using the Drug Abuse Treatment Cost Analysis Program (DATCAP). Costs per episode were calculated by multiplying DATCAP-derived program-specific costs by each client's length of stay. Differences in length of stay, and in per-episode costs, were compared between residential and day hospital subjects. Lengths of stay at residential treatment were significantly longer than at day hospital, in the sample overall and in disaggregated analyses. This difference was especially marked among non-Whites. The average cost per week was USD 575 per week at day hospital, versus USD 370 per week at the residential programs. However, because of the longer stays in residential, per-episode costs were significantly higher in the sample overall and among non-Whites (and marginally higher for men). These cost results must be considered in light of the null findings comparing outcomes between subjects randomized to residential versus day hospital programs. The longer stays in the sample overall and for non-White clients at residential programs came at higher costs but did not lead to better rates of abstinence. The short stays in day hospital among non-Whites call into question the attractiveness of day hospital for minority clients. Outcomes and costs at residential versus day hospital programs were similar for women and for Whites. For non-Whites, and marginally for men, a preference for residential care would appear to come at a higher cost. Lengths of stay in residential treatment were significantly longer than in day hospital, but costs per week were lower. Women and Whites appear to be equally well-served in residential and day hospital programs, with no significant cost differential. Provision of residential treatment for non-Whites may be more costly than day hospital, because their residential stays are likely to be 3 times longer than they would be if treated in day hospital. For men, residential care will be marginally more costly. IMPLICATIONS FOR HEALTH POLICY FORMULATION: Residential treatment appears to represent a cost-effective alternative to day hospital for female and White clients with severe alcohol and drug problems who are not at environmental risk. The much shorter stays in day hospital than at residential among non-Whites highlight the need for research to better understand how to best meet the needs and preferences of non-White clients when considering both costs and outcomes.

Pomeroy House: A Residential Treatment Program for Recovering Alcoholic Mothers and Their Children.

ERIC Educational Resources Information Center

Norwood, Lucille

Pomeroy House, a long-term residential treatment program in San Francisco, California, was created to help recovering alcoholic mothers and their children. Eight to 10 families stay at Pomeroy House for a minimum period of 6 months with extensions of up to 9 or 12 months, and the alcoholic mothers care for their children while recovering from…

A study protocol to investigate the management of depression and challenging behaviors associated with dementia in aged care settings.

PubMed

McCabe, Marita P; Mellor, David; Davison, Tanya E; Karantzas, Gery; von Treuer, Kathryn; O'Connor, Daniel W

2013-09-19

The high occurrence and under-treatment of clinical depression and behavioral and psychological symptoms of dementia (BPSD) within aged care settings is concerning, yet training programs aimed at improving the detection and management of these problems have generally been ineffective. This article presents a study protocol to evaluate a training intervention for facility managers/registered nurses working in aged care facilities that focuses on organisational processes and culture as well as knowledge, skills and self-efficacy. A Randomised Control Trial (RCT) will be implemented across 18 aged care facilities (divided into three conditions). Participants will be senior registered nurses and personal care attendants employed in the aged care facility. The first condition will receive the training program (Staff as Change Agents - Enhancing and Sustaining Mental Health in Aged Care), the second condition will receive the training program and clinical support, and the third condition will receive no intervention. Pre-, post-, 6-month and 12-month follow-up measures of staff and residents will be used to demonstrate how upskilling clinical leaders using our transformational training approach, as well as the use of a structured screening, referral and monitoring protocol, can address the mental health needs of older people in residential care. The expected outcome of this study is the validation of an evidence-based training program to improve the management of depression and BPSD among older people in residential care settings by establishing routine practices related to mental health. This relatively brief but highly focussed training package will be readily rolled out to a larger number of residential care facilities at a relatively low cost. Australia and New Zealand Clinical Trials Register (ANZCTR): The Universal Trial Number (UTN) is U1111-1141-0109.

FAQ about Recreational Therapy (RT)

MedlinePlus

... increasing number are being hired in residential facilities, community mental health centers, adult day care programs, substance abuse centers, hospice care, community centers, and in school systems. There is a ...

The care of Filipino juvenile offenders in residential facilities evaluated using the risk-need-responsivity model.

PubMed

Spruit, Anouk; Wissink, Inge B; Stams, Geert Jan J M

2016-01-01

According to the risk-need-responsivity model of offender, assessment and rehabilitation treatment should target specific factors that are related to re-offending. This study evaluates the residential care of Filipino juvenile offenders using the risk-need-responsivity model. Risk analyses and criminogenic needs assessments (parenting style, aggression, relationships with peers, empathy, and moral reasoning) have been conducted using data of 55 juvenile offenders in four residential facilities. The psychological care has been assessed using a checklist. Statistical analyses showed that juvenile offenders had a high risk of re-offending, high aggression, difficulties in making pro-social friends, and a delayed socio-moral development. The psychological programs in the residential facilities were evaluated to be poor. The availability of the psychological care in the facilities fitted poorly with the characteristics of the juvenile offenders and did not comply with the risk-need-responsivity model. Implications for research and practice are discussed. Copyright © 2016 Elsevier Ltd. All rights reserved.

Teaching Applied Behavior Analysis Knowledge Competencies to Direct-Care Service Providers: Outcome Assessment and Social Validation of a Training Program

ERIC Educational Resources Information Center

Luiselli, James K.; Bass, Jennifer D.; Whitcomb, Sara A.

2010-01-01

Staff training is a critical performance improvement objective within behavioral health care organizations. This study evaluated a systematic training program for teaching applied behavior analysis knowledge competencies to newly hired direct-care employees at a day and residential habilitation services agency for adults with intellectual and…

Examining Pretreatment Differences Between Veterans in Residential Versus Outpatient Treatment for Alcohol Use Disorder and Comorbid Combat-Related PTSD.

PubMed

Haller, Moira; Colvonen, Peter J; Davis, Brittany C; Trim, Ryan S; Bogner, Rebecca; Sevcik, John; Norman, Sonya B

2016-01-01

Veterans with alcohol use disorder (AUD) and co-occurring posttraumatic stress disorder (PTSD) have access to various residential and outpatient treatment programs through the VA Healthcare System. There is a need to better understand the characteristics and needs of veterans who engage in residential versus outpatient treatment in order to help inform veteran care and decisions about treatment services. The present study examined whether veterans with both AUD and combat-related PTSD who were enrolled in residential (n = 103) or outpatient treatment programs (n = 76) differed on pretreatment psychiatric symptoms, substance use and associated problems/behaviors, or demographics. Veterans completed self-report measures (which referenced symptoms in the past 30 days or 2 weeks) within the first week of PTSD/AUD treatment. Veterans in residential treatment had slightly worse PTSD symptoms compared to outpatient veterans; the groups reported similar levels of depression symptoms. Residential veterans had higher frequency of drug use, were more confident in their ability to be abstinent, attended more self-help meetings, spent more time around risky people or places, were more satisfied with their progress toward recovery goals, were more bothered by arguments with family/friends, and spent fewer days at work or school compared to outpatient veterans; the groups did not differ on drinking (frequency of use, binge drinking) or cravings. With respect to demographics, residential veterans were more likely to be married and non-Hispanic Caucasian (rather than minority races/ethnicities) compared to outpatient veterans. The finding that PTSD symptoms were more severe among veterans in residential substance use treatment highlights the importance of taking advantage of this crucial opportunity to engage veterans in evidence-based PTSD treatment. Consistent with other research, findings also indicated that individuals entering residential care have a higher level of impairment than those beginning outpatient care.

A smartphone application to support recovery from alcoholism: a randomized clinical trial.

PubMed

Gustafson, David H; McTavish, Fiona M; Chih, Ming-Yuan; Atwood, Amy K; Johnson, Roberta A; Boyle, Michael G; Levy, Michael S; Driscoll, Hilary; Chisholm, Steven M; Dillenburg, Lisa; Isham, Andrew; Shah, Dhavan

2014-05-01

Patients leaving residential treatment for alcohol use disorders are not typically offered evidence-based continuing care, although research suggests that continuing care is associated with better outcomes. A smartphone-based application could provide effective continuing care. To determine whether patients leaving residential treatment for alcohol use disorders with a smartphone application to support recovery have fewer risky drinking days than control patients. An unmasked randomized clinical trial involving 3 residential programs operated by 1 nonprofit treatment organization in the Midwestern United States and 2 residential programs operated by 1 nonprofit organization in the Northeastern United States. In total, 349 patients who met the criteria for DSM-IV alcohol dependence when they entered residential treatment were randomized to treatment as usual (n = 179) or treatment as usual plus a smartphone (n = 170) with the Addiction-Comprehensive Health Enhancement Support System (A-CHESS), an application designed to improve continuing care for alcohol use disorders. Treatment as usual varied across programs; none offered patients coordinated continuing care after discharge. A-CHESS provides monitoring, information, communication, and support services to patients, including ways for patients and counselors to stay in contact. The intervention and follow-up period lasted 8 and 4 months, respectively. Risky drinking days--the number of days during which a patient's drinking in a 2-hour period exceeded 4 standard drinks for men and 3 standard drinks for women, with standard drink defined as one that contains roughly 14 g of pure alcohol (12 oz of regular beer, 5 oz of wine, or 1.5 oz of distilled spirits). Patients were asked to report their risky drinking days in the previous 30 days on surveys taken 4, 8, and 12 months after discharge from residential treatment. For the 8 months of the intervention and 4 months of follow-up, patients in the A-CHESS group reported significantly fewer risky drinking days than did patients in the control group, with a mean of 1.39 vs 2.75 days (mean difference, 1.37; 95% CI, 0.46-2.27; P = .003). The findings suggest that a multifeatured smartphone application may have significant benefit to patients in continuing care for alcohol use disorders. clinicaltrials.gov Identifier: NCT01003119.

Self-help memory training for healthy older adults in a residential care center: specific and transfer effects on performance and beliefs.

PubMed

Cavallini, Elena; Bottiroli, Sara; Capotosto, Emanuela; De Beni, Rossana; Pavan, Giorgio; Vecchi, Tomaso; Borella, Erika

2015-08-01

Cognitive flexibility has repeatedly been shown to improve after training programs in community-dwelling older adults, but few studies have focused on healthy older adults living in other settings. This study investigated the efficacy of self-help training for healthy older adults in a residential care center on memory tasks they practiced (associative and object list learning tasks) and any transfer to other tasks (grocery lists, face-name learning, figure-word pairing, word lists, and text learning). Transfer effects on everyday life (using a problem-solving task) and on participants' beliefs regarding their memory (efficacy and control) were also examined. With the aid of a manual, the training adopted a learner-oriented approach that directly encouraged learners to generalize strategic behavior to new tasks. The maintenance of any training benefits was assessed after 6 months. The study involved 34 residential care center residents (aged 70-99 years old) with no cognitive impairments who were randomly assigned to two programs: the experimental group followed the self-help training program, whereas the active control group was involved in general cognitive stimulation activities. Training benefits emerged in the trained group for the tasks that were practiced. Transfer effects were found in memory and everyday problem-solving tasks and on memory beliefs. The effects of training were generally maintained in both practiced and unpracticed memory tasks. These results demonstrate that learner-oriented self-help training enhances memory performance and memory beliefs, in the short term at least, even in residential care center residents. Copyright © 2014 John Wiley & Sons, Ltd.

A smartphone application to support recovery from alcoholism: A randomized controlled trial

PubMed Central

Gustafson, David H.; McTavish, Fiona M.; Chih, Ming-Yuan; Atwood, Amy K.; A. Johnson, Roberta; G. Boyle, Michael; S. Levy, Michael; Driscoll, Hilary; M. Chisholm, Steven; Dillenburg, Lisa; Isham, Andrew; Shah, Dhavan

2014-01-01

Importance: Patients leaving treatment for alcohol-use disorders (AUDs) are not typically offered evidence-based continuing care, although research suggests that continuing care is associated with better outcomes. A smartphone-based application could provide effective continuing care. Objective: To determine whether patients leaving residential treatment for AUDs with a smartphone application to support recovery have fewer risky drinking days than control-group patients. Design: An un-blinded randomized controlled trial. Patients were randomized to treatment as usual or treatment as usual plus a smartphone with A-CHESS, an application designed to improve continuing care for AUDs. “A-CHESS” stands for Addiction – Comprehensive Health Enhancement Support System. Setting: Three residential programs operated by one treatment organization in the Midwestern US and 2 residential programs operated by one organization in the Northeastern US. Participants: 349 patients who met the criteria for DSM-IV alcohol dependence when they entered residential treatment. 179 were randomized to the control group and 170 to the treatment group. Intervention: Treatment as usual varied across programs; none offered patients coordinated continuing care after discharge. A-CHESS provides monitoring, information, communication, and support services to patients, including ways for patients and counselors to stay in contact. The intervention lasted 8 months and the follow-up period lasted 4 months. Main Outcome Measure: Risky drinking days—the number of days during which a patient’s drinking in a 2-hour period exceeded, for men, 4 standard drinks and for women, 3 standard drinks. Patients were asked to report their risky drinking days in the previous 30 days on surveys taken 4, 8, and 12 months after discharge from residential treatment. Results: For the 8 months of the intervention and 4 months of follow-up, patients in the A-CHESS group reported significantly fewer risky drinking days than patients in the control group (M = 1.39 vs. 2.75, respectively; P = .003; 95% CI [.46, 2.27]). Conclusions and Relevance: The findings suggest that a multi-featured smartphone application may have significant benefit to patients in continuing care for AUDs. Trial registration: clinicaltrials.gov Identifier: NCT01003119 PMID:24671165

25 CFR 20.507 - What requirements must foster care providers meet?

Code of Federal Regulations, 2010 CFR

2010-04-01

... ASSISTANCE AND SOCIAL SERVICES PROGRAMS Child Assistance Foster Care § 20.507 What requirements must foster care providers meet? If a child needs foster care, the social services worker must select care that... contain an approved current home study. (c) An off-reservation foster home, or residential care facility...

25 CFR 20.507 - What requirements must foster care providers meet?

Code of Federal Regulations, 2011 CFR

2011-04-01

... ASSISTANCE AND SOCIAL SERVICES PROGRAMS Child Assistance Foster Care § 20.507 What requirements must foster care providers meet? If a child needs foster care, the social services worker must select care that... contain an approved current home study. (c) An off-reservation foster home, or residential care facility...

25 CFR 20.507 - What requirements must foster care providers meet?

Code of Federal Regulations, 2014 CFR

2014-04-01

... ASSISTANCE AND SOCIAL SERVICES PROGRAMS Child Assistance Foster Care § 20.507 What requirements must foster care providers meet? If a child needs foster care, the social services worker must select care that... contain an approved current home study. (c) An off-reservation foster home, or residential care facility...

25 CFR 20.507 - What requirements must foster care providers meet?

Code of Federal Regulations, 2013 CFR

2013-04-01

... ASSISTANCE AND SOCIAL SERVICES PROGRAMS Child Assistance Foster Care § 20.507 What requirements must foster care providers meet? If a child needs foster care, the social services worker must select care that... contain an approved current home study. (c) An off-reservation foster home, or residential care facility...

25 CFR 20.507 - What requirements must foster care providers meet?

Code of Federal Regulations, 2012 CFR

2012-04-01

... ASSISTANCE AND SOCIAL SERVICES PROGRAMS Child Assistance Foster Care § 20.507 What requirements must foster care providers meet? If a child needs foster care, the social services worker must select care that... contain an approved current home study. (c) An off-reservation foster home, or residential care facility...

The efficacy of a multifactorial memory training in older adults living in residential care settings.

PubMed

Vranić, Andrea; Španić, Ana Marija; Carretti, Barbara; Borella, Erika

2013-11-01

Several studies have shown an increase in memory performance after teaching mnemonic techniques to older participants. However, transfer effects to non-trained tasks are generally either very small, or not found. The present study investigates the efficacy of a multifactorial memory training program for older adults living in a residential care center. The program combines teaching of memory strategies with activities based on metacognitive (metamemory) and motivational aspects. Specific training-related gains in the Immediate list recall task (criterion task), as well as transfer effects on measures of short-term memory, long-term memory, working memory, motivational (need for cognition), and metacognitive aspects (subjective measure of one's memory) were examined. Maintenance of training benefits was assessed after seven months. Fifty-one older adults living in a residential care center, with no cognitive impairments, participated in the study. Participants were randomly assigned to two programs: the experimental group attended the training program, while the active control group was involved in a program in which different psychological issues were discussed. A benefit in the criterion task and substantial general transfer effects were found for the trained group, but not for the active control, and they were maintained at the seven months follow-up. Our results suggest that training procedures, which combine teaching of strategies with metacognitive-motivational aspects, can improve cognitive functioning and attitude toward cognitive activities in older adults.

Health status, quality of life, residential stability, substance use, and health care utilization among adults applying to a supportive housing program.

PubMed

Hwang, Stephen W; Gogosis, Evie; Chambers, Catharine; Dunn, James R; Hoch, Jeffrey S; Aubry, Tim

2011-12-01

Supportive housing, defined as subsidized housing in conjunction with site-based social services, may help improve the health and residential stability of highly disadvantaged individuals. This study examined changes in health status, quality of life, substance use, health care utilization, and residential stability among 112 homeless and vulnerably housed individuals who applied to a supportive housing program in Toronto, Canada, from December 2005 to June 2007. Follow-up interviews were conducted every 6 months for 18 months. Comparisons were made between individuals who were accepted into the program (intervention) and those who were wait-listed (usual care) using repeated-measures analyses. Individuals who were accepted into the housing program experienced significantly greater improvements in satisfaction with living situation compared with individuals in the usual care group (time, F(3,3,261) = 47.68, p < 0.01; group × time, F(3,3,261) = 14.60, p < 0.01). There were no significant differences in other quality of life measures, health status, health care utilization, or substance use between the two groups over time. Significant improvement in residential stability occurred over time, independent of assigned housing group (time, F(3,3,261) = 9.96, p < 0.01; group × time, F(3,3,261) = 1.74, p = 0.17). The ability to examine the effects of supportive housing on homeless individuals was limited by the small number of participants who were literally homeless at baseline and by the large number of participants who gained stable housing during the study period regardless of their assigned housing status. Nonetheless, this study shows that highly disadvantaged individuals with a high prevalence of poor physical and mental health and substance use can achieve stable housing.

76 FR 15028 - Airport Improvement Program (AIP): Interim Policy Regarding Access to Airports From Residential...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-18

... resolution. The goal of the interim policy is to strike a careful balance by accommodating residential... will allow the agency to complete a separate, ongoing general aviation airport study that is analyzing the federally assisted general aviation airport system. The interim policy adopts the changes proposed...

Family Contact and Recidivism: A Longitudinal Study of Adjudicated Delinquents in Residential Care

ERIC Educational Resources Information Center

Ryan, Joseph P.; Yang, Huilan

2005-01-01

Families are critical to understanding and interrupting patterns of delinquent and criminal behavior. The objective of this study was to determine whether specific types of contact with family members are associated with a reduced risk of recidivism after a long-term residential program for juvenile delinquents. Family contact reports were…

Interprofessional education in practice: Evaluation of a work integrated aged care program.

PubMed

Lawlis, Tanya; Wicks, Alison; Jamieson, Maggie; Haughey, Amy; Grealish, Laurie

2016-03-01

Health professional clinical education is commonly conducted in single discipline modes, thus limiting student collaboration skills. Aged care residential facilities, due to the chronic and complex health care needs of residents, provide an ideal placement to provide a collaborative experience. Interprofessional education is widely acknowledged as the pedagogical framework through which to facilitate collaboration. The aim of the evaluation was to assess student attitudes towards collaboration after active involvement in an interprofessional education program. Students studying nursing, occupational therapy, and aged care were invited to complete a version of the Readiness for Interprofessional Learning Scale before and after participating in a three-week pilot interprofessional program. A positive change in student attitudes towards other health professionals and the importance of working in interprofessional teams was reported with significant differences between two statements indicated: Learning with health-care students before qualifications would improve relationships after qualifications; and I learned a lot from the students from the other disciplines. The innovative pilot project was found to enhance student learning in interprofessional teams and the aged care environment. Further development of this and similar interprofessional programs is required to develop sustainable student projects that have health benefits for residents in aged care residential facilities. Copyright © 2015 Elsevier Ltd. All rights reserved.

A systematic review protocol of educational programs for nursing staff on management of resident-to-resident elder mistreatment in residential aged care homes.

PubMed

Ellis, Julie M; Ayala Quintanilla, Beatriz Paulina; Ward, Louise; Campbell, Fergus; Hillel, Stav; Downing, Carolyn; Teresi, Jeanne; Ramirez, Mildred

2018-05-06

To review evidence concerning educational programs for nursing staff on management of resident-to-resident elder mistreatment with the aim of preventing and reducing this abuse in residential aged care homes. Although elder abuse has received considerable attention, very little is known regarding resident-to-resident elder mistreatment in residential aged care homes and about interventions/programs to prevent and reduce this harm. Nurses play an essential role in identifying and managing aggressive interactions. However, many nurses may not recognize these behaviours as forms of abuse. Thus, it is important to ascertain if educational programs for nursing staff have been developed and implemented. Quantitative systematic review registered on PROSPERO (CRD42017080925). A systematic search of English published studies between 1980 - 2017 will be conducted in CINAHL, Embase, MEDLINE, ProQuest, PsychInfo and Scopus. Risk of bias and quality of the studies will be evaluated by using the Cochrane Collaboration's tool and the Methodological Index for Nonrandomized studies. A meta-analysis will be performed, if sufficient homogeneity exists; otherwise, data will be summarized by using a narrative description. This study was funded in January 2017. Nursing staff should play a pivotal role in preventing and/or reducing resident-to-resident elder mistreatment. Therefore, it is important to identify available educational programs for nursing staff dealing with this abuse. Consequently, this review may provide evidence-based care for nursing staff to assist them in protecting older residents from experiencing abuse or being abused and in improving their well-being. © 2018 John Wiley & Sons Ltd.

Integrated approach to oral health in aged care facilities using oral health practitioners and teledentistry in rural Queensland.

PubMed

Tynan, Anna; Deeth, Lisa; McKenzie, Debra; Bourke, Carolyn; Stenhouse, Shayne; Pitt, Jacinta; Linneman, Helen

2018-04-16

Residents of residential aged care facilities are at very high risk of developing complex oral diseases and dental problems. Key barriers exist in delivering oral health services to residential aged care facilities, particularly in regional and rural areas. A quality improvement study incorporating pre- and post chart audits and pre- and post consultation with key stakeholders, including staff and residents, expert opinion on cost estimates and field notes were used. One regional and three rural residential aged care facilities situated in a non-metropolitan hospital and health service in Queensland. Number of appointments avoided at an oral health facility Feedback on program experience by staff and residents Compliance with oral health care plan implementation Observations of costs involved to deliver new service. The model developed incorporated a visit by an oral health therapist for screening, education, simple intervention and referral for a teledentistry session if required. Results showed an improvement in implementation of oral health care plans and a minimisation of need for residents to attend an oral health care facility. Potential financial and social cost savings for residents and the facilities were also noted. Screening via the oral health therapist and teledentistry appointment minimises the need for a visit to an oral health facility and subsequent disruption to residents in residential aged care facilities. © 2018 National Rural Health Alliance Ltd.

Difficult relationships--interactions between family members and staff in long-term care.

PubMed

Norris, S

2000-01-01

Staff of long-term care facilities and family members have a common responsibility to ensure the best course of treatment and everyday care for residents who often cannot speak for themselves. Understanding the difference between instrumental and preservative care, and who the proper agent is to provide care in each category will not only improve staff/family interactions, but residential care in general. The Resident Enrichment and Activity Program improves the family/staff relationship obliquely by involving family in social activities; the Family Involvement in Care program, and the Patterns in Caregiving program directly target the relationship and involve the facility's administration to effect policy change.

Work-related change in residential elderly care: Trust, space and connectedness

PubMed Central

van der Borg, Wieke E; Verdonk, Petra; Dauwerse, Linda; Abma, Tineke A

2017-01-01

Increasing care needs and a declining workforce put pressure on the quality and continuity of long-term elderly care. The need to attract and retain a solid workforce is increasingly acknowledged. This study reports about a change initiative that aimed to improve the quality of care and working life in residential elderly care. The research focus is on understanding the process of workforce change and development, by retrospectively exploring the experiences of care professionals. A responsive evaluation was conducted at a nursing home department in the Netherlands one year after participating in the change program. Data were gathered by participant observations, interviews and a focus and dialogue group. A thematic analysis was conducted. Care professionals reported changes in workplace climate and interpersonal interactions. We identified trust, space and connectedness as important concepts to understand perceived change. Findings suggest that the interplay between trust and space fostered interpersonal connectedness. Connectedness improved the quality of relationships, contributing to the well-being of the workforce. We consider the nature and contradictions within the process of change, and discuss how gained insights help to improve quality of working life in residential elderly care and how this may reflect in the quality of care provision. PMID:28626242

Every Child and Family Matters: A Program Prepared for Campus Setting and Community Outreach. Leader's Guide (Experimental Edition).

ERIC Educational Resources Information Center

Salvation Army. New York, NY.

This guide is one of a series of Education for Parenthood manuals developed by the Salvation Army for use in programs to prepare teenagers for parenthood or for child care careers. This volume outlines four courses for troubled girls and young adult women who receive residential care or who may be served through community outreach. The program was…

Operating characteristics of residential care communities, by community bed size: United States, 2012.

PubMed

Caffrey, Christine; Harris-Kojetin, Lauren; Rome, Vincent; Sengupta, Manisha

2014-11-01

In 2012, the majority of residential care communities had 4–25 beds, yet 71% of residents lived in communities with more than 50 beds. A lower percentage of communities with 4–25 beds were chain-affiliated, nonprofit, and in operation 10 years or more, compared with communities with 26–50 and more than 50 beds. Dementia-exclusive care or dementia care units were more common as community size increased. A higher percentage of communities with more than 50 beds screened for cognitive impairment and offered dementia-specific programming compared with communities with 4–25 and 26–50 beds. A higher percentage of communities with more than 50 beds screened for depression compared with communities with 4–25 beds. Compared with communities with 4–25 beds, a higher percentage of communities with 26–50 beds and more than 50 beds provided therapeutic, hospice, mental health, and dental services; but a lower percentage of communities with more than 50 beds provided skilled nursing services than did smaller communities. This report presents national estimates of residential care communities, using data from the first wave of NSLTCP. This brief profile of residential care communities provides useful information to policymakers, providers, researchers, and consumer advocates as they plan to meet the needs of an aging population. The findings also highlight the diversity of residential care communities across different sizes. Corresponding state estimates and their standard errors for the national figures in this data brief can be found on the NSLTCP website at http://www.cdc.gov/nchs/nsltcp/ nsltcp_products.htm. These national and state estimates establish a baseline for monitoring trends among residents living in residential care. All material appearing in this report is in the public domain and may be reproduced or copied without permission; citation as to source, however, is appreciated.

The School Breakfast Program

ERIC Educational Resources Information Center

US Department of Agriculture, 2009

2009-01-01

The School Breakfast Program is a federally assisted meal program operating in public and nonprofit private schools and residential child care institutions. It began as a pilot project in 1966, and was made permanent in 1975. The School Breakfast Program is administered at the Federal level by the Food and Nutrition Service. At the State level,…

The effectiveness of an integrated collaborative care model vs. a shifted outpatient collaborative care model on community functioning, residential stability, and health service use among homeless adults with mental illness: a quasi-experimental study.

PubMed

Stergiopoulos, Vicky; Schuler, Andrée; Nisenbaum, Rosane; deRuiter, Wayne; Guimond, Tim; Wasylenki, Donald; Hoch, Jeffrey S; Hwang, Stephen W; Rouleau, Katherine; Dewa, Carolyn

2015-08-28

Although a growing number of collaborative mental health care models have been developed, targeting specific populations, few studies have utilized such interventions among homeless populations. This quasi-experimental study compared the outcomes of two shelter-based collaborative mental health care models for men experiencing homelessness and mental illness: (1) an integrated multidisciplinary collaborative care (IMCC) model and (2) a less resource intensive shifted outpatient collaborative care (SOCC) model. In total 142 participants, 70 from IMCC and 72 from SOCC were enrolled and followed for 12 months. Outcome measures included community functioning, residential stability, and health service use. Multivariate regression models were used to compare study arms with respect to change in community functioning, residential stability, and health service use outcomes over time and to identify baseline demographic, clinical or homelessness variables associated with observed changes in these domains. We observed improvements in both programs over time on measures of community functioning, residential stability, hospitalizations, emergency department visits and community physician visits, with no significant differences between groups over time on these outcome measures. Our findings suggest that shelter-based collaborative mental health care models may be effective for individuals experiencing homelessness and mental illness. Future studies should seek to confirm these findings and examine the cost effectiveness of collaborative care models for this population.

A Behavioral Approach to Improving Self-Care Skills in OBS Patients.

ERIC Educational Resources Information Center

McEvoy, Cathy L.; Patterson, Roger L.

Traditionally, the treatment of geriatric patients suffering from Organic Brain Syndrome (OBS) has been characterized by non-therapeutic custodial care. To determine whether elderly clients with dementia can benefit from self-care skill training, and to compare their progress with clients without OBS, 30 clients of the Residential Aging Program in…

77 FR 58403 - Announcing the Award of 24 Single-Source Program Expansion Supplement Grants Under the...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-09-20

...] Announcing the Award of 24 Single-Source Program Expansion Supplement Grants Under the Unaccompanied Alien... under its Unaccompanied Alien Children's (UAC) Program where grantees provide a range of custodial/residential shelter care and services for recently arrived unaccompanied alien children. SUMMARY: The...

Implementation of an Initial Training Program for New Employees in a Profoundly Mentally and Physically Handicapped Children and Adult Residential Facility.

ERIC Educational Resources Information Center

Hoeft, Linda A.

A project was designed to reduce the turnover of direct care staff in a community-based residential facility that provides a home and educational or adult day training services for 54 severely or profoundly mentally and physically handicapped children and adults. The project sought to reduce total staff turnover by 40%, reduce employee…

Children With Intellectual Disability and Hospice Utilization: The Moderating Effect of Residential Care.

PubMed

Lindley, Lisa C

2017-01-01

Children with intellectual disability commonly lack access to pediatric hospice care services. Residential care may be a critical component in providing access to hospice care for children with intellectual disability. This research tested whether residential care intensifies the relationship between intellectual disability and hospice utilization (ie, hospice enrollment, hospice length of stay), while controlling for demographic characteristics. Multivariate regression analyses were conducted using 2008 to 2010 California Medicaid claims data. The odds of children with intellectual disability in residential care enrolling in hospice care were 3 times higher than their counterparts in their last year of life, when controlling for demographics. Residential care promoted hospice enrollment among children with intellectual disability. The interaction between intellectual disability and residential care was not related to hospice length of stay. Residential care did not attenuate or intensify the relationship between intellectual disability and hospice length of stay. The findings highlight the important role of residential care in facilitating hospice enrollment for children with intellectual disability. More research is needed to understand the capability of residential care staff to identify children with intellectual disability earlier in their end-of-life trajectory and initiate longer hospice length of stays.

Building a Re-ED Culture

ERIC Educational Resources Information Center

Mills, Connie

2011-01-01

Youth Villages is a private nonprofit organization, headquartered in Memphis, Tennessee. Originally providing residential services, it now also offers a full continuum including intensive in-home services, foster care, adoption, and transitional living services for young people who age out of foster care. Each of the programs has its own…

Marketing Residential Treatment Programs for Eating Disorders: A Call for Transparency.

PubMed

Attia, Evelyn; Blackwood, Kristy L; Guarda, Angela S; Marcus, Marsha D; Rothman, David J

2016-06-01

Residential behavioral treatment is a growing sector of the health care industry and is used by a large proportion of adolescent and adult patients with eating disorders. These programs and the organizations that own them have developed extensive marketing strategies that target clinicians and include promotional gifts, meals, travel reimbursement, and continuing education credit. Legislation and policy changes have limited these types of activities when conducted by the pharmaceutical industry, and awareness of conflicts of interest associated with clinician-targeted advertising of drugs and devices has increased. However, similar practices by the behavioral health care industry have evolved without oversight. The authors urge clinicians to consider how marketing strategies by treatment facilities may influence their referral behaviors and call for improved transparency regarding gifts and payments from treatment facilities.

Well-Being With Objects: Evaluating a Museum Object-Handling Intervention for Older Adults in Health Care Settings.

PubMed

Thomson, Linda J M; Chatterjee, Helen J

2016-03-01

The extent to which a museum object-handling intervention enhanced older adult well-being across three health care settings was examined. The program aimed to determine whether therapeutic benefits could be measured objectively using clinical scales. Facilitator-led, 30 to 40 min sessions handling and discussing museum objects were conducted in acute and elderly care (11 one-to-ones), residential (4 one-to-ones and 1 group of five), and psychiatric (4 groups of five) settings. Pre-post measures of psychological well-being (Positive Affect and Negative Affect Schedule) and subjective wellness and happiness (Visual Analogue Scales) were compared. Positive affect and wellness increased significantly in acute and elderly and residential care though not psychiatric care whereas negative affect decreased and happiness increased in all settings. Examination of audio recordings revealed enhanced confidence, social interaction, and learning. The program allowed adults access to a museum activity who by virtue of age and ill health would not otherwise have engaged with museum objects. © The Author(s) 2014.

National School Lunch Program

ERIC Educational Resources Information Center

US Department of Agriculture, 2009

2009-01-01

The National School Lunch Program is a federally assisted meal program operating in over 101,000 public and non-profit private schools and residential child care institutions. It provides nutritionally balanced, low-cost or free lunches to more than 30.5 million children each school day in 2008. In 1998, Congress expanded the National School Lunch…

Exploring staff diabetes medication knowledge and practices in regional residential care: triangulation study.

PubMed

Wellard, Sally Jane; Rasmussen, Bodil; Savage, Sally; Dunning, Trisha

2013-07-01

This study is drawn from a larger project that aimed to identify the staffing and organisational factors influencing the quality of diabetes care for older people living in residential care in regional Victoria, Australia. The focus of the current study is on medication management for residents with diabetes. With a continuous rise in diabetes in the population, there is an associated increase in the prevalence of diabetes in aged care residential settings. However, there is little specific guidance on how to manage diabetes in older people living in institutional settings who experience multiple concurrent chronic conditions. A triangulation strategy consisting of three phases. A one-shot cross-sectional survey (n = 68) focus group interviews and a case file audit (n = 20). Data were collected between May 2009-January 2010. Staff knowledge of diabetes and its contemporary medication management was found to be suboptimal. Challenges to managing residents with diabetes included limited time, resident characteristics and communication systems. Additionally, the variability in medical support available to residents and a high level of polypharmacy added to the complexity of medication management of resident. The current study suggests administering medicine to residents in aged care settings is difficult and has potentially serious medical, professional and economic consequences. Limitations to staff knowledge of contemporary diabetes care and medications potentially place residents with diabetes at risk of receiving less than optimal diabetes care. Providing evidence-based guidelines about diabetes care in residential care settings is essential to achieve acceptable outcomes and increase the quality of life for residents in public aged care. Continuing education programs in diabetes care specifically related to medication must be provided to all health professionals and encompass scope of practice. © 2013 John Wiley & Sons Ltd.

Aging in Hong Kong: the institutional population.

PubMed

Woo, Jean; Chau, Patsy P H

2009-09-01

The Hong Kong population is aging rapidly, such that there are concerns about residential care adequacy in terms of number of places as well as quality of care. A total of 1820 residents living in a representative sample of residential care facilities were surveyed. The survey showed a substantial proportion with cognitive dysfunction, mood problems, communication and vision problems, chronic disabling diseases, impairment in activities of daily living, and undernutrition. Programs of activities and rehabilitation were generally unavailable. Those in for-profit facilities had a worse profile. An approximate estimation of numbers of staff required based on case mix revealed considerable understaffing among the for-profit facilities. Issues of quality of care would be all the more important with anticipated future increase in the institutional population of older people.

Symposium: Compliance and Quality in Residential Life. Foreword.

ERIC Educational Resources Information Center

Kennedy, Edward M.

1992-01-01

The senator from Massachusetts introduces this special issue by reviewing his family's interest in persons with mental retardation, the potential of the Americans with Disabilities Act, the Intermediate Care Facilities for the Mentally Retarded (ICF/MR) program, and the importance of improving care for residents of ICFs. (DB)

Characteristics of Owners of Residential Care Facilities.

ERIC Educational Resources Information Center

Horgan, Dianne D.; And Others

Although researchers have investigated quality and cost of residential care, little is known about the people who own and manage residential care facilities. In an attempt to find out more about these managers, members of the National Association of Residential Care Facilities (NARCF) were surveyed. Members (N=175) responded to questionnaires…

38 CFR 17.65 - Approvals and provisional approvals of community residential care facilities.

Code of Federal Regulations, 2010 CFR

2010-07-01

... approvals of community residential care facilities. 17.65 Section 17.65 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Community Residential Care § 17.65 Approvals and provisional approvals of community residential care facilities. (a) An approval of a facility meeting all of...

38 CFR 17.67 - Request for a hearing.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Community Residential Care § 17.67 Request for a hearing. The community residential care facility operator... of VA approval until the hearing official issues a written decision on the community residential care... after the time limit, if the community residential care facility shows that the failure of the request...

Feasibility of implementing oral health guidelines in residential care settings: views of nursing staff and residential care workers.

PubMed

Hilton, Shaylee; Sheppard, Justine Joan; Hemsley, Bronwyn

2016-05-01

To determine the views of nurses and on the feasibility of implementing current evidence-based guidelines for oral care, examining barriers and facilitators to implementation. This mixed-methods study involved an online survey of 35 nurses and residential care workers, verified and expanded upon by one focus group of six residential care workers. Results reflected that nurses and residential care workers (a) have little or no training in recommended oral care techniques, and (b) lack access to the equipment and professional supports needed to provide adequate oral care. Basic oral care might be performed less than once per day in some settings and patients with problematic behaviours, dysphagia, or sensitivities associated with poor oral health might be less likely to receive oral care. While lack of time was highlighted as a barrier in the survey findings, focus group members considered that time should not be a barrier to prioritising oral care practices on a daily basis in residential care settings. There are several important discrepancies between the recommendations made in evidence-based guidelines for oral care and the implementation of such practices in residential care settings. Nursing and residential care staff considered adequate oral care to be feasible if access, funding and training barriers are removed and facilitators enhanced. Copyright © 2015 Elsevier Inc. All rights reserved.

How to help depressed older people living in residential care: a multifaceted shared-care intervention for late-life depression.

PubMed

Llewellyn-Jones, R H; Baikie, K A; Castell, S; Andrews, C L; Baikie, A; Pond, C D; Willcock, S M; Snowdon, J; Tennant, C C

2001-12-01

To describe a population-based, multifaceted shared-care intervention for late-life depression in residential care as a new model of geriatric practice, to outline its development and implementation, and to describe the lessons learned during the implementation process. A large continuing-care retirement community in Sydney, Australia, providing three levels of care (independent living units, assisted-living complexes, and nursing homes). The intervention was implemented for the entire non-nursing home population (residents in independent and assisted living: N = 1,466) of the facility and their health care providers. Of the 1,036 residents whowere eligible and agreed to be interviewed, 281 (27.1%) were classified as depressed according to the Geriatric Depression Scale. INTERVENTION DESCRIPTION: The intervention included: (a) multidisciplinary collaboration between primary care physicians, facility health care providers, and the local psychogeriatric service; (b) training for primary care physicians and other facility health care providers about detecting and managing depression; and (c) depression-related health education/promotion programs for residents. The intervention was widely accepted by residents and their health care providers, and was sustained and enhanced by the facility after the completion of the study. It is possible to implement and sustain a multifaceted shared-care intervention for late-life depression in a residential care facility where local psychogeriatric services are scarce, staff-to-resident ratios are low, and the needs of depressed residents are substantial.

29 CFR 778.601 - Special overtime provisions available for hospital and residential care establishments under...

Code of Federal Regulations, 2010 CFR

2010-07-01

... residential care establishments under section 7(j). 778.601 Section 778.601 Labor Regulations Relating to... provisions available for hospital and residential care establishments under section 7(j). (a) The statutory provision. Section 7(j) of the Act provides, for hospital and residential care establishment employment...

The effectiveness of an aged care specific leadership and management program on workforce, work environment, and care quality outcomes: design of a cluster randomised controlled trial.

PubMed

Jeon, Yun-Hee; Simpson, Judy M; Chenoweth, Lynn; Cunich, Michelle; Kendig, Hal

2013-10-25

A plethora of observational evidence exists concerning the impact of management and leadership on workforce, work environment, and care quality. Yet, no randomised controlled trial has been conducted to test the effectiveness of leadership and management interventions in aged care. An innovative aged care clinical leadership program (Clinical Leadership in Aged Care--CLiAC) was developed to improve managers' leadership capacities to support the delivery of quality care in Australia. This paper describes the study design of the cluster randomised controlled trial testing the effectiveness of the program. Twenty-four residential and community aged care sites were recruited as managers at each site agreed in writing to participate in the study and ensure that leaders allocated to the control arm would not be offered the intervention program. Sites undergoing major managerial or structural changes were excluded. The 24 sites were randomly allocated to receive the CLiAC program (intervention) or usual care (control), stratified by type (residential vs. community, six each for each arm). Treatment allocation was masked to assessors and staff of all participating sites. The objective is to establish the effectiveness of the CLiAC program in improving work environment, workforce retention, as well as care safety and quality, when compared to usual care. The primary outcomes are measures of work environment, care quality and safety, and staff turnover rates. Secondary outcomes include manager leadership capacity, staff absenteeism, intention to leave, stress levels, and job satisfaction. Differences between intervention and control groups will be analysed by researchers blinded to treatment allocation using linear regression of individual results adjusted for stratification and clustering by site (primary analysis), and additionally for baseline values and potential confounders (secondary analysis). Outcomes measured at the site level will be compared by cluster-level analysis. The overall costs and benefits of the program will also be assessed. The outcomes of the trial have the potential to inform actions to enhance leadership and management capabilities of the aged care workforce, address pressing issues about workforce shortages, and increase the quality of aged care services. Australian New Zealand Clinical Trials Registry (ACTRN12611001070921).

Progressive Resistance and Balance Training for Falls Prevention in Long-Term Residential Aged Care: A Cluster Randomized Trial of the Sunbeam Program.

PubMed

Hewitt, Jennifer; Goodall, Stephen; Clemson, Lindy; Henwood, Timothy; Refshauge, Kathryn

2018-04-01

Falls prevention is an international priority, and residents of long-term aged care fall approximately 3 times more often than community dwellers. There is a relative scarcity of published trials in this setting. Our objective was to undertake a randomized controlled trial to test the effect of published best practice exercise in long-term residential aged care. The trial was designed to determine if combined high level balance and moderate intensity progressive resistance training (the Sunbeam Program) is effective in reducing the rate of falls in residents of aged care facilities. A cluster randomized controlled trial of 16 residential aged care facilities and 221 participants was conducted. The broad inclusion criterion was permanent residents of aged care. Exclusions were diagnosed terminal illness, no medical clearance, permanent bed- or wheelchair-bound status, advanced Parkinson's disease, or insufficient cognition to participate in group exercise. Assessments were taken at baseline, after intervention, and at 12 months. Randomization was performed by computer-generated sequence to receive either the Sunbeam program or usual care. A cluster refers to an aged care facility. The program consisted of individually prescribed progressive resistance training plus balance exercise performed in a group setting for 50 hours over a 25-week period, followed by a maintenance period for 6 months. The primary outcome measure was the rate of falls (number of falls and days followed up). Secondary outcomes included physical performance (Short Physical Performance Battery), quality of life (36-item Short-Form Health Survey), functional mobility (University of Alabama Life Space Assessment), fear of falling (Falls Efficacy Scale International), and cognition (Addenbrooke's Cognitive Evaluation-revised). The rate of falls was reduced by 55% in the exercise group (incidence rate ratio = 0.45, 95% confidence interval 0.17-0.74); an improvement was also seen in physical performance (P = .02). There were no serious adverse events. The Sunbeam Program significantly reduced the rate of falls and improved physical performance in residents of aged care. This finding is important as prior work in this setting has returned inconsistent outcomes, resulting in best practice guidelines being cautious about recommending exercise in this setting. This work provides an opportunity to improve clinical practice and health outcomes for long-term care residents. Copyright © 2017 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

Should we educate care staff to improve the oral health and oral hygiene of people with intellectual disability in residential care? Real world lessons from a randomized controlled trial.

PubMed

Mac Giolla Phadraig, Caoimhin; Guerin, Suzanne; Nunn, June

2015-01-01

This study assessed the impact of a multitiered oral health educational program on the oral health and oral hygiene of people with intellectual disabilities (ID). In a controlled pretest, posttest trial, with cluster randomization, a pyramidal training program was delivered to residential staff who cared for a randomly allocated, purposively stratified intervention group of people with ID living in community care homes. A control group lived in centers where staff received no training. Clinical measures were carried out pre- and posttest. Difference in Modified Gingival Index (MGI) and Plaque Index (PI) was measured posttest using ANCOVA. Seventy-six participants took part, representing 49.0% of the invited sample (n = 155). Fourteen did not receive clinical examination. There was one dropout 6-9 months later. A 10.5% and 8.5% reduction in mean MGI and PI was evident at posttest but did not show statistically significant difference, when controlling for baseline covariates (p > 0.05, ANCOVA). Mean MGI and PI scores were not significantly different among people with ID whose care staff had and had not received oral health training. Limitations are discussed. The results indicate that this program failed to significantly improve oral health or oral hygiene, despite the intervention being "educationally" successful. More research is needed. © 2015 Special Care Dentistry Association and Wiley Periodicals, Inc.

Evaluation of Components of Residential Treatment by Medicaid ICF-MR Surveys: A Validity Assessment.

ERIC Educational Resources Information Center

Reid, Dennis H.; And Others

1991-01-01

Four studies found serious problems with components of the federal Medicaid program's survey process for evaluating intermediate care facilities for the mentally retarded--surveys did not discriminate between certified and noncertified units, direct-care staff behavior was very reactive to the survey's presence, and service providers had divergent…

The looming expansion and transformation of public substance abuse treatment under the Affordable Care Act.

PubMed

Buck, Jeffrey A

2011-08-01

Public substance abuse treatment services have largely operated as an independent part of the overall health care system, with unique methods of administration, funding, and service delivery. The Affordable Care Act of 2010 and other recent health care reforms, coupled with declines in state general revenue spending, will change this. Overall funding for these substance abuse services should increase, and they should be better integrated into the mainstream of general health care. Reform provisions are also likely to expand the variety of substance abuse treatment providers and shift services away from residential and stand-alone programs toward outpatient programs and more integrated programs or care systems. As a result, patients should have better access to care that is more medically based and person-centered.

Comparing clinical and demographic characteristics of people with mental illness in hospital- and community-based residential rehabilitation units in Queensland.

PubMed

Meehan, Tom; Stedman, Terry; Parker, Stephen; Curtis, Bretine; Jones, Donna

2017-05-01

Objective The aim of the present study was to examine care pathways and characteristics of mental health consumers participating in both hospital- and community-based residential rehabilitation programs. Methods An audit of consumers (n=240) in all publicly funded residential rehabilitation units in Queensland was performed on the same day in 2013. Data collection focused on demographic characteristics, clinical information and measures of consumer functioning. Results Significant differences emerged for consumers in community- and hospital-based services with regard to age, length of stay, functioning, Mental Health Act status, guardianship status, family contact and risk of violence. Consumers in hospital-based programs have more severe and complex problems. Conclusions Consumers in residential rehabilitation units have high levels of disability, poor physical health and high levels of vulnerability. Nonetheless, it is likely that a sizeable proportion of consumers occupying rehabilitation beds in Queensland could be discharged if more 'step-down' options to move patients on were available. What is known about the topic? A small subgroup of people with severe and complex mental health problems is likely to require time in a residential rehabilitation program. This group is characterised by failure to respond to treatment, severe negative symptoms and some degree of cognitive impairment. What does this paper add? Patients currently occupying residential rehabilitation beds in Queensland have high levels of disability, poor physical health and high levels of vulnerability. Patients in hospital-based programs are more severely disabled than those in community-based programs. What are the implications for practitioners? It is likely that a sizeable proportion of patients occupying rehabilitation beds in Queensland could be discharged if more 'step-down' options were available. Future planning initiatives need to focus on developing a greater array of community support options to facilitate the discharge of people from residential services.

Residential Group Care Quarterly. Volume 5, Number 3, Winter 2005

ERIC Educational Resources Information Center

Michael, Jennifer, Ed.

2005-01-01

This issue of "Residential Group Care Quarterly" contains the following articles: (1) "Promising Practices for Adequately Funding and Reimbursing Residential Services" (Lloyd Bullard); (2) "Closing the Gender Gap" (Erin Andersen); (3) "Residential Child Care: Guidelines for Physical Techniques, Crisis Prevention, and Management" (Kurk Lalemand);…

25 CFR 20.508 - What must the social services agency do when a child is placed in foster care, residential care...

Code of Federal Regulations, 2011 CFR

2011-04-01

... 25 Indians 1 2011-04-01 2011-04-01 false What must the social services agency do when a child is... INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR HUMAN SERVICES FINANCIAL ASSISTANCE AND SOCIAL SERVICES PROGRAMS Child Assistance Foster Care § 20.508 What must the social services agency do when a child is...

25 CFR 20.508 - What must the social services agency do when a child is placed in foster care, residential care...

Code of Federal Regulations, 2010 CFR

2010-04-01

... 25 Indians 1 2010-04-01 2010-04-01 false What must the social services agency do when a child is... INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR HUMAN SERVICES FINANCIAL ASSISTANCE AND SOCIAL SERVICES PROGRAMS Child Assistance Foster Care § 20.508 What must the social services agency do when a child is...

Iraq and Afghanistan Veterans: National Findings from VA Residential Treatment Programs

PubMed Central

Cook, Joan M.; Dinnen, Stephanie; O’Donnell, Casey; Bernardy, Nancy; Rosenheck, Robert; Desai, Rani

2013-01-01

A quality improvement effort was undertaken in Department of Veterans Affairs’ (VA) residential treatment programs for Posttraumatic Stress Disorder (PTSD) across the United States. Qualitative interviews were conducted with over 250 directors, providers, and staff during site visits of 38 programs. The aims of this report are to describe clinical issues and distinctive challenges in working with veterans from Iraq and Afghanistan and approaches to addressing their needs. Providers indicated that the most commonly reported problems were: acute PTSD symptomotology; other complex mental health symptom presentations; broad readjustment problems; and difficulty with time demands of and readiness for intensive treatment. Additional concerns included working with active duty personnel and mixing different eras in therapy. Programmatic solutions address structure (e.g., blended versus era-specific therapy), content (e.g., physical activity), and adaptations (e.g., inclusion of family; shortened length of stay). Clinical implications for VA managers and policy makers as well as non-VA health care systems and individual health care providers are noted. PMID:23458113

Leadership and capacity building in international chiropractic research: introducing the chiropractic academy for research leadership (CARL).

PubMed

Adams, Jon; Kawchuk, Greg; Breen, Alexander; De Carvalho, Diana; Eklund, Andreas; Fernandez, Matthew; Funabashi, Martha; Holmes, Michelle M; Johansson, Melker S; de Luca, Katie; Moore, Craig; Pagé, Isabelle; Pohlman, Katherine A; Swain, Michael S; Wong, Arnold Y L; Hartvigsen, Jan

2018-01-01

In an evidence-based health care environment, healthcare professions require a sustainable research culture to remain relevant. At present however, there is not a mature research culture across the chiropractic profession largely due to deficiencies in research capacity and leadership, which may be caused by a lack of chiropractic teaching programs in major universities. As a response to this challenge the Chiropractic Academy for Research Leadership, CARL, was created with the aim of develop a global network of successful early-career chiropractic researchers under the mentorship of three successful senior academics from Australia, Canada, and Denmark. The program centres upon an annual week-long program residential that rotates continental locations over the first three-year cycle and between residentials the CARL fellows work on self-initiated research and leadership initiatives. Through a competivite application process, the first cohort was selected and consists of 13 early career researchers from five professions in seven countries who represent diverse areas of interests of high relevance for chiropractic. The first residential was held in Odense, Denmark, with the second being planned in April 2018 in Edmonton, Canada, and the final residential to be held in Sydney, Australia in 2019.

Spatial access to residential care resources in Beijing, China

PubMed Central

2012-01-01

Background As the population is ageing rapidly in Beijing, the residential care sector is in a fast expansion process with the support of the municipal government. Understanding spatial accessibility to residential care resources by older people supports the need for rational allocation of care resources in future planning. Methods Based on population data and data on residential care resources, this study uses two Geographic Information System (GIS) based methods – shortest path analysis and a two-step floating catchment area (2SFCA) method to analyse spatial accessibility to residential care resources. Results Spatial accessibility varies as the methods and considered factors change. When only time distance is considered, residential care resources are more accessible in the central city than in suburban and exurban areas. If care resources are considered in addition to time distance, spatial accessibility is relatively poor in the central city compared to the northeast to southeast side of the suburban and exurban areas. The resources in the northwest to southwest side of the city are the least accessible, even though several hotspots of residential care resources are located in these areas. Conclusions For policy making, it may require combining various methods for a comprehensive analysis. The methods used in this study provide tools for identifying underserved areas in order to improve equity in access to and efficiency in allocation of residential care resources in future planning. PMID:22877360

Medication management policy, practice and research in Australian residential aged care: Current and future directions.

PubMed

Sluggett, Janet K; Ilomäki, Jenni; Seaman, Karla L; Corlis, Megan; Bell, J Simon

2017-02-01

Eight percent of Australians aged 65 years and over receive residential aged care each year. Residents are increasingly older, frailer and have complex care needs on entry to residential aged care. Up to 63% of Australian residents of aged care facilities take nine or more medications regularly. Together, these factors place residents at high risk of adverse drug events. This paper reviews medication-related policies, practices and research in Australian residential aged care. Complex processes underpin prescribing, supply and administration of medications in aged care facilities. A broad range of policies and resources are available to assist health professionals, aged care facilities and residents to optimise medication management. These include national guiding principles, a standardised national medication chart, clinical medication reviews and facility accreditation standards. Recent Australian interventions have improved medication use in residential aged care facilities. Generating evidence for prescribing and deprescribing that is specific to residential aged care, health workforce reform, medication-related quality indicators and inter-professional education in aged care are important steps toward optimising medication use in this setting. Copyright © 2016 Elsevier Ltd. All rights reserved.

Fear and overprotection in Australian residential aged-care facilities: The inadvertent impact of regulation on quality continence care.

PubMed

Ostaszkiewicz, Joan; O'Connell, Beverly; Dunning, Trisha

2016-06-01

Most residents in residential aged-care facilities are incontinent. This study explored how continence care was provided in residential aged-care facilities, and describes a subset of data about staffs' beliefs and experiences of the quality framework and the funding model on residents' continence care. Using grounded theory methodology, 18 residential aged-care staff members were interviewed and 88 hours of field observations conducted in two facilities. Data were analysed using a combination of inductive and deductive analytic procedures. Staffs' beliefs and experiences about the requirements of the quality framework and the funding model fostered a climate of fear and risk adversity that had multiple unintended effects on residents' continence care, incentivising dependence on continence management, and equating effective continence care with effective pad use. There is a need to rethink the quality of continence care and its measurement in Australian residential aged-care facilities. © 2015 AJA Inc.

Assessment of Needs of Adults with Developmental Disabilities in Skilled Nursing and Intermediate Care Facilities in Illinois.

ERIC Educational Resources Information Center

Uehara, Edwina S.; And Others

1991-01-01

This study evaluated 2,815 adults with developmental disabilities in 328 Illinois intermediate care and skilled nursing facilities. Only 10 percent were determined to be appropriately placed in medical settings; 27 percent were enrolled in day training programs; and many individuals recommended for alternative residential settings had medical and…

Make a Move: A Comprehensive Effect Evaluation of a Sexual Harassment Prevention Program in Dutch Residential Youth Care.

PubMed

van Lieshout, Sanne; Mevissen, Fraukje E F; van Breukelen, Gerard; Jonker, Marianne; Ruiter, Robert A C

2016-06-27

Sexual harassment-unwanted sexual comments, advances, or behaviors-and sexual violence are still prevalent worldwide, leading to a variety of physical, cognitive, and emotional problems among those being harassed. In particular, youth in care are at risk of becoming perpetrators (and victims) of sexual harassment. However, in general, there are very few interventions targeting this at-risk group, and no such programs exist in the Netherlands. To this end, a group intervention program-Make a Move-targeting determinants of sexual harassment was developed. This program was implemented and evaluated among boys (N = 177) in Dutch residential youth care (20 institutions). A pre-test, post-test, and 6-month follow-up design including an intervention and a waiting list control group with randomized assignment of institutions (cluster randomized trial) was used to measure the effects of the intervention on determinants of sexual harassment. Multilevel (mixed) regression analysis with Bonferroni correction for multiple testing (α = .005) showed no significant effects of Make a Move on determinants of sexual harassment (ps > .03, Cohen's ds < .44). Results are discussed in light of a three-way explanatory model focusing on intervention content, evaluation, and implementation as potential explanations for not finding any measurable intervention effects. © The Author(s) 2016.

Residential therapeutic communities for female substance abusers.

PubMed Central

De Leon, G.; Jainchill, N.

1991-01-01

Therapeutic communities provide a unique model for the needs of chemically dependent mothers who are pregnant or of child bearing age. These programs have been treating female addicts, many of whom reflect the profile and needs of the current generation of addicted mothers in clinical problems, social disadvantages, and poor socialization. Specific issues of their recovery can be most efficiently addressed in a residential community that provides housing and a comprehensive approach including medical, social, psychological care, parental training, and child care. Most evident is that these women need a lifestyle change, an opportunity for maturation. In this regard, the therapeutic community offers the essential element of community as a setting for learning right living. PMID:1868279

78 FR 32124 - Community Residential Care

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-29

... DEPARTMENT OF VETERANS AFFAIRS 38 CFR Part 17 RIN 2900-AO62 Community Residential Care AGENCY...) amends its regulations concerning approval of non-VA community residential care facilities to allow VA to... deficiencies in standards that cannot be corrected, and into more restrictive and/or costly care. In addition...

Advance care planning for residents in aged care facilities: what is best practice and how can evidence-based guidelines be implemented?

PubMed

Lyon, Cheryl

2007-12-01

Background  Advance care planning in a residential care setting aims to assist residents to make decisions about future healthcare and to improve end-of-life care through medical and care staff knowing and respecting the wishes of the resident. The process enables individuals and others who are important to them, to reflect on what is important to the resident including their beliefs/values and preferences about care when they are dying. This paper describes a project conducted as part of the Joanna Briggs Institute Clinical Aged Care Fellowship Program implemented at the Manningham Centre in metropolitan Melbourne in a unit providing services for 46 low and high care residents. Objectives  The objectives of the study were to document implementation of best practice in advance care planning in a residential aged care facility using a cycle of audit, feedback and re-audit cycle audit with a clinical audit software program, the Practical Application of Clinical Evidence System. The evidence-based guidelines found in 'Guidelines for a Palliative Approach in Residential Aged Care' were used to inform the process of clinical practice review and to develop a program to implement advance care planning. Results  The pre-implementation audit results showed that advance care planning practice was not based on high level evidence as initial compliance with five audit criteria was 0%. The barriers to implementation that became apparent during the feedback stage included the challenge of creating a culture where advance care planning policy, protocols and guidelines could be implemented, and advance care planning discussions held, by adequately prepared health professionals and carers. Opportunities were made to equip the resident to discuss their wishes with family, friends and healthcare staff. Some residents made the decision to take steps to formally document those wishes and/or appoint a Medical Enduring Power of Attorney to act on behalf of the resident when they are unable to communicate wishes. The post-implementation audit showed a clear improvement as compliance ranged from 15-100% for the five audit criteria. Strong leadership by the project team was effective in engaging staff in this quality improvement program. Conclusion  The outcomes of the project were extremely positive and demonstrate a genuine improvement in practice. All audit criteria indicate that the Manningham Centre is now positively working towards improved practice based on the best available evidence. It is hoped that as the expertise developed during this project is shared, other areas of gerontological practice will be similarly improved and more facilities caring for the older person will embrace evidence-based practice.

SUBSTANCE-ABUSING MOTHERS IN RESIDENTIAL TREATMENT WITH THEIR BABIES: IMPORTANCE OF PRE- AND POSTNATAL MATERNAL REFLECTIVE FUNCTIONING

PubMed Central

Pajulo, Marjukka; Pyykkönen, Nina; Kalland, Mirjam; Sinkkonen, Jari; Helenius, Hans; Punamäki, Raija-Leena; Suchman, Nancy

2012-01-01

A residential treatment program has been developed specifically for substance-abusing pregnant and parenting women in Finland, focusing on simultaneously supporting maternal abstinence from substances and the mother–baby relationship. The aims of the study are to explore maternal pre- and postnatal reflective functioning and its association with background factors, maternal exposure to trauma, and psychiatric symptoms, postnatal interaction, child development, and later child foster care placement. Participants were 34 mother–baby pairs living in three residential program units during the pre- to postnatal period. We employed self-report questionnaires on background, trauma history, and psychiatric symptoms (Brief Symptom Inventory: L.R. Derogatis, 1993; Edinburgh Postnatal Depression Scale: J.L. Cox, J.M. Holden, & R. Sagovsky, 1987; Traumatic Antecedents Questionnaire: B. Van der Kolk, 2003), videotaped mother–child interactions coded for sensitivity, control, and unresponsiveness (Care Index for Infants and Toddlers: P. Crittenden, 2003); a standardized test of child development (Bayley Scales of Infant Development-II: N. Bayley, 1993); and semistructured interviews for maternal reflective functioning (Pregnancy Interview: A. Slade, E. Bernbach, J. Grienenberger, D.W. Levy, & A. Locker, 2002; Parent Development Interview: A. Slade et al., 2005). Pre- and postnatal maternal reflective functioning (RF) was on average low, but varied considerably across participants. Average RF increased significantly during the intervention. Increase in RF level was found to be associated with type of abused substance and maternal trauma history. Mothers who showed lower postnatal RF levels relapsed to substance use more often after completing a residential treatment period, and their children were more likely to be placed in foster care. The intensive focus on maternal RF is an important direction in the development of efficacious treatment for this very high risk population. PMID:22899872

Quality failures in residential aged care in Australia: The relationship between structural factors and regulation imposed sanctions.

PubMed

Baldwin, Richard; Chenoweth, Lynnette; Dela Rama, Marie; Liu, Zhixin

2015-12-01

To examine the relationship between structural factors and the imposition of sanctions on residential aged care services across Australia for regulatory compliance failure. Poisson Regression analysis was used to examine the association between the number of sanctions imposed and the structural characteristics of residential aged care services in Australia. Residential aged care services that have a greater likelihood of having government sanctions imposed on them are operated by for-profit providers and located in remote locations and in Victoria, Queensland, South Australia, Northern Territory and the Australian Capital Territory. The findings confirm the international literature on the relationship between residential aged care service location, ownership type and the likelihood of sanctions. In the light of the predicted expansion of residential aged care services, policy makers should give consideration to structural elements most likely to be associated with a failure to meet and maintain service standards. © 2014 ACOTA.

Emergency residential care settings: A model for service assessment and design.

PubMed

Graça, João; Calheiros, Maria Manuela; Patrício, Joana Nunes; Magalhães, Eunice Vieira

2018-02-01

There have been calls for uncovering the "black box" of residential care services, with a particular need for research focusing on emergency care settings for children and youth in danger. In fact, the strikingly scant empirical attention that these settings have received so far contrasts with the role that they often play as gateway into the child welfare system. To answer these calls, this work presents and tests a framework for assessing a service model in residential emergency care. It comprises seven studies which address a set of different focal areas (e.g., service logic model; care experiences), informants (e.g., case records; staff; children/youth), and service components (e.g., case assessment/evaluation; intervention; placement/referral). Drawing on this process-consultation approach, the work proposes a set of key challenges for emergency residential care in terms of service improvement and development, and calls for further research targeting more care units and different types of residential care services. These findings offer a contribution to inform evidence-based practice and policy in service models of residential care. Copyright © 2017 Elsevier Ltd. All rights reserved.

78 FR 25184 - Federal Housing Administration (FHA): Section 232 Healthcare Facility Insurance Program...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-30

... DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT 24 CFR Parts 5, 200, 207, and 232 [Docket No. FR-5465... Residential Care Facilities, Office of Healthcare Programs, Office of Housing, Department of Housing and Urban Development, 451 7th Street SW., Room 6264, Washington, DC 20410-8000; telephone number 202-708- 0599 (this is...

VA residential substance use disorder treatment program providers' perceptions of facilitators and barriers to performance on pre-admission processes.

PubMed

Ellerbe, Laura S; Manfredi, Luisa; Gupta, Shalini; Phelps, Tyler E; Bowe, Thomas R; Rubinsky, Anna D; Burden, Jennifer L; Harris, Alex H S

2017-04-04

In the U.S. Department of Veterans Affairs (VA), residential treatment programs are an important part of the continuum of care for patients with a substance use disorder (SUD). However, a limited number of program-specific measures to identify quality gaps in SUD residential programs exist. This study aimed to: (1) Develop metrics for two pre-admission processes: Wait Time and Engagement While Waiting, and (2) Interview program management and staff about program structures and processes that may contribute to performance on these metrics. The first aim sought to supplement the VA's existing facility-level performance metrics with SUD program-level metrics in order to identify high-value targets for quality improvement. The second aim recognized that not all key processes are reflected in the administrative data, and even when they are, new insight may be gained from viewing these data in the context of day-to-day clinical practice. VA administrative data from fiscal year 2012 were used to calculate pre-admission metrics for 97 programs (63 SUD Residential Rehabilitation Treatment Programs (SUD RRTPs); 34 Mental Health Residential Rehabilitation Treatment Programs (MH RRTPs) with a SUD track). Interviews were then conducted with management and front-line staff to learn what factors may have contributed to high or low performance, relative to the national average for their program type. We hypothesized that speaking directly to residential program staff may reveal innovative practices, areas for improvement, and factors that may explain system-wide variability in performance. Average wait time for admission was 16 days (SUD RRTPs: 17 days; MH RRTPs with a SUD track: 11 days), with 60% of Veterans waiting longer than 7 days. For these Veterans, engagement while waiting occurred in an average of 54% of the waiting weeks (range 3-100% across programs). Fifty-nine interviews representing 44 programs revealed factors perceived to potentially impact performance in these domains. Efficient screening processes, effective patient flow, and available beds were perceived to facilitate shorter wait times, while lack of beds, poor staffing levels, and lengths of stay of existing patients were thought to lengthen wait times. Accessible outpatient services, strong patient outreach, and strong encouragement of pre-admission outpatient treatment emerged as facilitators of engagement while waiting; poor staffing levels, socioeconomic barriers, and low patient motivation were viewed as barriers. Metrics for pre-admission processes can be helpful for monitoring residential SUD treatment programs. Interviewing program management and staff about drivers of performance metrics can play a complementary role by identifying innovative and other strong practices, as well as high-value targets for quality improvement. Key facilitators of high-performing facilities may offer programs with lower performance useful strategies to improve specific pre-admission processes.

The Effects of Staff Training on the Types of Interactions Observed at Two Group Homes for Foster Care Children

ERIC Educational Resources Information Center

Crosland, Kimberly A.; Dunlap, Glen; Sager, Wayne; Neff, Bryon; Wilcox, Catherine; Blanco, Alfredo; Giddings, Tamela

2008-01-01

Objectives: An extensive literature base exists for behavioral parent training; however, few studies have focused on training direct care staff at group home and residential facilities for children. This study was conducted to determine whether a behavioral staff training program consisting of classroom training and in-home feedback would improve…

Avoiding Institutional Outcomes for Older Adults Living with Disability: The Use of Community-Based Aged Care Supports

ERIC Educational Resources Information Center

Ellison, Caroline; White, Amy; Chapman, Libby

2011-01-01

Background: Most people with a disability want to remain living in their own home as they age. Without additional support, people with a disability may not be able to avoid moving into residential aged care, attending day programs, or becoming isolated from participation in the wider community. This study examined whether participants perceived…

The effectiveness of an aged care specific leadership and management program on workforce, work environment, and care quality outcomes: design of a cluster randomised controlled trial

PubMed Central

2013-01-01

Background A plethora of observational evidence exists concerning the impact of management and leadership on workforce, work environment, and care quality. Yet, no randomised controlled trial has been conducted to test the effectiveness of leadership and management interventions in aged care. An innovative aged care clinical leadership program (Clinical Leadership in Aged Care − CLiAC) was developed to improve managers’ leadership capacities to support the delivery of quality care in Australia. This paper describes the study design of the cluster randomised controlled trial testing the effectiveness of the program. Methods Twenty-four residential and community aged care sites were recruited as managers at each site agreed in writing to participate in the study and ensure that leaders allocated to the control arm would not be offered the intervention program. Sites undergoing major managerial or structural changes were excluded. The 24 sites were randomly allocated to receive the CLiAC program (intervention) or usual care (control), stratified by type (residential vs. community, six each for each arm). Treatment allocation was masked to assessors and staff of all participating sites. The objective is to establish the effectiveness of the CLiAC program in improving work environment, workforce retention, as well as care safety and quality, when compared to usual care. The primary outcomes are measures of work environment, care quality and safety, and staff turnover rates. Secondary outcomes include manager leadership capacity, staff absenteeism, intention to leave, stress levels, and job satisfaction. Differences between intervention and control groups will be analysed by researchers blinded to treatment allocation using linear regression of individual results adjusted for stratification and clustering by site (primary analysis), and additionally for baseline values and potential confounders (secondary analysis). Outcomes measured at the site level will be compared by cluster-level analysis. The overall costs and benefits of the program will also be assessed. Discussion The outcomes of the trial have the potential to inform actions to enhance leadership and management capabilities of the aged care workforce, address pressing issues about workforce shortages, and increase the quality of aged care services. Trial registration Australian New Zealand Clinical Trials Registry (ACTRN12611001070921) PMID:24160714

Emergency department access targets and the older patient: a retrospective cohort study of emergency department presentations by people living in residential aged care facilities.

PubMed

Street, Maryann; Marriott, Jonathon R; Livingston, Patricia M

2012-11-01

There is limited research on the effect of emergency access targets on health outcomes for older patients from Residential Aged Care Facilities. The aims were to: (1) identify length of stay for Residential Aged Care patients relative to access targets; and (2) examine hospital admission rates, readmission rates, inpatient costs and mortality. Retrospective cohort study of all emergency presentations for Residential Aged Care patients in 2009 at one Australian metropolitan health service. The 4637 emergency presentations by 3184 Residential Aged Care patients in 2009 represented 3.4% of all emergency presentations. Mean length of stay was 7.9 hours (SD=4.5 hours); 84% of Residential Aged Care patients remained in the Emergency Department longer than four hours. Admitted patients were 3.6 times more likely to spend more than eight hours in the Emergency Department compared with those not admitted (p<0.001). Patients in the urgent triage category were 9.5 times more likely to spend more than eight hours in the Emergency Department compared to patients triaged as non-urgent (p<0.001). Inpatient costs were associated with length of admission and median cost per day was $AUD 1175. Few Residential Aged Care patients were discharged within the four hours access target. This has implications for health care outcomes and costs associated with providing emergency care for patients living in Residential Aged Care Facilities. Copyright © 2012 College of Emergency Nursing Australasia Ltd. Published by Elsevier Ltd. All rights reserved.

The prevalence of child sexual abuse in out-of-home care: a comparison between abuse in residential and in foster care.

PubMed

Euser, Saskia; Alink, Lenneke R A; Tharner, Anne; van Ijzendoorn, Marinus H; Bakermans-Kranenburg, Marian J

2013-11-01

We investigated the 2010 year prevalence of child sexual abuse (CSA) in residential and foster care and compared it with prevalence rates in the general population. We used two approaches to estimate the prevalence of CSA. First, 264 professionals working in residential or foster care (sentinels) reported CSA for the children they worked with (N = 6,281). Second, 329 adolescents staying in residential or foster care reported on their own experiences with CSA. Sentinels and adolescents were randomly selected from 82 Dutch out-of-home care facilities. We found that 3.5 per 1,000 children had been victims of CSA based on sentinel reports. In addition, 58 per 1,000 adolescents reported having experienced CSA. Results based on both sentinel report and self-report revealed higher prevalence rates in out-of-home care than in the general population, with the highest prevalence in residential care. Prevalence rates in foster care did not differ from the general population. According to our findings, children and adolescents in residential care are at increased risk of CSA compared to children in foster care. Unfortunately, foster care does not fully protect children against sexual abuse either, and thus its quality needs to be further improved.

The impact of a visual arts program on quality of life, communication, and well-being of people living with dementia: a mixed-methods longitudinal investigation.

PubMed

Windle, Gill; Joling, Karlijn J; Howson-Griffiths, Teri; Woods, Bob; Jones, Catrin Hedd; van de Ven, Peter M; Newman, Andrew; Parkinson, Clive

2018-03-01

ABSTRACTBackground:Research reviews highlight methodological limitations and gaps in the evidence base for the arts in dementia care. In response, we developed a 12-week visual art program and evaluated the impact on people living with dementia through a mixed-methods longitudinal investigation. One hundred and twenty-five people living with mild to severe dementia were recruited across three research settings in England and Wales (residential care homes, a county hospital, and community venues). Quantitative and qualitative data on quality of life (QoL), communication and perceptions of the program were obtained through interviews and self-reports with participants and their carers. Eight domains of well-being were measured using a standardized observation tool, and data compared to an alternative activity with no art. Across all sites, scores for the well-being domains of interest, attention, pleasure, self-esteem, negative affect, and sadness were significantly better in the art program than the alternative condition. Proxy-reported QoL significantly improved between baseline and 3-month follow-up, but no improvements in QoL were reported by the participants with dementia. This was contrasted by their qualitative accounts, which described a stimulating experience important for social connectedness, well-being, and inner-strength. Communication deteriorated between baseline and follow-up in the hospital setting, but improved in the residential care setting. The findings highlight the potential for creative aging within dementia care, the benefits of art activities and the influence of the environment. We encourage dementia care providers and arts and cultural services to work toward embedding art activities within routine care provision.

Nurse-led multidisciplinary initiatives to improve outcomes and reduce hospital admissions for older adults: The Care coordination through Emergency Department, Residential Aged Care and Primary Health Collaboration project.

PubMed

Marsden, Elizabeth; Craswell, Alison; Taylor, Andrea; Coates, Kaye; Crilly, Julia; Broadbent, Marc; Glenwright, Amanda; Johnston, Colleen; Wallis, Marianne

2018-04-03

This article describes the Care coordination through Emergency Department, Residential Aged Care and Primary Health Collaboration (CEDRiC) project. CEDRiC is designed to improve the health outcomes for older people with an acute illness. It attempts this via enhanced primary care in residential aged care facilities, focused and streamlined care in the emergency department and enhanced intersectoral communication and referral. Implementing this approach has the potential to decrease inappropriate hospital admissions while improving care for older people in residential aged care and community settings. This article discusses an innovative way of caring for older adults in an ageing population utilising the existing evidence. A formal evaluation is currently underway. © 2018 AJA Inc.

Organisational and environmental characteristics of residential aged care units providing highly person-centred care: a cross sectional study.

PubMed

Sjögren, Karin; Lindkvist, Marie; Sandman, Per-Olof; Zingmark, Karin; Edvardsson, David

2017-01-01

Few studies have empirically investigated factors that define residential aged care units that are perceived as being highly person-centred. The purpose of this study was to explore factors characterising residential aged care units perceived as being highly person-centred, with a focus on organisational and environmental variables, as well as residents' and staff' characteristics. A cross-sectional design was used. Residents ( n  = 1460) and staff ( n  = 1213) data from 151 residential care units were collected, as well as data relating to characteristics of the organisation and environment, and data measuring degree of person-centred care. Participating staff provided self-reported data and conducted proxy ratings on residents . Descriptive and comparative statistics, independent samples t-test, Chi 2 test, Eta Squared and Phi coefficient were used to analyse data. Highly person-centred residential aged care units were characterized by having a shared philosophy of care, a satisfactory leadership, interdisciplinary collaboration and social support from colleagues and leaders, a dementia-friendly physical environment, staff having time to spend with residents, and a smaller unit size. Residential aged care units with higher levels of person-centred care had a higher proportion of staff with continuing education in dementia care, and a higher proportion of staff receiving regular supervision, compared to units with lower levels of person-centred care. It is important to target organisational and environmental factors, such as a shared philosophy of care, staff use of time, the physical environment, interdisciplinary support, and support from leaders and colleagues, to improve person-centred care in residential care units. Managers and leaders seeking to facilitate person-centred care in daily practice need to consider their own role in supporting, encouraging, and supervising staff.

Implementing the first regional hospice palliative care program in Ontario: the Champlain region as a case study.

PubMed

Pereira, José; Contant, Jocelyne; Barton, Gwen; Klinger, Christopher

2016-07-26

Regionalization promotes planning and coordination of services across settings and providers to meet population needs. Despite the potential advantages of regionalization, no regional hospice palliative care program existed in Ontario, Canada, as of 2010. This paper describes the process and early results of the development of the first regional hospice palliative care program in Ontario. The various activities and processes undertaken and the formal agreements, policies and documents are described. A participative approach, started in April 2009, was used. It brought together over 26 health service providers, including residential hospices, a palliative care unit, community and hospital specialist consultation teams, hospitals, community health and social service agencies (including nursing), individual health professionals, volunteers, patients and families. An extensive stakeholder and community vetting process was undertaken that included work groups (to explore key areas such as home care, the hospital sector, hospice and palliative care unit beds, provision of care in rural settings, e-health and education), a steering committee and input from over 320 individuals via e-mail and town-halls. A Transitional Leadership Group was elected to steer the implementation of the Regional Program over the summer of 2010. This group established the by-laws and details regarding the governance structure of the Regional Program, including its role, responsibilities, reporting structures and initial performance indicators that the Local Health Integration Network (LHIN) approved. The Regional Program was formally established in November 2010 with a competency-based Board of 14 elected members to oversee the program. Early work involved establishing standards and performance indicators for the different sectors and settings in the region, and identifying key clinical needs such as the establishment of more residential hospice capacity in Ottawa and a rural framework to ensure access for citizens in rural and remote regions. Challenges encountered are explored as are the process enablers and facilitators. The paper views the development and implementation process from the perspectives of several frameworks and models related to change management. Following on several initial achievements, the long term success of the Regional Program will depend on consolidating the early gains and demonstrating changes based on key measurable outcomes.

Management of urinary incontinence in residential care.

PubMed

Lim, David S

2016-07-01

Urinary incontinence is prevalent in residential care and rates are expected to increase with the ageing population in Australia. It contributes to poor quality of life (QoL), functional impairments in activities of daily living, and deterioration of mental and sexual health. Management depends on the type of incontinence, its aetiology, the severity of symptoms, the effects on QoL, and patient factors. Treatment options include active treatment and passive containment. However, not all active treatment options are feasible in residential care. There is little evidence to advise on standard best practice. The aims of this article are to review treatment options for urinary incontinence in residential care, feasibility of service delivery and challenges associated with this. A greater understanding of the issues surrounding the management of urinary incontinence in residential care is required to deliver satisfactory patient-centred care on a consistent basis.

Residential Care: Back to First Principles.

ERIC Educational Resources Information Center

Burns, David A.

Residential care must be redefined, free from jargon and rhetoric. Over the past 20 years, the social welfare approach, which encompasses the medical model, has dominated legislative and practical thinking about residential care. This theoretical thinking reached its culmination in the concept of the therapeutic community. The therapeutic…

25 CFR 20.509 - What must the social services worker do when a child is placed in foster care or residential care...

Code of Federal Regulations, 2013 CFR

2013-04-01

... dated by the parties involved that specifies the roles and responsibilities of the biological parents... 25 Indians 1 2013-04-01 2013-04-01 false What must the social services worker do when a child is... AFFAIRS, DEPARTMENT OF THE INTERIOR HUMAN SERVICES FINANCIAL ASSISTANCE AND SOCIAL SERVICES PROGRAMS Child...

25 CFR 20.509 - What must the social services worker do when a child is placed in foster care or residential care...

Code of Federal Regulations, 2011 CFR

2011-04-01

... dated by the parties involved that specifies the roles and responsibilities of the biological parents... 25 Indians 1 2011-04-01 2011-04-01 false What must the social services worker do when a child is... AFFAIRS, DEPARTMENT OF THE INTERIOR HUMAN SERVICES FINANCIAL ASSISTANCE AND SOCIAL SERVICES PROGRAMS Child...

25 CFR 20.509 - What must the social services worker do when a child is placed in foster care or residential care...

Code of Federal Regulations, 2010 CFR

2010-04-01

... dated by the parties involved that specifies the roles and responsibilities of the biological parents... 25 Indians 1 2010-04-01 2010-04-01 false What must the social services worker do when a child is... AFFAIRS, DEPARTMENT OF THE INTERIOR HUMAN SERVICES FINANCIAL ASSISTANCE AND SOCIAL SERVICES PROGRAMS Child...

25 CFR 20.509 - What must the social services worker do when a child is placed in foster care or residential care...

Code of Federal Regulations, 2012 CFR

2012-04-01

... dated by the parties involved that specifies the roles and responsibilities of the biological parents... 25 Indians 1 2012-04-01 2011-04-01 true What must the social services worker do when a child is... AFFAIRS, DEPARTMENT OF THE INTERIOR HUMAN SERVICES FINANCIAL ASSISTANCE AND SOCIAL SERVICES PROGRAMS Child...

25 CFR 20.509 - What must the social services worker do when a child is placed in foster care or residential care...

Code of Federal Regulations, 2014 CFR

2014-04-01

... dated by the parties involved that specifies the roles and responsibilities of the biological parents... 25 Indians 1 2014-04-01 2014-04-01 false What must the social services worker do when a child is... AFFAIRS, DEPARTMENT OF THE INTERIOR HUMAN SERVICES FINANCIAL ASSISTANCE AND SOCIAL SERVICES PROGRAMS Child...

Residential Group Care Quarterly. Volume 5, Number 1, Summer 2004

ERIC Educational Resources Information Center

Kirkwood, Scott, Ed.

2004-01-01

This issue of "Residential Group Care Quarterly" contains the following articles: (1) "National Definitions and Data Collection for Residential Care Facilities' Use of Restraint and Seclusion" (Lloyd Bullard); (2) "CWLA Publishes Best Practices in Behavior Support and Intervention Assessment Instrument" (Nupur Gupta); (3) "Initial Findings of an…

38 CFR 17.70 - Written decision following a hearing.

Code of Federal Regulations, 2011 CFR

2011-07-01

... shall consider the safety and health of the residents of the community residential care facility and the... AFFAIRS MEDICAL Community Residential Care § 17.70 Written decision following a hearing. (a) The hearing... community residential care facility's noncompliance with VA standards shall be based on the preponderance of...

38 CFR 17.70 - Written decision following a hearing.

Code of Federal Regulations, 2010 CFR

2010-07-01

... shall consider the safety and health of the residents of the community residential care facility and the... AFFAIRS MEDICAL Community Residential Care § 17.70 Written decision following a hearing. (a) The hearing... community residential care facility's noncompliance with VA standards shall be based on the preponderance of...

38 CFR 17.68 - Notice and conduct of hearing.

Code of Federal Regulations, 2010 CFR

2010-07-01

... MEDICAL Community Residential Care § 17.68 Notice and conduct of hearing. (a) Upon receipt of a request for an oral hearing, the hearing official shall: (1) Notify the community residential care facility operator of the date, time, and location for the hearing; and (2) Notify the community residential care...

38 CFR 17.66 - Notice of noncompliance with VA standards.

Code of Federal Regulations, 2010 CFR

2010-07-01

... AFFAIRS MEDICAL Community Residential Care § 17.66 Notice of noncompliance with VA standards. If the hearing official determines that an approved community residential care facility does not comply with the... standards must be met in order to avoid revocation of VA approval; (c) The community residential care...

38 CFR 17.69 - Waiver of opportunity for hearing.

Code of Federal Regulations, 2010 CFR

2010-07-01

... MEDICAL Community Residential Care § 17.69 Waiver of opportunity for hearing. If representatives of a community residential care facility which receive a notice of noncompliance under § 17.66 of this part fail...) Consider the representatives of the community residential care facility to have waived their opportunity...

Homesick: residential and care patterns in patients with severe mental illness.

PubMed

de Mooij, Liselotte D; Kikkert, Martijn; Lommerse, Nick M; Theunissen, Jan; de Koning, Mariken B; de Haan, Lieuwe; Beekman, Aartjan T F; Duurkoop, Pim W R A; Dekker, Jack J M

2016-12-03

Changes in the residential and care settings of patients with severe mental illness (SMI) are a concern because of the large variety of possible negative consequences. This study describes patterns of changes in the residential and care settings of SMI patients and explores associations between these changes, sociodemographics, and clinical characteristics. From January 2006 to January 2012, all data relating to changes in residential and/or care setting by SMI patients (N = 262) were collected from electronic case files. Data covering psychopathology, substance use, and medication adherence were assessed in 2006. There were more changes in the residential than in the care setting. In 6 years, only 22% of our sample did not move, 23% changed residence once, 19% twice, 10% three times, and 26% four or more times. Substance use predicted changes of care and/or residential setting and rehospitalisation. The severity of negative symptoms predicted rehospitalisation and duration of hospitalisation. Disorganisation symptoms predicted the duration of hospitalisation. A majority of patients with SMI changed residential and/or care settings several times in 6 years. Patients with substance use or severe negative and disorganisation symptoms may need more intensive and customised treatment. Further research is needed to investigate prevention programmes for highly-frequent movers.

Evaluating an interprofessional disease state and medication management review model.

PubMed

Hoti, Kreshnik; Forman, Dawn; Hughes, Jeffery

2014-03-01

There is lack of literature data reporting an incorporation of medication management reviews in students' interprofessional education (IPE) and practice programs in aged care settings. This pilot study reports how an interprofessional disease state and medication management review program (DSMMR) was established in a residential aged care facility in Perth, Western Australia. Students from the professions of nursing, pharmacy and physiotherapy focused on a wellness check in the areas of cognition, falls and continence while integrating a medication management review. Students' attitudes were explored using a pre- and post-placement questionnaire. Students indicated positive experience with the IPE DSMMR program which also resulted in their positive attitudinal shift towards IPE and practice. These findings indicated that aged care can be a suitable setting for student interprofessional programs focusing on DSMMR.

Residential segregation and the survival of U.S. urban public hospitals.

PubMed

Ko, Michelle; Needleman, Jack; Derose, Kathryn Pitkin; Laugesen, Miriam J; Ponce, Ninez A

2014-06-01

Residential segregation is associated geographic disparities in access to care, but its impact on local health care policy, including public hospitals, is unknown. We examined the effects of racial residential segregation on U.S. urban public hospital closures from 1987 to 2007, controlling for hospital, market, and policy characteristics. We found that a high level of residential segregation moderated the protective effects of Black population composition, such that a high level of residential segregation, in combination with a high percentage of poor residents, conferred a higher likelihood of hospital closure. More segregated and poorer communities face disadvantages in access to care that may be compounded as a result of instability in the health care safety net. Policy makers should consider the influence of social factors such as residential segregation on the allocation of the safety net resources.

Quality in residential care from the perspective of people living with dementia: The importance of personhood.

PubMed

Milte, R; Shulver, W; Killington, M; Bradley, C; Ratcliffe, J; Crotty, M

2016-01-01

Providing quality care for people with dementia to meet the growing demand for services is a significant challenge to Australia and globally. When it comes to planning for current and future care needs, limited information is available on what people living with dementia and their family members consider the meaning of "quality" in residential care services. To describe the meaning of quality residential care from the perspective of people with cognitive impairment and their family members. Qualitative data collection via in-depth interviews and focus groups was undertaken with people with dementia or cognitive impairment living in residential care or the community (n=15), and family members of people with dementia (n=26). Thematic analysis was undertaken to identify key themes. The theme of supporting personhood was identified as the overarching concept of importance to both people with dementia and their family members and as the foundation for quality care. There were subtle differences in how this concept was expressed by people with dementia themselves and their family members. However, for both groups, access to meaningful activities and opportunities to feel useful and valued were identified as important ways to support personhood in residential care. Separate to this theme of personhood, family members also talked about the importance of a supportive physical environment in the care home, while for the people with dementia themselves maintaining a connection with family was an important contributor to their experience of good quality residential care. Supporting personhood was identified as a critical key concept underpinning quality residential aged care, from the perspective of both people with cognitive impairment and their family members. This highlights the important contribution that the psychological and social characteristics of care make to providing a good quality residential care experience from the perspective of consumers with dementia. Copyright © 2015 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

Participatory arts programs in residential dementia care: Playing with language differences.

PubMed

Swinnen, Aagje; de Medeiros, Kate

2017-01-01

This article examines connections between language, identity, and cultural difference in the context of participatory arts in residential dementia care. Specifically, it looks at how language differences become instruments for the language play that characterizes the participatory arts programs, TimeSlips and the Alzheimer's Poetry Project. These are two approaches that are predominantly spoken-word driven. Although people living with dementia experience cognitive decline that affects language, they are linguistic agents capable of participating in ongoing negotiation processes of connection, belonging, and in- and exclusion through language use. The analysis of two ethnographic vignettes, based on extensive fieldwork in the closed wards of two Dutch nursing homes, illustrates how TimeSlips and the Alzheimer's Poetry Project support them in this agency. The theoretical framework of the analysis consists of literature on the linguistic agency of people living with dementia, the notions of the homo ludens (or man the player) and ludic language, as well as linguistic strategies of belonging in relation to place.

A culture of education: Enhancing school performance of youth living in residential group care in Ontario.

PubMed

Gharabaghi, Kiaras

2011-01-01

This article presents a synthesis of what is known about the educational experiences of youth living in residential group care based on a literature review that highlights both the experiences of the youth themselves and the operational context of residential group care in Ontario as it pertains to educational performance. The author argues that there is little emphasis on education within the residential group care sector in Ontario that could translate into more productive educational experiences for youth. The article then provides a framework for developing a culture of education for residential group care that can be acted upon expeditiously. Enhancing the educational performance of young people living in group care will require a cultural approach that provides for daily and pervasive education supports and encouragement, and aims to enhance the lived experience of young people pursuant to their education.

Love, intimacy and sexuality in residential dementia care: A spousal perspective.

PubMed

Roelofs, Tineke Sm; Luijkx, Katrien G; Embregts, Petri Jcm

2017-01-01

The experiences and needs of spouses of residential care facility residents with dementia, regarding friendship, love, intimacy, and sexuality were explored. Understanding of how spouses make sense of their experiences was pursued. Semi-structured interviews were held with nine spouses of people with dementia, living in high intensive 24-hour care units within residential care facilities. The results show that friendship, love, intimacy, and sexuality were still embedded in the couples' marital lives, but all in their own way. Changing roles and a shift in purpose of the relationship recurred. Although intimacy was found to be still important in the lives of spouses, emotional, and practical residential care facility barriers were experienced by the spouses, of which the absence of communication were most important. Our findings on the experiences of spouses with regard to intimacy and sexuality can help residential care facility staff and policymakers to recognize the needs of couples and take these into account.

The Grog Mob: lessons from an evaluation of a multi-disciplinary alcohol intervention for Aboriginal clients.

PubMed

d'Abbs, Peter; Togni, Samantha; Rosewarne, Clive; Boffa, John

2013-10-01

To evaluate a 12-month trial of an evidence-based non-residential treatment program for Indigenous clients with alcohol problems, offering three streams of care: pharmacotherapy, psychological and social support. Process evaluation of program implementation; outcome evaluation of client outcomes. despite constraints of time and remoteness, the trial demonstrated the feasibility of implementing such a program. The medical stream generated fewer pharmacotherapy prescriptions than expected. The most active stream was the psychological therapy stream. between March 2008 and April 2009, 129 clients were referred to the program, of whom 49 consented to have de-identified data used for the evaluation. Of these, 19 clients received one or more streams of care, 15 of whom (78.9%) subsequently stopped or reduced drinking. However, among the remaining 30 consenting clients who had not received an intervention, 70.0% also reported stopping or reducing drinking. The evidence of program effectiveness is therefore equivocal and evaluation over a longer period is required. The trial demonstrated the viability of, and demand for, evidence-based non-residential treatment for Indigenous clients with alcohol problems. Reasons behind an apparent reluctance among GPs to prescribe pharmacotherapy for Indigenous clients, and steps to overcome this, need further attention. © 2013 The Authors. ANZJPH © 2013 Public Health Association of Australia.

Substance Use among Young People Living in Residential State Care

ERIC Educational Resources Information Center

McCrystal, Patrick; Percy, Andrew; Higgins, Kathryn

2008-01-01

Existing empirical evidence on substance use among young people living in residential state care during adolescence is comparatively limited. This paper reports on substance use trends of young people living in residential state care during three annual data-sweeps when aged 14, 15 and 16 years. A repeated cross-sectional research design was…

A Challenging Job: Physical and Sexual Violence towards Group Workers in Youth Residential Care

ERIC Educational Resources Information Center

Alink, Lenneke R. A.; Euser, Saskia; Bakermans-Kranenburg, Marian J.; van IJzendoorn, Marinus H.

2014-01-01

Background: Residential or group care social workers appear to be at increased risk for experiencing physical violence at work. However, little is known about "sexual harassment" in addition to physical victimization of social workers in "youth" residential or group care. Objective We investigated the prevalence of physical and…

Young People's Satisfaction with Residential Care: Identifying Strengths and Weaknesses in Service Delivery

ERIC Educational Resources Information Center

Southwell, Jenni; Fraser, Elizabeth

2010-01-01

This paper presents findings from a landmark Australian study investigating the experiences and perspectives of young people in residential care. Data from a representative sample are analyzed to identify young people's satisfaction with various aspects of their residential care experience: their sense of safety, normality, support, comfort in…

Changing Residential Child Care: A Systems Approach to Consultation Training and Development

ERIC Educational Resources Information Center

Gibson, Johnnie; Leonard, Marcella; Wilson, Mena

2004-01-01

In this article, the authors describe and illustrate their approach to consultancy, development and training in residential child care. When working together the authors form the MOSAIC Consortium and provide training and consultancy to residential child care services. The article draws on systems theory, systems thinking and the politics of child…

38 CFR 17.71 - Revocation of VA approval.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Community Residential Care § 17.71 Revocation of VA approval. (a) If a hearing official determines under § 17.70 of this part that a community residential care facility does not comply with the standards set forth in § 17.63 of this part and determines that the community residential care facility shall not have...

Residential Group Care Quarterly. Volume 6, Number 1, Summer 2005

ERIC Educational Resources Information Center

Michael, Jennifer, Ed.

2005-01-01

This issue of "Residential Group Care Quarterly" includes the following articles: (1) "Residential Treatment: Finding the Appropriate Level of Care" (Shay Bilchik); (2) "Family-Centered Practices" (Rodger McDaniel and Brenden McKinney); and (3) "Can the Community Serve Sex Offenders?" (Point/Counterpoint--Daniel Wallach and Wayne D. Parks).…

Placement Instability Among Young People Removed from Their Original Family and the Likely Mental Health Implications.

PubMed

Rice, Simon; Cotton, Sue; Moeller-Saxone, Kristen; Mihalopoulos, Cathrine; Magnus, Anne; Harvey, Carol; Humphreys, Cathy; Halperin, Stephen; Scheppokat, Angela; McGorry, Patrick; Herrman, Helen

2017-04-25

Young people in out-of-home care are more likely to experience poorer mental and physical health outcomes related to their peers. Stable care environments are essential for ameliorating impacts of disruptive early childhood experiences, including exposure to psychological trauma, abuse and neglect. At present there are very few high quality data regarding the placement stability history of young people in out-of-home care in Australia or other countries. To undertake the first systematic census of background, care type and placement stability characteristics of young people living in the out-of-home care sector in Australia. Data was collected from four non-government child and adolescent community service organisations located across metropolitan Melbourne in 2014. The sample comprised 322 young people (females 52.8%), aged between 12 - 17 years (mean age=14.86 [SD =1.63] years). Most young people (64.3%) were in home-based care settings (i.e., foster care, therapeutic foster care, adolescent care program, kinship care, and lead tenant care), relative to residential care (35.7%). However, the proportion in residential care is very high in this age group when compared with all children in out-of-home care (5%). Mean age of first removal was 9 years (SD =4.54). No gender differences were observed for care type characteristics. Three quarters of the sample (76.9%) had a lifetime history of more than one placement in the out-of-home care system, with more than a third (36.5%) having experienced ≥5 lifetime placements. Relative to home-based care, young people in residential care experienced significantly greater placement instability (χ 2 =63.018, p <0.001). Placement instability is common in the out-of-home care sector. Given stable care environments are required to ameliorate psychological trauma and health impacts associated with childhood maltreatment, well-designed intervention-based research is required to enable greater placement stability, including strengthening the therapeutic capacities of out-of-home carers of young people.

Mortality and health services utilisation among older people with advanced cognitive impairment living in residential care homes.

PubMed

Luk, James K H; Chan, W K; Ng, W C; Chiu, Patrick K C; Ho, Celina; Chan, T C; Chan, Felix H W

2013-12-01

To study the demography, clinical characteristics, service utilisation, mortality, and predictors of mortality in older residential care home residents with advanced cognitive impairment. Cohort longitudinal study. Residential care homes for the elderly in Hong Kong West. Residents of such homes aged 65 years or more with advanced cognitive impairment. In all, 312 such residential care home residents (71 men and 241 women) were studied. Their mean age was 88 (standard deviation, 8) years and their mean Barthel Index 20 score was 1.5 (standard deviation, 2.0). In all, 164 (53%) were receiving enteral feeding. Nearly all of them had urinary and bowel incontinence. Apart from Community Geriatric Assessment Team clinics, 119 (38%) of the residents attended other clinics outside their residential care homes. In all, 107 (34%) died within 1 year; those who died within 1 year used significantly more emergency and hospital services (P<0.001), and utilised more services from community care nurses for wound care (P=0.001), enteral feeding tube care (P=0.018), and urinary catheter care (P<0.001). Independent risk factors for 1-year mortality were active pressure sores (P=0.0037), enteral feeding (P=0.008), having a urinary catheter (P=0.0036), and suffering from chronic obstructive pulmonary disease (P=0.011). A history of pneumococcal vaccination was protective with respect to 1-year mortality (P=0.004). Residents of residential care homes for the elderly with advanced cognitive impairment were frail, exhibited multiple co-morbidities and high mortality. They were frequent users of out-patient, emergency, and in-patient services. The development of end-of-life care services in residential care homes for the elderly is an important need for this group of elderly.

AiRCare: A naturalistic evaluation of the effectiveness of a protracted telephone-based recovery assistance program on continuing care outcomes.

PubMed

Proctor, Steven L; Wainwright, Jaclyn L; Herschman, Philip L; Kopak, Albert M

2017-02-01

Substance use disorder treatments are increasingly being contextualized within a disease management framework. Within this context, there is an identified need to maintain patients in treatment for longer periods of time in order to help them learn how to manage their disease. One way to meet this need is through telephone-based interventions that engage patients, and include more active outreach attempts and involvement of the patient's family. This study sought to evaluate the effectiveness of three formats of an intensive 12-month post-discharge telephone-based case management approach (AiRCare) on adherence to continuing care plans and substance use outcomes. Data were abstracted from electronic medical records for 379 patients (59.9% male) discharged from a residential treatment program located in the southwestern U.S. from 2013 to 2015. Patients were categorized into one of three groups and received telephone contacts based on their self-selection upon admission to residential treatment (i.e., patient only, family only, and both patient and family). Outcome variables included re-engagement and re-admission rates, quality of life, abstinence rates at 6 and 12 months, and compliance with continuing care plans. Favorable short- and long-term outcomes were found for the majority of patients, irrespective of case management group. There appeared to be some value in the addition of family contacts to patient contacts with respect to reducing risk for 12-month re-admission to residential care. These positive but preliminary indications of the effectiveness of AiRCare require replication in a well-powered, randomized controlled trial. Copyright © 2016 Elsevier Inc. All rights reserved.

Inter-Agency Collaboration between a Clinical Early Intervention Program and a Residential Care Setting To Meet the Needs of a Toddler.

ERIC Educational Resources Information Center

Herz, Susan; And Others

This paper discusses the interagency collaboration between a clinical assessment and intervention program for toddlers offered through the psychiatry department of a large metropolitan west coast medical center and a group home for infants and young children who are positive for the human immunodeficiency virus (HIV). The paper presents the case…

Evaluating the Impact of Dental Care on Housing Intervention Program Outcomes Among Homeless Veterans

PubMed Central

Nunez, Elizabeth; Gibson, Gretchen; Jones, Judith A.; Schinka, John A.

2013-01-01

Objectives. In this retrospective longitudinal cohort study, we examined the impact of dental care on outcomes among homeless veterans discharged from a Department of Veterans Affairs (VA) transitional housing intervention program. Methods. Our sample consisted of 9870 veterans who were admitted into a VA homeless intervention program during 2008 and 2009, 4482 of whom received dental care during treatment and 5388 of whom did not. Primary outcomes of interest were program completion, employment or stable financial status on discharge, and transition to permanent housing. We calculated descriptive statistics and compared the 2 study groups with respect to demographic characteristics, medical and psychiatric history (including alcohol and substance use), work and financial support, and treatment outcomes. Results. Veterans who received dental care were 30% more likely than those who did not to complete the program, 14% more likely to be employed or financially stable, and 15% more likely to have obtained residential housing. Conclusions. Provision of dental care has a substantial positive impact on outcomes among homeless veterans participating in housing intervention programs. This suggests that homeless programs need to weigh the benefits and cost of dental care in program planning and implementation. PMID:23678921

Understanding Interactions of Formerly Incarcerated HIV-Positive Men and Transgender Women with Addiction Treatment, Medical, and Criminal Justice Systems

PubMed Central

Harawa, Nina T.; Amani, Bita; Bowers, Jane Rohde; Sayles, Jennifer N.; Cunningham, William

2017-01-01

Background Low levels of medical care engagement have been noted for HIV-positive people leaving systems of incarceration in the United States. Substance misuse frequently co-occurs with criminal justice involvement in individuals who are living with HIV. Methods We analyzed data from in-depth interviews with 19 HIV-positive individuals who were currently or formerly incarcerated in order to elucidate challenges faced in accessing care and maintaining HIV treatment regimens when cycling out of (and often back into) custody. Our thematic analysis used an ecosocial framework to describe participants’ shifts between substance abuse treatment, medical care, and criminal justice systems. Results Dominant themes included the dramatic increase in HIV-treatment-related autonomy required following release from jail because of differences in care delivery between custody-based and community-based care systems; the important, but temporary stabilization provided by residential substance abuse treatment programs; and the inconsistency of substance abuse treatment approaches with chronic care models of disease management. Conclusions Enhanced integration of criminal justice, medical care, and substance abuse treatment institutions in planning for reentry of HIV populations may ease the impact of the dramatic shifts in context that often dissuade linkage and retention. This integration should include coordination with custody release processes, periodic assessments for active substance misuse in HIV treatment settings, support for (re)establishing health-promoting social networks, and options for long-term, residential substance abuse treatment programs. PMID:28804052

Parental Involvement in Residential Care and Perceptions of their Offspring's Life Satisfaction in Residential Facilities for Adults with Intellectual Disability

ERIC Educational Resources Information Center

Schwartz, Chaya

2005-01-01

Background: This study examined parental involvement in relocation and post-placement care of offspring in residential facilities for adults with intellectual disability, as well as the characteristics of residents, parents, and residential institutions and the effect of those variables on parental perceptions of their offspring's life…

The feasibility of a holistic wellness program for HIV/AIDS patients residing in a voluntary inpatient treatment program.

PubMed

Morgan, Vanessa

2014-03-01

The purpose of this project was to examine the feasibility of an ongoing holistic wellness program in a residential facility treating persons with HIV/AIDS. The goal was to create a voluntary, four week holistic wellness intensive within the established inpatient behavioral health treatment program. Participants were given practicable holistic self care tools to effectively manage HIV related symptoms, general medical issues, addiction, depression, stress and anxiety. The program incorporated evidence-based holistic activities including yoga, therapeutic dance, meditation, Reiki, and reflective journaling. Narrative survey results and post-program evaluation support that an ongoing holistic wellness program within the existing treatment model is feasible and could have numerous potential beneficial effects. This project clearly exemplified the ideal opportunity for holistic nurses to implement innovative holistic interventions within the current healthcare delivery system. It is the author's observation that future studies with a larger participant group to further examine measurable benefits can lend valuable information and insight into the future development of holistic wellness programs for residential treatment facilities.

Bullying in Adolescent Residential Care: The Influence of the Physical and Social Residential Care Environment

ERIC Educational Resources Information Center

Sekol, Ivana

2016-01-01

Background: To date, no study examined possible contributions of environmental factors to bullying and victimization in adolescent residential care facilities. Objective: By testing one part of the Multifactor Model of Bullying in Secure Setting (MMBSS; Ireland in "Int J Adolesc Med Health" 24(1):63-68, 2012), this research examined the…

Providing Residential Care Services for the Elderly. A Home-based Business Handbook. Bulletin No. 738.

ERIC Educational Resources Information Center

Williams, Doris K.

This publication is designed to help individuals or families determine whether their interests, resources, and skills are adequate to establish a small home-based business in residential care services. It discusses first the need for residential care. A discussion of setting up a business considers the following: common characteristics of…

Treatment Foster Care in a System of Care: Sequences and Correlates of Residential Placements

ERIC Educational Resources Information Center

Farmer, Elizabeth M. Z.; Wagner, H. Ryan; Burns, Barbara J.; Richards, Jesse T.

2003-01-01

We examined Treatment Foster Care (TFC) in residential trajectories for youth with psychiatric disorders and aggressive behavior. We analyzed residential placements of a statewide sample of youth during the 12 months preceding and following admission to TFC. Prior to TFC, the majority of youth were residing in more restrictive settings (group…

Attachment Style, Home-Leaving Age and Behavioral Problems among Residential Care Children

ERIC Educational Resources Information Center

Shechory, Mally; Sommerfeld, Eliane

2007-01-01

In a prospective study, the attachment style, home-leaving age, length of time in residential care, and behavioral problems among Israeli residential care children (N=68), were studied. Data analyses showed that children removed from their homes at a later age suffered from higher levels of anxiety, depression and social problems compared to…

Job satisfaction and intention to stay within community and residential aged care employees.

PubMed

Radford, Katrina; Meissner, Ellen

2017-09-01

This study investigated the different facets of job satisfaction that influence community care and residential care employees' intention to stay in the aged care workforce. A survey of four organisations in Australia was undertaken. t-Tests were conducted to analyse differences between groups. Regression analyses were performed to examine the factors influencing intentions to stay in the workforce. Community care workers were more satisfied with various facets of job satisfaction including work on their present job, supervision, people in their present job and the job in general. There was a difference between how the various facets of job satisfaction influenced intentions to stay for residential care compared to community care workers. Both workers were satisfied with their work conditions and work to different extents. There is an opportunity for residential care to look to the practices within the community care sector to improve employees' intentions to stay. © 2017 AJA Inc.

Positive and Negative Peer Influence in Residential Care.

PubMed

Huefner, Jonathan C; Smith, Gail L; Stevens, Amy L

2017-10-13

The potential for negative peer influence has been well established in research, and there is a growing interest in how positive peer influence also impacts youth. No research, however, has concurrently examined positive and negative peer influence in the context of residential care. Clinical records for 886 residential care youth were used in a Hierarchical Linear Model analysis to examine the impact of negative and positive peer influence on naturally occurring patterns of serious problem behavior over time. Negative peer influence, where the majority of youth in a home manifested above the average number of serious behavior problems, occurred 13.7% of the time. Positive peer influence, where the majority of youth manifested no serious problem behaviors for the month, occurred 47.7% of the time. Overall, youth problem behavior improved over time. There were significantly lower rates of serious problem behavior in target youth during positive peer influence months. Conversely, there were significantly higher rates of serious problem behaviors in target youth during negative peer influence months. Negative peer influence had a relatively greater impact on target peers' serious behavior problems than did positive peer influence. Caregiver experience significantly reduced the impact of negative peer influence, but did not significantly augment positive peer influence. Months where negative peer influence was combined with inexperienced caregivers produced the highest rates of serious problem behavior. Our results support the view that residential programs for troubled youth need to create circumstances that promote positive and control for negative peer influence.

Silver Memories: implementation and evaluation of a unique radio program for older people.

PubMed

Travers, Catherine; Bartlett, Helen P

2011-03-01

A unique radio program, Silver Memories, specifically designed to address social isolation and loneliness in older people by broadcasting music (primarily), serials and other programs relevant to the period when older people grew up--the 1920-1950s--first aired in Brisbane, Australia, in April 2008. The impact of the program upon older listeners' mood, quality of life (QOL) and self-reported loneliness was independently evaluated. One hundred and thirteen community-dwelling persons and residents of residential care facilities, aged 60 years and older participated in a three month evaluation of Silver Memories. They were asked to listen to the program daily and baseline and follow-up measures of depression, QOL and loneliness were obtained. Participants were also asked for their opinions regarding the program's quality and appeal. The results showed a statistically significant improvement in measures of depression and QOL from baseline to follow-up but there was no change on the measure of loneliness. The results did not vary by living situation (community vs. residential care), whether the participant was lonely or not lonely, socially isolated or not isolated, or whether there had been any important changes in the participant's health or social circumstances throughout the evaluation. It was concluded that listening to Silver Memories appears to improve the QOL and mood of older people and is an inexpensive intervention that is flexible and readily implemented.

Investing in organisational culture: nursing students' experience of organisational learning culture in aged care settings following a program of cultural development.

PubMed

Grealish, Laurie; Henderson, Amanda

2016-10-01

Concerns around organisational learning culture limit nursing student placements in aged care settings to first year experiences. Determine the impact of an extended staff capacity building program on students' experiences of the organisational learning culture in the aged care setting. Pre and post-test design. A convenience sample of first, second and third year Bachelor of Nursing students attending placements at three residential aged care facilities completed the Clinical Learning Organisational Culture Survey. Responses between the group that attended placement before the program (n = 17/44; RR 38%) and the group that attended following the program (n = 33/72; RR 45%) were compared. Improvements were noted in the areas of recognition, accomplishment, and influence, with decreases in dissatisfaction. Organisational investment in building staff capacity can produce a positive learning culture. The aged care sector offers a rich learning experience for students when staff capacity to support learning is developed.

Avoiding institutional outcomes for older adults living with disability: the use of community-based aged care supports.

PubMed

Ellison, Caroline; White, Amy; Chapman, Libby

2011-09-01

Most people with a disability want to remain living in their own home as they age. Without additional support, people with a disability may not be able to avoid moving into residential aged care, attending day programs, or becoming isolated from participation in the wider community. This study examined whether participants perceived access to community-based aged care supports assisted with avoiding receiving more institutional models of service as they age. Qualitative research processes were used to explore the perceptions of 60 individuals with a disability aged 50 years and over, in relation to ageing and the value of community-based aged care. Findings indicated that participants receiving community-based aged care supports reported benefits including opportunities to develop relationships, maintain daily living skills and participate in community activities. Due to a lack of confidence in the availability of access to mainstream community-based aged care services, many participants felt vulnerable or unsure about their future and ability to remain living in their own home. Several participants commented that this meant that an undesired early relocation into residential aged care or congregate disability services appeared inevitable.

Music for Engaging Young People in Education

ERIC Educational Resources Information Center

Cheong-Clinch, Carmen

2009-01-01

Two music programs were developed specifically to meet therapeutic objectives for newly arrived immigrant and refugee students and for adolescent boys in a residential care facility. The author's observations justify further research to establish whether music can support and nurture the social, physical and mental wellbeing of young people,…

38 CFR 17.73 - Medical foster homes-general.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 1 2012-07-01 2012-07-01 false Medical foster homes... MEDICAL Community Residential Care § 17.73 Medical foster homes—general. (a) Purpose. Through the medical foster home program, VA recognizes and approves certain medical foster homes for the placement of...

38 CFR 17.73 - Medical foster homes-general.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 1 2014-07-01 2014-07-01 false Medical foster homes... MEDICAL Community Residential Care § 17.73 Medical foster homes—general. (a) Purpose. Through the medical foster home program, VA recognizes and approves certain medical foster homes for the placement of...

38 CFR 17.73 - Medical foster homes-general.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 1 2013-07-01 2013-07-01 false Medical foster homes... MEDICAL Community Residential Care § 17.73 Medical foster homes—general. (a) Purpose. Through the medical foster home program, VA recognizes and approves certain medical foster homes for the placement of...

Modeling the Association Between Home Care Service Use and Entry Into Residential Aged Care: A Cohort Study Using Routinely Collected Data.

PubMed

Jorgensen, Mikaela; Siette, Joyce; Georgiou, Andrew; Warland, Andrew; Westbrook, Johanna

2018-02-01

To examine home care service-related and person-based factors associated with time to entry into permanent residential aged care. Longitudinal cohort study using routinely collected client management data. A large aged care service provider in New South Wales and the Australian Capital Territory, Australia. A total of 1116 people aged 60 years and older who commenced home care services for higher-level needs between July 1, 2015 and June 30, 2016. Survival analysis methods were used to examine service-related and person-based factors that were associated with time between first home care service and entry into permanent residential aged care. Predictors included service hours per week, combination of service types, demographics, needs, hospital leave, and change in care level. Cluster analysis was used to determine patterns of types of services used. By December 31, 2016, 21.1% of people using home care services had entered into permanent residential care (n = 235). After adjusting for significant factors such as age and care needs, each hour of service received per week was associated with a 6% lower risk of entry into residential care (hazard ratio = 0.94, 95% confidence interval 0.90-0.98). People who were predominant users of social support services, those with an identified carer, and those born in a non-main English-speaking country also remained in their own homes for longer. Greater volume of home care services was associated with significantly delayed entry into permanent residential care. This study provides much-needed evidence about service outcomes that could be used to inform older adults' care choices. Crown Copyright © 2017. Published by Elsevier Inc. All rights reserved.

Closing the Research to Practice Gap in Therapeutic Residential Care: Service Provider-University Partnerships Focused on Evidence-Based Practice

ERIC Educational Resources Information Center

Thompson, Ronald W.; Duppong Hurley, Kristin; Trout, Alexandra L.; Huefner, Jonathan C.; Daly, Daniel L.

2017-01-01

Residential care has been criticized for its high cost and limited research evidence. While recent studies and reviews of the literature suggest that a number of evidence-based practices are being implemented in residential care settings, more research is needed to develop and test empirically based practices that can be successfully implemented…

Building a Successful Care Path in Residential Care: Findings from Qualitative Research with Young People and Professionals in Italy

ERIC Educational Resources Information Center

Serbati, Sara; Gioga, Gianmaria

2017-01-01

Qualitative methods (i.e. semi-structured interviews) were used in this micro-research to explore the different ways in which young people and social and residential workers perceive the outcomes of the residential care experience. By comparing the participants' points of view, it was possible to investigate different ways of thinking about…

Profile of children placed in residential psychiatric program: Association with delinquency, involuntary mental health commitment, and reentry into care.

PubMed

Yampolskaya, Svetlana; Mowery, Debra; Dollard, Norín

2014-05-01

This study examined characteristics and profiles of youth receiving services in 1 of Florida's Medicaid-funded residential mental health treatment programs--State Inpatient Psychiatric Program (SIPP)--between July 1, 2004, and June 30, 2008 (N=1,432). Latent class analysis (LCA) was used to classify youth, and 3 classes were identified: Children With Multiple Needs, Children With No Caregivers, and Abused Children With Substantial Maltreatment History. The results of LCA showed that Children With Multiple Needs experienced the greatest risk for adverse outcomes. Compared with youth in the other 2 classes, these children were more likely to get readmitted to SIPP, more likely to become involved with the juvenile justice system, and more likely to experience involuntary mental health assessments. Implications of the findings are discussed. PsycINFO Database Record (c) 2014 APA, all rights reserved

Quality of life, autonomy, satisfaction, and costs associated with mental health supported accommodation services in England: a national survey.

PubMed

Killaspy, Helen; Priebe, Stefan; Bremner, Stephen; McCrone, Paul; Dowling, Sarah; Harrison, Isobel; Krotofil, Joanna; McPherson, Peter; Sandhu, Sima; Arbuthnott, Maurice; Curtis, Sarah; Leavey, Gerard; Shepherd, Geoff; Eldridge, Sandra; King, Michael

2016-12-01

Little research has been done into the effectiveness of mental health supported accommodation services. We did a national survey to investigate provision and costs of services and assess service user quality of life and outcomes across England. We randomly sampled three types of services from 14 nationally representative regions-residential care, supported housing, and floating outreach-and recruited up to ten service users per service. Service quality and costs and service users' quality of life, autonomy, and satisfaction with care were assessed in a standardised manner with validated tools and compared by multilevel modelling. 619 service users were recruited from 22 residential care, 35 supported housing, and 30 floating outreach services. Those in residential care and supported housing had more severe mental health problems than those in floating outreach. 348 (57%) were assessed as being at risk of severe self-neglect and 229 (37%) as being vulnerable to exploitation in the previous 2 years. Residential care was most expensive but provided for people with the greatest needs. The mean annual budget was £466 687 for residential care (range £276 000-777 920), compared with £365 452 for supported housing (£174 877-818 000), and £172 114 for floating outreach (£17 126-491 692). Quality of care was best in supported housing. People in supported housing and floating outreach were more socially included but experienced more crime than those in residential care. After adjustment for service quality and service user sociodemographic and clinical factors, quality of life was similar for service users in residential care and supported housing (mean difference -0·138, 95% CI -0·402 to 0·126, p=0·306) and lower for those in floating outreach than in residential care (-0·424, -0·734 to -0·114, p=0·007). However, autonomy was greater for those in supported housing than for those in residential care (0·145, 0·010 to 0·279, p=0.035). Satisfaction with care was similar across services. Supported housing might be cost-effective, but the benefits need to be weighed against the risks associated with increased autonomy. National Institute for Health Research. Copyright © 2016 Elsevier Ltd. All rights reserved.

77 FR 13887 - Energy Conservation Program: Test Procedures for Residential Clothes Washers

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-07

... Energy Conservation Program: Test Procedures for Residential Clothes Washers; Final Rule #0;#0;Federal... Conservation Program: Test Procedures for Residential Clothes Washers AGENCY: Office of Energy Efficiency and...) establishes new test procedures for residential clothes washers under the Energy Policy and Conservation Act...

Residential Care

MedlinePlus

... per year.* Most families pay for residential care costs out of their own pockets. Types of benefits that may cover nursing care include long-term ... need to be met before receiving benefits), Veterans benefits and Medicaid. Medicare does not cover the cost of long-term care in a care facility. ...

Do Diabetic Patients Living in Racially Segregated Neighborhoods Experience Different Access and Quality of Care?

PubMed Central

Chan, Kitty S.; Gaskin, Darrell J.; Dinwiddie, Gniesha Y.; McCleary, Rachael

2012-01-01

Background Place of residence, particularly residential segregation, has been implicated in health and health care disparities. However, prior studies have not focused on care for diabetes, a prevalent condition for minority populations. Objective To examine the association of residential segregation with a range of access and quality of care outcomes among Black and Hispanic diabetics using a nationally representative U.S. sample. Research Design Cross-sectional study using data for 1598 adult diabetics from the 2006 Medical Expenditure Panel Survey (MEPS) linked to residential segregation information for Blacks and Hispanics based on the 2000 census. Relationships of five dimensions of residential segregation (dissimilarity, isolation, clustering, concentration and centralization) with access and quality of care outcomes were examined using linear, logistic and multinomial logistic regression models, controlling for respondent characteristics and community utilization and hospital capacity. Results Black and Hispanic diabetics had comparable or better access to providers, but received fewer recommended services. Living in a segregated community was associated with more recommended services received, but also problems with seeing a specialist. The relationship of residential segregation to diabetes care varied depending on type of segregation and race/ethnic group assessed. Conclusions Residential segregation influences the care experience of diabetics in the U.S. Our study highlights the importance of investigating how different types of segregation may affect diabetes care received by patients from different race and ethnic groups. PMID:22525608

25 CFR 39.219 - What happens if a residential program does not maintain residency levels required by this subpart?

Code of Federal Regulations, 2010 CFR

2010-04-01

... 25 Indians 1 2010-04-01 2010-04-01 false What happens if a residential program does not maintain residency levels required by this subpart? 39.219 Section 39.219 Indians BUREAU OF INDIAN AFFAIRS..., Student Counts, and Verifications Residential Programs § 39.219 What happens if a residential program does...

The Academic and Functional Academic Skills of Youth Who Are at Risk for Language Impairment in Residential Care

ERIC Educational Resources Information Center

Hagaman, Jessica L.; Trout, Alexandra L.; DeSalvo, Cathy; Gehringer, Robert; Epstein, Michael H.

2010-01-01

Purpose: Undiagnosed language impairment (LI) for youth in residential care is a concern as similar populations have shown elevated levels of language delays. Therefore, the purposes of this study were to identify the percentage of youth in residential care who are at risk for LI and to compare the demographic, academic achievement, and functional…

More action needed: Psychotropic prescribing in Australian residential aged care.

PubMed

Westbury, Juanita; Gee, Peter; Ling, Tristan; Kitsos, Alex; Peterson, Gregory

2018-02-01

For at least two decades, concerns have been raised about inappropriate psychotropic prescribing in Australian residential aged care facilities, due to their modest therapeutic benefit and increased risk of falls and mortality. To date, the majority of prevalence data has been collected in Sydney exclusively and it is not known if recent initiatives to promote appropriate psychotropic prescribing have impacted utilisation. Thus, we aimed to comprehensively analyse psychotropic use in a large national sample of residential aged care facility residents. A cross-sectional, retrospective cohort study of residents from 150 residential aged care facilities distributed nationally during April 2014-October 2015. Antipsychotic, anxiolytic/hypnotic and antidepressant utilisation was assessed, along with anticonvulsant and anti-dementia drug use. Negative binomial regression analysis was used to examine variation in psychotropic use. Full psychotropic prescribing data was available from 11,368 residents. Nearly two-thirds (61%) were taking psychotropic agents regularly, with over 41% prescribed antidepressants, 22% antipsychotics and 22% of residents taking benzodiazepines. Over 30% and 11% were charted for 'prn' (as required) benzodiazepines and antipsychotics, respectively. More than 16% of the residents were taking sedating antidepressants, predominantly mirtazapine. South Australian residents were more likely to be taking benzodiazepines ( p < 0.05) and residents from New South Wales/Australian Capital Territory less likely to be taking them ( p < 0.01), after adjustment for rurality and size of residential aged care facility. Residents located in New South Wales/Australian Capital Territory were also significantly less likely to take antidepressants ( p < 0.01), as were residents from outer regional residential aged care facilities ( p < 0.01). Antipsychotic use was not associated with State, rurality or residential aged care facility size. Regular antipsychotic use appears to have decreased in residential aged care facilities but benzodiazepine prevalence is higher, particularly in South Australian residential aged care facilities. Sedating antidepressant and 'prn' psychotropic prescribing is widespread. Effective interventions to reduce the continued reliance on psychotropic management, in conjunction with active promotion of non-pharmacological strategies, are urgently required.

Improving and ensuring best practice continence management in residential aged care.

PubMed

Heckenberg, Gayle

2008-06-01

Background  Continence Management within residential aged care is an every day component of care that requires assessment, implementation of strategies, resource allocation and evaluation. At times the management of incontinence of aged residents can be challenging and unsuccessful. The project chosen through the Clinical Fellowship program was Continence Management with the aim of raising awareness of best practice to assist in improving and providing person-centred resident care. Aims/objectives •  Review the literature on best practice management of incontinence •  Evaluate current practice in continence management for elderly residents within residential aged care services •  Improve adherence to best practice strategies of care for incontinence •  Raise awareness within the nursing home of the best practice management of incontinence •  Promote appropriate and effective use of resources for continence management •  Deliver individualised person-centred care to residents. •  Ensure best practice in continence management Methods  The Joanna Briggs Institute (JBI) Practical Application of Clinical Evidence System clinical audit tool was utilised to measure current practice against best practice. The results identify gaps that require improvement. The Getting Research into Practice process then allowed analysis of the level of compliance with each of the audit criteria, which would identify any barriers in implementing a selected course of action and aim to improve compliance. The project team was consulted with additional stakeholder consultation to form an action plan and implement strategies to improve practice. Results  Although 100% compliance with all audit criteria in audit 1 and 2 was not achieved, there was improvement in the criteria concerning the documented fluid intake for residents. Further strategies have been identified and implemented and this continues to be a 'work in progress'. Staff now have an acute awareness of what best practice means and the impact their practices have on continence management. The JBI clinical audit and feedback cycle will continue to facilitate the measuring and implementation of best practice for resident outcomes in residential aged care. © 2008 The Author. Journal Compilation © Blackwell Publishing Asia Pty Ltd.

Observations of Group Care Worker-Child Interaction in Residential Youth Care: Pedagogical Interventions and Child Behavior

ERIC Educational Resources Information Center

Bastiaanssen, Inge L. W.; Delsing, Marc J. M. H.; Geijsen, Luuk; Kroes, Gert; Veerman, Jan W.; Engels, Rutger C. M. E.

2014-01-01

Background: The work of group care workers in residential youth care is often described as professional parenting. Pedagogical interventions of group care workers influence the quality of care for looked-after children. Objective: The aim of the current study was to observe the pedagogical interventions of group care workers within residential…

75 FR 2595 - Proposed Information Collection (Application for Furnishing Long-Term Care Services to...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-01-15

... (Application for Furnishing Long- Term Care Services to Beneficiaries of Veterans Affairs, and Residential Care... comments for information needed to determine non-Federal nursing home or residential care home qualification to provide care to veteran patients. DATES: Written comments and recommendations on the proposed...

38 CFR 17.61 - Eligibility.

Code of Federal Regulations, 2010 CFR

2010-07-01

... or VA medical center, domiciliary, or nursing home care; or (2) Such care or services were furnished... Residential Care § 17.61 Eligibility. VA health care personnel may assist a veteran by referring such veteran for placement in a privately or publicly-owned community residential care facility if: (a) At the time...

Stability and Change of Adolescents' Aggressive Behavior in Residential Youth Care

ERIC Educational Resources Information Center

Eltink, E. M. A.; Ten Hoeve, J.; De Jongh, T.; Van der Helm, G. H. P.; Wissink, I. B.; Stams, G. J. J. M.

2018-01-01

Background: Aggression in residential youth care institutions is a frequent problem. Objective: The present short-term longitudinal study examined individual and institutional predictors of aggression in a group of 198 adolescents placed in open, semi-secure and secure residential institutions from the perspective of the importation and…

The Easter Seal Directory of Resident Camps for Persons with Special Health Needs.

ERIC Educational Resources Information Center

National Easter Seal Society for Crippled Children and Adults, Chicago, IL.

The directory of resident camps is designed for persons with special health needs (children and adults with physical, mental, social, or emotional handicaps). Published by the National Easter Seal Society for Crippled Children and Adults, the listing contains residential facilities only (day care camp program information is not included). Listed…

Young Women and the City: Adolescent Deviance and the Transformation of Educational Policy, 1870-1960.

ERIC Educational Resources Information Center

Sedlak, Michael W.

1983-01-01

Evangelical residential homes and intermediate care facilities in urban centers, professional clinical programs, and financial assistance from the federal government characterize three periods in the history of institutional response to pregnant and delinquent young women. Each period is analyzed in terms of funding sources, clientele, and…

Social Behavior of Mentally Handicapped Clients in Different Community Settings.

ERIC Educational Resources Information Center

Romer, Daniel; Berkson, Gershon

To study the influence that community settings have upon peer relationships and social behavior, 81 mentally disabled (retarded and emotionally disturbed retarded) adults were observed in their intermediate care residential facility and in one of four workshop programs. In summary, Ss tended to have more extensive affiliation and to aggregate more…

The policy and politics of the 2015 long-term care reform in the Netherlands.

PubMed

Maarse, J A M Hans; Jeurissen, P P Patrick

2016-03-01

As of 2015 a major reform in LTC is taking place in the Netherlands. An important objective of the reform is to reign in expenditure growth to safeguard the fiscal sustainability of LTC. Other objectives are to improve the quality of LTC by making it more client-tailored. The reform consists of four interrelated pillars: a normative reorientation, a shift from residential to non-residential care, decentralization of non-residential care and expenditure cuts. The article gives a brief overview of these pillars and their underlying assumptions. Furthermore, attention is paid to the political decision-making process and the politics of implementation and evaluation. Perceptions of the effects of the reform so far widely differ: positive views alternate with critical views. Though the reform is radical in various aspects, LTC care will remain a largely publicly funded provision. A statutory health insurance scheme will remain in place to cover residential care. The role of municipalities in publicly funded non-residential care is significantly upgraded. The final section contains a few policy lessons. Copyright © 2016 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

Does the Aged Care Funding Instrument provide increased funding in residential care? Comparisons with the Residential Classification Scale.

PubMed

Chan, Geoffrey Z P; Chin, Collin K L; McKitrick, Douglas J; Warne, Roger W

2014-06-01

To determine whether the Aged Care Funding Instrument (ACFI) provides more funding than the Residential Classification Scale (RCS) for residents in the Hellenic Residential Care Facility. All residents within the care facility were assessed over a six 6-month period using ACFI, RCS and Clifton Assessment Procedures for the Elderly (CAPE) scores. Differences in funding levels were calculated using ACFI and RCS instruments against a standardised CAPE score. CAPE dependency RCS funding per resident per day varied from $32.20 for grade A to $116.20 for grade E4 residents. CAPE ACFI funding varied from $20.20 for grade A to $127.50 for grade E4. There was no significant difference in mean overall funding between the two scales (ACFI $92.50 vs RCS $90.35, P = 0.76). The ACFI does provide a small but not significant increase in funding to residents in residential care. It redirects funding to higher dependency residents. © 2013 The Authors. Australasian Journal on Ageing © 2013 ACOTA.

Implementation of sustainable evidence-based practice for the assessment and management of pain in residential aged care facilities.

PubMed

Savvas, Steven; Toye, Christine; Beattie, Elizabeth; Gibson, Stephen J

2014-12-01

Pain is common in residential aged care facilities (RACFs). In 2005, the Australian Pain Society developed 27 recommendations for good practice in the identification, assessment, and management of pain in these settings. This study aimed to address implementation of the standards and evaluate outcomes. Five facilities in Australia participated in a comprehensive evaluation of RACF pain practice and outcomes. Pre-existing pain management practices were compared with the 27 recommendations, before an evidence-based pain management program was introduced that included training and education for staff and revised in-house pain-management procedures. Post-implementation audits evaluated the program's success. Aged care staff teams also were assessed on their reports of self-efficacy in pain management. The results show that before the implementation program, the RACFs demonstrated full compliance on 6 to 12 standards. By the project's completion, RACFs demonstrated full compliance with 10 to 23 standards and major improvements toward compliance in the remaining standards. After implementation, the staff also reported better understanding of the standards (p < .001) or of facility pain management guidelines (p < .001), increased confidence in therapies for pain management (p < .001), and increased confidence in their training to assess pain (p < .001) and recognize pain in residents with dementia who are nonverbal (p = .003). The results show that improved evidence-based practice in RACFs can be achieved with appropriate training and education. Investing resources in the aged care workforce via this implementation program has shown improvements in staff self-efficacy and practice. Copyright © 2014 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

Implementation and effect of life space crisis intervention in special schools with residential treatment for students with emotional and behavioral disorders (EBD).

PubMed

DOosterlinck, Franky; Goethals, Ilse; Broekaert, Eric; Boekaert, Eric; Schuyten, Gilberte; De Maeyer, Jessica

2008-03-01

The increase of violence in present-day society calls for adequate crisis interventions for students with behavioral problems. Life Space Crisis Intervention (LSCI) is a systematic and formatted response to a student's crisis, based on cognitive, behavioral, psychodynamic and developmental theory. The following research article evaluates a LSCI Program with students referred to special schools with residential treatment because of severe behavioral problems. The evaluation was conducted using a quasi experimental pre-test-post-test control group design. Thirty-one match paired students were pre-tested before the interventions started and post-tested after a period of 11 months. Five standardized questionnaires were examined to assess the effectiveness of the LSCI Program. General Linear Model (GLM) with repeated measures was used to analyze all data. For the total group of subjects (n = 62) it was found that students' perception about their athletic competence decrease significantly after 11 months in residential care. A positive effect of LSCI was found on direct aggression and social desirability.

Mississippi Curriculum Framework for Residential Carpentry Technology (Program CIP: 46.0201--Carpenter). Postsecondary Programs.

ERIC Educational Resources Information Center

Mississippi Research and Curriculum Unit for Vocational and Technical Education, State College.

This document, which is intended for use by community and junior colleges throughout Mississippi, contains curriculum frameworks for certificate of residential carpentry and residential carpentry technology programs. Presented in the introductory section are program descriptions and suggested course sequences for both programs. Section I lists…

Exploring nursing expertise in residential care for older people: a mixed method study.

PubMed

Phelan, Amanda; McCormack, Brendan

2016-10-01

To explore the expertise of Registered Nurses in residential care for older people. As older people in residential care have many complex dependencies, nursing expertise is an essential component of care excellence. However, the work of these nurses can be invisible and, therefore, unrecognized. Thus, additional attention is required to illuminate such nursing expertise. A mixed method design was used in this study. The research took place in 2012 in the Republic of Ireland. Twenty-three case study nurses were recruited from nursing homes. Each case study nurse involved five data collection methods: shadowing, interview with a colleague, interview with a resident, a demographic profile and a director of nursing survey. The study was also informed by a modified focus group. Qualitative data were analysed using directed content analysis using a conceptual framework generated from the literature on nursing expertise. Quantitative data were analysed using SPSS and presented in descriptive statistics. The findings from the case studies and the modified focus group are presented in seven themes, which represent nursing expertise in residential care of older people: transitions, context of the nursing home, saliency, holistic practice knowledge, knowing the resident, moral agency and skilled know how. Nursing expertise in residential care of older people is a complex phenomenon which encompasses many aspects of care delivery in a person-centred framework. By rendering this expertise visible, the need for appropriate and adequate skill mix for a growing residential care population is presented. © 2016 John Wiley & Sons Ltd.

Modular health services: a single case study approach to the applicability of modularity to residential mental healthcare.

PubMed

Soffers, Rutger; Meijboom, Bert; van Zaanen, Jos; van der Feltz-Cornelis, Christina

2014-05-09

The Dutch mental healthcare sector has to decrease costs by reducing intramural capacity with one third by 2020 and treating more patients in outpatient care. This transition necessitates enabling patients to become as self-supporting as possible, by customising the residential care they receive to their needs for self-development. Theoretically, modularity might help mental healthcare institutions with this. Modularity entails the decomposition of a healthcare service in parts that can be mixed-and-matched in a variety of ways, and combined form a functional whole. It brings about easier and better configuration, increased transparency and more variety without increasing costs. this study aims to explore the applicability of the modularity concept to the residential care provided in Assisted Living Facilities (ALFs) of Dutch mental healthcare institutions. A single case study is carried out at the centre for psychosis in Etten-Leur, part of the GGz Breburg IMPACT care group. The design enables in-depth analysis of a case in a specific context. This is considered appropriate since theory concerning healthcare modularity is in an early stage of development. The present study can be considered a pilot case. Data were gathered by means of interviews, observations and documentary analysis. At the centre for psychosis, the majority of the residential care can be decomposed in modules, which can be grouped in service bundles and sub-bundles; the service customisation process is sufficiently fit to apply modular thinking; and interfaces for most of the categories are present. Hence, the prerequisites for modular residential care offerings are already largely fulfilled. For not yet fulfilled aspects of these prerequisites, remedies are available. The modularity concept seems applicable to the residential care offered by the ALF of the mental healthcare institution under study. For a successful implementation of modularity however, some steps should be taken by the ALF, such as developing a catalogue of modules and a method for the personnel to work with this catalogue in application of the modules. Whether implementation of modular residential care might facilitate the transition from intramural residential care to outpatient care should be the subject of future research.

Modular health services: a single case study approach to the applicability of modularity to residential mental healthcare

PubMed Central

2014-01-01

Background The Dutch mental healthcare sector has to decrease costs by reducing intramural capacity with one third by 2020 and treating more patients in outpatient care. This transition necessitates enabling patients to become as self-supporting as possible, by customising the residential care they receive to their needs for self-development. Theoretically, modularity might help mental healthcare institutions with this. Modularity entails the decomposition of a healthcare service in parts that can be mixed-and-matched in a variety of ways, and combined form a functional whole. It brings about easier and better configuration, increased transparency and more variety without increasing costs. Aim: this study aims to explore the applicability of the modularity concept to the residential care provided in Assisted Living Facilities (ALFs) of Dutch mental healthcare institutions. Methods A single case study is carried out at the centre for psychosis in Etten-Leur, part of the GGz Breburg IMPACT care group. The design enables in-depth analysis of a case in a specific context. This is considered appropriate since theory concerning healthcare modularity is in an early stage of development. The present study can be considered a pilot case. Data were gathered by means of interviews, observations and documentary analysis. Results At the centre for psychosis, the majority of the residential care can be decomposed in modules, which can be grouped in service bundles and sub-bundles; the service customisation process is sufficiently fit to apply modular thinking; and interfaces for most of the categories are present. Hence, the prerequisites for modular residential care offerings are already largely fulfilled. For not yet fulfilled aspects of these prerequisites, remedies are available. Conclusion The modularity concept seems applicable to the residential care offered by the ALF of the mental healthcare institution under study. For a successful implementation of modularity however, some steps should be taken by the ALF, such as developing a catalogue of modules and a method for the personnel to work with this catalogue in application of the modules. Whether implementation of modular residential care might facilitate the transition from intramural residential care to outpatient care should be the subject of future research. PMID:24886367

Expressions of Prayer in Residential Care Homes.

PubMed

Reimer-Kirkham, Sheryl; Sharma, Sonya; Smith, Brenda; Schutt, Kelly; Janzen, Kyla

2018-01-01

Although the value of spiritual care in the care of older adults is supported by research, few studies have focused specifically on prayer in residential care settings. This ethnographic study with fifteen chaplains and administrators in eleven residential care homes involved analyses of walking interviews and research diaries. Findings revealed the spaces in which prayer happens and the forms it takes. The identities of chaplains-their own spiritual practices, religious beliefs, and positioning within the facility-shaped their dis/comfort with prayer and how they located prayer within public and private spaces. Where organizational leadership endorsed the legitimacy of chaplaincy services, prayer was more likely to be offered. Even in these circumstances, however, religious diversity and questions about secularism left chaplains ambivalent about the appropriateness of prayer. The results demonstrate the relevance of religion and spirituality to residential care, and illustrate how prayer functions as an opportunity for connection and understanding.

75 FR 15495 - Agency Information Collection (Application for Furnishing Long-Term Care Services to...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-29

... (Application for Furnishing Long- Term Care Services to Beneficiaries of Veterans Affairs, and Residential Care... Furnishing Long-Term Care Services to Beneficiaries of Veterans Affairs, VA Form 10-1170. b. Residential Care... agencies wishing to provide long term care to veterans receiving VA benefits. b. VA Form 10-2407 is an...

"There's No Place Like Home": A Scoping Review on the Impact of Homelike Residential Care Models on Resident-, Family-, and Staff-Related Outcomes.

PubMed

Ausserhofer, Dietmar; Deschodt, Mieke; De Geest, Sabina; van Achterberg, Theo; Meyer, Gabriele; Verbeek, Hilde; Sjetne, Ingeborg Strømseng; Malinowska-Lipień, Iwona; Griffiths, Peter; Schlüter, Wilfried; Ellen, Moriah; Engberg, Sandra

2016-08-01

There is increasing emphasis on promoting "homelike" residential care models enabling care-dependent people to continue living in a self-determined manner. Yet, little is known about the outcomes of homelike residential care models. We aimed to (1) identify homelike residential care models for older care-dependent people with and without dementia, and (2) explore the impact of these models on resident-, family-, and staff-related outcomes. We applied a scoping review method and conducted a comprehensive literature search in PubMed, Embase, and CINAHL in May 2015. We included 14 studies, reported in 21 articles. Studies were conducted between 1994 and 2014, most using a quasi-experimental design and comparing the Eden Alternative (n = 5), nondementia-specific small houses (eg Green House homes) (n = 2), and dementia-specific small houses (n = 7) with usual care in traditional nursing homes. The studies revealed evidence of benefit related to physical functioning of residents living in dementia-specific small houses and satisfaction with care of residents living in nondementia-specific small houses compared with those living in traditional nursing homes. We did not find other significant benefits related to physical and psychosocial outcomes of residents, or in family- and staff-related outcomes. The current evidence on homelike residential care models is limited. Comparative-effectiveness research building on a clear theoretical framework and/or logic model and including a standardized set of resident-, family-, and staff-related outcomes, as well as cost evaluation, is needed to provide a stronger evidence base to justify the uptake of more homelike residential care models. Copyright © 2016 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

Compassion Fatigue and Compassion Satisfaction among Residential Child Care Workers: The Role of Personality Resources

ERIC Educational Resources Information Center

Zerach, Gadi

2013-01-01

This study assessed compassion fatigue (CF) and compassion satisfaction (CS) among Israeli residential child-care workers (RCWs) working in residential treatment facilities for children and youth at risk (N = 147) as compared to educational boarding schools workers (BSWs; N = 74). Furthermore, we assessed the relationship of potential…

Compassion Fatigue Risk and Self-Care Practices among Residential Treatment Center Childcare Workers

ERIC Educational Resources Information Center

Eastwood, Callum D.; Ecklund, Kathryn

2008-01-01

Exploration of the presence of risk for compassion fatigue among residential childcare workers (RCW) at residential treatment facilities and the relationship between self-care practices and compassion fatigue were explored. Using the Professional Quality of Life Survey (ProQOL-R III) to assess compassion fatigue, burnout, and compassion…

A contemplative care approach to training and supporting hospice volunteers: a prospective study of spiritual practice, well-being, and fear of death.

PubMed

Scherwitz, Larry; Pullman, Marcie; McHenry, Pamela; Gao, Billy; Ostaseski, Frank

2006-01-01

Inspired by a 2,500-year-old Buddhist tradition, the Zen Hospice Project (ZHP) provides residential hospice care, volunteer programs, and educational efforts that cultivate wisdom and compassion in service. The present study was designed to understand how being with dying hospice residents affects hospice volunteers well-being and the role of spiritual practice in ameliorating the fear of death. A one-year longitudinal study of two volunteer cohorts (N = 24 and N = 22) with repeated measures of spiritual practice, well-being, and hospice performance during one-year service as volunteers. The Zen Hospice Guest House and Laguna Honda Residential Hospital of San Francisco, CA. All 46 individuals who became ZHP volunteers during two years. A 40-hour training program for beginning hospice volunteers stressing compassion, equanimity, mindfulness, and practical bedside care; a one-year caregiver assignment five hours per week; and monthly group meeting. Self-report FACIT spiritual well-being, general well-being, self-transcendence scale, and a volunteer coordinator-rated ZHP performance scale. The volunteers had a high level of self-care and well-being at baseline and maintained both throughout the year; they increased compassion and decreased fear of death. Those (n = 20) practicing yoga were found to have consistently lower fear of death than the group average (P = .04, P = .008, respectively). All rated the training and program highly, and 63% continued to volunteer after the first year's commitment. The results suggest that this approach to training and supporting hospice volunteers fosters emotional well-being and spiritual growth.

Leadership Development Initiative: Growing Global Leaders… Advancing Palliative Care.

PubMed

Ferris, Frank D; Moore, Shannon Y; Callaway, Mary V; Foley, Kathleen M

2018-02-01

The International Palliative Care Leadership Development Initiative (LDI) was a model demonstration project that aimed to expand the global network of palliative care leaders in low- and moderate-resource countries who are well positioned to apply their new leadership skills. Thirty-nine palliative medicine physicians from 25 countries successfully completed the two-year curriculum that included three thematic residential courses, mentorship, and site visits by senior global palliative care leaders and personal projects to apply their new leadership skills. The focus on self-reflection, leadership behaviors and practices, strategic planning, high-level communication, and teaching skills led to significant personal and professional transformation among the participants, mentors, and the LDI team. The resulting residential course curriculum and the personal leadership stories and biosketches of the leaders are now available open access at IPCRC.net. Already, within their first-year postgraduation, the leaders are using their new leadership skills to grow palliative care capacity through significant changes in policy, improved opioid/other medication availability, new and enhanced educational curricula and continuing education activities, and development/expansion of palliative care programs in their organizations and regions. We are not aware of another palliative care initiative that achieves the global reach and ripple effect that LDI has produced. Copyright © 2017 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

Proximity to Pediatric Cardiac Surgical Care among Adolescents with Congenital Heart Defects in 11 New York Counties.

PubMed

Sommerhalter, Kristin M; Insaf, Tabassum Z; Akkaya-Hocagil, Tugba; McGarry, Claire E; Farr, Sherry L; Downing, Karrie F; Lui, George K; Zaidi, Ali N; Van Zutphen, Alissa R

2017-11-01

Many individuals with congenital heart defects (CHDs) discontinue cardiac care in adolescence, putting them at risk of adverse health outcomes. Because geographic barriers may contribute to cessation of care, we sought to characterize geographic access to comprehensive cardiac care among adolescents with CHDs. Using a population-based, 11-county surveillance system of CHDs in New York, we characterized proximity to the nearest pediatric cardiac surgical care center among adolescents aged 11 to 19 years with CHDs. Residential addresses were extracted from surveillance records documenting 2008 to 2010 healthcare encounters. Addresses were geocoded using ArcGIS and the New York State Street and Address Maintenance Program, a statewide address point database. One-way drive and public transit time from residence to nearest center were calculated using R packages gmapsdistance and rgeos with the Google Maps Distance Matrix application programming interface. A marginal model was constructed to identify predictors associated with one-way travel time. We identified 2522 adolescents with 3058 corresponding residential addresses and 12 pediatric cardiac surgical care centers. The median drive time from residence to nearest center was 18.3 min, and drive time was 30 min or less for 2475 (80.9%) addresses. Predicted drive time was longest for rural western addresses in high poverty census tracts (68.7 min). Public transit was available for most residences in urban areas but for few in rural areas. We identified areas with geographic barriers to surgical care. Future research is needed to determine how these barriers influence continuity of care among adolescents with CHDs. Birth Defects Research 109:1494-1503, 2017.© 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

Effects of injectable extended-release naltrexone (XR-NTX) for opioid dependence on residential rehabilitation outcomes and early follow-up.

PubMed

Leslie, Douglas L; Milchak, William; Gastfriend, David R; Herschman, Philip L; Bixler, Edward O; Velott, Diana L; Meyer, Roger E

2015-04-01

Little is known about the use of extended-release naltrexone (XR-NTX) during residential rehabilitation, and its effects on early outcomes and rates of follow-up treatment. This study examined patient characteristics and rates of treatment completion and engagement in post-residential care of opioid dependent patients who received XR-NTX during residential rehabilitation, compared with patients who did not receive this medication. Electronic records for opioid dependent patients from three Pennsylvania residential detoxification and treatment facilities (N = 7,687) were retrospectively analyzed. We determined the proportion of patients who received XR-NTX (INJ), and compared rates of treatment completion and engagement in follow-up care relative to a naturalistic control group of patients recommended for, but not administered, XR-NTX (Non-INJ). Data on whether the patient initiated follow-up care were available from one site (N = 3,724). Overall, 598 (7.8%) patients were recommended for XR-NTX and of these, 168 (28.1%) received injections. Compared to non-INJ patients, INJ patients were less likely to leave against medical advice (4.8% vs. 30.2%, p < .001) and more likely to initiate follow-up care (37.7% vs. 19.7%, p < .001). These differences remained significant after controlling for demographic covariates using regression analysis. XR-NTX was associated with higher rates of residential and early post-residential care engagement in patients with opioid dependence. XR-NTX may be an effective adjunct in the residential treatment and aftercare of patients with opioid dependence. © American Academy of Addiction Psychiatry.

Making Sense of Varying Standards of Care: The Experiences of Staff Working in Residential Care Environments for Adults with Learning Disabilities

ERIC Educational Resources Information Center

Hutchison, Andrew; Kroese, Biza Stenfert

2016-01-01

Research evidence reveals that adults with learning disabilities who live in residential care facilities are being exposed to considerable variation in the standards of care they receive. High profile cases of substandard care have also raised concerns regarding the appropriateness of existing care provisions and practices. While attempts have…

25 CFR 39.216 - How does ISEF fund residential programs?

Code of Federal Regulations, 2010 CFR

2010-04-01

... 25 Indians 1 2010-04-01 2010-04-01 false How does ISEF fund residential programs? 39.216 Section 39.216 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR EDUCATION THE INDIAN SCHOOL EQUALIZATION PROGRAM Administrative Procedures, Student Counts, and Verifications Residential Programs § 39.216...

28 CFR 550.53 - Residential Drug Abuse Treatment Program (RDAP).

Code of Federal Regulations, 2014 CFR

2014-07-01

... 28 Judicial Administration 2 2014-07-01 2014-07-01 false Residential Drug Abuse Treatment Program... INSTITUTIONAL MANAGEMENT DRUG PROGRAMS Drug Abuse Treatment Program § 550.53 Residential Drug Abuse Treatment... components: (1) Unit-based component. Inmates must complete a course of activities provided by drug abuse...

28 CFR 550.53 - Residential Drug Abuse Treatment Program (RDAP).

Code of Federal Regulations, 2011 CFR

2011-07-01

... 28 Judicial Administration 2 2011-07-01 2011-07-01 false Residential Drug Abuse Treatment Program... INSTITUTIONAL MANAGEMENT DRUG PROGRAMS Drug Abuse Treatment Program § 550.53 Residential Drug Abuse Treatment... components: (1) Unit-based component. Inmates must complete a course of activities provided by drug abuse...

28 CFR 550.53 - Residential Drug Abuse Treatment Program (RDAP).

Code of Federal Regulations, 2010 CFR

2010-07-01

... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Residential Drug Abuse Treatment Program... INSTITUTIONAL MANAGEMENT DRUG PROGRAMS Drug Abuse Treatment Program § 550.53 Residential Drug Abuse Treatment... components: (1) Unit-based component. Inmates must complete a course of activities provided by drug abuse...

28 CFR 550.53 - Residential Drug Abuse Treatment Program (RDAP).

Code of Federal Regulations, 2012 CFR

2012-07-01

... 28 Judicial Administration 2 2012-07-01 2012-07-01 false Residential Drug Abuse Treatment Program... INSTITUTIONAL MANAGEMENT DRUG PROGRAMS Drug Abuse Treatment Program § 550.53 Residential Drug Abuse Treatment... components: (1) Unit-based component. Inmates must complete a course of activities provided by drug abuse...

28 CFR 550.53 - Residential Drug Abuse Treatment Program (RDAP).

Code of Federal Regulations, 2013 CFR

2013-07-01

... 28 Judicial Administration 2 2013-07-01 2013-07-01 false Residential Drug Abuse Treatment Program... INSTITUTIONAL MANAGEMENT DRUG PROGRAMS Drug Abuse Treatment Program § 550.53 Residential Drug Abuse Treatment... components: (1) Unit-based component. Inmates must complete a course of activities provided by drug abuse...

The Cost-Effectiveness of Independent Housing for the Chronically Mentally Ill: Do Housing and Neighborhood Features Matter?

PubMed Central

Harkness, Joseph; Newman, Sandra J; Salkever, David

2004-01-01

Objective To determine the effects of housing and neighborhood features on residential instability and the costs of mental health services for individuals with chronic mental illness (CMI). Data Sources Medicaid and service provider data on the mental health service utilization of 670 individuals with CMI between 1988 and 1993 were combined with primary data on housing attributes and costs, as well as census data on neighborhood characteristics. Study participants were living in independent housing units developed under the Robert Wood Johnson Foundation Program on Chronic Mental Illness in four of nine demonstration cities between 1988 and 1993. Study Design Participants were assigned on a first-come, first-served basis to housing units as they became available for occupancy after renovation by the housing providers. Multivariate statistical models are used to examine the relationship between features of the residential environment and three outcomes that were measured during the participant's occupancy in a study property: residential instability, community-based service costs, and hospital-based service costs. To assess cost-effectiveness, the mental health care cost savings associated with some residential features are compared with the cost of providing housing with these features. Data Collection/Extraction Methods Health service utilization data were obtained from Medicaid and from state and local departments of mental health. Non-mental-health services, substance abuse services, and pharmaceuticals were screened out. Principal Findings Study participants living in newer and properly maintained buildings had lower mental health care costs and residential instability. Buildings with a richer set of amenity features, neighborhoods with no outward signs of physical deterioration, and neighborhoods with newer housing stock were also associated with reduced mental health care costs. Study participants were more residentially stable in buildings with fewer units and where a greater proportion of tenants were other individuals with CMI. Mental health care costs and residential instability tend to be reduced in neighborhoods with many nonresidential land uses and a higher proportion of renters. Mixed-race neighborhoods are associated with reduced probability of mental health hospitalization, but they also are associated with much higher hospitalization costs if hospitalized. The degree of income mixing in the neighborhood has no effect. Conclusions Several of the key findings are consistent with theoretical expectations that higher-quality housing and neighborhoods lead to better mental health outcomes among individuals with CMI. The mental health care cost savings associated with these favorable features far outweigh the costs of developing and operating properties with them. Support for the hypothesis that “diverse-disorganized” neighborhoods are more accepting of individuals with CMI and, hence, associated with better mental health outcomes, is mixed. PMID:15333112

WHERE HAS THE COMPASSION GONE FROM THE RESIDENTIAL AGED CARE ENVIRONMENT?

PubMed

Oliver, Kim

2017-02-01

Would working in residential aged care be your dream job as a newly qualified nurse, probably not, but why not? Montayre (2015) suggests that although nurses don't like to talk about it, or even less, what the real problem is perceived to be with this practice area, residential aged care nursing is thought to be less exciting, monotonous, and requiring less skill than other areas such as emergency nursing, or medical nursing.

Nursing staff work patterns in a residential aged care home: a time-motion study.

PubMed

Qian, Siyu; Yu, Ping; Hailey, David

2016-11-01

Objective Residential aged care services are challenged by an increasing number of residents and a shortage of nursing staff. Developing strategies to overcome this challenge requires an understanding of nursing staff work patterns. The aim of the present study was to investigate the work processes followed by nursing staff and how nursing time is allocated in a residential aged care home. Methods An observational time-motion study was conducted at two aged care units for 12 morning shifts. Seven nurses were observed, one per shift. Results In all, there were 91h of observation. The results showed that there was a common work process followed by all nurse participants. Medication administration, documentation and verbal communication were the most time-consuming activities and were conducted most frequently. No significant difference between the two units was found in any category of activities. The average duration of most activities was less than 1min. There was no difference in time utilisation between the endorsed enrolled nurses and the personal carers in providing nursing care. Conclusion Medication administration, documentation and verbal communication were the major tasks in morning shifts in a residential aged care home. Future research can investigate how verbal communication supports nursing care. What is known about the topic? The aging population will substantially increase the demand for residential aged care services. There is a lack of research on nurses' work patterns in residential aged care homes. What does this paper add? The present study provides a comprehensive understanding of nurses' work patterns in a residential aged care home. There is a common work process followed by nurses in providing nursing care. Medication administration, verbal communication and documentation are the most time-consuming activities and they are frequently conducted in the same period of time. Wound care, physical review and documentation on desktop computers are arranged flexibly by the nurses. What are the implications for practitioners? When developing a task reallocation strategy to improve work efficiency, effort can be put into tasks that can be arranged more flexibly.

Factors Associated With Injurious Falls in Residential Care Facilities.

PubMed

Towne, Samuel D; Cho, Jinmyoung; Smith, Matthew Lee; Ory, Marcia G

2017-06-01

Despite a growing literature on the epidemiology of falls, little is known about injurious falls in residential care facilities (RCFs). Addressing this gap, this study examined demographic, interpersonal, institutional, and community factors associated with injurious falls in RCFs. We conducted analyses using a nationally representative sample ( n = 733,309) of RCF residents (2010) examining whether or not a resident experienced a fall that resulted in any injury (past year). Overall, 15% of RCF residents experienced an injurious fall. Residents needing assistance with activities of daily living were more likely to experience injurious falls (adjusted-OR = 1.85), whereas males (adjusted-OR = 0.74) and those residing in smaller facilities (adjusted-OR = 0.68) were less likely. Other resident sociodemographic characteristics, payment status, social connectedness, and rurality were not significant independent predictors. Research further exploring multifactorial fall prevention screening and treatment programs in RCFs is recommended for reducing injurious falls in this understudied setting.

Successful ingredients in the SMILE study: resident, staff, and management factors influence the effects of humor therapy in residential aged care.

PubMed

Brodaty, Henry; Low, Lee-Fay; Liu, Zhixin; Fletcher, Jennifer; Roast, Joel; Goodenough, Belinda; Chenoweth, Lynn

2014-12-01

To test the hypothesis that individual and institutional-level factors influence the effects of a humor therapy intervention on aged care residents. Data were from the humor therapy group of the Sydney Multisite Intervention of LaughterBosses and ElderClowns, or SMILE, study, a single-blind cluster randomized controlled trial of humor therapy conducted over 12 weeks; assessments were performed at baseline, week 13, and week 26. One hundred eighty-nine individuals from 17 Sydney residential aged care facilities were randomly allocated to the humor therapy intervention. Professional performers called "ElderClowns" provided 9-12 weekly humor therapy 2-hour sessions, augmented by trained staff, called "LaughterBosses." Outcome measures were as follows: Cornell Scale for Depression in Dementia, Cohen-Mansfield Agitation Inventory, Neuropsychiatric Inventory, the withdrawal subscale of Multidimensional Observation Scale for Elderly Subjects, and proxy-rated quality of life in dementia population scale. Facility-level measures were as follows: support of the management for the intervention, commitment levels of LaughterBosses, Environmental Audit Tool scores, and facility level of care provided (high/low). Resident-level measures were engagement, functional ability, disease severity, and time-in-care. Multilevel path analyses simultaneously modeled resident engagement at the individual level (repeated measures) and the effects of management support and staff commitment to humor therapy at the cluster level. Models indicated flow-on effects, whereby management support had positive effects on LaughterBoss commitment, and LaughterBoss commitment increased resident engagement. Higher resident engagement was associated with reduced depression, agitation, and neuropsychiatric scores. Effectiveness of psychosocial programs in residential aged care can be enhanced by management support, staff commitment, and active resident engagement. Copyright © 2014 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

Refining the COPES to Measure Social Climate in Therapeutic Residential Youth Care

ERIC Educational Resources Information Center

Leipoldt, Jonathan D.; Kayed, Nanna S.; Harder, Annemiek T.; Grietens, Hans; Rimehaug, Tormod

2018-01-01

Background: Previous studies have shown that social climate in therapeutic residential youth care (TRC) is important to the welfare of residents, staff, and assessing treatment outcomes. The most influential theory on social climate in residential settings is the theory of Moos. The measurement of the concepts and aspects of this theory using the…

The Role of Therapeutic Alliance in Therapy Outcomes for Youth in Residential Care

ERIC Educational Resources Information Center

Handwerk, Michael L.; Huefner, Jonathan C.; Ringle, Jay L.; Howard, Brigid K.; Soper, Stephen H.; Almquist, Julie K.; Chmelka, M. Beth

2008-01-01

This study examined the impact of therapeutic alliance (TA) on therapy outcomes for youth with behavioral and emotional problems residing in residential care. Study participants were 71 youth in an out-of-home family-style residential treatment facility who were referred to an onsite psychotherapy clinic. A therapeutic alliance scale was completed…

Assessment of eHealth capabilities and utilization in residential care settings.

PubMed

Towne, Samuel D; Lee, Shinduk; Li, Yajuan; Smith, Matthew Lee

2016-12-01

The US National Survey of Residential Care Facilities was used to conduct cross-sectional analyses of residential care facilities (n = 2302). Most residential care facilities lacked computerized capabilities for one or more of these capabilities in 2010. Lacking computerized systems supporting electronic health information exchange with pharmacies was associated with non-chain affiliation (p < .05). Lacking electronic health information exchange with physicians was associated with being a small-sized facility (vs large) (p < .05). Lacking computerized capabilities for discharge/transfer summaries was associated with for-profit status (p < .05) and small-sized facilities (p < .05). Lacking computerized capabilities for medical provider information was associated with non-chain affiliation (p < .05), small- or medium-sized facilities (p < .05), and for-profit status (p < .05). Lack of electronic health record was associated with non-chain affiliation (p < .05), small- or medium-sized facilities (p < .05), for-profit status (p < .05), and location in urban areas (p < .05). eHealth disparities exist across residential care facilities. As the older adult population continues to grow, resources must be in place to provide an integrated system of care across multiple settings. © The Author(s) 2015.

Forgotten Children: A Program for the Multihandicapped.

ERIC Educational Resources Information Center

Frampton, Merle E.; And Others

In a cerebral palsy-blind experimental school unit for day and residential care, a staff of 13 served 30 children in 6 years with 12 to 17 children each year. All but six children who were found to be nontrainable progressed: eight became trainable, eight trainable and partly educable, and eight educable. Variable progress was found characteristic…

United States Living Arrangements of People with Intellectual and/or Developmental Disabilities in 1995

ERIC Educational Resources Information Center

Larson, Sheryl A.; Doljanac, Robert; Lakin, K. Charlie

2005-01-01

In the United States, data on the number of people with intellectual or developmental disabilities (ID/DD) living in institutional and other congregate care settings have been gathered and reported since 1977 through the Residential Information Systems Program (RISP) at the University of Minnesota (e.g., Prouty & Lakin, 1997). These data were…

Development and piloting of a treatment foster care program for older youth with psychiatric problems.

PubMed

McMillen, J Curtis; Narendorf, Sarah Carter; Robinson, Debra; Havlicek, Judy; Fedoravicius, Nicole; Bertram, Julie; McNelly, David

2015-01-01

Older youth in out-of-home care often live in restrictive settings and face psychiatric issues without sufficient family support. This paper reports on the development and piloting of a manualized treatment foster care program designed to step down older youth with high psychiatric needs from residential programs to treatment foster care homes. A team of researchers and agency partners set out to develop a treatment foster care model for older youth based on Multi-dimensional Treatment Foster Care (MTFC). After matching youth by mental health condition and determining for whom randomization would be allowed, 14 youth were randomized to treatment as usual or a treatment foster home intervention. Stakeholders were interviewed qualitatively at multiple time points. Quantitative measures assessed mental health symptoms, days in locked facilities, employment and educational outcomes. Development efforts led to substantial variations from the MTFC model and a new model, Treatment Foster Care for Older Youth was piloted. Feasibility monitoring suggested that it was difficult, but possible to recruit and randomize youth from and out of residential homes and that foster parents could be recruited to serve them. Qualitative data pointed to some qualified clinical successes. Stakeholders viewed two team roles - that of psychiatric nurse and skills coaches - very highly. However, results also suggested that foster parents and some staff did not tolerate the intervention well and struggled to address the emotion dysregulation issues of the young people they served. Quantitative data demonstrated that the intervention was not keeping youth out of locked facilities. The intervention needed further refinement prior to a broader trial. Intervention development work continued until components were developed to help address emotion regulation problems among fostered youth. Psychiatric nurses and skills coaches who work with youth in community settings hold promise as important supports for older youth with psychiatric needs.

The effect of a music therapy social skills training program on improving social competence in children and adolescents with social skills deficits.

PubMed

Gooding, Lori F

2011-01-01

Three separate studies were conducted in school, residential and after-school care settings to test the effectiveness of a music therapy-based social skills intervention program on improving social competence in children and adolescents. A total of 45 children (n = 12; n = 13; n = 20) aged 6-17 years with social skills deficits participated in a group-based five session intervention program. The same curriculum, adapted to be age appropriate, was used at all 3 sites. Specific deficits within the social skills areas of peer relations and self-management skills were targeted. Active interventions like music performance, movement to music and improvisation were used. Cognitive-behavioral techniques like modeling, feedback, transfer training and problem solving were also incorporated. Data on social functioning were collected before, during, and after the music therapy intervention from participants, appropriate adult personnel and via behavioral observations. Results indicated that significant improvements in social functioning were found in (a) school participant pre and post self-ratings, (b) researcher pre and post ratings of school participants, (c) case manager's pre and post treatment ratings for the residential participants, (d) after-school care participants' pre and post self-ratings, and (e) behavioral observations at all three settings. Additional changes, although not significant, were noted in teacher ratings, residential participant self- and peer ratings, and after-school case manager ratings. Results from these studies suggest that the music therapy intervention was effective in improving social competence in children and adolescents with social deficits. More research is warranted to provide additional guidance about the use of music therapy interventions to improve social functioning.

Needs of Aboriginal and Torres Strait Islander clients residing in Australian residential aged-care facilities.

PubMed

Brooke, Nicole J

2011-08-01

This review was undertaken to identify evidence-based practice guidelines to support the care needs of Aboriginal and Torres Strait Islander clients residing in residential aged-care facilities. A systematic literature review was undertaken. An electronic search of online databases and subsequent manual retrieval process was undertaken to identify relevant reports and studies that explored interventions for care of an Aboriginal and Torres Strait Islander person. Very limited published material identified strategies necessary within residential aged care. Sixty-seven articles were considered for inclusion, and a subsequent review resulted in 34 being included due to direct alignment with the study aim. Strategies recommended within the review cover areas such as care, communication, palliative care, activities and the environment. Care for an Aboriginal and Torres Strait Islander person in an Australian residential aged-care facility requires a collaborative and individual approach. Cultural safety principles should be maintained across a culturally competent workforce. Aboriginal and Torres Strait Islander persons in care is a significant experience that should not be considered 'routine' as there is much to consider in the care of this person and their community. © 2011 The Author. Australian Journal of Rural Health © National Rural Health Alliance Inc.

Current role challenges in New Zealand aged residential care: the potential consequences for healthcare assistant role expansion.

PubMed

Shannon, Kay; McKenzie-Green, Barbara

2016-01-01

Challenges facing healthcare assistants in aged residential care are a focus of global debate. These challenges involve remuneration, education, skill mix, work conditions and organisational structures. We enter the discussion by acknowledging current work, education and remuneration for healthcare assistants. We then consider the supervisory relationships between registered nurses (RNs), enrolled nurses (ENs) and healthcare assistants, educational levels for RNs, ENs and healthcare assistants, and the interplay between organisation and practice in aged residential care. We suggest that improving work for the healthcare assistant has the potential to lead change in all role levels. Discussion paper. We argue that adjustments to work structures, education and skill advancement of RNs, ENs and healthcare assistants could improve staff working conditions and clarify practice boundaries. The ultimate result is likely to be an improvement to quality of care and the life of residents in aged residential care.

28 CFR 550.52 - Non-residential drug abuse treatment services.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 28 Judicial Administration 2 2014-07-01 2014-07-01 false Non-residential drug abuse treatment... INSTITUTIONAL MANAGEMENT DRUG PROGRAMS Drug Abuse Treatment Program § 550.52 Non-residential drug abuse treatment services. All institutions must have non-residential drug abuse treatment services, provided...

28 CFR 550.52 - Non-residential drug abuse treatment services.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Non-residential drug abuse treatment... INSTITUTIONAL MANAGEMENT DRUG PROGRAMS Drug Abuse Treatment Program § 550.52 Non-residential drug abuse treatment services. All institutions must have non-residential drug abuse treatment services, provided...

28 CFR 550.52 - Non-residential drug abuse treatment services.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 28 Judicial Administration 2 2012-07-01 2012-07-01 false Non-residential drug abuse treatment... INSTITUTIONAL MANAGEMENT DRUG PROGRAMS Drug Abuse Treatment Program § 550.52 Non-residential drug abuse treatment services. All institutions must have non-residential drug abuse treatment services, provided...

28 CFR 550.52 - Non-residential drug abuse treatment services.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 28 Judicial Administration 2 2013-07-01 2013-07-01 false Non-residential drug abuse treatment... INSTITUTIONAL MANAGEMENT DRUG PROGRAMS Drug Abuse Treatment Program § 550.52 Non-residential drug abuse treatment services. All institutions must have non-residential drug abuse treatment services, provided...

28 CFR 550.52 - Non-residential drug abuse treatment services.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 28 Judicial Administration 2 2011-07-01 2011-07-01 false Non-residential drug abuse treatment... INSTITUTIONAL MANAGEMENT DRUG PROGRAMS Drug Abuse Treatment Program § 550.52 Non-residential drug abuse treatment services. All institutions must have non-residential drug abuse treatment services, provided...

Social isolation and loneliness among older people: issues and future challenges in community and residential settings.

PubMed

Grenade, Linda; Boldy, Duncan

2008-08-01

Although often associated with older age, loneliness and social isolation are not well understood in terms of their prevalence, risk and protective factors. Evidence suggests that only a minority of community-dwelling older people are "severely" lonely or isolated, however a number of factors need to be considered to fully understand the extent and significance of the problem. Community-based studies have identified a variety of risk factors for loneliness/isolation including widowhood, no (surviving) children, living alone, deteriorating health, and life events (eg, loss and bereavement). Having a confidant has been identified as a protective factor for loneliness. However, evidence is often unclear or inconclusive, especially within residential settings. We identified the need to conduct more residential care-focused research; the importance of addressing a variety of methodological concerns; and the need for practitioners to develop intervention programs that are appropriately targeted, evidence-based and evaluated.

End-of-Life Care Policies in Flemish Residential Care Facilities Accommodating Persons with Intellectual Disabilities

ERIC Educational Resources Information Center

D'Haene, I.; Pasman, H. R. W.; Deliens, L.; Bilsen, J.; Mortier, F.; Stichele, R. Vander

2010-01-01

Objective: This article aims to describe the presence, content and implementation strategies of written policies on end-of-life decisions in Flemish residential care facilities (RCFs) accommodating persons with intellectual disabilities (ID), and to describe training, education and quality assessments of end-of-life care. Methods: A…

Trial Implementation of a Telerehabilitation Exercise System in Residential Aged Care.

PubMed

Hutchinson, Marie; Wendt, Neil; Smith, Stuart Trevor

2018-01-01

The 2011 Productivity Commission report, Caring for Older Australians, observed that as the number of older Australians rises and the demand for aged care services increases, there will be a commensurate increase in demand for a well-trained aged care workforce. One of the significant issues impacting upon the ability of the aged services sector to respond to a growing number of older adults is to attract and retain sufficient numbers of staff. A number of factors are acknowledged to contribute to a failure of the aged care sector to attract and retain workers including: poor sector reputation, poor working conditions, including high client-staff ratios, a lack of career paths and professional development opportunities and low rates of remuneration. Poor perceptions about working in the aged care sector (e.g. that aged care nursing is less glamorous than nursing in the acute care sector) appear to develop early, with many nursing students indicating that they do not view aged care as an attractive career choice. Undergraduate nursing students have often found clinical placements in aged care unsatisfactory and unsettling, dissuading them from considering aged care as an employment option on graduation. In the following we describe one way we have attempted to address this issue by training undergraduate health sciences students (occupational therapy, nursing) to deliver a physical activity program to residents of an aged care facility using a novel telerehabilitation technology that enables remote prescription and monitoring of exercise programs. The main purpose of this quality assurance trial was to explore the feasibility and safety of supervised use of a novel telerehabilitation exercise system with older adults living in residential aged care. Four residents were recruited into the study and all displayed limitations in mobility, balance, strength and endurance. None had any had previous experience with computer games or interactive technologies. Resident diagnoses included multiple chronic health conditions and mild cognitive impairment. Over the six-week period, only one session was declined by a resident, providing an overall adherence rate of 98.5%. According to the resident's scores of perceived level of enjoyment, at the end of the first week the program was rated as always enjoyable by 75% of the residents. At the conclusion of the program, 100% responded as always enjoying the exercises and activities. Active sitting and standing time for residents across the program increased markedly. A novel finding from our study is that senior undergraduate students are capable of designing and delivering telerehabilitation programs to residents in aged care facilities. Whilst attention has been given to telesimulation in undergraduate preparation (where learners are off site and connected to simulated laboratory), our trial opens opportunities for a further paradigm shift towards teleplacement.

Demand of elderly people for residential care: an exploratory study

PubMed Central

van Bilsen, PMA; Hamers, JPH; Groot, W; Spreeuwenberg, C

2006-01-01

Background Because of the rapid aging population, the demand for residential care exceeds availability. This paper presents the results of a study that focuses on the demand of elderly people for residential care and determinants (elderly people's personal characteristics, needs and resources) that are associated with this demand. Furthermore, the accuracy of the waiting list as a reflection of this demand has been examined. Methods 67 elderly people waiting for admission into a home for the elderly, are subjected to semi-structured interviews. The data are analyzed by using multivariate statistics. Results Elderly people who indicate that they would refuse an offer of admission into a home for the elderly feel healthier (p = 0.02), have greater self-care agency (p = 0.02) and perceive less necessity of admission (p < 0.01), compared to those who would accept such an offer. Especially the inability to manage everyday activities and the lack of a social network are highly associated with the elderly people's demand for residential care. Furthermore, it is evident that waiting lists for homes for the elderly do not accurately reflect the demand for residential care, since 35% of the elderly people on a waiting list did not actually experience an immediate demand for residential care and stated that they would not accept an offer of admission. Quite a lot of respondents just registered out of a sense of precaution; a strategic decision dictated by current shortages in care provision and a vulnerable health status. Conclusion The results contribute to the understanding of waiting lists and the demand for residential care. It became apparent that not everybody who asks for admission into a home for the elderly, really needed it. The importance of elderly people's resources like social networks and the ability to manage everyday activities in relation to the demand for care became clear. These findings are important because they indicate that resources also play a role in predicting elderly people's demand and as a result can guide the development and the (re)design of adequate health care services. PMID:16566822

38 CFR 17.72 - Availability of information.

Code of Federal Regulations, 2010 CFR

2010-07-01

... MEDICAL Community Residential Care § 17.72 Availability of information. VA standards will be made... otherwise regulating or inspecting community residential care facilities. (Authority: 38 U.S.C. 1730) [54 FR...

Factors Associated with Abuse in Residential Child Care Institutions.

ERIC Educational Resources Information Center

Colton, Matthew

2002-01-01

Examines factors associated with abuse of children in residential child care institutions including: failings in staff recruitment, training, and supervision; ineffective management and accountability; development of inappropriate institutional cultures; public ambivalence toward children in care; slow response to threats posed to children in…

National estimation of children in residential care institutions in Cambodia: a modelling study.

PubMed

Stark, Lindsay; Rubenstein, Beth L; Pak, Kimchoeun; Kosal, Sok

2017-01-16

The primary objective of this study was to collect baseline data on the number of children living in residential care institutions in Cambodia. The secondary objective was to describe the characteristics of the children (eg, age, sex, duration of stay, education and health). The data were intended to guide recent efforts by the Government of Cambodia to reduce the number of children living in residential care institutions and increase the number of children growing up in supportive family environments. Data were collected in Cambodia across 24 sites at the commune level. Communes-administrative divisions roughly equivalent to counties-were selected by the National Institute of Statistics using a two-stage sampling method. Government lists and key informant interviews were used to construct a complete roster of institutions across the 24 communes. All identified institutions were visited to count the number of children and gather data on their basic characteristics. The rate of children in residential care in the selected communes was calculated as a percentage of total population using a Poisson model. This rate was applied to all districts in Cambodia with at least one reported residential care institution. A total of 3588 children were counted across 122 institutions. A child living in a residential care institution was defined as anyone under the age of 18 years who was sleeping in the institution for at least four nights per week during the data collection period. There are an estimated 48 775 children living in residential care institutions in Cambodia. The vast majority of children have a living parent and are school-aged. More than half are between 13 and 17 years of age. Nearly 1 of every 100 children in Cambodia is living in residential care. This raises substantial concerns for child health, protection and national development. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Training unemployed women for adult day care in Izmir, Turkey: a program evaluation.

PubMed

Hussein, Shereen; Oğlak, Sema

2014-01-01

The proportion of older people in Turkey is increasing steadily with a subsequent growth of long-term care (LTC) needs. There is a scarcity of formal care provisions for residential and particularly nonresidential settings. Thus, formal caregiving is not meeting LTC needs nor attracting workers as a labor option. The authors examine the hypothesis that LTC may offer work opportunities for women unfamiliar with caregiving as an occupation, and also examine the need and acceptance of different types of LTC beyond residential care. The authors evaluate an innovative project introducing these two elements to 76 women in İzmir, Turkey, using an analysis framework that incorporates factors related to applications and progression; management assessment; trainees' self-assessment reflecting on their views on aging; and older people's perception of the experience and its impact on their well-being. Trainees reported a major positive shift in their attitudes toward working in LTC and toward the aging process. Users reported discovering a new dimension to care, which directly affected their quality of life. Overall, this community-based initiative appeared effective in enhancing the awareness of the concept of adult day centers providing a social model of care, and appears promising in addressing the growing need for formal LTC in Turkey.

General practice after-hours incentive funding: a rationale for change.

PubMed

Neil, Amanda L; Nelson, Mark R; Richardson, Tracy; Mann-Leonard, Meghan; Palmer, Andrew J

2015-07-20

After-hours incentive funding for general practice was introduced in 1998 through the introduction of the Practice Incentives Program (PIP). In 2010, a national audit of the PIP identified after-hours incentive funding as having the greatest levels of non-compliance across 12 PIP components. The audit specified the need for secondary data sources to ensure practice compliance. In this article, we examine the drivers of the 1998-2013 PIP mechanism to inform development of a fair, transparent and auditable after-hours incentive funding scheme for Tasmania. The PIP after-hours incentive funding mechanism paid, at diminishing levels, for anticipated burden of care (practice size), claimed method of providing care (stream) and remoteness of practice. Increasing remoteness rather than practice size or stream is the primary determinant of urgent after-hours attendances per practice in Tasmania; after-hours attendances to residential aged care facilities are unrelated to individual practice location or stream but concentrated in urban areas. The PIP after-hours incentive funding mechanism does not preferentially support practices that provide after-hours care and arguably led to perverse incentives. A new after-hours incentive funding mechanism embodying pre-specified objectives - such as support for (unavoidable) burden and/or provision of care to residential aged care facilities - is required. Claimed provision is considered an inappropriate funding determinant.

Learning to deal constructively with troubled conscience related to care providers' perceptions of deficient teamwork in residential care of older people--a participatory action research study.

PubMed

Ericson-Lidman, Eva; Strandberg, Gunilla

2015-06-01

Conscience can be perceived as an asset that helps care providers to provide good care, but it can also be a burden that generates stress of conscience (stress related to a troubled conscience). Participatory action research (PAR) has been shown to be successful in supporting care providers in residential care of older people to learn to deal with their troubled conscience in challenging and demanding care situations. The aim of the study was to describe an intervention process to assist care providers in residential care of older people to constructively deal with their troubled conscience related to perceptions of deficient teamwork. The study design was grounded in PAR. Nine enrolled nurses (ENs), two nursing aids (NAs), one Registered Nurse (RN) and their manager participated in 12 PAR sessions. All sessions were tape-recorded, and a domain analysis of the transcriptions was performed. Findings show that a PAR-based intervention can support care providers to understand, handle and take measures against deficient teamwork. Using troubled conscience as a driving force can increase the opportunities to improve quality of care in residential care for older people. During the PAR process, participants raised their awareness of the need to view the team in a wider sense and that the manager and the Registered Nurse should also be members of the team to improve team outcome. To improve clinical practice, we suggest that teams in residential care of older people should be enabled to share and reflect on challenging situations that generate troubled conscience. However, as shown in this study, care providers might need support in order to facilitate and promote sharing and reflecting on what their conscience tells them. © 2014 Nordic College of Caring Science.

Effectiveness of interventions to improve family-staff relationships in the care of people with dementia in residential aged care: a systematic review protocol.

PubMed

Nguyen, Mynhi; Pachana, Nancy A; Beattie, Elizabeth; Fielding, Elaine; Ramis, Mary-Anne

2015-11-01

The objective of this review is to identify and appraise existing evidence regarding the effectiveness of interventions designed to enhance staff-family relationships for people with dementia living in residential aged care facilities.More specifically, the objectives are to identify the effectiveness of constructive communication, cooperation programs, and practices or strategies to enhance family-staff relationships. The effectiveness of these interventions will be measured by comparing the intervention to no intervention, comparing one intervention with another, or comparing pre- and post-interventions.Specifically the review question is: What are the most effective interventions for improving communication and cooperation to enhance family-staff relationships in residential aged care facilities? In our aging world, dementia is prevalent and is a serious health concern affecting approximately 35.6 million people worldwide. This figure is expected to increase two-fold by 2030 and three-fold by 2050. Although younger-onset dementia is increasingly recognized, dementia is most commonly a disease that affects the elderly. Among those aged 65 to 85, the prevalence of dementia increases exponentially, and doubles with every five-year increase in age.Dementia is defined as a syndrome, commonly chronic or progressive in nature, and caused by a range of brain disorders that affect memory, thinking and the ability to perform activities of daily living. While the rate of progression and manifestation of decline differs, all cases of dementia share a similar trajectory of decline. The progressive decline in cognitive functions and ultimately physical function that these people face affects not only the person with the disease but also their family caregivers and health care staff.The manifestation of dementia presents unique and extreme challenges for the family caregiver. Generally it causes great physical, emotional and social strain because the caregiving process is long in duration, unfamiliar, unpredictable and ambiguous. In the later stages of dementia, many family caregivers relocate their relative to a residential aged care facility, most often when the burden of care outweighs the means of the caregiver. This is especially likely when the person with dementia ages, and has lower cognitive function increased limitations in activities in daily living and poorer self-related health. As a result, approximately 50% of all persons aged 65 years or over admitted into residential aged care facilities have dementia.The relocation of a relative into a residential aged care facility can be complex and distressing for family caregivers. While relocation alleviates many issues for the family caregiver, it does not consequently reduce their stress. The stress experienced by the family caregivers who remain involved post-relocation often continues and may even worsen. This is because family caregivers are uncertain about how to transition from a direct caregiving role to a more indirect, supportive interpersonal role, and may be provided with little support from care staff in this regard. Although family caregivers experience a new form of stress post-relocation, family involvement in residential aged care settings has been shown to be beneficial to residents with dementia, their families and care staff.Family involvement is widely acknowledged to provide the resident physical and emotional healing, optimal well-being, and the sustainment of quality of life. Family caregivers benefit from improved satisfaction with the facility and experiences of care, and greater well-being. Care staff benefit from enhanced job satisfaction and greater motivation to remain in their job. The key to these positive outcomes is effective communication and strong relationships between care staff and family caregivers.Effective communication between care staff and family caregivers is crucial for residents with dementia. This is because residents with cognitive impairment may have difficulties articulating their needs, concerns and preferences effectively. Family caregivers rely on staff for information about their relative's behavior in the residential aged care facility; however they themselves have in-depth information about the resident's physical, psychosocial and emotional histories that are necessary for developing individualized care support plans. Family involvement can support care staff in reducing residents' behavioral symptoms by assisting to identify social and emotional needs, or unmet medical needs. Ineffective communication from family caregivers in conveying information to care staff may be disruptive in the caregiving process, and may lead to disagreement regarding respective roles and approaches to caring for the resident. Consequently, family caregivers may withhold information that may support care staff and improve care. They may also be concerned about negative repercussions for the resident.Care staff and family caregivers generally have differing needs and expectations. Care staff are usually in the position where they have to manage a relationship with the family, which is based on multiple roles. Perceptions of family caregivers by care staff include seeing them as colleagues, subordinates, or people who themselves may be in need of nursing care. These different perceptions lead to role ambiguity and result in separate approaches to the caregiving process.Cohen et al. suggest in their study that family involvement can benefit people with dementia in residential aged care settings, their family carers and staff; however further research is required. The relationship between care staff and family caregivers is often challenging due to problems with communication, role ambiguity of both care staff and family carers, and differing approaches to caring for the resident. These problems highlight the need for interventions to constructively enhance the quality of family-staff relationships. For example, one intervention called Partners and Caregiving has been reported as being designed to increase cooperation and effective communication between staff and family. In this study, staff and family members were randomly subjected to treatment and control conditions. The treatment group received parallel training sessions on communication and conflict resolution techniques, followed by a joint meeting with the facility administrators. The results of the study demonstrated improved outcomes in the form of improved attitudes of staff and family members towards each other, less conflict between family and staff, and fewer intentions of staff to quit. Further research is vital in order to identify effective family-staff intervention studies that can provide directions for implementation in residential aged care facilities. Furthermore, it is equally important to identify interventions that are ineffective, so as to provide insights into potential pitfalls to avoid in order to improve staff and family members' relationships and the provision of care to people living with dementia in the future.Previous systematic reviews have focused on factors associated with constructive family-staff relationships in caring for older adults in the institutional setting and the family's involvement in decision making for people with dementia in residential aged care facilites. This review will however specifically investigate interventions for improving communication and cooperation that promote effective family-staff relationships when caring for people with dementia living in residential aged care facilities.

Using the Care Dependency Scale for identifying patients at risk for pressure ulcer.

PubMed

Dijkstra, Ate; Kazimier, Hetty; Halfens, Ruud J G

2015-11-01

The aim of this study was to evaluate risk screening for pressure ulcer by using the Care Dependency Scale (CDS) for patients receiving home care or admitted to a residential or nursing home in the Netherlands. Pressure ulcer is a serious and persistent problem for patients throughout the Western world. Pressure ulcer is among the most common adverse events in nursing practice and when a pressure ulcer occurs it has many consequences for patients and healthcare professionals. Cross-sectional design. The convenience sample consisted of 13,633 study participants, of whom 2639 received home care from 15 organisations, 4077 were patients from 67 residential homes and 6917 were admitted in 105 nursing homes. Data were taken from the Dutch National Prevalence Survey of Care Problems that was carried out in April 2012 in Dutch healthcare settings. For the three settings, cut-off points above 80% sensitivity were established, while in the residential home sample an almost 60% combined specificity score was identified. The CDS items 'Body posture' (home care), 'Getting dressed and undressed' (residential homes) and 'Mobility' (nursing homes) were the most significant variables which affect PU. The CDS is able to distinguish between patients at risk for pressure ulcer development and those not at risk in both home care and residential care settings. In nursing homes, the usefulness of the CDS for pressure ulcer detection is limited. © 2015 John Wiley & Sons Ltd.

The Association between the Working Alliance with Adolescent Girls in Residential Care and Their Trauma-Related Symptoms in Emerging Adulthood

ERIC Educational Resources Information Center

Ayotte, Marie-Hélène; Lanctôt, Nadine; Tourigny, Marc

2017-01-01

Background: Until now, the relations between the working alliance and trauma-related symptoms have received little or no study in residential-care settings. However, considering the high prevalence of past experiences of interpersonal trauma among young people in residential centers, it is essential to examine this issue more closely. Objective:…

Independent Living & Disability Policy in the Netherlands: Three Models of Residential Care & Independent Living. Monograph Number Twenty-Seven.

ERIC Educational Resources Information Center

DeJong, Gerben

The monograph examines the way in which the Netherlands' three-part system of residential care and independent living (IL) for people with physical disabilities interacts with the country's health and social welfare systems. The three-part system comprises: the residential center model, the clustered housing model, and the independent housing…

What Do They Do at Home? The Literacies of Children Living in Residential Care in Malaysia

ERIC Educational Resources Information Center

Tan, Jennifer

2015-01-01

This paper presents an ethnographic study of the out of school literacy practices of children living in residential care in Malaysia. Although residential homes generate much publicity, especially during the festive seasons, not much is known about the children living within the confines of these homes. Even more lacking is research on their…

78 FR 49607 - Energy Conservation Program: Test Procedures for Residential Clothes Dryers

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-14

... reasonably designed to produce test results which measure energy efficiency, energy use or estimated annual... Energy Conservation Program: Test Procedures for Residential Clothes Dryers; Final Rule #0;#0;Federal... Conservation Program: Test Procedures for Residential Clothes Dryers AGENCY: Office of Energy Efficiency and...

How Does the Context of Reception Matter? The Role of Residential Enclaves in Maternal Smoking During Pregnancy Among Mexican-Origin Mothers.

PubMed

Noah, Aggie J; Landale, Nancy S; Sparks, Corey S

2015-08-01

This study investigated whether and how different patterns of group exposure within residential contexts (i.e., living in a Mexican immigrant enclave, a Mexican ethnic enclave, a pan-Hispanic enclave, or a non-Hispanic white neighborhood) are associated with smoking during pregnancy among Mexican-origin mothers. Using a hierarchical linear modeling approach, we found that Mexican-origin mothers' residential contexts are important for understanding their smoking during pregnancy. Residence in an ethnic enclave is associated with decreased odds of smoking during pregnancy, while residence in a non-Hispanic white neighborhood is associated with increased odds of smoking during pregnancy, above and beyond the mothers' individual characteristics. The magnitude of the associations between residence in an ethnic enclave and smoking during pregnancy is similar across the different types of ethnic enclaves examined. The important roles of inter- and intra-group exposures suggests that in order to help Mexican-origin women, policy makers should more carefully design place-based programs and interventions that target geographic areas and the specific types of residential contexts in which women are at greater risk.

Dementia Special Care Units in Residential Care Communities: United States, 2010

MedlinePlus

... of selection) of 81%. More details about sampling design and data collection are available elsewhere ( 4 ). Differences between communities with ... AJ, Harris-Kojetin LD, Sengupta M, et al. Design and operation of the 2010 National Survey of Residential Care Facilities. National Center for Health ...

78 FR 34386 - Agency Forms Undergoing Paperwork Act Review

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-07

...-to-date sampling frames of residential care facilities. Three year clearance is requested. Section... care facilities within each state that meet the NSLTCP definition and (2) for each relevant licensure... study definition of a residential care facility is one that is licensed, registered, listed, certified...

Documentation for Students in Residential Care: Network of Relations of Human and Non-Human Actants

ERIC Educational Resources Information Center

Severinsson, Susanne

2016-01-01

Swedish and international research points to serious problems for the education of students with social, emotional and behavioural difficulties (SEBD) in the care of social welfare, for example, in residential care. The aim of this article is to elucidate how documentation, care plans (CPs) and individual educational plans (IEPs) outline the…

Behavioral and emotional problems in a Kuala Lumpur children's home.

PubMed

Abd Rahman, Fairuz Nazri; Mohd Daud, Tuti Iryani; Nik Jaafar, Nik Ruzyanei; Shah, Shamsul Azhar; Tan, Susan Mooi Koon; Wan Ismail, Wan Salwina

2013-08-01

There is a dearth of studies on behavioral and emotional problems in residential care children in Malaysia. This study describes the behavioral and emotional problems in a sample of children in a government residential care home and compares them with their classmates living with their birth parents. A comparative cross-sectional study was carried out where carers from both groups were asked to fill in the translated Bahasa Melayu version of the Child Behavior Check List. Forms for 53 residential care children and 61 classmates were completed. The residential care children had significantly higher scores on the rule-breaking (P < 0.001) and Diagnostic and Statistical Manual of Mental Disorders (DSM) conduct problem subscales (P < 0.001). Residential care children's age significantly correlated with DSM somatic problems (P = 0.03) and post-traumatic stress (P = 0.023). Duration of care was significantly positively correlated with rule-breaking (P = 0.008), DSM conduct problems (P = 0.018) and externalizing scores (P = 0.017). Abuse and neglect cases had higher anxiety and depression scores (P = 0.024). Number of reasons in care positively correlated with several subscales, including total behavioral problem score (P = 0.005). Logistic regression revealed the greater number of reasons for placement a child had was significantly associated with having externalizing scores in the clinical range (P = 0.016). However, after Bonferroni correction, only the initial findings regarding rule-breaking and DSM conduct problem scores remained significant. Challenges exist in managing residential care children in Malaysia, especially regarding externalizing behavior. More studies are required to describe the Malaysian scene. © 2013 The Authors. Pediatrics International © 2013 Japan Pediatric Society.

78 FR 53625 - Energy Conservation Program for Consumer Products: Test Procedures for Residential Furnaces and...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-30

... Program for Consumer Products: Test Procedures for Residential Furnaces and Boilers; Correction AGENCY... Federal Register that amended the test procedure for residential furnaces and boilers (78 FR 41265). Due...., Washington, DC 20585-0121. Telephone: (202) 586-6590. Email: residential_furnaces_and_boilers@ee.doe.gov . Mr...

Residential Programming for Mentally Retarded Persons. Volume II, A Developmental Model for Residential Services.

ERIC Educational Resources Information Center

National Association for Retarded Children, Arlington, TX. South Central Regional Office.

The second of a series of four booklets on residential programing for the mentally retarded (MR) presents a developmental model for residential services based on the premise that MR persons are capable of growth, development, and learning. Architectural factors, staff resistance and financial considerations are described as impediments to…

Increasing Role of Nurse Practitioners in House Call Programs.

PubMed

Yao, Nengliang Aaron; Rose, Karen; LeBaron, Virginia; Camacho, Fabian; Boling, Peter

2017-04-01

Residence-based primary care provides homebound frail patients with a care plan that is individually tailored to manage multiple chronic conditions and functional limitations using a variety of resources. We (1) examine the visit volume and Medicare payments for residence-based health care provided by nurse practitioners (NPs) in the Medicare fee-for-service environment; (2) compare NP's residential visits to those of internists and family physicians; and (3) compare the geographical service area of full-time house call NPs versus NPs who make nursing facility visits a major portion of their work. An observational study using secondary data. Medicare Provider Utilization and Payment Data. Medicare beneficiaries. Medicare payments for home and domiciliary care visits, the number of residence-based medical visits, provider volume, geographical distribution of full-time house call providers. About 3,300 NPs performed over 1.1 million home and domiciliary care visits in 2013, accounting for 22% of all residential visits to Medicare fee-for-service beneficiaries. A total of 310 NPs individually made more than 1,000 residential visits (defined as a full-time house call provider); among full-time house call providers, including physicians, NPs are now the most common provider type. There are substantial variations in the geographic distribution of full-time house call NPs, internists, and family physicians. Full time NP's service area is about 30% larger than family physicians and internists. Nursing home residents are far more likely to receive NP visits than are homebound persons receiving home visits. NPs are now the largest type of provider delivering residence-based care and NPs provide care over the largest geographical service area. However, the vast majority of frail Americans are more likely to receive NP's care in a nursing facility versus at home. © 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics Society.

76 FR 22453 - Energy Conservation Program: Energy Conservation Standards for Residential Clothes Dryers and...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-21

.... These impacts continue well beyond 2100. Table I-3 shows the annualized values for the clothes dryer... Conservation Program: Energy Conservation Standards for Residential Clothes Dryers and Room Air Conditioners... 1904-AA89 Energy Conservation Program: Energy Conservation Standards for Residential Clothes Dryers and...

Measuring Therapeutic Alliance with Children in Residential Treatment and Therapeutic Day Care

ERIC Educational Resources Information Center

Roest, Jesse; van der Helm, Peer; Strijbosch, Eefje; van Brandenburg, Mariëtte; Stams, Geert Jan

2016-01-01

Purpose: This study examined the construct validity and reliability of a therapeutic alliance measure (Children's Alliance Questionnaire [CAQ]) for children with psychosocial and/or behavioral problems, receiving therapeutic residential care or day care in the Netherlands. Methods: Confirmatory factor analysis of a one-factor model ''therapeutic…

38 CFR 17.63 - Approval of community residential care facilities.

Code of Federal Regulations, 2011 CFR

2011-07-01

... residential care is not the responsibility of the United States Government or VA. (2) The resident or an... resident will be greater than the average cost of care for other residents, or if the resident chooses to... State and local regulations including construction, maintenance, and sanitation regulations; (2) Meet...

38 CFR 17.63 - Approval of community residential care facilities.

Code of Federal Regulations, 2012 CFR

2012-07-01

... residential care is not the responsibility of the United States Government or VA. (2) The resident or an... resident will be greater than the average cost of care for other residents, or if the resident chooses to... State and local regulations including construction, maintenance, and sanitation regulations; (2) Meet...

38 CFR 17.63 - Approval of community residential care facilities.

Code of Federal Regulations, 2013 CFR

2013-07-01

... residential care is not the responsibility of the United States Government or VA. (2) The resident or an... resident will be greater than the average cost of care for other residents, or if the resident chooses to... State and local regulations including construction, maintenance, and sanitation regulations; (2) Meet...

38 CFR 17.63 - Approval of community residential care facilities.

Code of Federal Regulations, 2014 CFR

2014-07-01

... residential care is not the responsibility of the United States Government or VA. (2) The resident or an... resident will be greater than the average cost of care for other residents, or if the resident chooses to... State and local regulations including construction, maintenance, and sanitation regulations; (2) Meet...

It Takes a Village: Moving Forward Towards Independence Offers Hope and Life Lessons to Young Adults with Learning Disabilities

ERIC Educational Resources Information Center

Exceptional Parent, 2010

2010-01-01

Moving Forward Towards Independence, a California-based nonprofit organization founded in 1998 by a group of parents, is a unique residential program where young adults with disabilities learn to enjoy productive, fulfilling and healthy lives within a caring, responsive community made up of fellow residents, trained staff members, parents and…

77 FR 67067 - Medicare Program; Home Health Prospective Payment System Rate Update for Calendar Year 2013...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-11-08

..., as we described in the CY 2012 proposed and final rule. A research team of highly qualified personnel... period and from a follow-up year (for example, 2009). In addition, based on our past experience in... increasing lengths of stay in residential post-acute care for these patients. For example, within the 30 days...

Social and Affective Concerns High-Ability Adolescents Indicate They Would Like to Discuss with a Caring Adult: Implications for Educators

ERIC Educational Resources Information Center

Jen, Enyi; Wu, Jiaxi; Gentry, Marcia

2016-01-01

This exploratory study investigated the social and affective concerns of 280 high-ability students in Grades 5 through 12 who participated in a summer residential program. Content analysis of responses from an open-ended survey indicated that high-ability adolescents expressed concerns regarding feelings and emotions, future aspirations, and…

Personalized multistep cognitive behavioral therapy for obesity

PubMed Central

Dalle Grave, Riccardo; Sartirana, Massimiliano; El Ghoch, Marwan; Calugi, Simona

2017-01-01

Multistep cognitive behavioral therapy for obesity (CBT-OB) is a treatment that may be delivered at three levels of care (outpatient, day hospital, and residential). In a stepped-care approach, CBT-OB associates the traditional procedures of weight-loss lifestyle modification, ie, physical activity and dietary recommendations, with specific cognitive behavioral strategies that have been indicated by recent research to influence weight loss and maintenance by addressing specific cognitive processes. The treatment program as a whole is delivered in six modules. These are introduced according to the individual patient’s needs in a flexible and personalized fashion. A recent randomized controlled trial has found that 88 patients suffering from morbid obesity treated with multistep residential CBT-OB achieved a mean weight loss of 15% after 12 months, with no tendency to regain weight between months 6 and 12. The treatment has also shown promising long-term results in the management of obesity associated with binge-eating disorder. If these encouraging findings are confirmed by the two ongoing outpatient studies (one delivered individually and one in a group setting), this will provide evidence-based support for the potential of multistep CBT-OB to provide a more effective alternative to standard weight-loss lifestyle-modification programs. PMID:28615960

Measuring chronic pain intensity among veterans in a residential rehabilitation treatment program.

PubMed

Randleman, Mary L; Douglas, Mary E; DeLane, Alice M; Palmer, Glen A

2014-01-01

The purpose of this study was to identify whether veterans with chronic pain, substance abuse, and posttraumatic stress disorder (PTSD) diagnoses residing in a Residential Rehabilitation Treatment Program (RRTP) perceived a higher level of pain than those veterans who had chronic pain but did not have active substance abuse issues or PTSD. A sample of veterans (n = 200) with chronic pain undergoing treatment for either chemical dependency and/or PTSD in an RRTP and a Surgical Specialty Care outpatient clinic at a Department of Veterans Affairs medical center took part in the study. Multiple analysis of variance and further univariate statistics were examined to determine the association between groups on the different scales. There was a considerable difference in terms of which group of veterans perceived a higher rate of pain even with the use of the same four pain assessment scales (i.e., Numeric Rating, Visual Analog, Faces, and Mankoski). Scores were significantly higher for the RRTP group than the Surgical Specialty Care group on all screening measures (p < .001). Veterans with chronic pain, substance abuse, and/or PTSD diagnoses residing in an RRTP tended to have a higher perception of chronic pain compared to those without substance abuse or PTSD diagnoses.

Job Satisfaction among Care Aides in Residential Long-Term Care: A Systematic Review of Contributing Factors, Both Individual and Organizational

PubMed Central

Squires, Janet E.; Hoben, Matthias; Linklater, Stefanie; Carleton, Heather L.; Graham, Nicole; Estabrooks, Carole A.

2015-01-01

Despite an increasing literature on professional nurses' job satisfaction, job satisfaction by nonprofessional nursing care providers and, in particular, in residential long-term care facilities, is sparsely described. The purpose of this study was to systematically review the evidence on which factors (individual and organizational) are associated with job satisfaction among care aides, nurse aides, and nursing assistants, who provide the majority of direct resident care, in residential long-term care facilities. Nine online databases were searched. Two authors independently screened, and extracted data and assessed the included publications for methodological quality. Decision rules were developed a priori to draw conclusions on which factors are important to care aide job satisfaction. Forty-two publications were included. Individual factors found to be important were empowerment and autonomy. Six additional individual factors were found to be not important: age, ethnicity, gender, education level, attending specialized training, and years of experience. Organizational factors found to be important were facility resources and workload. Two additional factors were found to be not important: satisfaction with salary/benefits and job performance. Factors important to care aide job satisfaction differ from those reported among hospital nurses, supporting the need for different strategies to improve care aide job satisfaction in residential long-term care. PMID:26345545

The impact of therapeutic massage on adult residents living with complex and high level disabilities: A brief report.

PubMed

Cooke, Marie; Emery, Helen; Brimelow, Rachel; Wollin, Judy

2016-10-01

Research into the effects of touch in disabled adults in residential care remains largely unexplored in the current literature. Evidence suggests however, that massage therapy may improve mood state, including anxiety and stress, reduce pain and improve sleep/wake behavior and fatigue. These benefits are of importance as they have substantial impact on quality of life. This pilot study evaluated the effect of therapeutic massage on the quality of life of adults with complex care needs living in residential care. Participants were recruited from three residential homes (Queensland, Australia) for 18-65 year olds with severe disability. 25 participants were recruited and received a massage program consisting of five weeks of twice weekly massages. Structured interviews were conducted pre-post intervention. Additionally, mood was ascertained preceding and following each massage session. Mood of participants improved markedly immediately following massage session (p < 0.05) and pre-massage mood was observed to increase over the study period. However, pre- and post-intervention measures indicated massage did not improve pain, sleepiness, depression or stress levels or sustain positive mood three days post-intervention. Participants' satisfaction with their current health significantly improved (Z = -2.51, p = 0.012), as did their satisfaction with their current happiness (Z = -2.06, p = 0.04), suggesting that massage therapy offered some improvement in quality of life. The results of this pilot indicates that massage may be of benefit to people living with high care needs and represents a practical innovation providing tactile stimulation that may be integrated into care. Copyright © 2016 Elsevier Inc. All rights reserved.

A business model for managing system change through strategic financing and performance indicators: a case study.

PubMed

Armstrong, Mary I; Milch, Heidi; Curtis, Peter; Endress, Phillip

2012-06-01

This article describes how a system of care operated by a county government agency used a fiscal crisis as the opportunity to reform its children's system. A cross-system response to the crisis is outlined that includes a system of care framework coupled with a business model, inter-departmental collaboration and leadership, the use of strategic reinvestment strategies, and a quality improvement system that focuses on key indicators. Implementation of the system change is described with a specific focus on cross-system entry points, financing strategies that re-allocate funds from deep-end programs to community-based services, and management oversight through the use of performance indicators to monitor and support effectiveness. This article examines the results of the system change, including the diversion of youth from system penetration, the reduction in residential treatment bed days, the re-allocation of these savings to community-based services, and the outcomes of children who were diverted from residential care and served in the community. The article offers a number of recommendations for other communities contemplating system change.

Multifaceted shared care intervention for late life depression in residential care: randomised controlled trial

PubMed Central

Llewellyn-Jones, Robert H; Baikie, Karen A; Smithers, Heather; Cohen, Jasmine; Snowdon, John; Tennant, Chris C

1999-01-01

Objective To evaluate the effectiveness of a population based, multifaceted shared care intervention for late life depression in residential care. Design Randomised controlled trial, with control and intervention groups studied one after the other and blind follow up after 9.5 months. Setting Population of residential facility in Sydney living in self care units and hostels. Participants 220 depressed residents aged ⩾65 without severe cognitive impairment. Intervention The shared care intervention included: (a) multidisciplinary consultation and collaboration, (b) training of general practitioners and carers in detection and management of depression, and (c) depression related health education and activity programmes for residents. The control group received routine care. Main outcome measure Geriatric depression scale. Results Intention to treat analysis was used. There was significantly more movement to “less depressed” levels of depression at follow up in the intervention than control group (Mantel-Haenszel stratification test, P=0.0125). Multiple linear regression analysis found a significant intervention effect after controlling for possible confounders, with the intervention group showing an average improvement of 1.87 points on the geriatric depression scale compared with the control group (95% confidence interval 0.76 to 2.97, P=0.0011). Conclusions The outcome of depression among elderly people in residential care can be improved by multidisciplinary collaboration, by enhancing the clinical skills of general practitioners and care staff, and by providing depression related health education and activity programmes for residents. Key messagesLarge numbers of depressed elderly people live in residential care but few receive appropriate managementA population based, multifaceted shared care intervention for late life depression was more effective than routine care in improving depression outcomeThe outcome of late life depression can be improved by enhancing the clinical skills of general practitioners and care staff and by providing depression related health education and activity programmes for residentsThe intervention needs further refining and evaluation to improve its effectiveness and to determine how best to implement it in other residential care settings PMID:10480824

Living in institutional care: residents' experiences and coping strategies.

PubMed

Timonen, Virpi; O'Dwyer, Ciara

2009-01-01

Insights into daily living in residential care settings are rare. This article draws on a qualitative dataset (semi-structured interviews and recordings of residents' council meetings) that gives a glimpse of the experiences and coping strategies of (older) people living in residential care. The data highlight the range of unmet needs of the residents, similar to the categories of physiological, safety, love, esteem, and self-actualization needs in Maslow's hierarchy of needs theory. Our analysis indicates that "higher" and "lower" needs are closely intertwined and mutually reinforcing and should therefore be accorded equal emphasis by professionals (including social workers) employed within residential care settings.

Quality of residential care for older people: does education for healthcare assistants make a difference?

PubMed

Smith, Barbara; Kerse, Ngaire; Parsons, Matthew

2005-05-06

To determine the impact of a healthcare assistant education programme on the quality of care for older people living in a residential home in Auckland, New Zealand. A pre- and post-intervention evaluation study was undertaken within a residential home for older people. Quality of care was established by two periods of non-participant time-sampling observation of residents, separated by a programme of 10 interactive teaching sessions for healthcare assistants. Informed consent was gained from all observed residents and staff. Using the Quality Assessment Project (QAP) quality measure, the non-participant time-sampling observation data identified a 12.5% increase in resident care that was considered appropriate and adequate (chi-squared=12.05) and an 11.53% decrease in resident care that was considered inappropriate and inadequate (chi-squared=11.43). The intermediate grades did not alter significantly. Residents with low functional activity scores (Barthel Index) received better care after the education intervention (chi-squared=32.99), as did residents with moderate cognitive impairment (Abbreviated Mental Test Score [AMTS]<8/10). Healthcare assistant education can positively impact on the quality of care given to older people in residential care.

Residential staff responses to adolescent self-harm: The helpful and unhelpful.

PubMed

Johnson, Dan R; Ferguson, Kirstin; Copley, Jennifer

2017-07-01

Adolescent self-harm is prevalent in residential and secure care and is the cause of distress to those harming themselves, to the staff caring for them and for other young people living with them. This article sought service user views on what staff supports were effective and what were counter-productive in order to improve the care offered to young people. Seven young people living in residential or secure care were interviewed. Thematic analysis was used to elicit key themes. Global themes of safety and care were elicited. The young people understood and accepted that the role of staff was to provide these. Within these themes, they noted numerous responses that had both helpful and unhelpful effects, including increased observation, removal of means and extra collaborative support. Service users made numerous recommendations to increase the helpful effects of staff support. Young people provided informed and helpful guidance on how best to care for them. Their views can help mental health professionals and care staff increase their helpful responses making them more effective and less counter-productive. This study is a rare representation of the views of young people in residential and secure care and how to respond to their self-harm behaviour.

Episodic and Semantic Memories of a Residential Environmental Education Program

ERIC Educational Resources Information Center

Knapp, Doug; Benton, Gregory M.

2006-01-01

This study used a phenomenological approach to investigate the recollections of participants of an environmental education (EE) residential program. Ten students who participated in a residential EE program in the fall of 2001 were interviewed in the fall of 2002. Three major themes relating to the participants' long-term memory of the residential…

Belongingness--The Critical Variable in the Residential Treatment of Alcoholism.

ERIC Educational Resources Information Center

Machell, David F.

Many alcohol treatment programs have stressed a sense of belongingness as a means for successful treatment of alcoholics in a residential setting. An examination of the effectiveness of this strategy in highly structured and less structured programs involved 200 chronic, recidivistic male adult alcoholics in a residential program. Subjects were…

Introducing consumer directed care in residential care settings for older people in Australia: views of a citizens' jury.

PubMed

Laver, Kate; Gnanamanickam, Emmanuel; Whitehead, Craig; Kurrle, Susan; Corlis, Megan; Ratcliffe, Julie; Shulver, Wendy; Crotty, Maria

2018-07-01

Objectives Health services worldwide are increasingly adopting consumer directed care approaches. Traditionally, consumer directed care models have been implemented in home care services and there is little guidance as to how to implement them in residential care. This study used a citizens' jury to elicit views of members of the public regarding consumer directed care in residential care. Methods A citizens' jury involving 12 members of the public was held over two days in July 2016, exploring the question: For people with dementia living in residential care facilities, how do we enable increased personal decision making to ensure that care is based on their needs and preferences? Jury members were recruited through a market research company and selected to be broadly representative of the general public. Results The jury believed that person-centred care should be the foundation of care for all older people. They recommended that each person's funding be split between core services (to ensure basic health, nutrition and hygiene needs are met) and discretionary services. Systems needed to be put into place to enable the transition to consumer directed care including care coordinators to assist in eliciting resident preferences, supports for proxy decision makers, and accreditation processes and risk management strategies to ensure that residents with significant cognitive impairment are not taken advantage of by goods and service providers. Transparency should be increased (perhaps using technologies) so that both the resident and nominated family members can be sure that the person is receiving what they have paid for. Conclusions The views of the jury (as representatives of the public) were that people in residential care should have more say regarding the way in which their care is provided and that a model of consumer directed care should be introduced. Policy makers should consider implementation of consumer directed care models that are economically viable and are associated with high levels of satisfaction among users.

The effectiveness of environment assessment tools to guide refurbishment of Australian residential aged care facilities: A systematic review.

PubMed

Neylon, Samantha; Bulsara, Caroline; Hill, Anne-Marie

2017-06-01

To determine applicability of environment assessment tools in guiding minor refurbishments of Australian residential aged care facilities. Studies conducted in residential aged care settings using assessment tools which address the physical environment were eligible for inclusion in a systematic review. Given these studies are limited, tools which have not yet been utilised in research settings were also included. Tools were analysed using a critical appraisal screen. Forty-three publications met the inclusion criteria. Ten environment assessment tools were identified, of which four addressed all seven minor refurbishment domains of lighting, colour and contrast, sound, flooring, furniture, signage and way finding. Only one had undergone reliability and validity testing. There are four tools which may be suitable to use for minor refurbishment of Australian residential aged care facilities. Data on their reliability, validity and quality are limited. © 2017 AJA Inc.

Development and validation of a Social Images Evaluation Questionnaire for youth in residential care

PubMed Central

2017-01-01

Social images are defined as prevailing shared ideas about specific groups or societies without concrete or objective evidence of their accuracy or truthfulness. These images frequently have a negative impact on individuals and groups. Although of outmost importance, the study of the social images of youth in residential care is still scarce. In this article we present two studies for the development and validation of the Social Images Evaluation Questionnaire (SIEQ). In study 1, participants were asked to freely generate words that could be associated to youth in residential care in order to obtain a list of attributes to be used in the SIEQ. In study 2, the main psychometric characteristics of the SIEQ were tested with samples of laypeople and professionals. The main results support the proposal of a new and psychometrically sound measurement–the SIEQ–to analyze the social images of youth in residential care. PMID:28662056

Organizational capacities for 'residential care homes for the elderly' to provide culturally appropriate end-of-life care for Chinese elders and their families.

PubMed

Kong, Sui-Ting; Fang, Christine Meng-Sang; Lou, Vivian Weiqun

2017-01-01

Developing culturally appropriate end-of-life care for Chinese elderly and families is not an endemic challenge for Hong Kong, but that of the Western countries with a noticeable trend of rising Chinese population. The particular development of Hong Kong healthcare system, which is currently the major provider of end-of-life care, makes Hong Kong a fruitful case for understanding the confluence of the West and the East cultures in end-of-life care practices. This study therefore aims at building our best practice to enhance the capacity of residential care homes in providing culturally appropriate end-of-life care. We conducted two phases of research, a questionnaire survey and a qualitative study, which respectively aims at (1) understanding the EoL care service demand and provision in RCHEs, including death facts and perceived barriers and challenges in providing quality end-of-life care in care homes, and (2) identifying the necessary organizational capacities for the 'relational personhood' to be sustained in the process of ageing and dying in residential care homes. Findings shed light on how to empower residential care homes with necessary environmental, structural and cultural-resource-related capacity for providing quality end-of-life care for Chinese elders and their families. Copyright © 2016 Elsevier Inc. All rights reserved.

Technical support documentation for the Automated Residential Energy Standard (ARES) in support of proposed interim energy conservation voluntary performance standards for new non-federal residential buildings: Volume 2

DOE Office of Scientific and Technical Information (OSTI.GOV)

NONE

The Automated Residential Energy Standard (ARES) program is designed to identify levels of thermal integrity (e.g., insulation levels, glazing layers, equipment efficiencies, etc.) that are cost effective for typical residential structures and to create a residential energy standard based on these levels. This document contains technical background the explains the data and the algorithms used by the program.

Small Child Care Facilities in Residential Areas.

ERIC Educational Resources Information Center

Giegerich & Associates, Inc., Rockville, MD.

One part of a three-part investigation prepared for the Montgomery County Planning Board in Silver Spring, Maryland, this study addresses planning and site planning issues arising from the location of child care facilities in residential settings. The study, which emphasizes homes and centers which care for 7 to 20 children, provides a detailed…

An Empirical Typology of Residential Care/Assisted Living Based on a Four-State Study

ERIC Educational Resources Information Center

Park, Nan Sook; Zimmerman, Sheryl; Sloane, Philip D.; Gruber-Baldini, Ann L.; Eckert, J. Kevin

2006-01-01

Purpose: Residential care/assisted living describes diverse facilities providing non-nursing home care to a heterogeneous group of primarily elderly residents. This article derives typologies of assisted living based on theoretically and practically grounded evidence. Design and Methods: We obtained data from the Collaborative Studies of Long-Term…

Education Secured? The School Performance of Adolescents in Secure Residential Youth Care

ERIC Educational Resources Information Center

Harder, Annemiek T.; Huyghen, Anne-Marie N.; Knot-Dickscheit, Jana; Kalverboer, Margrite E.; Köngeter, Stefan; Zeller, Maren; Knorth, Erik J.

2014-01-01

Background: Despite poor school performance by adolescents in secure residential care and the potential importance of education during care, little is known about how to achieve academic success with these adolescents. Objective: Therefore, the aim of the present study is to assess adolescents' academic achievement during secure residential…

38 CFR 17.62 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Residential Care § 17.62 Definitions. For the purpose of §§ 17.61 through 17.72: (a) The term community... care, of the daily living activities of referred veterans in an approved home in the community by the... hearing means the in person testimony of representatives of a community residential care facility and of...

Components of a System of Care: What Does the Research Say?

ERIC Educational Resources Information Center

Rivera, Vestena Robbins; Kutash, Krista

This document presents a review of recent research literature on eight components in a system of care for children with serious emotional disturbances. It is intended to be a guide and source of information to communities for building systems of care. Components include: residential services (psychiatric hospitals and residential treatment…

Medical Service Utilization among Youth with School-Identified Disabilities in Residential Care

ERIC Educational Resources Information Center

Lambert, Matthew C.; Trout, Alexandra L.; Nelson, Timothy D.; Epstein, Michael H.; W. Thompson, Ronald

2016-01-01

Background: Behavioral, social, emotional, and educational risks among children and youth with school identified disabilities served in residential care have been well documented. However, the health care needs and medical service utilization of this high-risk population are less well known. Given the risks associated with children with…

The Voices of Youth in Out-of-Home Care regarding Developing Healthy Dating Relationships

ERIC Educational Resources Information Center

Duppong Hurley, Kristin; Trout, Alexandra; Wheaton, Nikki; Buddenberg, Laura; Howard, Brigid; Weigel, Megan

2013-01-01

Minimal attention has been focused on difficulties for youth in residential care regarding building healthy dating relationships, despite the significant risks to this group of adolescents. This study provided a unique opportunity to conduct focus groups with youth in residential care on issues surrounding dating relationships. The majority of…

Mapping the Rural Adolescent Girls' Participation in Residential Non-Formal Education Program--A Study in Lunkaransar Block, Rajasthan, India

ERIC Educational Resources Information Center

Sharma, Shilpa

2002-01-01

The present study, "Mapping Rural Adolescent Girl's Participation in Residential Non- Formal Education Program--A Study in Lunkaransar Block, Rajasthan", was an attempt to understand the dimensions of rural adolescent girls' participation in the "Balika Shivir" Program. It is a six month residential non-formal education program…

Residence Life Programs and the First-Year Experience. The Freshman Year Experience. Monograph Series No. 5.

ERIC Educational Resources Information Center

Zeller, William, Ed.; And Others

This monograph contains papers which suggest means of implementing residential programs, services, and facilities that will help to meet the needs of first-year college students. Fourteen papers are presented and are as follows: "Reflections on the First Year Residential Experience" (John N. Gardner); "The Role of Residential Programs in the…

Oral health status and dental service use of adults with learning disabilities living in residential institutions and in the community.

PubMed

Tiller, S; Wilson, K I; Gallagher, J E

2001-09-01

To investigate the oral health status of adults on Sheffield's Learning Disability Case Register, and their reported use of dental services. A short questionnaire interview of subjects with learning disabilities or their carers followed by a standardised epidemiological examination, by one trained and calibrated examiner. Residential homes, day centres or community homes of people with learning disabilities in Sheffield. A 20% random sample of adults (18-65 years) on the register. A response rate of 209 (67%) was achieved, 62% (n=130) of whom were living in the community. People living in residential care were significantly older (43.2 years) than those based in the community (36.3 years) (P<0.05). Both groups had similar mean DMFT scores; however, adults living in the community had significantly more untreated decay (DT = 1.6) and poorer oral hygiene than their counterparts in residential care (DT = 0.7). Adults in residential care had significantly more missing teeth (MT = 10.1) than those in community care (MT = 7.5). General and community dental services were the main providers of dental care. Subjects living in the community were significantly less likely to have a dentist and to use community dental services than their residential counterparts; they were more likely to attend only when having trouble. Adults with learning disabilities living in the community have greater unmet oral health needs than their residential counterparts and are less likely to have regular contact with dental services. Commissioners and providers of dental services have a responsibility to ensure that the health of adults with learning disabilities is not compromised by 'normalisation'.

Residential care workers and residents: the New Zealand story.

PubMed

Kiata, Liz; Kerse, Ngaire; Dixon, Robyn

2005-05-06

To describe the nature and size of long-term residential care homes in New Zealand; funding of facilities; and the ethnic and gender composition of residents and residential care workers nationwide. A postal, fax, and email survey of all long-term residential care homes in New Zealand. Completed surveys were received from an eligible 845 facilities (response rate: 55%). The majority of these (54%) facilities housed less than 30 residents. Of the 438 (94%) facilities completing the questions about residents' ethnicity, 432 (99%) housed residents from New Zealand European (Pakeha) descent, 156 (33%) housed at least 1 Maori resident, 71 (15%) at least 1 Pacific (Islands) resident, and 61 (13%) housed at least 1 Asian resident. Facilities employed a range of ethnically diverse staff, with 66% reporting Maori staff. Less than half of all facilities employed Pacific staff (43%) and Asian staff (33%). Registered nursing staff were mainly between 46 and 60 years (47%), and healthcare assistant staff were mostly between 25 and 45 years old (52%). Wide regional variation in the ethnic make up of staff was reported. About half of all staff were reported to have moved within the previous 2 years. The age and turnover of the residential care workforce suggests the industry continues to be under threat from staffing shortages. While few ethnic minority residents live in long-term care facilities, staff come from diverse backgrounds, especially in certain regions.

The incidence of depression and its risk factors in Dutch nursing homes and residential care homes.

PubMed

Boorsma, Marijke; Joling, Karlijn; Dussel, Martine; Ribbe, Miel; Frijters, Dinnus; van Marwijk, Harm W J; Nijpels, Giel; van Hout, Hein

2012-11-01

Although it is known that depression is highly prevalent in institutionalized older adults, little is known about its incidence and risk factors in nursing homes and residential care homes. The aim of this study was to investigate and compare the incidence and associated risk factors for depression in Dutch nursing homes and residential care homes. Data on depression were extracted from the Vrije Universiteit naturalistic cohort on routine care monitoring with the Minimum Data Set of the Resident Assessment Instrument. A total of 1,324 residents in six nursing homes and 1,723 residents in 23 residential care homes with an average follow-up of 1.2 years. Depression was defined as a clinical diagnosis according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, criteria and the use of antidepressants. Residents with prevalent depression at baseline were excluded. The incidence rate was 13.6 per 100 person years in the nursing homes and 10.2 per 100 person years in the residential care homes. The independent risk factors for in-home depression for residents in nursing homes included dementia (OR: 1.7; 95% CI: 1.02-2.95) and a score of 3 or more on the Depression Rating Scale (odds ratio [OR]: 2.1; 95% confidence interval [CI]: 1.23-3.70). A protective effect was seen on the use of a hearing aid (OR: 0.3; 95% CI: 0.12-0.80). In the residential care homes, being male (OR: 2.1; 95% CI: 1.27-3.30), having cancer (OR: 2.9; 95% CI: 1.64-4.95), and a score of 2 or higher on the Cognitive Performance Scale (OR: 1.5; 95% CI: 1.05-2.22) increased the risk to develop depression. Age greater than 85 years (OR: 0.5; 95% CI: 0.31-0.67) and hearing impairment (OR: 0.8; 95% CI: 0.60-1.00) appeared to be protective. The incidence rate for depression in residents of Dutch nursing homes and residential care homes was high and the associated risk factors found may have important implications for staff. 2012 American Association for Geriatric Psychiatry

Development and evaluation of an educational intervention for general practitioners and staff caring for people with dementia living in residential facilities.

PubMed

Beer, Christopher; Lowry, Rachel; Horner, Barbara; Almeida, Osvaldo P; Scherer, Samuel; Lautenschlager, Nicola T; Bretland, Nick; Flett, Penelope; Schaper, Frank; Flicker, Leon

2011-03-01

Despite high levels of participation in dementia education, general practitioners (GPs) and residential care facility (RCF) staff report perceived learning needs. Small group education, which is flexible, individualized, practical and case-based, is sought. We aimed to develop educational interventions for GPs and RCF staff tailored to meet their perceived educational needs. We used a consultative process to develop education programs. A flexible program for RCF staff was developed in 30-minute blocks, which could be combined in sessions of different lengths. The RCF program aimed to facilitate sustainable change by engaging local "Dementia Champions". For GPs, face-to-face and self-directed packages were developed. We collected participant feedback to evaluate the program. GPs and RCF staff were recruited as part of a larger intervention study. Sixteen of the 27 GPs who were offered the dementia education participated. Two of the 16 GPs participated in both learning packages. A total of 45 GP feedback responses were received from 16 GPs: 28 out of 45 GPs (62%) reported that the participants' learning needs were entirely met. Eighteen of 19 facilities offered the intervention participated and 326 RCF staff attended one or more of the 94 RCF education sessions. Feedback was collected from 93 sessions: 1013 out of 1067 RCF staff feedback responses (95%) reported that the session met the participants' learning needs. Qualitative feedback was also strongly positive. Participants perceived the education programs as meeting their needs. Despite explicit attempts to provide flexible delivery options, overall participation rates remained low.

Beyond family satisfaction: Family-perceived involvement in residential care.

PubMed

Irving, Justine

2015-09-01

To explore perceived family involvement and its relationship with satisfaction and facility impressions. A questionnaire was posted to residents' next of kin from four South Australian residential aged care facilities. One hundred and fifty next of kin participated in the survey. Family-perceived involvement was significantly and positively correlated with satisfaction and facility impressions. The findings of this study add to the limited body of research into family involvement in long-term residential care. Feedback from the family regarding particular aspects of involvement may also improve the experience of long-term care for both family and resident, and assist with the identification of specific issues towards which organisations may target their quality improvement efforts. © 2014 ACOTA.

Evaluation of an aged care nurse practitioner service: quality of care within a residential aged care facility hospital avoidance service.

PubMed

Dwyer, Trudy; Craswell, Alison; Rossi, Dolene; Holzberger, Darren

2017-01-13

Reducing avoidable hospitialisation of aged care facility (ACF) residents can improve the resident experience and their health outcomes. Consequently many variations of hospital avoidance (HA) programs continue to evolve. Nurse practitioners (NP) with expertise in aged care have the potential to make a unique contribution to hospital avoidance programs. However, little attention has been dedicated to service evaluation of this model and the quality of care provided. The purpose of this study was to evaluate the quality of an aged care NP model of care situated within a HA service in a regional area of Australia. Donabedian's structure, process and outcome framework was applied to evaluate the quality of the NP model of care. The Australian Nurse Practitioner Study standardised interview schedules for evaluating NP models of care guided the semi-structured interviews of nine health professionals (including ACF nurses, medical doctors and allied health professionals), four ACF residents and their families and two NPs. Theory driven coding consistent with the Donabedian framework guided analysis of interview data and presentation of findings. Structural dimensions identified included the 'in-reach' nature of the HA service, distance, limitations of professional regulation and the residential care model. These dimensions influenced the process of referring the resident to the NP, the NPs timely response and interactions with other professionals. The processes where the NPs take time connecting with residents, initiating collaborative care plans, up-skilling aged care staff and function as intra and interprofessional boundary spanners all contributed to quality outcomes. Quality outcomes in this study were about timely intervention, HA, timely return home, partnering with residents and family (knowing what they want) and resident and health professional satisfaction. This study provides valuable insights into the contribution of the NP model of care within an aged care, HA service and how staff manipulated the process dimensions to improve referral to the NPs. NP service in this study was dynamic, flexible and responsive to both patient and organisational demands.

Temperament and Behaviour of Infants Aged 4-12 Months on Admission to a Private Mother-Baby Unit and at 1- and 6-Month Follow-Up

ERIC Educational Resources Information Center

Fisher, Jane; Rowe, Heather; Feekery, Colin

2004-01-01

While infant behaviour is influenced by maternal care, infant crying and dysregulated sleep can reciprocally affect maternal mood. The temperament and behaviour of two 4-12-months-old infant cohorts admitted with their mothers to a residential parenting program were examined using behaviour charts and the Short Infant Temperament Questionnaire…

Molecular and Clinical Based Cardiovascular Care Program

DTIC Science & Technology

2007-01-01

et al. Effects of a vegetarian diet and selected yoga techniques in the treatment of coronary heart disease. Clinical Research. 1979;27:702A. 2...efforts to demonstrate that lifestyle change (ultra-low fat vegan diet ; yoga as a stress management technique; aerobic exercise; group support) could...participated in the diet and stress management interventions within a residential setting 1, demonstrated increased treadmill time as well as reduced

Estimating length of stay in publicly-funded residential and nursing care homes: a retrospective analysis using linked administrative data sets.

PubMed

Steventon, Adam; Roberts, Adam

2012-10-31

Information about how long people stay in care homes is needed to plan services, as length of stay is a determinant of future demand for care. As length of stay is proportional to cost, estimates are also needed to inform analysis of the long-term cost effectiveness of interventions aimed at preventing admissions to care homes. But estimates are rarely available due to the cost of repeatedly surveying individuals. We used administrative data from three local authorities in England to estimate the length of publicly-funded care homes stays beginning in 2005 and 2006. Stays were classified into nursing home, permanent residential and temporary residential. We aggregated successive placements in different care home providers and, by linking to health data, across periods in hospital. The largest group of stays (38.9%) were those intended to be temporary, such as for rehabilitation, and typically lasted 4 weeks. For people admitted to permanent residential care, median length of stay was 17.9 months. Women stayed longer than men, while stays were shorter if preceded by other forms of social care. There was significant variation in length of stay between the three local authorities. The typical person admitted to a permanent residential care home will cost a local authority over £38,000, less payments due from individuals under the means test. These figures are not apparent from existing data sets. The large cost of care home placements suggests significant scope for preventive approaches. The administrative data revealed complexity in patterns of service use, which should be further explored as it may challenge the assumptions that are often made.

Estimating length of stay in publicly-funded residential and nursing care homes: a retrospective analysis using linked administrative data sets

PubMed Central

2012-01-01

Background Information about how long people stay in care homes is needed to plan services, as length of stay is a determinant of future demand for care. As length of stay is proportional to cost, estimates are also needed to inform analysis of the long-term cost effectiveness of interventions aimed at preventing admissions to care homes. But estimates are rarely available due to the cost of repeatedly surveying individuals. Methods We used administrative data from three local authorities in England to estimate the length of publicly-funded care homes stays beginning in 2005 and 2006. Stays were classified into nursing home, permanent residential and temporary residential. We aggregated successive placements in different care home providers and, by linking to health data, across periods in hospital. Results The largest group of stays (38.9%) were those intended to be temporary, such as for rehabilitation, and typically lasted 4 weeks. For people admitted to permanent residential care, median length of stay was 17.9 months. Women stayed longer than men, while stays were shorter if preceded by other forms of social care. There was significant variation in length of stay between the three local authorities. The typical person admitted to a permanent residential care home will cost a local authority over £38,000, less payments due from individuals under the means test. Conclusions These figures are not apparent from existing data sets. The large cost of care home placements suggests significant scope for preventive approaches. The administrative data revealed complexity in patterns of service use, which should be further explored as it may challenge the assumptions that are often made. PMID:23110445

The relationship of residential instability to medical care utilization among poor mothers in New York City.

PubMed

Duchon, L M; Weitzman, B C; Shinn, M

1999-12-01

This study examines the relationship between residential instability, including mobility and previous homelessness, and the use of medical care among previously sheltered and never-sheltered mothers in New York City. The study represents one of the first efforts to follow up on families after they are no longer homeless. Mothers from 543 welfare families in New York City were interviewed, once in 1988 (Time 1) and again beginning in 1992 (Time 2). The sample included 251 families who first entered shelters after their 1988 interview, and 292 families who spent no time in shelters before or after that point. Mothers were asked about the source and volume of medical care used in the year before follow-up. Bivariate and multivariate analyses showed that previously sheltered mothers had a greater reliance on emergency departments (EDs) and weaker ties to private physicians or health maintenance organizations (HMOs) than did mothers who never used shelters. Mobility before the Time 1 interview was associated with greater reliance on EDs and absence of a usual source of care. More recent mobility was not associated with a usual source of care. Current residential stability reduced the likelihood of using an emergency department or having no regular source of care. None of the measures of residential instability were related to the volume of outpatient care used by mothers. A history of residential instability, particularly previous shelter use, strongly predicts where poor mothers currently seek health care. Further research is needed to determine whether these patterns of health care use existed before mothers entered shelters. The study provides evidence that upon leaving shelters, mothers are not being well integrated into primary care services.

When work happens in the house: perceptions of how residential care staff choose to spend work time in transitional living units for people with brain injury.

PubMed

Chapparo, Christine; Shepherd, Belinda

2010-01-01

This naturalistic study explored the influence of various contextual factors on the decision making of residential care staff (RCS) who worked and lived with clients with brain injury in transitional living environments. The findings reported here arose from the results of a larger study that investigated the multiple contextual, personal, professional and theoretical influences on RCS decision making. Eleven residential care staff who were employed in brain injury transitional living units in Sydney, Australia participated. Qualitative data were derived from interviews, participant observation and reviews of videotaped staff and client interactions with the residential care staff. The RCS identified time and organisational motivators as major influences on daily decision making at work. They described how decisions were made by them about how to prioritise time at work from two personal perspectives, that of 'hospital person' and ;house person', adopted relative to contextual influences at the time. Residential care staff who are in close personal contact with clients for long periods of time make decisions about their work that is largely based on their personal notions of running a house'. Further research is required to describe the emergent phenomenon of staff 'house' behaviour.

Children in Residential Group Care with No Family Ties: Facing Existential Aloneness

ERIC Educational Resources Information Center

Dvir, Orly; Weiner, Anita; Kupermintz, Hagai

2012-01-01

The issue of children living in residential group care in Israel completely without family ties is studied in order to explore the feelings of staff and uncover possible characteristics of these children. Data were collected through focus groups, questionnaires, and life stories of children who left group care at 18 years of age. Results reveal…

Stress and Coping among Owners and Managers of Residential Care Facilities.

ERIC Educational Resources Information Center

Walker, Hollie; And Others

Stress and burnout are common in the caregiving professions. Stress negatively affects both the caregivers and patients. In order to help caregivers deal with stress effectively and to improve the care in residential care facilities, it is essential to learn more about the particular stressors that managers of such facilities experience. In this…

Securing the Downside Up: Client and Care Factors Associated with Outcomes of Secure Residential Youth Care

ERIC Educational Resources Information Center

Harder, Annemiek T.; Knorth, Erik J.; Kalverboer, Margrite E.

2012-01-01

Background: Although secure residential care has the potential of reducing young people's behavioral problems, it is often difficult to achieve positive outcomes. Research suggests that there are several common success factors of treatment, of which the client's motivation for treatment and the quality of the therapeutic relationship between…

Resident Satisfaction and Its Components in Residential Aged Care

ERIC Educational Resources Information Center

Chou, Shu-Chiung; Boldy, Duncan P.; Lee, Andy H.

2002-01-01

Purpose: The purpose of this study was to assess the direction and magnitude of the effects among the components of resident satisfaction in residential aged care and to examine if the relationships among satisfaction components vary according to facility type (i.e., nursing home and hostel). Briefly, a hostel is a low-care facility in which…

Staff Behavior toward Children and Adolescents in a Residential Facility: A Self-Report Questionnaire

ERIC Educational Resources Information Center

Huitink, C.; Embregts, P. J. C. M.; Veerman, J. W.; Verhoeven, L.

2011-01-01

The purpose of the present study was to examine psychometric properties of the Staff Behavior toward Clients questionnaire (SBC), a self-report measure for care staff working with children and adolescents with mild to borderline intellectual disabilities in residential care. Ninety-nine care staff completed the SBC and the Strengths and…

Interprofessional student teams augmenting service provision in residential aged care.

PubMed

Kent, Fiona; Lai, Francis; Beovich, Bronwyn; Dodic, Miodrag

2016-09-01

The aim of this study was to determine the usefulness of student-led interprofessional consultations within residential aged care in augmenting patient care and enhancing student education. Volunteer fourth and final year health-care students conducted interprofessional consultations. In a mixed methods design, residents' health-care changes and perspectives were collected prospectively, and student and educator perceptions were measured by survey and interview. Sixteen aged care residents were consulted by interprofessional teams. Students identified two new health issues and proposed 17 recommendations for referrals and five changes to medication management. At six-weeks follow-up, two recommendations had been acted upon clinically, and two medication changes had been implemented. Reasons for the low uptake of recommendations were determined. Residents, students and educators reported high levels of satisfaction. Residential care facilities offer a useful interprofessional learning environment. Student consultations are positively regarded by patients, students and educators and may augment existing health services. © 2016 AJA Inc.

Resource utilization groups (RUGs): defining chronic care, rehabilitation and nursing home case mix in Canada.

PubMed

Botz, C K; Bestard, S; Demaray, M; Molloy, G

1993-01-01

The two major purposes of this study were: (1) to evaluate Resource Utilization Groups (RUGs III) as a unified method for classifying all residential, chronic care and rehabilitation patients at the St. Joseph's Health Centre, London, and (2) to compare the potential funding implications of RUGs and other patient/resident classification systems. RUGs were used to classify a total of 336 patients/residents in residential, extended care, chronic care and rehabilitation beds at the Health Centre. Patients were also concurrently classified according to the Alberta Long Term Care Classification System and the Medicus Long Term Care System. Results show that RUGs provide relatively more credit for higher acuity patients than do the Alberta or Medicus systems. If used as a basis for funding, chronic care and rehabilitation hospitals would be entitled to more funding (relative to residential/nursing homes) under RUGs than under the other two patient classification mechanisms.

Branching out to residential lands: Missions and strategies of five tree distribution programs in the U.S.

Treesearch

Vi D. Nguyen; Lara A. Roman; Dexter H. Locke; Sarah K. Mincey; Jessica R. Sanders; Erica Smith Fichman; Mike Duran-Mitchell; Sarah Lumban Tobing

2017-01-01

Residential lands constitute a major component of existing and possible tree canopy in many cities in the United States. To expand the urban forest on these lands, some municipalities and nonprofit organizations have launched residential yard tree distribution programs, also known as tree giveaway programs. This paper describes the operations of five tree distribution...

The Efficacy of Coerced Treatment for Offenders: An Evaluation of Two Residential Forensic Drug and Alcohol Treatment Programs.

ERIC Educational Resources Information Center

Baird, Francis X.; Frankel, Arthur J.

2001-01-01

Reviews the history of community-based treatment for offenders with drug and alcohol addiction. Describes the treatment regimen in two residential programs for offenders with drug and alcohol problems, including a description of the components of the residential treatment model utilized in these two programs. Findings support the efficacy of…

25 CFR 39.801 - What is the formula to determine the amount necessary to sustain a school's academic or...

Code of Federal Regulations, 2013 CFR

2013-04-01

... sustain a school's academic or residential program? 39.801 Section 39.801 Indians BUREAU OF INDIAN AFFAIRS... To Sustain an Academic or Residential Program § 39.801 What is the formula to determine the amount necessary to sustain a school's academic or residential program? (a) The Secretary's formula to determine...

25 CFR 39.801 - What is the formula to determine the amount necessary to sustain a school's academic or...

Code of Federal Regulations, 2014 CFR

2014-04-01

... sustain a school's academic or residential program? 39.801 Section 39.801 Indians BUREAU OF INDIAN AFFAIRS... To Sustain an Academic or Residential Program § 39.801 What is the formula to determine the amount necessary to sustain a school's academic or residential program? (a) The Secretary's formula to determine...

25 CFR 39.801 - What is the formula to determine the amount necessary to sustain a school's academic or...

Code of Federal Regulations, 2012 CFR

2012-04-01

... sustain a school's academic or residential program? 39.801 Section 39.801 Indians BUREAU OF INDIAN AFFAIRS... To Sustain an Academic or Residential Program § 39.801 What is the formula to determine the amount necessary to sustain a school's academic or residential program? (a) The Secretary's formula to determine...

Career Development Programs in Residential Schools for the Deaf: A Survey

ERIC Educational Resources Information Center

Twyman, Lee H.; Ouellette, Sue E.

1978-01-01

Sixty-four residential schools for the deaf were surveyed regarding ten aspects of career education programs, including objectives, details of program implementation, program content, special needs, environmental factors, and occupational choices. (DLS)

Photovoltaic Residential Applications Program Implementation Workshop Proceedings

NASA Technical Reports Server (NTRS)

Barbieri, R. H.

1980-01-01

Two major aspects of the workshop are presented: (1) presentations on the Photovoltaic program and the National Solar Heating and Cooling Demonstration program, and (2) discussions on the issues pertinent to the Residential Application program.

75 FR 78694 - Proposed Residential Exchange Program Settlement Agreement Proceeding (REP-12); Public Hearing...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-16

... DEPARTMENT OF ENERGY Bonneville Power Administration [BPA File No.: REP-12] Proposed Residential... Review and Comment AGENCY: Bonneville Power Administration (BPA), Department of Energy (DOE). ACTION: Notice of Residential Exchange Program Settlement Agreement Proceeding (REP-12). SUMMARY: BPA is...

Exploratory investigation of communication management in residential-aged care: a comparison of staff knowledge, documentation and observed resident-staff communication.

PubMed

Bennett, Michelle K; Ward, Elizabeth C; Scarinci, Nerina A

2016-05-01

There is a high prevalence of communication difficulty among older people living in residential-aged care. Such functional deficits can have a negative impact on resident quality of life, staff workplace satisfaction and the provision of quality care. Systematic research investigating the nature of communication management in residential-aged care and factors impacting optimal communication management is lacking. To use data triangulation across multiple sources to describe resident-staff communication and communication management in residential-aged care. Participants included a sample of 14 residents and 29 staff directly involved in communication interactions with residents. Data were obtained from: (1) resident file review (n = 14), (2) observation of resident-staff communication (n = 14), (3) resident surveys (n = 14) and (4) staff surveys (n = 29). Data from each source were examined separately then triangulated. All residents had limited opportunity for meaningful communication with staff. Documentation of residents' communication needs and strategies to facilitate resident-staff communication was insufficient to provide individualized recommendations. Although staff were observed to use various strategies to facilitate communication with residents, staff agreement about the applicability of these strategies to individual residents was inconsistent. Differences in resident-staff communication for residents who experience nil/mild versus moderate/severe communication difficulty were also found. Resident-staff communication and communication management in residential-aged care is limited in scope and challenged in meeting residents' individual communication needs. Improvements in both documentation and staff knowledge of residents' communication needs are necessary. Strategies to facilitate communication with individual residents must be tailored, evidence based, documented in care plans and delivered to staff through ongoing education. Increased involvement of specialist providers such as speech pathologists to support better communication management in residential-aged care may provide one way of facilitating such change. © 2015 Royal College of Speech and Language Therapists.

Residential therapeutic communities in the mainstream: diversity and issues.

PubMed

De Leon, G

1995-01-01

Not all residential drug abuse treatment programs are therapeutic communities (TCs), not all TCs are in residential settings, and not all programs that call themselves TCs employ the same social and psychological models of treatment. The term "therapeutic community" is widely used to represent a distinct approach in almost any setting, including community residences, hospital wards, prisons, and homeless shelters. One effect of this labeling has been to cloud understanding of the TC as a drug abuse treatment approach, how well it works, where it works best, and for which clients it is most appropriate. This article attempts to further a general understanding of residential TCs. Distinctions are drawn between residential drug abuse treatment and residential TCs. The diversity of programs within the TC modality is described in terms of modifications of the model and applications to special populations; and the essential elements of the TC program model are briefly outlined. Finally, movement into the mainstream has surfaced issues for the TC in terms of policy and practice, several of which are highlighted.

Registered nurses' experience of delegating the administration of medicine to unlicensed personnel in residential care homes.

PubMed

Gransjön Craftman, Åsa; Grape, Charlotte; Ringnell, Katarina; Westerbotn, Margareta

2016-11-01

The aim was to describe registered nurses' experience in the context of delegating the administration of medication to unlicensed personnel in residential care homes. The residents in residential care homes have a need for extensive care and nursing, and large amounts of medicines are common practice. Registered nurses' workload and difficulties in fulfilling their duties, such as administration of medicines, have led to frequent delegation of this task between the registered nurses and unlicensed assisting personnel. It is, of course, a great responsibility to ensure that the care of the older people remains safe while maintaining quality in the prevailing situation. A qualitative inductive descriptive study. Data were collected using audio-recorded semistructured interviews with a purposive sample of 18 registered nurses and interpreted using manifest content analysis. The study was approved by the ethical research committee. Registered nurses found the organisation unsupportive with regard to nursing interventions. The delegation context was experienced as a grey zone; the rules and regulations were not in line with the unspoken expectation to delegate the administration of medicine to unlicensed personnel, in order to be able to manage their daily work. The slimmed organisation of residential care homes relies upon registered nurses' use of delegation of medicine administration to unlicensed assistant personnel. It becomes an inevitable assignment entailing a challenging responsibility for patient safety and the quality of care. The results of this study may contribute to a better understanding of the complexity of caring for older people in residential care homes and to improving the work environment of all healthcare personnel. © 2016 John Wiley & Sons Ltd.

How Does the Context of Reception Matter? The Role of Residential Enclaves in Maternal Smoking During Pregnancy Among Mexican-Origin Mothers

PubMed Central

Noah, Aggie J.; Landale, Nancy S.; Sparks, Corey S.

2015-01-01

This study investigated whether and how different patterns of group exposure within residential contexts (i.e., living in a Mexican immigrant enclave, a Mexican ethnic enclave, a pan-Hispanic enclave, or a non-Hispanic white neighborhood) are associated with smoking during pregnancy among Mexican-origin mothers. Using a hierarchical linear modeling approach, we found that Mexican-origin mothers’ residential contexts are important for understanding their smoking during pregnancy. Residence in an ethnic enclave is associated with decreased odds of smoking during pregnancy, while residence in a non-Hispanic white neighborhood is associated with increased odds of smoking during pregnancy, above and beyond the mothers’ individual characteristics. The magnitude of the associations between residence in an ethnic enclave and smoking during pregnancy is similar across the different types of ethnic enclaves examined. The important roles of inter- and intra-group exposures suggests that in order to help Mexican-origin women, policy makers should more carefully design place-based programs and interventions that target geographic areas and the specific types of residential contexts in which women are at greater risk. PMID:25652060

Residential Learning Communities. What Works Clearinghouse Intervention Report

ERIC Educational Resources Information Center

What Works Clearinghouse, 2014

2014-01-01

Residential learning communities in postsecondary education, also known as living-learning programs, aim to improve student learning and success by integrating students' academic and daily living environments. Students participating in these programs live together (usually in a residential dormitory), take certain classes together, and engage in…

77 FR 24341 - Energy Conservation Program: Test Procedures for Residential Clothes Washers; Correction

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-24

... Program: Test Procedures for Residential Clothes Washers; Correction AGENCY: Office of Energy Efficiency... final rule establishing new and amended test procedures for residential clothes washers, published in... Energy (DOE) erroneously referenced the new test procedure, rather than the currently effective test...

77 FR 20291 - Energy Conservation Program: Test Procedures for Residential Clothes Washers; Correction

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-04

... Conservation Program: Test Procedures for Residential Clothes Washers; Correction AGENCY: Office of Energy.... Department of Energy (DOE) is correcting a final rule establishing revised test procedures for residential... factor calculation section of the currently applicable test procedure. DATES: Effective: April 6, 2012...

Residential care for abandoned children and their integration into a family-based setting in Uganda: lessons for policy and programming.

PubMed

Walakira, Eddy J; Ochen, Eric A; Bukuluki, Paul; Alllan, Sue

2014-01-01

This article describes a model of care for abandoned and neglected infants in need of urgent physical, social, and medical support as implemented by the Child's i Foundation, an international, nongovernmental organization operating in Uganda. The model discounts the need for long-term care of young children within institutions and challenges the basis for intercountry adoption. Underpinned by the essentials of care continuum provided under the Uganda National Alternative Care Framework (Ministry of Gender, Labour and Social Development, 2012), the model emphasizes the need to effect the reintegration of the separated child within the family of his or her birth, or locally organize foster care or adoption. Highlighting policy and programming lessons, the model showcases a holistic approach to the problem and puts emphasis on interventions that are protective, promotional, and transformational and the use of a community-oriented approach. The model offers guidance to both government and nongovernment actors in addressing the problems of child neglect and abandonment through the implementation of the alternative care framework. © 2014 Michigan Association for Infant Mental Health.

Use of Electronic Health Records in Residential Care Communities

MedlinePlus

... this stage, and on other aspects of sampling design and data collection, are available elsewhere ( 11 ). Differences among subgroups were ... AJ, Harris-Kojetin LD, Sengupta M, et al. Design and operation of the 2010 National Survey of Residential Care Facilities [PDF 2.10 MB] . ...

Residential Treatment of Substance Abusing Adolescents: Trends in the Post-Managed Care Era

ERIC Educational Resources Information Center

MacMaster, Samuel A.; Ellis, Rodney A.; Cooper, Lyle

2005-01-01

This paper explores historical and recent trends in the delivery of residential adolescent substance abuse treatment, looking specifically at the impact of managed care on the service delivery system. Three historical eras are conceptualized by the authors: (1) an era prior to managed care in which services were provided on a fee for service basis…

Drumming as a Medium to Promote Emotional and Social Functioning of Children in Middle Childhood in Residential Care

ERIC Educational Resources Information Center

Flores, Kim; van Niekerk, Caroline; le Roux, Liana

2016-01-01

This study explores the potential of drumming to enhance emotional and social functioning of children in residential care. Fifteen children (aged 7-12) from a child and youth care centre in South Africa attended four months of weekly drumming sessions. Gestalt theory principles informed the workshops' theoretical foundation and interpretation of…

Nitrogen input from residential lawn care practices in suburban watersheds in Baltimore county, MD

Treesearch

Neely L. Law; Lawrence E. Band; J. Morgan Grove

2004-01-01

A residential lawn care survey was conducted as part of the Baltimore Ecosystem Study, a Long-term Ecological Research project funded by the National Science Foundation and collaborating agencies, to estimate the nitrogen input to urban watersheds from lawn care practices. The variability in the fertilizer N application rates and the factors affecting the application...

Prevalence of Weight Problems among Youth with High-Incidence Disabilities in Residential Care

ERIC Educational Resources Information Center

Trout, Alexandra L.; Lambert, Matthew C.; Nelson, Timothy D.; Thompson, Ronald W.

2014-01-01

The prevalence of weight problems among youth in general and youth in out-of-home care has been well documented; however, the prevalence of obesity/overweight among youth with high-incidence disabilities in more restrictive settings, such as residential care, has not been assessed. The purpose of the present study was to evaluate the prevalence of…

Exploratory Investigation of Communication Management in Residential-Aged Care: A Comparison of Staff Knowledge, Documentation and Observed Resident-Staff Communication

ERIC Educational Resources Information Center

Bennett, Michelle K.; Ward, Elizabeth C.; Scarinci, Nerina A.

2016-01-01

Background: There is a high prevalence of communication difficulty among older people living in residential-aged care. Such functional deficits can have a negative impact on resident quality of life, staff workplace satisfaction and the provision of quality care. Systematic research investigating the nature of communication management in…

Examining the Impact of a Residential College on Student Academic Success and Persistence at New York University

ERIC Educational Resources Information Center

Crisman, Tyler

2012-01-01

This study explored the effects of participation in a residential college living/learning program as well as a themed-floor living/learning program at New York University on students' cumulative GPAs at graduation and likelihood of earning a degree from the institution. The two residential learning program models studied varied in terms of size,…

Multifaceted shared care intervention for late life depression in residential care: randomised controlled trial.

PubMed

Llewellyn-Jones, R H; Baikie, K A; Smithers, H; Cohen, J; Snowdon, J; Tennant, C C

1999-09-11

To evaluate the effectiveness of a population based, multifaceted shared care intervention for late life depression in residential care. Randomised controlled trial, with control and intervention groups studied one after the other and blind follow up after 9.5 months. Population of residential facility in Sydney living in self care units and hostels. 220 depressed residents aged >/=65 without severe cognitive impairment. The shared care intervention included: (a) multidisciplinary consultation and collaboration, (b) training of general practitioners and carers in detection and management of depression, and (c) depression related health education and activity programmes for residents. The control group received routine care. Geriatric depression scale. Intention to treat analysis was used. There was significantly more movement to "less depressed" levels of depression at follow up in the intervention than control group (Mantel-Haenszel stratification test, P=0.0125). Multiple linear regression analysis found a significant intervention effect after controlling for possible confounders, with the intervention group showing an average improvement of 1.87 points on the geriatric depression scale compared with the control group (95% confidence interval 0.76 to 2.97, P=0.0011). The outcome of depression among elderly people in residential care can be improved by multidisciplinary collaboration, by enhancing the clinical skills of general practitioners and care staff, and by providing depression related health education and activity programmes for residents.

Incremental predictive validity of the Addiction Severity Index psychiatric composite score in a consecutive cohort of patients in residential treatment for drug use disorders.

PubMed

Thylstrup, Birgitte; Bloomfield, Kim; Hesse, Morten

2018-01-01

The Addiction Severity Index (ASI) is a widely used assessment instrument for substance abuse treatment that includes scales reflecting current status in seven potential problem areas, including psychiatric severity. The aim of this study was to assess the ability of the psychiatric composite score to predict suicide and psychiatric care after residential treatment for drug use disorders after adjusting for history of psychiatric care. All patients treated for drug use disorders in residential treatment centers in Denmark during the years 2000-2010 with complete ASI data were followed through national registers of psychiatric care and causes of death (N=5825). Competing risks regression analyses were used to assess the incremental predictive validity of the psychiatric composite score, controlling for previous psychiatric care, length of intake, and other ASI composite scores, up to 12years after discharge. A total of 1769 patients received psychiatric care after being discharged from residential treatment (30.3%), and 27 (0.5%) committed suicide. After adjusting for all covariates, psychiatric composite score was associated with a higher risk of receiving psychiatric care after residential treatment (subhazard ratio [SHR]=3.44, p<0.001), and of committing suicide (SHR=11.45, p<0.001). The ASI psychiatric composite score has significant predictive validity and promises to be useful in identifying patients with drug use disorders who could benefit from additional mental health treatment. Copyright © 2017 Elsevier Ltd. All rights reserved.

Residential Workers' Pack.

ERIC Educational Resources Information Center

Rimmer, Alan, Ed.

The packet of information is intended to help residential workers with disturbed children in the United Kingdom. The first section on theory contains two papers: "Which Children Come Into Residential Care?" (Robin Benians); and "Models of Treatment: Behavioral, Psychodynamic, Cognitive" (Daphne Lennox). The next section…

Where's the evidence? a systematic review of economic analyses of residential aged care infrastructure.

PubMed

Easton, Tiffany; Milte, Rachel; Crotty, Maria; Ratcliffe, Julie

2017-03-21

Residential care infrastructure, in terms of the characteristics of the organisation (such as proprietary status, size, and location) and the physical environment, have been found to directly influence resident outcomes. This review aimed to summarise the existing literature of economic evaluations of residential care infrastructure. A systematic review of English language articles using AgeLine, CINAHL, Econlit, Informit (databases in Health; Business and Law; Social Sciences), Medline, ProQuest, Scopus, and Web of Science with retrieval up to 14 December 2015. The search strategy combined terms relating to nursing homes, economics, and older people. Full economic evaluations, partial economic evaluations, and randomised trials reporting more limited economic information, such as estimates of resource use or costs of interventions were included. Data was extracted using predefined data fields and synthesized in a narrative summary to address the stated review objective. Fourteen studies containing an economic component were identified. None of the identified studies attempted to systematically link costs and outcomes in the form of a cost-benefit, cost-effectiveness, or cost-utility analysis. There was a wide variation in approaches taken for valuing the outcomes associated with differential residential care infrastructures: 8 studies utilized various clinical outcomes as proxies for the quality of care provided, and 2 focused on resident outcomes including agitation, quality of life, and the quality of care interactions. Only 2 studies included residents living with dementia. Robust economic evidence is needed to inform aged care facility design. Future research should focus on identifying appropriate and meaningful outcome measures that can be used at a service planning level, as well as the broader health benefits and cost-saving potential of different organisational and environmental characteristics in residential care. International Prospective Register of Systematic Reviews (PROSPERO) registration number CRD42015015977 .

Advance care planning for older people in Australia presenting to the emergency department from the community or residential aged care facilities.

PubMed

Street, Maryann; Ottmann, Goetz; Johnstone, Megan-Jane; Considine, Julie; Livingston, Patricia M

2015-09-01

The purpose of this retrospective, cross-sectional study was to determine the prevalence of advance care planning (ACP) among older people presenting to an Emergency Department (ED) from the community or a residential aged care facility. The study sample comprised 300 older people (aged 65+ years) presenting to three Victorian EDs in 2011. A total of 150 patients transferred from residential aged care to ED were randomly selected and then matched to 150 people who lived in the community and attended the ED by age, gender, reason for ED attendance and triage category on arrival. Overall prevalence of ACP was 13.3% (n = 40/300); over one-quarter (26.6%, n = 40/150) of those presenting to the ED from residential aged care had a documented Advance Care Plan, compared to none (0%, n = 0/150) of the people from the community. There were no significant differences in the median ED length of stay, number of investigations and interventions undertaken in ED, time seen by a doctor or rate of hospital admission for those with an Advance Care Plan compared to those without. Those with a comorbidity of cerebrovascular disease or dementia and those assessed with impaired brain function were more likely to have a documented Advance Care Plan on arrival at ED. Length of hospital stay was shorter for those with an Advance Care Plan [median (IQR) = 3 days (2-6) vs. 6 days (2-10), P = 0.027] and readmission lower (0% vs. 13.7%). In conclusion, older people from the community transferred to ED were unlikely to have a documented Advance Care Plan. Those from residential aged care who were cognitively impaired more frequently had an Advance Care Plan. In the ED, decisions of care did not appear to be influenced by the presence or absence of Advance Care Plans, but length of hospital admission was shorter for those with an Advance Care Plan. © 2014 John Wiley & Sons Ltd.

Public hospital bed crisis: too few or too misused?

PubMed

Scott, Ian A

2010-08-01

* Increasing demand on public hospital beds has led to what many see as a hospital bed crisis requiring substantial increases in bed numbers. By 2050, if current bed use trends persist and as the numbers of frail older patients rise exponentially, a 62% increase in hospital beds will be required to meet expected demand, at a cost almost equal to the entire current Australian healthcare budget. * This article provides an overview of the effectiveness of different strategies for reducing hospital demand that may be viewed as primarily (although not exclusively) targeting the hospital sector - increasing capacity and throughput and reducing readmissions - or the non-hospital sector - facilitating early discharge or reducing presentations and admissions to hospital. Evidence of effectiveness was retrieved from a literature search of randomised trials and observational studies using broad search terms. * The principal findings were as follows: (1) within the hospital sector, throughput could be substantially improved by outsourcing public hospital clinical services to the private sector, undertaking whole-of-hospital reform of care processes and patient flow that address both access and exit block, separating acute from elective beds and services, increasing rates of day-only or short stay admissions, and curtailing ineffective or marginally effective clinical interventions; (2) in regards to the non-hospital sector, potentially the biggest gains in reducing hospital demand will come from improved access to residential care, rehabilitation services, and domiciliary support as patients awaiting such services currently account for 70% of acute hospital bed-days. More widespread use of acute care and advance care planning within residential care facilities and population-based chronic disease management programs can also assist. * This overview concludes that, in reducing hospital bed demand, clinical process redesign within hospitals and capacity enhancement of non-hospital care services and chronic disease management programs are effective strategies that should be considered before investing heavily in creating additional hospital beds devoid of any critical reappraisal of current models of care.

Effectiveness and Implementation of Evidence-Based Practices in Residential Care Settings

PubMed Central

James, Sigrid; Alemi, Qais; Zepeda, Veronica

2013-01-01

Purpose Prompted by calls to implement evidence-based practices (EBPs) into residential care settings (RCS), this review addresses three questions: (1) Which EBPs have been tested with children and youth within the context of RCS? (2) What is the evidence for their effectiveness within such settings? (3) What implementation issues arise when transporting EBPs into RCS? Methods Evidence-based psychosocial interventions and respective outcome studies, published from 1990–2012, were identified through a multi-phase search process, involving the review of four major clearinghouse websites and relevant electronic databases. To be included, effectiveness had to have been previously established through a comparison group design regardless of the setting, and interventions tested subsequently with youth in RCS. All outcome studies were evaluated for quality and bias using a structured appraisal tool. Results Ten interventions matching a priori criteria were identified: Adolescent Community Reinforcement Approach, Aggression Replacement Training, Dialectical Behavioral Therapy, Ecologically-Based Family Therapy, Eye Movement and Desensitization Therapy, Functional Family Therapy, Multimodal Substance Abuse Prevention, Residential Student Assistance Program, Solution-Focused Brief Therapy, and Trauma Intervention Program for Adjudicated and At-Risk Youth. Interventions were tested in 13 studies, which were conducted in different types of RCS, using a variety of study methods. Outcomes were generally positive, establishing the relative effectiveness of the interventions with youth in RCS across a range of psychosocial outcomes. However, concerns about methodological bias and confounding factors remain. Most studies addressed implementation issues, reporting on treatment adaptations, training and supervision, treatment fidelity and implementation barriers. Conclusion The review unearthed a small but important body of knowledge that demonstrates that EBPs can be implemented in RCS with encouraging results. PMID:23606781

Effectiveness and Implementation of Evidence-Based Practices in Residential Care Settings.

PubMed

James, Sigrid; Alemi, Qais; Zepeda, Veronica

2013-04-01

Prompted by calls to implement evidence-based practices (EBPs) into residential care settings (RCS), this review addresses three questions: (1) Which EBPs have been tested with children and youth within the context of RCS? (2) What is the evidence for their effectiveness within such settings? (3) What implementation issues arise when transporting EBPs into RCS? Evidence-based psychosocial interventions and respective outcome studies, published from 1990-2012, were identified through a multi-phase search process, involving the review of four major clearinghouse websites and relevant electronic databases. To be included, effectiveness had to have been previously established through a comparison group design regardless of the setting, and interventions tested subsequently with youth in RCS. All outcome studies were evaluated for quality and bias using a structured appraisal tool. Ten interventions matching a priori criteria were identified: Adolescent Community Reinforcement Approach, Aggression Replacement Training, Dialectical Behavioral Therapy, Ecologically-Based Family Therapy, Eye Movement and Desensitization Therapy, Functional Family Therapy, Multimodal Substance Abuse Prevention, Residential Student Assistance Program, Solution-Focused Brief Therapy, and Trauma Intervention Program for Adjudicated and At-Risk Youth. Interventions were tested in 13 studies, which were conducted in different types of RCS, using a variety of study methods. Outcomes were generally positive, establishing the relative effectiveness of the interventions with youth in RCS across a range of psychosocial outcomes. However, concerns about methodological bias and confounding factors remain. Most studies addressed implementation issues, reporting on treatment adaptations, training and supervision, treatment fidelity and implementation barriers. The review unearthed a small but important body of knowledge that demonstrates that EBPs can be implemented in RCS with encouraging results.

A Retrospective Critical Analysis of Family Support in Practice within a Residential Care Setting

ERIC Educational Resources Information Center

Thorne, Jeanne

2007-01-01

The article is based on a practice task, which was completed as part of the Higher Diploma/Masters in Family Support Studies at NUI Galway. The practice task explored in this article was conducted in a residential care unit that specialised in working with children and families. The care team based in the unit strived to provide more than…

Directory of Facilities for Mentally Ill Children in the United States.

ERIC Educational Resources Information Center

National Association for Mental Health, New York, NY.

Facilities for mentally ill children are listed by states in this directory for parents and professional people. Each entry includes information on diagnostic considerations, capacity, admission criteria, whether the facility is residential or day care, geographic eligibility, and fees. Separate indexes list residential and day care facilities and…

Residential Group Care Quarterly. Volume 5, Number 2, Fall 2004

ERIC Educational Resources Information Center

Kirkwood, Scott, Ed.

2004-01-01

This issue of "Residential Group Care Quarterly" contains the following articles: (1) "Achieving Better Outcomes for Children and Families: Reducing the Use of Restraint and Seclusion" (Katherine Johnson); (2) "STAR Project Outcomes" (Nancy Campbell); (3) "The Devereux Glenholme School" (Mary Guilfoile); (4) "Lessons Learned in the Reduction of…

Communication Supports in Congregate Residential Care Settings in Ohio

ERIC Educational Resources Information Center

Mitchell, Pamela R.

2009-01-01

Background: Communication skills are important to the pursuit of increased self-determination in individuals with disabilities. The aim of this investigation was to gather information about communication supports in state-run residential care facilities in Ohio, and to compare findings with a previous investigation on this topic examining such…

Factors Influencing Residents' Satisfaction in Residential Aged Care

ERIC Educational Resources Information Center

Chou, Shu-Chiung; Boldy, Duncan P.; Lee, Andy H.

2003-01-01

Purpose: The aim of this study was to identify the important factors influencing residents' satisfaction in residential aged care and to provide a better understanding of their interrelationships. Design and Methods: A cross-sectional survey design was used to collect the required information, including resident satisfaction, resident dependency…

Risk Profiles of Children Entering Residential Care: A Cluster Analysis

ERIC Educational Resources Information Center

Hagaman, Jessica L.; Trout, Alexandra L.; Chmelka, M. Beth; Thompson, Ronald W.; Reid, Robert

2010-01-01

Children in residential care are a heterogeneous population, presenting various combinations of risks. Existing studies on these children suggest high variability across multiple domains (e.g., academics, behavior). Given this heterogeneity, it is important to begin to identify the combinations and patterns of multiple risks, or risk profiles,…

From homeless to housed: caring for people in transition.

PubMed

Drury, Lin J

2008-01-01

This ethnographic study was conducted to determine what homeless people experience during the transition from street life into community housing. Data were gathered through participant observation at a program designed to secure housing and support services for homeless people upon discharge from a psychiatric hospital. Sixty homeless, mentally ill adults were followed from hospital discharge through their first 2 years in community housing. Homeless people interact with health care providers across a cultural divide produced by vast differences in their lived experiences. This cultural distance limits access to the services that these individuals require to achieve residential stability.

Supporting Residential Student Organization Advisers: A 21st Century Adviser Training and Development Program

ERIC Educational Resources Information Center

Shapiro, Cory Adam

2012-01-01

The purpose for this doctoral action research study was to discover if and how an updated training and development curriculum benefited residential student organization advisers at Arizona State University (ASU). Eleven advisers of residential student organizations completed a pilot training and development program and agreed to participate in a…

77 FR 51948 - Airport Improvement Program (AIP): Policy Regarding Access to Airports From Residential Property...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-28

...-0754] Airport Improvement Program (AIP): Policy Regarding Access to Airports From Residential Property... Airports From Residential Property that was published in the Federal Register on July 30, 2012. The FAA is... policy, based on Federal law, concerning through-the- fence access to a federally obligated airport from...

Treatment Programs in the National Drug Abuse Treatment Clinical Trials Network

PubMed Central

McCarty, Dennis; Fuller, Bret; Kaskutas, Lee Ann; Wendt, William W.; Nunes, Edward V.; Miller, Michael; Forman, Robert; Magruder, Kathryn M.; Arfken, Cynthia; Copersino, Marc; Floyd, Anthony; Sindelar, Jody; Edmundson, Eldon

2008-01-01

Drug abuse treatment programs and university-based research centers collaborate to test emerging therapies for alcohol and drug disorders in the National Drug Abuse Treatment Clinical Trials Network (CTN). Programs participating in the CTN completed organizational (n = 106 of 112; 95% response rate) and treatment unit surveys (n = 348 of 384; 91% response rate) to describe the levels of care, ancillary services, patient demographics, patient drug use and co-occurring conditions. Analyses describe the corporations participating in the CTN and provide an exploratory assessment of variation in treatment philosophies. A diversity of treatment centers participate in the CTN; not for profit organizations with a primary mission of treating alcohol and drug disorders dominate. Compared to N-SSATS (National Survey of Substance Abuse Treatment Services), programs located in medical settings are over-represented and centers that are mental health clinics are under-represented. Outpatient, methadone, long-term residential and inpatient treatment units differed on patients served and services proved. Larger programs with higher counselor caseloads in residential settings reported more social model characteristics. Programs with higher social model scores were more likely to offer self-help meetings, vocational services and specialized services for women. Conversely, programs with accreditation had less social model influence. The CTN is an ambitious effort to engage community-based treatment organizations into research and more fully integrate research and practice. PMID:17875368

Retention of court-referred youths in residential treatment programs: client characteristics and treatment process effects.

PubMed

Orlando, Maria; Chan, Kitty S; Morral, Andrew R

2003-05-01

The juvenile justice system relies heavily on residential treatment services for adolescents. Because treatment dropout limits the likely effectiveness of these services, in this study we examine the client and program characteristics associated with program retention among a sample of adolescent probationers referred to residential rehabilitation by the Juvenile Court in Los Angeles. Participants in the present study (n = 291) are a subset of those in the Adolescent Outcomes Project, conducted within RAND's Drug Policy Research Center, to examine the outcomes of youths entering treatment at seven residential treatment programs. Three months after a preadmission interview, youths were asked about their perceptions of counselors at the program, other residents, and their feelings of safety in the program. In addition, they were asked whether they needed and had received various services (e.g., job training, legal advice, family counseling). Results of a multivariate survival analysis revealed that pretreatment characteristics including motivation and substance use severity, as well as treatment program factors including safety, and perceived over- and underprovision of services, contribute significantly to the prediction of retention. Pretreatment environmental risk factors and ratings of program counselor and resident support were marginally significant. These results imply that changes in adolescent residential program delivery may serve to increase retention rates, thus improving long-term outcomes.

Hospital in the Nursing Home program reduces emergency department presentations and hospital admissions from residential aged care facilities in Queensland, Australia: a quasi-experimental study.

PubMed

Fan, Lijun; Hou, Xiang-Yu; Zhao, Jingzhou; Sun, Jiandong; Dingle, Kaeleen; Purtill, Rhonda; Tapp, Sam; Lukin, Bill

2016-02-09

There has been considerable publicity regarding population ageing and hospital emergency department (ED) overcrowding. Our study aims to investigate impact of one intervention piloted in Queensland Australia, the Hospital in the Nursing Home (HiNH) program, on reducing ED and hospital attendances from residential aged care facilities (RACFs). A quasi-experimental study was conducted at an intervention hospital undertaking the program and a control hospital with normal practice. Routine Queensland health information system data were extracted for analysis. Significant reductions in the number of ED presentations per 1000 RACF beds (rate ratio (95 % CI): 0.78 (0.67-0.92); p = 0.002), number of hospital admissions per 1000 RACF beds (0.62 (0.50-0.76); p < 0.0001), and number of hospital admissions per 100 ED presentations (0.61 (0.43-0.85); p = 0.004) were noticed in the experimental hospital after the intervention; while there were no significant differences between intervention and control hospitals before the intervention. Pre-test and post-test comparison in the intervention hospital also presented significant decreases in ED presentation rate (0.75 (0.65-0.86); p < 0.0001) and hospital admission rate per RACF bed (0.66 (0.54-0.79); p < 0.0001), and a non-significant reduction in hospital admission rate per ED presentation (0.82 (0.61-1.11); p = 0.196). Hospital in the Nursing Home program could be effective in reducing ED presentations and hospital admissions from RACF residents. Implementation of the program across a variety of settings is preferred to fully assess the ongoing benefits for patients and any possible cost-savings.

Outcomes in knowledge, attitudes and confidence of nursing staff working in nursing and residential care homes following a dementia training programme.

PubMed

Scerri, Anthony; Scerri, Charles

2017-11-08

Dementia training programmes for staff working in long-term care settings have been found to be effective in improving staff outcomes. This study investigated the impact of a dementia training programme for all Maltese nursing staff working in public nursing/residential homes on their knowledge, attitudes and confidence. Additionally, we identified the predictors of these domains before and after the programme. A 14-hour training programme focusing on dementia management, care and policy was developed for all nursing staff working in public nursing and residential homes in Malta. A pretest-posttest design was used to evaluate the participants' knowledge of dementia, attitudes and confidence in working with residents with dementia using validated tools. Demographic variables were measured and compared with each staff domain. The majority of nursing staff attended the training programme with 261 fully completed questionnaires being collected pre-training and 214 post-training. The programme significantly improved nursing staff knowledge, attitudes and confidence. Stepwise regression analysis of each staff domain showed that the strongest predictor in all models at pre-training was the intensity of previous training programmes. Furthermore, staff who attended previous training continued to improve in their attitudes and confidence following programme completion. The study continues to shed further evidence on the impact of dementia training programs on staff outcomes. It also indicated that the intensity of previous participation in dementia training programmes was related to the participants' knowledge, attitudes and confidence and that continual exposure to training had a cumulative effect.

Strengthening community-based programming for juvenile sexual offenders: key concepts and paradigm shifts.

PubMed

Hunter, John A; Gilbertson, Stephen A; Vedros, Dani; Morton, Michael

2004-05-01

The past decade has been witness to a sharp increase in residential placement of adjudicated delinquent youth, including juvenile sexual offenders. It is argued that this trend has fiscal implications and may be clinically contraindicated for less characterologically disturbed and dangerous youth. The authors advocate greater investment of public funds in the development and refinement of community-based intervention programs. It is believed that clinically and legally integrated programming, using newer social-ecological methodologies and supports, offers promise of reducing the number of youth who require residential placement, shortening residential lengths of stay and improving the transition of residentially treated youth back into community settings. Key concepts relevant to bolstering community-based programming for juvenile sexual offenders are identified and discussed. Two programs are described, and program evaluation data reviewed, in support of the viability of innovative community-based approaches to the management of this population.

Concept mapping to improve team work, team learning and care of the person with dementia and behavioural and psychological symptoms.

PubMed

Aberdeen, Suzanne M; Byrne, Graeme

2018-04-01

The incidence of behavioural and psychological symptoms of dementia in residential aged care facilities is high. Effective team work and knowledgeable staff are cited as important facilitators of appropriate care responses to clients with these symptoms, but to achieve this within a resource-poor workplace can be challenging. In the study reported in this paper, concept mapping was trialled to enhance multifocal person-centred assessment and care planning as well as team learning. The outcomes of team concept mapping were evaluated using a quasi-experimental design with pre- and post-testing in 11 selected Australian residential aged care facilities , including two control residential aged care facilities , over a nine-month period. It was demonstrated that use of concept mapping improved team function, measured as effectiveness of care planning, as well as enhancing learning, with increased knowledge of dementia care even amongst staff who were not directly involved with the process. It is suggested that these results may be generalizable to other countries and care settings.

Nurses' experiences providing palliative care to individuals living in rural communities: aspects of the physical residential setting.

PubMed

Kaasalainen, S; Brazil, K; Williams, A; Wilson, D; Willison, K; Marshall, D; Taniguchi, A; Phillips, C

2014-01-01

Efforts are needed to improve palliative care in rural communities, given the unique characteristics and inherent challenges with respect to working within the physical aspects of residential settings. Nurses who work in rural communities play a key role in the delivery of palliative care services. Hence, the purpose of this study was to explore nurses' experiences of providing palliative care in rural communities, with a particular focus on the impact of the physical residential setting. This study was grounded in a qualitative approach utilizing an exploratory descriptive design. Individual telephone interviews were conducted with 21 community nurses. Data were analyzed by thematic content analysis. Nurses described the characteristics of working in a rural community and how it influences their perception of their role, highlighting the strong sense of community that exists but how system changes over the past decade have changed the way they provide care. They also described the key role that they play, which was often termed a 'jack of all trades', but focused on providing emotional, physical, and spiritual care while trying to manage many challenges related to transitioning and working with other healthcare providers. Finally, nurses described how the challenges of working within the physical constraints of a rural residential setting impeded their care provision to clients who are dying in the community, specifically related to the long distances that they travel while dealing with bad weather. These study findings contribute to our understanding of the experiences of nurses working in rural communities in terms of the provision of palliative care and the influence of the physical residential setting that surrounds them. These findings are important since nurses play a major role in caring for community-dwelling clients who are dying, but they are confronted with many obstacles. As such, these results may help inform future decisions about how to best improve access to important services and ways to support them while providing palliative care to rural individuals.

Nurse-led management of chronic disease in a residential care setting.

PubMed

Neylon, Julie

2015-11-01

Introduction of the advanced nurse practitioner (ANP) role has enabled nurses to develop their clinical knowledge and skills, providing greater service provision and improved access to healthcare services. It can also help with the challenges of providing care to an ageing population in primary care. This article reports on the evaluation of an ANP-led clinic in two residential care homes that provides annual reviews for chronic disease management (CDM). A mixed method approach was used to evaluate the service using clinical data obtained from the electronic patient record system and software and patient satisfaction questionnaires. The number of patients receiving CDM reviews in the homes increased as a result of the clinic. Completed satisfaction questionnaires further demonstrated patients' satisfaction and willingness to engage with the service. The service highlights the ANP's effectiveness in managing residential care home patients with chronic diseases and improving their access to healthcare services.

Development of a model of situational leadership in residential care for older people.

PubMed

Lynch, Brighide M; McCormack, Brendan; McCance, Tanya

2011-11-01

The aim of the present study was to present the process used to develop a composite model of situational leadership enacted within a person-centred nursing framework in residential care. Transforming the culture of the residential unit from a restrictive institution to a vibrant community of older adults requires transformational leadership. Situational leadership is one form of transformational leadership, which claims that there is not one leadership style that works in all situations. A model of situational leadership in residential care was developed through a series of systematic steps that identified direct linkages between situational leadership and the main constructs of the Person-Centred Nursing Framework. The process included reviewing the evidence, undertaking a comparative analysis, identifying key concepts, connecting the concepts and developing a model. A conceptual model is presented which integrates person-centredness with leadership thinking in order to effectively impact on the follower's performance in managing the care environment and delivering person-centred care. Currently the model is being utilized in an action research study to evaluate the role of leaders in the practice setting of long-term care. While some of the connecting concepts have been identified in the present study, more work needs to be done to unravel these connections in further study of leaders in practice. © 2011 Blackwell Publishing Ltd.

ARES (Automated Residential Energy Standard) 1.2: User`s guide, in support of proposed interim energy conservation voluntary performance standards for new non-federal residential buildings: Volume 1

DOE Office of Scientific and Technical Information (OSTI.GOV)

NONE

The ARES (Automated Residential Energy Standard) User`s Guide is designed to the user successfully operate the ARES computer program. This guide assumes that the user is familiar with basic PC skills such as using a keyboard and loading a disk drive. The ARES computer program was designed to assist building code officials in creating a residential energy standard based on local climate and costs.

Official conceptualizations of person-centered care: which person counts?

PubMed

O'Dwyer, Ciara

2013-08-01

Numerous studies have indicated that a "psycho-social" person-centered care approach, involving the delivery of a compassionate, respectful model of care, leads to a high quality of life, particularly for older people living in residential care. This has prompted policy-makers to endorse this approach. Yet, some commentators have argued that the model of person-centered care in official government policies equates to a "consumer-based" rather than a psycho-social approach, as it focuses solely on offering service-users more choice and on promoting independence. However, as such arguments are made in the absence of any empirical analysis, it is unclear both whether such a distinction exists in practice, and, if so, how this alternative model developed. This study explores the development of minimum standards for residential care settings for older people in Ireland in order to address this gap in our understanding of person-centered care. Findings confirm that a consumer-driven model of person-centered care underpins the Irish Standards; residential care is portrayed as a hotel-like service and residents as discerning consumers, which may be unsuitable for older people in residential care with limited capacity to make key choices. Analysis indicates that this model can be seen both as an extension of consumer-driven policies endorsed by many neo-liberal governments, and also of policy-makers' fears of losing their autonomy when they reach the "Fourth Age". This study is particularly illuminating, given the similarities between the Irish care system with England, Scotland, Wales, Northern Ireland and Australia. Copyright © 2013 Elsevier Inc. All rights reserved.

25 CFR 39.802 - What is the student unit value in the formula?

Code of Federal Regulations, 2013 CFR

2013-04-01

... EQUALIZATION PROGRAM Determining the Amount Necessary To Sustain an Academic or Residential Program § 39.802... each student in an academic or residential program. There are two types of student unit values: the...

25 CFR 39.802 - What is the student unit value in the formula?

Code of Federal Regulations, 2012 CFR

2012-04-01

... EQUALIZATION PROGRAM Determining the Amount Necessary To Sustain an Academic or Residential Program § 39.802... each student in an academic or residential program. There are two types of student unit values: the...

25 CFR 39.802 - What is the student unit value in the formula?

Code of Federal Regulations, 2014 CFR

2014-04-01

... EQUALIZATION PROGRAM Determining the Amount Necessary To Sustain an Academic or Residential Program § 39.802... each student in an academic or residential program. There are two types of student unit values: the...

Residential Group Care Quarterly. Volume 7, Number 3, Winter 2007

ERIC Educational Resources Information Center

Shenk, Emily, Ed.

2007-01-01

"Residential Group Care Quarterly" is published four times a year by the Child Welfare League of America (CWLA). This issue contains the following articles: (1) Building a Lasting Agency: The Leadership Institute (Letitia Howland); (2) For Our Safety: Examining High-Risk Interventions for Children and Youth (Michael A. Nunno, Lloyd Bullard, and…

Residential Group Care Quarterly. Volume 7, Number 4, Spring 2007

ERIC Educational Resources Information Center

Shenk, Emily, Ed.

2007-01-01

"Residential Group Care Quarterly" is published four times a year by the Child Welfare League of America (CWLA). The Child Welfare League of America is the nation's oldest and largest membership-based child welfare organization. It is committed to engaging people everywhere in promoting the wellbeing of children, youth, and their families, and…

Institutionalized Children in Russia: Grouping the Regions by the Scale of the Phenomenon

ERIC Educational Resources Information Center

Kazakova, A. Yu.

2018-01-01

This study provides an initial classification of information on the social and geographic distribution of children's residential care institutions in Russia, and it characterizes the relationship between this information and the level of criminalization and victimization of minors. We provide data on the number of such residential care facilities…

Insomnia, Sleepiness, and Depression in Adolescents Living in Residential Care Facilities

ERIC Educational Resources Information Center

Moreau, Vincent; Belanger, Lynda; Begin, Gilles; Morin, Charles M.

2009-01-01

The main objective of this study was to document sleep patterns and disturbances reported by youths temporarily living in residential care facilities. A secondary objective was to examine the relationships between sleep disturbances and mood and daytime sleepiness. A self-reported questionnaire on sleep patterns and habits assessing duration,…

Deliberate Self-Harm among Children in Tertiary Care Residential Treatment: Prevalence and Correlates

ERIC Educational Resources Information Center

Stewart, Shannon L.; Baiden, Philip; Theall-Honey, Laura; den Dunnen, Wendy

2014-01-01

Background: Few studies have examined deliberate self-harm (DSH) among children in residential treatment in Canada. Most of the existing studies examined adolescent students or children from pediatric emergency departments. Objectives: The objectives of this study were to examine the prevalence of DSH among children in tertiary care residential…

76 FR 34996 - Proposed Data Collections Submitted for Public Comment and Recommendations

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-15

... categories of residential care facilities within each state that meet the NSLTCP definition and (2) for each... which the agency is responsible. The NSLTCP study definition of a residential care facility is one that..., Office of the Chief Science Officer, Centers for Disease Control and Prevention. [FR Doc. 2011-14791...

Dignity and respect: facilitating meaningful occupation for SeSotho elders.

PubMed

Du Toit, Sanetta H J; Böning, Wilmarié; Van Der Merwe, Tania Rauch

2014-03-01

Frail and vulnerable adults are divested of meaningful encounters when modernization and urbanization force them to embrace an unconventional residential care environment as a home. The aim of this article is to report on a study of SeSotho elders living in residential care to illustrate how more meaningful and culturally relevant experiences could be facilitated for them. A content analysis was done of the individual opinions of 15 collaborators as a secondary scrutiny of information obtained during a nominal group process. MAJOR FINDINGS. Findings revealed that elders were prone to experience loneliness, helplessness, and boredom due to situations dominated by occupational injustice. Co-occupations, training of staff, and environmental adaptations that allow a sense of interdependence could contribute in facilitating occupational justice for elders from a traditional South African indigenous background living in residential care. Human dignity and respect are upheld within residential care when elders have access to purposeful and meaningful activities of their choice that are culturally appropriate. Occupational therapists should advocate for doing, belonging, and becoming by facilitating meaningful occupational participation that is culturally relevant for their clients.

Challenging behavior and related factors in people with intellectual disability living in residential care centers in Israel.

PubMed

Sinai, Amanda; Tenenbaum, Ariel; Aspler, Shoshana; Lotan, Meir; Morad, Mohammed; Merrick, Joav

2013-01-01

Adults with intellectual disabilities have higher rates of mental ill-health and problem behaviors than the general population. In this study, we present data on trends in challenging behavior in residential care centers in Israel from 1998 to 2008 and further data on trends in employment of psychiatrists from 1998 to 2009 and psychotropic medication use from 1998 to 2008. Data was collected from annual questionnaires sent out to all residential care centers in Israel, from the Office of the Medical Director, Division for Intellectual and Developmental Disabilities, Ministry of Social Affairs and Social Services. Rates of challenging behaviors in people with intellectual disabilities living in residential care centers in Israel continues to rise. Alongside this, trends in regular psychotropic medication use also continues to increase. Consideration of biological, psychological, social, and environmental factors in the assessment and management of people with intellectual disabilities and challenging behaviors is important. This is best conducted using a multidisciplinary approach, which may include psychiatric assessment. Non-pharmacological interventions should always be considered either alongside, or instead of medication.

Challenging Behavior and Related Factors in People with Intellectual Disability Living in Residential Care Centers in Israel

PubMed Central

Sinai, Amanda; Tenenbaum, Ariel; Aspler, Shoshana; Lotan, Meir; Morad, Mohammed; Merrick, Joav

2013-01-01

Introduction: Adults with intellectual disabilities have higher rates of mental ill-health and problem behaviors than the general population. Method: In this study, we present data on trends in challenging behavior in residential care centers in Israel from 1998 to 2008 and further data on trends in employment of psychiatrists from 1998 to 2009 and psychotropic medication use from 1998 to 2008. Data was collected from annual questionnaires sent out to all residential care centers in Israel, from the Office of the Medical Director, Division for Intellectual and Developmental Disabilities, Ministry of Social Affairs and Social Services. Results: Rates of challenging behaviors in people with intellectual disabilities living in residential care centers in Israel continues to rise. Alongside this, trends in regular psychotropic medication use also continues to increase. Conclusion: Consideration of biological, psychological, social, and environmental factors in the assessment and management of people with intellectual disabilities and challenging behaviors is important. This is best conducted using a multidisciplinary approach, which may include psychiatric assessment. Non-pharmacological interventions should always be considered either alongside, or instead of medication. PMID:24350182

Hearing impairment, disability and handicap in elderly people living in residential care and in the community.

PubMed

Stumer, J; Hickson, L; Worrall, L

1996-02-01

This study aimed to compare the prevalence of hearing impairment, disability and handicap in the elderly living in residential care with those living in the community, and to examine the relationship between impairment, disability and handicap in both groups. Fifty community-based and 129 residential subjects were assessed using pure-tone audiometry as a measure of impairment, and a self-assessment questionnaire as a measure of disability and handicap. Community-based subjects were also assessed using a test of speech discrimination as an objective measure of disability. Results indicated 95% of residential subjects and 70% of community-based subjects were hearing-impaired, while 27% of residential subjects and 42% of community-based subjects demonstrated significant disability/handicap. Significant correlations were obtained between impairment, disability and handicap in both subject groups. The implications of the findings for the aural rehabilitation of the elderly are discussed.

"It's not as easy as saying, 'just get them to eat more veggies'": Exploring healthy eating in residential care in Australia.

PubMed

Cox, Rachael; Emond, Ruth; Punch, Samantha; McIntosh, Ian; Hall, Kate; Simpson, Angela; Skouteris, Helen

2017-10-01

Young people living in residential out-of-home care (henceforth OoHC) are at increased risk of becoming overweight or obese. Currently, recognition of the everyday mechanisms that might be contributing to excess weight for children and young people in this setting is limited. The aim of this study was to better understand the barriers and complexities involved in the provision of a 'healthy' food environment in residential OoHC. Heightening awareness of these factors and how they might compromise a young person's physical health, will inform the development, refinement and evaluation of more sensitive and tailored weight-related interventions for this population. The paper presents a nuanced picture of the complexity of everyday food routines in residential care, and illustrates the ways in which food is 'done' in care; how food can be both symbolic of care but also used to exercise control; the way in which food can be used to create a 'family-like' environment; and the impact of traumatic experiences in childhood on subsequent behaviours and overall functioning in relation to food. It is argued that a health agenda designed for a mainstream population ignores the very complex relationship that children in residential OoHC may have with food. It is recommended that future intervention approaches account for personal food biographies, trauma and children's social backgrounds and how these are implicated in everyday practices and interactions around food. Copyright © 2017. Published by Elsevier Ltd.

Treatment of depression in low-level residential care facilities for the elderly.

PubMed

George, Kuruvilla; Davison, Tanya E; McCabe, Marita; Mellor, David; Moore, Kathleen

2007-12-01

The rate of recognition and treatment of depressed older people in nursing homes is low. Data from the low-level residential care population have not been reported. This study aimed to collect information about the treatment of depression among older persons living in low-level residential care (hostels). The participants comprised 300 elderly residents from ten low-level residential care facilities from various suburbs in metropolitan Melbourne. The participants were interviewed by a trained clinical psychologist to determine the presence or absence of major or minor depressive disorder using the Structured Clinical Interview for DSM-IV Axis I Disorder (SCID-I). Each participant was also administered the Standardized Mini-mental State Examination (SMMSE) to determine level of cognitive function. The clinical psychologist then reviewed all cases in consultation with a geropsychiatrist experienced in the diagnosis of depression among older people, prior to assigning a diagnosis of depression. An important finding in this study was the low treatment for currently depressed residents, with less than half of those in the sample who were depressed receiving treatment. However, 61 of the 96 residents out of the sample of 300 who were on antidepressants were not currently depressed. There is an under recognition and under treatment of currently depressed older people in low-level residential care facilities (hostels) just as has been reported in studies in nursing homes. However, there are high numbers receiving antidepressants who are not currently depressed.

NSF CAREER: Establishing at the University of New Mexico a Student Residential College/Honors Program with Extensive Faculty Involvement

NASA Astrophysics Data System (ADS)

Simpson, J. J.

2011-12-01

As the educational component of my CAREER grant, I proposed integrating in an organized and widespread manner aspects of a Residential College / Honors Program into the culture of the University of New Mexico (UNM). Having such a program would provide UNM students the benefit of enhanced interactions with a variety of professors outside the classroom on a regular and personal basis. It would result not only in more visibility of professors' research and knowledge to students, but also in additional personal mentoring and encouragement. Similar programs already exist at Northwestern, Oxford, Cambridge, Harvard, Yale, and Princeton Universities, to name a few. As a student, I myself experienced the benefits of a Residential College Program at Northwestern University. In the first year of my CAREER award, I volunteered and served on a campus-wide Honors College Task Force wherein we generated a report for the Provost as to whether UNM should pursue establishing an Honors College having a residential component. Through this experience, I learned that there are many other faculty across campus excited about the possibilities offered by a Residential College / Honors Program, but also about the hurdles involved in gaining momentum and campus-wide and administrative support for such an endeavor. Here, I will present what I see as the benefits of a Residential College / Honors Program at Universities, my vision for one at UNM, and the challenges encountered and lessons learned thus far.

Optimising mobility through the sit-to-stand activity for older people living in residential care facilities: A qualitative interview study of healthcare aide experiences.

PubMed

Kagwa, Sharon A; Boström, Anne-Marie; Ickert, Carla; Slaughter, Susan E

2018-03-01

To explore the experience of HCAs encouraging residents living in residential care to complete the sit-to-stand activity and to identify the strategies HCAs used to integrate the activity into their daily work routines. Decreased mobility in advanced ageing is further reduced when entering a residential care facility. Interventions such as the sit-to-stand activity have been shown to have a positive effect on the mobility of older people. There is evidence to suggest that healthcare aides are able to support residents to complete the sit-to-stand activity as part of their daily work routines; however, little is known about how healthcare aides actually do this with residents living in residential care. A qualitative interview study included seven purposively sampled HCAs working in residential care facilities. Semistructured interviews were analysed using inductive qualitative content analysis. The HCAs' experience with the sit-to-stand activity was represented by the following four categories: Resident participation, Feeling misunderstood and disrespected, Time and workload, and Management involvement. HCAs identified three strategies to help them support residents to complete the sit-to-stand activity: Motivating residents, Completing activity in a group and Using time management skills. HCAs reported some encouragement from managers and cooperation from residents to complete the sit-to-stand activity with residents; however, they also felt constrained by time limitations and workload demands and they felt misunderstood and disrespected. HCAs were able to identify several strategies that helped them to integrate the sit-to-stand activity into their daily routines. This study highlights the challenges and supportive factors of implementing the sit-to-stand activity into the daily work routine of HCAs. The study also identifies the strategic role of nurse managers when implementing interventions in residential care facilities. © 2017 John Wiley & Sons Ltd.

Profile of Excellence.

ERIC Educational Resources Information Center

Journal of Educational Administration, 1988

1988-01-01

The Institute of Educational Administration (IEA) at Geelong, Victoria, Australia, is briefly described. Participants in IEA programs undertake a five-stage process: courses in educational administration; a four-week residential program; a fermentation exercise; advanced residential program; and an innovative project in their respective schools.…

Plenty of activity but little outcome data: a review of the "grey literature" on primary care anxiety and depression programs in Australia.

PubMed

Christensen, Helen; Griffiths, Kathleen M; Gulliver, Amelia

2008-06-16

To identify reports in the "grey literature" of programs conducted in Australian primary care to improve depression and anxiety outcomes, and to examine these reports for evidence of effectiveness. A systematic search was undertaken for grey literature reports using primary health care research databases, community and professional websites, clearinghouse sources, government reports, and reports from the Australian General Practice Network. Reports were included if they related to programs targeting depression or anxiety, contained qualitative or quantitative effectiveness data, and were published during 1995-2006. In total, 642 reports were identified, of which 43 met inclusion criteria. Of the 43 programs described, 30 were delivered in general practice, five in the community or residential care, three in schools, and five were Internet or computer based. Nine programs were also reported in the formal "black" literature, but most, including the Better Outcomes in Mental Health Care initiative, were not. Limited data on effectiveness or patient outcomes were available in the grey literature. There is currently no single service that identifies, describes and catalogues the range and effectiveness of mental health initiatives in Australia. There may be a role for a mental health information "clearinghouse" to facilitate dissemination and education, and to promote collaboration among researchers, practitioners, consumers and policymakers. Innovative schemes to disseminate evidence-based models and to encourage the collection of data on patient outcomes in such programs are needed.

Effects of a high‐intensity functional exercise program on depressive symptoms among people with dementia in residential care: a randomized controlled trial

PubMed Central

Conradsson, Mia; Hörnsten, Carl; Rosendahl, Erik; Lindelöf, Nina; Holmberg, Henrik; Nordström, Peter; Gustafson, Yngve; Littbrand, Håkan

2015-01-01

Objectives The aim of this study is to evaluate the effect of a high‐intensity functional exercise program on depressive symptoms among older care facility residents with dementia. Methods Residents (n = 186) with a diagnosis of dementia, age ≥ 65 years, Mini‐Mental State Examination score ≥ 10, and dependence in activities of daily living were included. Participants were randomized to a high‐intensity functional exercise program or a non‐exercise control activity conducted 45 min every other weekday for 4 months. The 15‐item Geriatric Depression Scale (GDS) and the Montgomery–Åsberg Depression Rating Scale (MADRS) were administered by blinded assessors at baseline, 4, and 7 months. Results No difference between the exercise and control activity was found in GDS or MADRS score at 4 or 7 months. Among participants with GDS scores ≥ 5, reductions in GDS score were observed in the exercise and control groups at 4 months (–1.58, P = 0.001 and –1.54, P = 0.004) and 7 months (–1.25, P = 0.01 and –1.45, P = 0.007). Among participants with MADRS scores ≥ 7, a reduction in MADRS score was observed at 4 months in the control group (–2.80, P = 0.009) and at 7 months in the exercise and control groups (–3.17, P = 0.003 and –3.34, P = 0.002). Conclusions A 4‐month high‐intensity functional exercise program has no superior effect on depressive symptoms relative to a control activity among older people with dementia living in residential care facilities. Exercise and non‐exercise group activities may reduce high levels of depressive symptoms. PMID:26644304

The quasi-market for adult residential care in the UK: Do for-profit, not-for-profit or public sector residential care and nursing homes provide better quality care?

PubMed

Barron, David N; West, Elizabeth

2017-04-01

There has been a radical transformation in the provision of adult residential and nursing home care in England over the past four decades. Up to the 1980s, over 80% of adult residential care was provided by the public sector, but today public sector facilities account for only 8% of the available places, with the rest being provided by a mixture of for-profit firms (74%) and non-profit charities (18%). The public sector's role is often now that of purchaser (paying the fees of people unable to afford them) and regulator. While the idea that private companies may play a bigger role in the future provision of health care is highly contentious in the UK, the transformation of the residential and nursing home care has attracted little comment. Concerns about the quality of care do emerge from time to time, often stimulated by high profile media investigations, scandals or criminal prosecutions, but there is little or no evidence about whether or not the transformation of the sector from largely public to private provision has had a beneficial effect on those who need the service. This study asks whether there are differences in the quality of care provided by public, non-profit or for-profit facilities in England. We use data on care quality for over 15,000 homes that are provided by the industry regulator in England: the Care Quality Commission (CQC). These data are the results of inspections carried out between April 2011 and October 2015. Controlling for a range of facility characteristics such as age and size, proportional odds logistic regression showed that for-profit facilities have lower CQC quality ratings than public and non-profit providers over a range of measures, including safety, effectiveness, respect, meeting needs and leadership. We discuss the implications of these results for the ongoing debates about the role of for-profit providers of health and social care. Copyright © 2017 Elsevier Ltd. All rights reserved.

Study protocol for the translating research in elder care (TREC): building context – an organizational monitoring program in long-term care project (project one)

PubMed Central

Estabrooks, Carole A; Squires, Janet E; Cummings, Greta G; Teare, Gary F; Norton, Peter G

2009-01-01

Background While there is a growing awareness of the importance of organizational context (or the work environment/setting) to successful knowledge translation, and successful knowledge translation to better patient, provider (staff), and system outcomes, little empirical evidence supports these assumptions. Further, little is known about the factors that enhance knowledge translation and better outcomes in residential long-term care facilities, where care has been shown to be suboptimal. The project described in this protocol is one of the two main projects of the larger five-year Translating Research in Elder Care (TREC) program. Aims The purpose of this project is to establish the magnitude of the effect of organizational context on knowledge translation, and subsequently on resident, staff (unregulated, regulated, and managerial) and system outcomes in long-term care facilities in the three Canadian Prairie Provinces (Alberta, Saskatchewan, Manitoba). Methods/Design This study protocol describes the details of a multi-level – including provinces, regions, facilities, units within facilities, and individuals who receive care (residents) or work (staff) in facilities – and longitudinal (five-year) research project. A stratified random sample of 36 residential long-term care facilities (30 urban and 6 rural) from the Canadian Prairie Provinces will comprise the sample. Caregivers and care managers within these facilities will be asked to complete the TREC survey – a suite of survey instruments designed to assess organizational context and related factors hypothesized to be important to successful knowledge translation and to achieving better resident, staff, and system outcomes. Facility and unit level data will be collected using standardized data collection forms, and resident outcomes using the Resident Assessment Instrument-Minimum Data Set version 2.0 instrument. A variety of analytic techniques will be employed including descriptive analyses, psychometric analyses, multi-level modeling, and mixed-method analyses. Discussion Three key challenging areas associated with conducting this project are discussed: sampling, participant recruitment, and sample retention; survey administration (with unregulated caregivers); and the provision of a stable set of study definitions to guide the project. PMID:19671166

Outcomes for youth residential treatment programs using administrative data from the child welfare system: a risk-adjustment application.

PubMed

McMillen, J Curtis; Lee, Bethany R; Jonson-Reid, Melissa

2008-05-01

This study assessed whether administrative data from the public child welfare system could be used to develop risk-adjusted performance reports for residential mental health programs for adolescents. Regression methods were used with 3,759 residential treatment spells for 2,784 children and youth to determine which outcomes could be adequately risk adjusted for case mix. Expected outcomes were created for each residential program given its case mix; then, expected and achieved outcomes were compared. For most programs, achieved results did not differ significantly from expected results for individual outcomes. Overall, outcomes achieved were not impressive. Only one quarter of spells resulted in a youth being maintained in a single less restrictive setting in the year following discharge. Methodological implications of this study suggest further refinements are needed for child welfare administrative data in order to develop risk-adjusted report cards of program performance.

Residential Substance Abuse Treatment for Urban American Indians and Alaska Natives, Part II: Costs.

PubMed

McFarland, Bentson H; Walker, Dale; Silk-Walker, Patricia

2017-01-01

The present study examined costs of two residential substance abuse treatment programs designed for urban American Indians and Alaska Natives (AI/ANs). Costs for one agency were well within national norms, while costs at the other program were less than expected from nationwide data. Economies of scale accounted for much of the difference between observed and expected costs. Culturally specific residential substance abuse treatment services can be provided to urban AI/ANs within budgets typically found at mainstream programs.

Sustainable kerbside recycling in the municipal garbage contract.

PubMed

Chowdhury, Moe

2009-12-01

In an era of global warming, rising energy costs and increasing volumes of wastes destined for landfills and incinerators, communities should set up environmentally sustainable services that are cost-effective for their citizens and revenue generators for municipalities. A win-win garbage collection and kerbside recycling program established more than eight years ago in a small rural community in Ohio, US is still going strong. It is offering a relatively inexpensive way for waste disposal by providing an incentive-based and highly participatory kerbside recycling and at the same time bringing in substantial franchise fees for the municipal coffers. Unlike garbage contracts in most communities that are designed for only residential waste collection, this program extends disposal and recycling services to non-residential establishments. It picks up hard-to-dispose household furniture, appliances and other bulky items without additional costs to the residents. By being creative and assessing local political and socio-economic milieu, public officials can implement a comprehensive service package for taking care of their community throwaways. However, before establishing such programs in partnership with a private firm, city administrators must understand the intricacies of bid specifications customized for municipal wastes and recyclable materials.

Day Hospital and Residential Addiction Treatment: Randomized and Nonrandomized Managed Care Clients

ERIC Educational Resources Information Center

Witbrodt, Jane; Bond, Jason; Kaskutas, Lee Ann; Weisner, Constance; Jaeger, Gary; Pating, David; Moore, Charles

2007-01-01

Male and female managed care clients randomized to day hospital (n=154) or community residential treatment (n=139) were compared on substance use outcomes at 6 and 12 months. To address possible bias in naturalistic studies, outcomes were also examined for clients who self-selected day hospital (n=321) and for clients excluded from randomization…

Drug Administration via Enteral Feeding Tube in Residential Care Facilities for Individuals with Intellectual Disability: A Focus Group Study on Guideline Implementation

ERIC Educational Resources Information Center

Joos, Elke; Van Tongelen, Inge; Wijnants, Karen; Mehuys, Els; Van Bocxlaer, Jan; Remon, Jean Paul; Grypdonck, Maria; Van Winckel, Myriam; Boussery, Koen

2016-01-01

People with profound intellectual disabilities often receive medication through enteral feeding tube (EFT). In a previous study, we found that current guidelines concerning medication preparation and administration through EFT are often not followed in residential care facilities (RCFs) for individuals with intellectual disabilities. The present…

Aggressive Adolescents in Residential Care: A Selective Review of Treatment Requirements and Models

ERIC Educational Resources Information Center

Knorth, Erik J.; Klomp, Martin; Van den Bergh, Peter M.; Noom, Marc J.

2007-01-01

This article presents a selective inventory of treatment methods of aggressive behavior. Special attention is paid to types of intervention that, according to research, are frequently used in Dutch residential youth care. These methods are based on (1) principles of (cognitive) behavior management and control, (2) the social competence model, and…

An Ethnographic Study of Stigma and Ageism in Residential Care or Assisted Living

ERIC Educational Resources Information Center

Dobbs, Debra; Eckert, J. Kevin; Rubinstein, Bob; Keimig, Lynn; Clark, Leanne; Frankowski, Ann Christine; Zimmerman, Sheryl

2008-01-01

Purpose: This study explored aspects of stigmatization for older adults who live in residential care or assisted living (RC-AL) communities and what these settings have done to address stigma. Design and Methods: We used ethnography and other qualitative data-gathering and analytic techniques to gather data from 309 participants (residents, family…

Increasing Emotional Regulation for Youths in Residential Care: Phases of Change

ERIC Educational Resources Information Center

Cimmarusti, Rocco A.

2011-01-01

Youths in residential care have likely experienced trauma as they have had atypical and disruptive events occur in their lives that has contributed to their out-of-home placement. For people who have been traumatized, the regulation of emotions is an important feature of their recovery. This article presents a model that traces phases from…

Can money buy green? Demographic and socioeconomic predictors of lawn-care expenditures and lawn greenness in urban residential areas

Treesearch

Weiqi Zhou; Austin Troy; J. Morgan Grove; Jennifer C. Jenkins

2009-01-01

It is increasingly important to understand how household characteristics influence lawn characteristics, as lawns play an important ecological role in human-dominated landscapes. This article investigates household and neighborhood socioeconomic characteristics as predictors of residential lawn-care expenditures and lawn greenness. The study area is the Gwynns Falls...

Characteristics and Psychosocial Predictors of Adolescent Nonsuicidal Self-Injury in Residential Care

ERIC Educational Resources Information Center

Gallant, Jason; Snyder, Gregory S.; von der Embse, Nathaniel P.

2014-01-01

This study examined characteristics and biopsychosocial predictors of nonsuicidal self-injury in a sample (N = 753) of youth in residential care admitted between 2005 and 2010. To model the data, the authors used t-tests, chi-square tests, and multiple logistic regressions stratified by gender. Results suggested that 12% of youth engaged in…

"It's Different, but It's the Same": Perspectives of Young Adults with Siblings with Intellectual Disabilities in Residential Care

ERIC Educational Resources Information Center

Jacobs, Paula; MacMahon, Ken

2017-01-01

Background: Siblings often play significant roles in the lives of people with intellectual disabilities. This study aimed to give voice to young adults whose siblings have an intellectual disability and are in residential care. Materials and Methods: Six participants were interviewed, with interpretative phenomenological analysis methodology…

Residential Child Care Institutions (RCCI) Food Services Manual.

ERIC Educational Resources Information Center

Idaho State Dept. of Education, Boise.

This food manual for small Idaho residential child care institutions with 10-15 students and no full-time cook, is designed to help directors serve meals that promote healthy eating behavior in their residents, serve meals that meet the USDA's Healthy School Meals Initiative, and manage the food service to assure the fiscal integrity of the…

Should we provide oral health training for staff caring for people with intellectual disabilities in community based residential care? A cost-effectiveness analysis.

PubMed

Mac Giolla Phadraig, Caoimhin; Nunn, June; Guerin, Suzanne; Normand, Charles

2016-04-01

Oral health training is often introduced into community-based residential settings to improve the oral health of people with intellectual disabilities (ID). There is a lack of appropriate evaluation of such programs, leading to difficulty in deciding how best to allocate scarce resources to achieve maximum effect. This article reports an economic analysis of one such oral health program, undertaken as part of a cluster randomized controlled trial. Firstly, we report a cost-effectiveness analysis of training care-staff compared to no training, using incremental cost-effectiveness ratios (ICERs). Effectiveness was measured as change in knowledge, reported behaviors, attitude and self-efficacy, using validated scales (K&BAS). Secondly, we costed training as it was scaled up to include all staff within the service provider in question. Data were collected in Dublin, Ireland in 2009. It cost between €7000 and €10,000 more to achieve modest improvement in K&BAS scores among a subsample of 162 care-staff, in comparison to doing nothing. Considering scaled up first round training, it cost between €58,000 and €64,000 to train the whole population of staff, from a combined dental and disability service perspective. Less than €15,000-€20,000 of this was additional to the cost of doing nothing (incremental cost). From a dental perspective, a further, second training cycle including all staff would cost between €561 and €3484 (capital costs) and €5815 (operating costs) on a two yearly basis. This study indicates that the program was a cost-effective means of improving self-reported measures and possibly oral health, relative to doing nothing. This was mainly due to low cost, rather than the large effect. In this instance, the use of cost effectiveness analysis has produced evidence, which may be more useful to decision makers than that arising from traditional methods of evaluation. There is a need for CEAs of effective interventions to allow comparison between programs. Suggestions to reduce cost are presented. Copyright © 2015 Elsevier Ltd. All rights reserved.

Computer-based nursing documentation in nursing homes: A feasibility study.

PubMed

Yu, Ping; Qiu, Yiyu; Crookes, Patrick

2006-01-01

The burden of paper-based nursing documentation has led to increasing complaints and decreasing job satisfaction amongst aged-care workers in Australian nursing homes. The automation of nursing documentation has been identified as one of the possible strategies to address this issue. A major obstacle to the introduction of IT solutions, however, has been a prevailing doubt concerning the ability and/or the willingness of aged-care workers to accept such innovation. This research investigates the attitudes of aged-care workers towards adopting IT innovation. Questionnaire survey were conducted in 13 nursing homes around the Illawarra and Sydney regions in Australia. The survey found that an unexpected 89.3% of participants supported the strategy of introducing electronic nursing documentation systems into residential aged-care facilities. 94.3% of them would use such a system depending on circumstances. Despite a shortage of computers in the workplace, which is a major barrier, this research provides strong evidence that care workers in residential aged-care facilities are willing to accept electronic nursing documentation practice and the uptake of information technology in residential aged-care is feasible in Australia.

PROMOTING SUPPORTIVE PARENTING IN NEW MOTHERS WITH SUBSTANCE-USE PROBLEMS: A PILOT RANDOMIZED TRIAL OF RESIDENTIAL TREATMENT PLUS AN ATTACHMENT-BASED PARENTING PROGRAM

PubMed Central

BERLIN, LISA J.; SHANAHAN, MEGHAN; CARMODY, KAREN APPLEYARD

2015-01-01

This pilot randomized trial tested the feasibility and efficacy of supplementing residential substance-abuse treatment for new mothers with a brief, yet rigorous, attachment-based parenting program. Twenty-one predominantly (86%) White mothers and their infants living together in residential substance-abuse treatment were randomly assigned to the program (n = 11) or control (n = 10) group. Program mothers received 10 home-based sessions of Dozier’s Attachment and Biobehavioral Catch-up (ABC) intervention. Postintervention observations revealed more supportive parenting behaviors among the randomly assigned ABC mothers. PMID:25424409

Residential aged care in Auckland, New Zealand 1988-2008: do real trends over time match predictions?

PubMed

Broad, Joanna B; Boyd, Michal; Kerse, Ngaire; Whitehead, Noeline; Chelimo, Carol; Lay-Yee, Roy; von Randow, Martin; Foster, Susan; Connolly, Martin J

2011-07-01

in Auckland, New Zealand in 1988, 7.7% of those aged over 65 years lived in licenced residential aged care. Age-specific rates approximately doubled for each 5-year age group after the age of 65 years. Even with changes in policies and market forces since 1988, population increases are forecast to drive large growth in demand. This study shows previously unrecognised 20-year trends in rates of care in a geographically defined population. four cross-sectional surveys of all facilities (rest homes and hospitals) licenced for long-term care of older people were conducted in Auckland, New Zealand in 1988, 1993, 1998 and 2008. Facility staff completed survey forms for each resident. Numbers of licenced and occupied beds and trends in age-specific and age-standardised rates in residential aged care are reported. over the 20-year period, Auckland's population aged over 65 years increased by 43% (from 91,000 to 130,000) but actual numbers in care reduced slightly. Among those aged over 65 years, the proportion living in care facilities reduced from 1 in 13 to 1 in 18. Age-standardised rates in rest-home level care reduced from 65 to 33 per thousand, and in hospital level care, from 29 to 23 per thousand. Had rates remained stable, over 13,200 people, 74% more than observed, would have been in care in 2008. growth predicted in the residential aged care sector is not yet evident. The introduction of standardised needs assessments before entry, increased availability of home-based services, and growth in retirement villages may have led to reduced utilisation.

Residential Services Position Paper.

ERIC Educational Resources Information Center

Pennsylvania State Dept. of Public Welfare, Harrisburg. Office of Mental Retardation.

The document states the future direction of the Pennsylvania Office of Mental Retardation in planning and policy development for residential programs. Section I provides an overview, traces the history of residential services in Pennsylvania, and describes the residential system in Pennsylvania as of June, 1978. Section II outlines a continuum of…

The Untreated Addiction: Going Tobacco-Free in a VA Substance Abuse Residential Rehabilitation Treatment Program (SARRTP).

PubMed

Conrad, Megan; Bolte, Teri; Gaines, Leigh; Avery, Zackery; Bodie, Linda

2018-05-02

Despite negative effects of tobacco on the human body and the high prevalence of smoking among those who enter treatment for substance use, few residential programs endorse a tobacco-free policy. Conventional wisdom suggests that it is overwhelming to quit more than one substance at a time, and as a result, many clinicians believe that a shift to a tobacco-free treatment environment is unfeasible. However, the most recent scientific literature suggests the opposite: targeting tobacco use during substance use treatment can increase abstinence rates from both smoking and substances of choice. Therefore, the purpose of the current project is to outline the process by which a residential substance use treatment program within a Veterans Affairs (VA) medical center implemented a tobacco-free policy. In addition, preliminary program evaluation data dispels the myth that eliminating tobacco use in a residential treatment program leads to a decline in patient interest and program utilization.

Optimizing care of residents with Parkinsonism in supervised facilities.

PubMed

Makoutonina, Margarita; Iansek, Robert; Simpson, Pam

2010-06-01

People with Parkinsonism (PWP) in residential facilities are usually elderly, cognitively impaired, physically disabled with poor quality of life and a high mortality rate. This paper aims to determine if the care of PWP in residential facilities could be improved by addressing staff knowledge on Parkinson related issues. A curriculum based on the Victorian Comprehensive Parkinson Program (VCPP) was developed and delivered to 118 staff members in 9 facilities across Melbourne. Measures of staff knowledge were undertaken at baseline, 1, 3 and 12 months. Data from a total of 49 residents were used in the analysis. Measures were taken at baseline, 1, 3 and 12 months included dementia screen (MMSE), geriatric depression scale (GDS), quality of life (PDQ39), fatigue (PDFS16), monthly falls diary, Unified Parkinson Disease Rating Scale (I,II,III) Hoehn & Yahr scale (H&Y) and resident/family questionnaire (RFQ) which focused on quality of care provision. It was found that the staff knowledge assessment scores (max = 37) significantly improved post education (P < 0.01) from baseline mean (11.1) and were maintained to 12 months mean (29.0). The residents group improved significantly for all measures at 1 month and these improvements were maintained up to 12 months (except for UPDRS III). This study demonstrated how a simple intervention, resulting in improved staff knowledge, produced a significant and clinically meaningful improvement in the care of PWP.

The Language Functioning of Youth at Entry to Residential Treatment

ERIC Educational Resources Information Center

Trout, Alexandra L.; Huscroft-D'Angelo, Jacqueline; DeSalvo, Catherine; Gehringer, Robert

2011-01-01

Although much is known about the behavioral and educational characteristics of youth at entry to residential care, little is known about youth language performance. Given the impact of language deficits on outcomes, this study assessed the specific language skills of 70 adolescents at entry to a residential treatment setting. Results revealed…

How architectural design affords experiences of freedom in residential care for older people.

PubMed

Van Steenwinkel, Iris; Dierckx de Casterlé, Bernadette; Heylighen, Ann

2017-04-01

Human values and social issues shape visions on dwelling and care for older people, a growing number of whom live in residential care facilities. These facilities' architectural design is considered to play an important role in realizing care visions. This role, however, has received little attention in research. This article presents a case study of a residential care facility for which the architects made considerable effort to match the design with the care vision. The study offers insights into residents' and caregivers' experiences of, respectively, living and working in this facility, and the role of architectural features therein. A single qualitative case study design was used to provide in-depth, contextual insights. The methods include semi-structured interviews with residents and caregivers, and participant observation. Data concerning design intentions, assumptions and strategies were obtained from design documents, through a semi-structured interview with the architects, and observations on site. Our analysis underlines the importance of freedom (and especially freedom of movement), and the balance between experiencing freedom and being bound to a social and physical framework. It shows the architecture features that can have a role therein: small-scaleness in terms of number of residents per dwelling unit, size and compactness; spatial generosity in terms of surface area, room to maneuver and variety of places; and physical accessibility. Our study challenges the idea of family-like group living. Since we found limited sense of group belonging amongst residents, our findings suggest to rethink residential care facilities in terms of private or collective living in order to address residents' social freedom of movement. Caregivers associated 'hominess' with freedom of movement, action and choice, with favorable social dynamics and with the building's residential character. Being perceived as homey, the facility's architectural design matches caregivers' care vision and, thus, helped them realizing this vision. Copyright © 2017 Elsevier Inc. All rights reserved.

[Alcohol and drug misuse of the elderly in health care facilities].

PubMed

Kuhn, S; Haasen, C

2012-05-01

A nationwide representative survey was conducted in residential care facilities and facilities offering care for the elderly in their homes (home care facilities) with the aim to estimate the rate of alcohol and drug misuse among this population and to evaluate the way in which nursing staff deal with the problem. A total of 5000 randomly selected facilities were contacted with a 2-page questionnaire. Reliable data were obtained from 550 residential care facilities and from 436 home care facilities. According to the investigated facilities, the mean rate of misuse among the elderly was 14%. Nearly all facilities acknowledge the necessity to react to these facts, but only a quarter of them considered their staff to be sufficiently trained. 38.4% of the residential care facilities and 26.9% of the home care facilities have a concept on how to react to misuse problems. Addiction services are rarely contacted. The prevalence of alcohol and drug misuse among the elderly in health care facilities is high compared to the same age cohort of the total population. The lack of networking between facilities for the elderly and addiction services is remarkable. © Georg Thieme Verlag KG Stuttgart · New York.

Staff satisfaction and its components in residential aged care.

PubMed

Chou, Shu-Chiung; Boldy, Duncan P; Lee, Andy H

2002-06-01

The purpose of this study was to assess the direction and magnitude of the effects among the components of staff satisfaction in residential aged care and to examine whether the relationships among satisfaction components vary according to facility type (i.e. nursing homes and hostels). A hostel is a low care facility in which residents are more independent, have a lower level of care needs, and receive personal but not nursing care. A cross-sectional survey design was adopted to collect the required information, and a stratified random sampling approach was utilized to select facilities. Structural equation modeling was used to examine relationships among satisfaction components. Seventy residential aged care facilities in Western Australia. The sample includes 610 nursing home and 373 hostel care staff. The relationships among satisfaction components are different for nursing home and hostel staff. Professional support is found to have a strong and positive effect on all other aspects of staff satisfaction. The findings lead to an improved understanding of the interrelationship among staff satisfaction components, which has important implications through enhancing professional support. This needs to be recognized and emphasized by managers, care providers, and policy makers so as to maintain stable personnel and continuity of care.

Moments of homecoming among people with advanced dementia disease in a residential care facility.

PubMed

Norberg, Astrid; Ternestedt, Britt-Marie; Lundman, Berit

2017-07-01

This study concerns moments of homecoming among people with advanced dementia disease living in a residential care facility. Our main finding from participant observations with nine residents was that the residents showed moments of homecoming, i.e. they alternated between verbal and/or nonverbal expressions of feeling at home and of not feeling at home. If care providers understand that they can help people with advanced dementia disease experience moments of homecoming, they can focus on aspects of care that can promote these experiences.

Assessing the Need for Higher Levels of Care Among Problem Gambling Outpatients.

PubMed

Ledgerwood, David M; Arfken, Cynthia L

2017-12-01

Most treatment for gambling disorder is provided on an outpatient basis. Only a small number of jurisdictions in North America provide higher levels of gambling treatment, such as residential or intensive outpatient (IOP) care, despite the potential need for these services. Further, there appear to be few guidelines for determining appropriate level of gambling treatment. The aim of the present study was to assess the appropriateness of higher levels of problem gambling care among clients receiving outpatient treatment. Problem gamblers and their therapists independently completed questionnaires that assessed the need and desire for residential and IOP treatment. About 42% of problem gambling outpatients noted that they would be "probably" or "definitely" willing to attend residential treatment, and about half indicated they would be equally likely to attend IOP. Therapists recommended about a third of their clients as appropriate for higher levels of care. For both client and therapist assessments, there was a significant association between desire or recommendation for level of treatment and severity of gambling and co-occurring problems. Further, therapist recommendations for level of care were significantly associated with client willingness to attend higher levels of treatment. Our data reveal the potential need for higher levels of care for problem gambling, as evaluated by clients and their therapists. Policy implications for the funding of residential and IOP treatment are discussed.

Staff supervision in residential care.

PubMed

Myers, Peter G; Bibbs, Tonya; Orozco, Candy

2004-04-01

Residential care workers must be offered opportunities for formalized and systematic supervision in individual and group formats to provide the highest possible level of care to children and adolescents whom they serve. Effective supervision with residential care staff should be open to exploring issues at all levels of their experience and in relation to each component of the broader organizational structure within which they work. Systems theory offers a useful lens through which to view supervising staff in residential treatment. Systems theory proposes that human behavior is shaped by interactional processes and internal factors. Although the development of the individual occurs within intrinsic cognitive and emotional spheres, it also is believed to be related to several other elements. These additional variables include the point at which the family and system function in their own life cycle, the historical and current emotional context, the current and changing structure of the system, narratives, and the cultural context. This article discussed how methods of training and supervision would be most effective if they were designed specifically for the developmental level of the participants. Some literature reviews have concluded that youth care workers, like all professionals, pass through developmental stages and progress through them in their work. To assist youth care workers in their jobs, supervisors must understand these stages and the ways in which they may be enacted in the workplace.

77 FR 70105 - Energy Conservation Program: Test Procedures for Residential Dishwashers, Dehumidifiers, and...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-11-23

... Conservation Program: Test Procedures for Residential Dishwashers, Dehumidifiers, and Conventional Cooking... conventional cooking products under the Energy Policy and Conservation Act. DATES: The effective date of this...

Daily Spiritual Experiences and Adolescent Treatment Response

PubMed Central

LEE, MATTHEW T.; VETA, PAIGE S.; JOHNSON, BYRON R.; PAGANO, MARIA E.

2014-01-01

The purpose of this study is to explore changes in belief orientation during treatment and the impact of increased daily spiritual experiences (DSE) on adolescent treatment response. One-hundred ninety-five adolescents court-referred to a 2-month residential treatment program were assessed at intake and discharge. Forty percent of youth who entered treatment as agnostic or atheist identified themselves as spiritual or religious at discharge. Increased DSE was associated with greater likelihood of abstinence, increased prosocial behaviors, and reduced narcissistic behaviors. Results indicate a shift in DSE that improves youth self-care and care for others that may inform intervention approaches for adolescents with addiction. PMID:25525291

Daily Spiritual Experiences and Adolescent Treatment Response.

PubMed

Lee, Matthew T; Veta, Paige S; Johnson, Byron R; Pagano, Maria E

2014-04-01

The purpose of this study is to explore changes in belief orientation during treatment and the impact of increased daily spiritual experiences (DSE) on adolescent treatment response. One-hundred ninety-five adolescents court-referred to a 2-month residential treatment program were assessed at intake and discharge. Forty percent of youth who entered treatment as agnostic or atheist identified themselves as spiritual or religious at discharge. Increased DSE was associated with greater likelihood of abstinence, increased prosocial behaviors, and reduced narcissistic behaviors. Results indicate a shift in DSE that improves youth self-care and care for others that may inform intervention approaches for adolescents with addiction.

[Effects of a physical restraint removal program on older people with dementia in residential care].

PubMed

Tortosa, M Ángeles; Granell, Rafael; Fuenmayor, Amadeo; Martínez, Mary

2016-01-01

To analyse the results of removing physical restraints from elderly patients with dementia living in nursing homes. This objective is part of a wider process of change in residential care. Quasi-experimental study conducted in two residences from May 2010 to May 2012. Information was collected at 7 time points and longitudinal analyses were performed. After training staff, the physical restraints in El Puig centre were phased out, while in the Conarda centre, restraints were still applied to elderly people. The main variables studied were: falls, psychotropic medication prescriptions, different indicators of mental impairment, and degree of dependence (Norton, NPI, Mini-mental, Tinetti, Barthel). In the El Puig centre all the physical restraints were removed. A slight improvement was seen in the number of falls, and their consequences. The ANOVA showed significant improvements in the centre that removed restraints in prescribing psychotropic medications, cognitive impairment, and behavioural changes. It is shown that removing physical restraints do not cause negative effects as regards the number of falls, and also positively affects the welfare and independence of elderly people (through changes in behaviour and mental impairment). Furthermore, it is demonstrated that this program must be accompanied by the reduction and control of medicines (withdrawal of the number of psychotropic prescriptions). Copyright © 2014 SEGG. Published by Elsevier Espana. All rights reserved.

Short-term residential care for dementia patients: predictors for utilization and expected quality from a family caregiver's point of view.

PubMed

Donath, Carolin; Winkler, Angelika; Grässel, Elmar

2009-08-01

Short-term residential care (SRC) has proved to be effective in reducing the burden on family caregivers of dementia patients. Nevertheless, little is known about the factors which influence its usage or the expectations of family caregivers regarding quality. In this paper we address the following questions: (i) which variables of the care situation, the caregivers and their attitudes act as predictors for the utilization of SRC facilities? (ii) What are the views of caregivers about the quality of SRC? The cross-sectional study was carried out as an anonymous written survey of family caregivers of dementia patients in four regions of Germany. With a 20% response it was possible to analyze the quantitative and qualitative data from 404 and 254 family caregivers respectively. Predictors for utilization were evaluated using binary logistic regression analysis. The answers to questions of quality were evaluated using qualitative content analysis. Significant predictors for the utilization of SRC are the assessment of the helpfulness of SRC and the caregiver's knowledge of the accessibility of SRC facilities. Family caregivers who had already used SRC most frequently expressed the wish for "good care" in SRC facilities, followed by a program of suitable activities for dementia patients. In order to increase the rate of utilization, family caregivers must be convinced of the relevant advantages of using SRC facilities. The staff should be trained in caring for dementia patients and appropriate activities should be available.

75 FR 19296 - Energy Conservation Program: Test Procedures and Energy Conservation Standards for Residential...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-14

... Procedures and Energy Conservation Standards for Residential Furnaces and Boilers AGENCY: Office of Energy... supplemental notice of proposed rulemaking (SNOPR) to amend the test procedures for furnaces and boilers, and... Procedures for Residential Furnaces and Boilers'' or ``NOPM for Energy Conservation Standards for Residential...

The role of social pedagogy in the training of residential child care workers.

PubMed

Jackson, Robin

2006-03-01

A requirement for most people working in residential child care in Denmark, Germany and the Netherlands is a qualification in social pedagogy. Social pedagogy is not narrowly concerned with a child's schooling but relates to the whole child - body, mind and spirit. This article describes the first social pedagogy course to be introduced and professionally recognized in the UK: the BA in Curative Education Programme. This 4-year programme blurs the line between 'classroom learning' and 'learning in practice'. A unique feature of the programme is that most students 'live the course' in residential care communities for children or adults with intellectual and developmental disabilities. The life-sharing aspect of the programme ensures that the principles of dignity, value and mutual respect can be meaningfully translated into practice. The social pedagogic model presents a timely challenge to current care philosophy and practice.

The Development of the strain in dementia care scale (SDCS).

PubMed

Edberg, Anna-Karin; Anderson, Katrina; Orrung Wallin, Anneli; Bird, Mike

2015-12-01

Though many staff gain satisfaction from working with people with dementia in residential facilities, they also experience significant stress. This is a serious issue because this in turn can affect the quality of care. There is, however, a lack of instruments to measure staff strain in the dementia-specific residential care environment, and the aim of this study, accordingly, was to develop the "Strain in Dementia Care Scale." The instrument was developed in three steps. In the first step, items were derived from six focus group discussions with 35 nurses in the United Kingdom, Australia, and Sweden concerning their experience of strain. In the second step, a preliminary 64-item scale was distributed to 927 dementia care staff in Australia and Sweden, which, based on exploratory factor analysis, resulted in a 29-item scale. In the final step, the 29-item scale was distributed to a new sample of 346 staff in Sweden, and the results were subjected to confirmatory factor analysis. The final scale comprised the following 27 items producing a five-factor solution: Frustrated empathy; difficulties understanding and interpreting; balancing competing needs; balancing emotional involvement; and lack of recognition. The scale can be used (a) as an outcome measurement in residential care intervention studies; (b) to help residential facilities identify interventions needed to improve staff well-being, and, by extension, those they care for; and (c) to generally make more salient the critical issue of staff strain and the importance of ameliorating it.

Prevalence of inappropriate medication use in residential long-term care facilities for the elderly: A systematic review.

PubMed

Storms, Hannelore; Marquet, Kristel; Aertgeerts, Bert; Claes, Neree

2017-12-01

Multi-morbidity and polypharmacy of the elderly population enhances the probability of elderly in residential long-term care facilities experiencing inappropriate medication use. The aim is to systematically review literature to assess the prevalence of inappropriate medication use in residential long-term care facilities for the elderly. Databases (MEDLINE, EMBASE) were searched for literature from 2004 to 2016 to identify studies examining inappropriate medication use in residential long-term care facilities for the elderly. Studies were eligible when relying on Beers criteria, STOPP, START, PRISCUS list, ACOVE, BEDNURS or MAI instruments. Inappropriate medication use was defined by the criteria of these seven instruments. Twenty-one studies met inclusion criteria. Seventeen studies relied on a version of Beers criteria with prevalence ranging between 18.5% and 82.6% (median 46.5%) residents experiencing inappropriate medication use. A smaller range, from 21.3% to 63.0% (median 35.1%), was reported when considering solely the 10 studies that used Beers criteria updated in 2003. Prevalence varied from 23.7% to 79.8% (median 61.1%) in seven studies relying on STOPP. START and ACOVE were relied on in respectively four (prevalence: 30.5-74.0%) and two studies (prevalence: 28.9-58.0%); PRISCUS, BEDNURS and MAI were all used in one study each. Beers criteria of 2003 and STOPP were most frequently used to determine inappropriate medication use in residential long-term care facilities. Prevalence of inappropriate medication use strongly varied, despite similarities in research design and assessment with identical instrument(s).

Prevalence of inappropriate medication use in residential long-term care facilities for the elderly: A systematic review

PubMed Central

Storms, Hannelore; Marquet, Kristel; Aertgeerts, Bert; Claes, Neree

2017-01-01

Abstract Background: Multi-morbidity and polypharmacy of the elderly population enhances the probability of elderly in residential long-term care facilities experiencing inappropriate medication use. Objectives: The aim is to systematically review literature to assess the prevalence of inappropriate medication use in residential long-term care facilities for the elderly. Methods: Databases (MEDLINE, EMBASE) were searched for literature from 2004 to 2016 to identify studies examining inappropriate medication use in residential long-term care facilities for the elderly. Studies were eligible when relying on Beers criteria, STOPP, START, PRISCUS list, ACOVE, BEDNURS or MAI instruments. Inappropriate medication use was defined by the criteria of these seven instruments. Results: Twenty-one studies met inclusion criteria. Seventeen studies relied on a version of Beers criteria with prevalence ranging between 18.5% and 82.6% (median 46.5%) residents experiencing inappropriate medication use. A smaller range, from 21.3% to 63.0% (median 35.1%), was reported when considering solely the 10 studies that used Beers criteria updated in 2003. Prevalence varied from 23.7% to 79.8% (median 61.1%) in seven studies relying on STOPP. START and ACOVE were relied on in respectively four (prevalence: 30.5–74.0%) and two studies (prevalence: 28.9–58.0%); PRISCUS, BEDNURS and MAI were all used in one study each. Conclusions: Beers criteria of 2003 and STOPP were most frequently used to determine inappropriate medication use in residential long-term care facilities. Prevalence of inappropriate medication use strongly varied, despite similarities in research design and assessment with identical instrument(s). PMID:28271916

[Childhood Experiences of Adolescents in Boarding Schools. A Comparison with Adolescents in Residential Care and with the General Population].

PubMed

Rau, Thea; Ohlert, Jeannine; Fegert, Jörg M; Andresen, Sabine; Pohling, Andrea; Allroggen, Marc

2018-01-01

Childhood Experiences of Adolescents in Boarding Schools. A Comparison with Adolescents in Residential Care and with the General Population Various studies indicate that students in boarding schools experience a lot of violence during their accommodation. However, it is not proved whether adolescents in boarding schools are also a burdensome group regarding early childhood experiences such as neglect and abuse. The aim of the study was to find out more about the experiences of adolescents in boarding schools and to determine whether there are differences between adolescents in residential care and between the general population. Furthermore, it should be examined whether boys and girls differ in their experiences. In the study, adolescents of boarding schools and of residential care all over Germany, starting at the age of 15 (n = 322), were asked regarding physical and emotional neglect/abuse, light/severe parent violence, negative/positive educational behavior of the parents. The results show that students in boarding schools were less likely to be affected by childhood maltreatment and more likely to have experienced positive parental behavior compared to children in residential care. Compared to the general population, students in boarding schools were more often and more severely affected by parental violence. Moreover, girls had experienced parental violence more often than boys. The results indicate that in boarding schools there is a need for support offers for adolescents with a history of violent experiences and that the risk group should be identified directly at the admission to the school.

The Association of Sitting Time With Sarcopenia Status and Physical Performance at Baseline and 18-Month Follow-Up in the Residential Aged Care Setting.

PubMed

Reid, Natasha; Keogh, Justin W; Swinton, Paul; Gardiner, Paul A; Henwood, Timothy R

2018-06-18

This study investigated the association of sitting time with sarcopenia and physical performance in residential aged care residents at baseline and 18-month follow-up. Measures included the International Physical Activity Questionnaire (sitting time), European Working Group definition of sarcopenia, and the short physical performance battery (physical performance). Logistic regression and linear regression analyses were used to investigate associations. For each hour of sitting, the unadjusted odds ratio of sarcopenia was 1.16 (95% confidence interval [0.98, 1.37]). Linear regression showed that each hour of sitting was significantly associated with a 0.2-unit lower score for performance. Associations of baseline sitting with follow-up sarcopenia status and performance were nonsignificant. Cross-sectionally, increased sitting time in residential aged care may be detrimentally associated with sarcopenia and physical performance. Based on current reablement models of care, future studies should investigate if reducing sedentary time improves performance among adults in end of life care.

Massage, a complementary therapy effectively promoting the health and well-being of older people in residential care settings: a review of the literature.

PubMed

McFeeters, Sarah; Pront, Leeanne; Cuthbertson, Lesley; King, Lindy

2016-12-01

To explore the potential benefits of massage within daily routine care of the older person in residential care settings. Globally, the proportion of people over 65 years is rapidly rising. Increased longevity means older people may experience a rise in physiological and psychological health problems. These issues potentially place an increased demand for quality long-term care for the older person. Complementary approaches such as massage appear to be needed in quality residential care. A critical literature review was undertaken. A literature review pertaining to massage in the older resident was conducted using a range of online databases. Fourteen studies dated 1993-2012 met the inclusion criteria and were critically evaluated as suitable resources for this review. Evidence suggests massage may be advantageous from client and nursing perspectives. Clients' perceive massage to positively influence factors such as pain, sleep, emotional status and psychosocial health. Evidence also demonstrates massage to benefit the client and organisation by reducing the necessity for restraint and pharmacological intervention. Massage may be incorporated into care provision and adopted by care providers and family members as an additional strategy to enhance quality of life for older people. Massage offers a practical activity that can be used to enhance the health and well-being of the older person in residential care. Massage offers benefit for promoting health and well-being of the older person along with potential increased engagement of family in care provision. Integration of massage into daily care activities of the older person requires ongoing promotion and implementation. © 2016 John Wiley & Sons Ltd.

The Impact of Child Sexual Abuse on the Education of Boys in Residential Care between 1950 and 1975

ERIC Educational Resources Information Center

Bode, Andrew; Goldman, Juliette D. G.

2012-01-01

Children's education may be adversely impacted by external factors during their childhood. For example, learning to learn, critical reflection, experiential learning and self-direction may be permanently impaired. Many children in out-of-home residential care during the last century suffered ongoing child abuse and neglect, including sexual abuse,…

Determinants and Effects of Nurse Staffing Intensity and Skill Mix in Residential Care/Assisted Living Settings

ERIC Educational Resources Information Center

Stearns, Sally C.; Park, Jeongyoung; Zimmerman, Sheryl; Gruber-Baldini, Ann L.; Konrad, Thomas R.; Sloane, Philip D.

2007-01-01

Purpose: Residential care/assisted living facilities have become an alternative to nursing homes for many individuals, yet little information exists about staffing in these settings and the effect of staffing. This study analyzed the intensity and skill mix of nursing staff using data from a four-state study, and their relationship to outcomes.…

Trauma Experiences, Maltreatment-Related Impairments, and Resilience among Child Welfare Youth in Residential Care

ERIC Educational Resources Information Center

Collin-Vezina, Delphine; Coleman, Kim; Milne, Lise; Sell, Jody; Daigneault, Isabelle

2011-01-01

The aim of this paper was to provide a description of the trauma experiences, trauma-related sequels, and resilience features of a sample of Canadian youth in residential care facilities, as well as to explore the impact of gender and of the number of different traumas experienced on trauma-related sequels and resilience features. A convenience…

Initiation of Substance Use by Adolescents after One Year in Residential Youth Care

ERIC Educational Resources Information Center

Monshouwer, Karin; Kepper, Annelies; van den Eijnden, Regina; Koning, Ina; Vollebergh, Wilma

2015-01-01

Background: Several studies have shown that substance use levels among adolescents living in residential youth care are high. However, it is not clear to what extent adolescents initiate (heavy) substance during their stay and to what extent these rates are higher than would be expected based on their risk profile. Objective: The aim of the…

Older Adults With Intellectual Disability in Residential Care Centers in Israel: Health Status and Service Utilization

ERIC Educational Resources Information Center

Merrick, Joav; Davidson, Philip W.; Morad, Mohammed; Janicki, Matthew P.; Wexler, Orren; Henderson, C. Michael

2004-01-01

To determine their health status, we studied 2,282 Israeli adults with intellectual disability who were at least 40 years of age and lived in residential care. Results showed that age is a significant factor in health status. The frequency of different disease categories (e.g., cardiovascular disease, cancer, and sensory impairments) increased…

Invited Review: Challenges of Residential and Community Care--"The Times They Are a-Changin"

ERIC Educational Resources Information Center

Jackson, R.

2011-01-01

This paper seeks to examine a number of issues which relate to the provision of appropriate and high-quality residential and community care for people with an intellectual disability. A number of key themes emerging from this Special Issue of the "Journal of Intellectual Disability Research" are identified and explored: (1) normalisation; (2)…

Smoke Detection: Critical Element of a University Residential Fire Safety Program.

ERIC Educational Resources Information Center

Robinson, Donald A.

1979-01-01

A program at the University of Massachusetts/Amherst to assess the fire protection needs of its residential system is described. The study culminated in a multiphase fire safety improvement plan. (JMF)

Current experiences and educational preferences of general practitioners and staff caring for people with dementia living in residential facilities.

PubMed

Beer, Christopher; Horner, Barbara; Almeida, Osvaldo P; Scherer, Samuel; Lautenschlager, Nicola T; Bretland, Nick; Flett, Penelope; Schaper, Frank; Flicker, Leon

2009-08-12

Residential care is important for older adults, particularly for those with advanced dementia and their families. Education interventions that achieve sustainable improvement in the care of older adults are critical to quality care. There are few systematic data available regarding the educational needs of Residential Care Facility (RCF) staff and General Practitioners (GPs) relating to dementia, or the sustainability of educational interventions. We sought to determine participation in dementia education, perceived levels of current knowledge regarding dementia, perceived unmet educational needs, current barriers, facilitators and preferences for dementia education. A mixed methods study design was utilised. A survey was distributed to a convenience sample of general practitioners, and staff in 223 consecutive residential care facilities in Perth, Western Australia. Responses were received from 102 RCF staff working in 10 facilities (out of 33 facilities who agreed to distribute the survey) and 202 GPs (19% of metropolitan GPs). Quantitative survey data were summarised descriptively and chi squared statistics were used to analyse the distribution of categorical variables. Qualitative data were collected from general practitioners, staff in residential care facilities and family carers of people with dementia utilizing individual interviews, surveys and focus groups. Qualitative data were analysed thematically. Among RCF staff and GPs attending RCF, participation in dementia education was high, and knowledge levels generally perceived as good. The individual experiences and needs of people with dementia and their families were emphasised. Participants identified the need for a person centred philosophy to underpin educational interventions. Limited time was a frequently mentioned barrier, especially in relation to attending dementia care education. Perceived educational needs relating to behaviours of concern, communication, knowledge regarding dementia, aspects of person centred care, system factors and the multidisciplinary team were consistently and frequently cited. Small group education which is flexible, individualized, practical and case based was sought. The effectiveness and sustainability of an educational intervention based on these findings needs to be tested. In addition, future interventions should focus on supporting cultural change to facilitate sustainable improvements in care.

Poverty, Residential Mobility, and Persistence across Urban and Rural Family Literacy Programs in Pennsylvania. Research Brief #1

ERIC Educational Resources Information Center

Schafft, Kai; Prins, Esther; Movit, Marcela

2008-01-01

This study examined how poverty and residential mobility influence low-income adults' persistence in family literacy programs in Pennsylvania. Twelve out of 20 program directors reported that learners typically moved at least once a year. In five of these high-mobility programs moving was reported to significantly hinder persistence. Geographic…

Does progressive resistance and balance exercise reduce falls in residential aged care? Randomized controlled trial protocol for the SUNBEAM program.

PubMed

Hewitt, Jennifer; Refshauge, Kathryn M; Goodall, Stephen; Henwood, Timothy; Clemson, Lindy

2014-01-01

Falls are common among older adults. It is reported that approximately 60% of residents of aged care facilities fall each year. This is a major cause of morbidity and mortality, and a significant burden for health care providers and the health system. Among community dwelling older adults, exercise appears to be an effective countermeasure, but data are limited and inconsistent among studies in residents of aged care communities. This trial has been designed to evaluate whether the SUNBEAM program (Strength and Balance Exercise in Aged Care) reduces falls in residents of aged care facilities. Is the program more effective and cost-effective than usual care for the prevention of falls? Single-blinded, two group, cluster randomized trial. 300 residents, living in 20 aged care facilities. Progressive resistance and balance training under the guidance of a physiotherapist for 6 months, then facility-guided maintenance training for 6 months. Usual care. Number of falls, number of fallers, quality of life, mobility, balance, fear of falling, cognitive well-being, resource use, and cost-effectiveness. Measurements will be taken at baseline, 6 months, and 12 months. The number of falls will be analyzed using a Poisson mixed model. A logistic mixed model will be used to analyze the number of residents who fall during the study period. Intention-to-treat analysis will be used. This study addresses a significant shortcoming in aged care research, and has potential to impact upon a substantial health care problem. Outcomes will be used to inform care providers, and guide health care policies.

Marketing Online Degree Programs: How Do Traditional-Residential Programs Compete?

ERIC Educational Resources Information Center

Adams, Jonathan; Eveland, Vicki

2007-01-01

A total of 150 university Web sites were segregated into one of three groups: accredited residential, regionally accredited online, and nonaccredited online institutions. The promotional imagery, marketing messages and marketing themes found on the landing pages of each university program Web sites were analyzed for similarities and differences. A…

Evaluating Injury Prevention Programs: The Oklahoma City Smoke Alarm Project.

ERIC Educational Resources Information Center

Mallonee, Sue

2000-01-01

Illustrates how evaluating the Oklahoma City Smoke Alarm Project increased its success in reducing residential fire-related injuries and deaths. The program distributed and tested smoke alarms in residential dwellings and offered educational materials on fire prevention and safety. Evaluation provided sound data on program processes and outcomes,…

Patient Navigation in Medically Underserved Areas study design: A trial with implications for efficacy, effect modification, and full continuum assessment.

PubMed

Molina, Yamile; Glassgow, Anne E; Kim, Sage J; Berrios, Nerida M; Pauls, Heather; Watson, Karriem S; Darnell, Julie S; Calhoun, Elizabeth A

2017-02-01

The Patient Navigation in Medically Underserved Areas study objectives are to assess if navigation improves: 1) care uptake and time to diagnosis; and 2) outcomes depending on patients' residential medically underserved area (MUA) status. Secondary objectives include the efficacy of navigation across 1) different points of the care continuum among patients diagnosed with breast cancer; and 2) multiple regular screening episodes among patients who did not obtain breast cancer diagnoses. Our randomized controlled trial was implemented in three community hospitals in South Chicago. Eligible participants were: 1) female, 2) 18+years old, 3) not pregnant, 4) referred from a primary care provider for a screening or diagnostic mammogram based on an abnormal clinical breast exam. Participants were randomized to 1) control care or 2) receive longitudinal navigation, through treatment if diagnosed with cancer or across multiple years if asymptomatic, by a lay health worker. Participants' residential areas were identified as: 1) established MUA (before 1998), 2) new MUA (after 1998), 3) eligible/but not designated as MUA, and 4) affluent/ineligible for MUA. Primary outcomes include days to initially recommended care after randomization and days to diagnosis for women with abnormal results. Secondary outcomes concern days to treatment initiation following a diagnosis and receipt of subsequent screening following normal/benign results. This intervention aims to assess the efficacy of patient navigation on breast cancer care uptake across the continuum. If effective, the program may improve rates of early cancer detection and breast cancer morbidity. Copyright © 2016 Elsevier Inc. All rights reserved.

Moderating Effect of Residential History on the Effects of a Fatherhood Program on Parenting Skills Satisfaction among Nonresident African American Fathers.

PubMed

Qian, Yiqing; De Loney, E Hill; Caldwell, Cleopatra Howard

2018-02-09

Nonresident African American (AA) fathers sometimes face challenges to achieving satisfaction with their parenting skills, which may inhibit their motivations for parenting. Studies have found that residential history of fathers is associated with parental involvement; however, current fatherhood programs rarely consider the influence of different residential history on fathering. In the current study, we examined whether nonresident AA fathers' residential history with their sons moderated their parenting skills satisfaction after participating in the Fathers and Sons Program. Our results indicated that after controlling for fathers' pretest parenting skills satisfaction, age, education, marital status, employment, and ever lived with their son's mother; there was a moderating effect of residential history on the intervention's effects on posttest parenting skills satisfaction. The regression analyses showed that fathers in the intervention group who had lived with their son increased their parenting skills satisfaction more at posttest compared with fathers who had never lived with their sons. However, fathers in the comparison group who had lived with their sons had lower posttest parenting skills satisfaction. Future fatherhood programs for nonresident AA fathers should develop more nuanced group-specific interventions that consider residential history as a critical factor to enhance their parenting skills satisfaction as a strategy for improving father involvement.

Moderating Effect of Residential History on the Effects of a Fatherhood Program on Parenting Skills Satisfaction among Nonresident African American Fathers

PubMed Central

De Loney, E. Hill; Caldwell, Cleopatra Howard

2018-01-01

Nonresident African American (AA) fathers sometimes face challenges to achieving satisfaction with their parenting skills, which may inhibit their motivations for parenting. Studies have found that residential history of fathers is associated with parental involvement; however, current fatherhood programs rarely consider the influence of different residential history on fathering. In the current study, we examined whether nonresident AA fathers’ residential history with their sons moderated their parenting skills satisfaction after participating in the Fathers and Sons Program. Our results indicated that after controlling for fathers’ pretest parenting skills satisfaction, age, education, marital status, employment, and ever lived with their son’s mother; there was a moderating effect of residential history on the intervention’s effects on posttest parenting skills satisfaction. The regression analyses showed that fathers in the intervention group who had lived with their son increased their parenting skills satisfaction more at posttest compared with fathers who had never lived with their sons. However, fathers in the comparison group who had lived with their sons had lower posttest parenting skills satisfaction. Future fatherhood programs for nonresident AA fathers should develop more nuanced group-specific interventions that consider residential history as a critical factor to enhance their parenting skills satisfaction as a strategy for improving father involvement. PMID:29425126

Constructing an Integrated and Evidenced-Based Model for Residential Services

ERIC Educational Resources Information Center

Metzger, Jed

2006-01-01

There is paucity in both the literature and in the practice of integrated, evidence-based models of residential care for youth. This article describes the assessment and the process that led to the redesign of services at a residential center. The article describes how evidence-based models for each of the four major disciplines (residential…

Performance-Based Contracting in Residential Care and Treatment: Driving Policy and Practice Change through Public-Private Partnership in Illinois

ERIC Educational Resources Information Center

Kearney, Kathleen A.; McEwen, Erwin; Bloom-Ellis, Brice; Jordan, Neil

2010-01-01

The National Quality Improvement Center on the Privatization of Child Welfare Services selected Illinois as a demonstration site in 2007 to evaluate performance-based contracting in residential treatment services. This article discusses the first two years of project implementation including developing residential treatment performance indicators,…

[Evaluating the activity of the Italian Mental Health Services inpatient and residential facilities: the PRISM (Process Indicator System for Mental health) indicators].

PubMed

Picardi, Angelo; Tarolla, Emanuele; de Girolamo, Giovanni; Gigantesco, Antonella; Neri, Giovanni; Rossi, Elisabetta; Biondi, Massimo

2014-01-01

This article describes the activities of a project aimed at developing a system of process and process/outcome indicators suitable to monitor over time the quality of psychiatric care of Italian inpatient and residential psychiatric facilities. This system, named PRISM (Process Indicator System for Mental health), was developed by means of a standardized evaluation made by a panel of experts and a consecutive pilot study in 17 inpatient and 13 residential psychiatric facilities. A total of 28 indicators were selected from a set of 251 candidate indicators developed by the most relevant and qualified Italian and international authorities. These indicators are derived by data from medical records and information about characteristics of facilities, and they cover processes of care, operational equipment of facilities, staff training and working, relationships with external agencies, and sentinel events. The procedure followed for the development of the indicator system was reliable and innovative. The data collected from the pilot study suggested a favourable benefit-cost ratio between the workload associated with regular use of the indicators into the context of daily clinical activities and the advantages related to the information gathered through regular use of the indicators. CONCLUSIONS.:The PRISM system provides additional information about the healthcare processes with respect to the information gathered via routine information systems, and it might prove useful for both continuous quality improvement programs and health services research.

RCT of a Mentoring and Skills Group Program: Placement and Permanency Outcomes for Foster Youth

PubMed Central

Culhane, Sara E.; Garrido, Edward; Knudtson, Michael D.

2012-01-01

OBJECTIVE: To examine the impact of a mentoring and skills group intervention for preadolescent children in foster care on placement stability and permanence at 1-year postintervention. METHODS: A randomized controlled trial was conducted with 9- to 11-year-old children who were maltreated and placed in foster care (n = 54 control; n = 56 intervention). State child welfare records provided information on number of placement changes, placement in residential treatment, and case closure (ie, permanency). Rates of adoption and reunification were also examined. Analysis was by intention to treat. RESULTS: After controlling for baseline functioning and preintervention placement history, intervention youth were 71% less likely to be placed in residential treatment (odds ratio [OR] = 0.29, 95% confidence interval [CI] 0.09–0.98). There were no significant treatment differences in predicting placement changes or permanency for the total sample. Among a subsample of children living in nonrelative foster care at baseline, intervention youth had 44% fewer placement changes (incidence ratio = 0.56, 95% CI 0.34–0.93), were 82% less likely to be placed in a residential treatment center (OR = 0.18, 95% CI 0.03–0.96), and were 5 times more likely to have attained permanency at 1 year postintervention (OR = 5.14, 95% CI 1.55–17.07). More intervention youth had reunified 1-year postintervention [χ2(1, N = 78) = 3.99; P < .05], and the pattern of findings suggested that intervention youth had higher rates of adoption. A significant interaction [χ2(1, N = 110) = 5.43; P = .02] demonstrated that the intervention attenuated the impact of baseline behavior problems on placement changes. CONCLUSIONS: The findings suggest that participation in a 9-month mentoring and skills group intervention leads to greater placement stability and permanence, especially for children in nonrelative foster care. PMID:22689870

Integrated employee assistance program/managed behavioral health plan utilization by persons with substance use disorders.

PubMed

Merrick, Elizabeth S Levy; Hodgkin, Dominic; Hiatt, Deirdre; Horgan, Constance M; Greenfield, Shelly F; McCann, Bernard

2011-04-01

New federal parity and health reform legislation, promising increased behavioral health care access and a focus on prevention, has heightened interest in employee assistance programs (EAPs). This study investigated service utilization by persons with a primary substance use disorder (SUD) diagnosis in a managed behavioral health care (MBHC) organization's integrated EAP/MBHC product (N = 1,158). In 2004, 25.0% of clients used the EAP first for new treatment episodes. After initial EAP utilization, 44.4% received no additional formal services through the plan, and 40.4% received regular outpatient services. Overall, outpatient care, intensive outpatient/day treatment, and inpatient/residential detoxification were most common. About half of the clients had co-occurring psychiatric diagnoses. Mental health service utilization was extensive. Findings suggest that for service users with primary SUD diagnoses in an integrated EAP/MBHC product, the EAP benefit plays a key role at the front end of treatment and is often only one component of treatment episodes. Copyright © 2011 Elsevier Inc. All rights reserved.

A cluster-randomised trial of staff education to improve the quality of life of people with dementia living in residential care: the DIRECT study.

PubMed

Beer, Christopher; Horner, Barbara; Flicker, Leon; Scherer, Samuel; Lautenschlager, Nicola T; Bretland, Nick; Flett, Penelope; Schaper, Frank; Almeida, Osvaldo P

2011-01-01

The Dementia In Residential care: EduCation intervention Trial (DIRECT) was conducted to determine if delivery of education designed to meet the perceived need of GPs and care staff improves the quality of life of participants with dementia living in residential care. This cluster-randomised controlled trial was conducted in 39 residential aged care facilities in the metropolitan area of Perth, Western Australia. 351 care facility residents aged 65 years and older with Mini-Mental State Examination ≤ 24, their GPs and facility staff participated. Flexible education designed to meet the perceived needs of learners was delivered to GPs and care facility staff in intervention groups. The primary outcome of the study was self-rated quality of life of participants with dementia, measured using the QOL-Alzheimer's Disease Scale (QOL-AD) at 4 weeks and 6 months after the conclusion of the intervention. Analysis accounted for the effect of clustering by using multi-level regression analysis. Education of GPs or care facility staff did not affect the primary outcome at either 4 weeks or 6 months. In a post hoc analysis excluding facilities in which fewer than 50% of staff attended an education session, self-rated QOL-AD scores were 6.14 points (adjusted 95%CI 1.14, 11.15) higher at four-week follow-up among residents in facilities randomly assigned to the education intervention. The education intervention directed at care facilities or GPs did not improve the quality of life ratings of participants with dementia as a group. This may be explained by the poor adherence to the intervention programme, as participants with dementia living in facilities where staff participated at least minimally seemed to benefit. ANZCTR.org.au ACTRN12607000417482.

Time spent on daytime direct care activities by personal carers in two Australian residential aged care facilities: a time-motion study.

PubMed

Qian, Siyu; Yu, Ping; Hailey, David M; Zhang, Zhenyu; Davy, Pamela J; Nelson, Mark I

2014-05-01

To examine the time, frequency and duration of each direct care activity conducted by personal carers in Australian residential aged care homes. A time-motion study was conducted to observe 46 personal carers at two high-care houses in two facilities (14 days at Site 1 and 16 days at Site 2). Twenty-three direct care activities were classified into eight categories for analysis. Overall, a personal carer spent approximately 45% of their time on direct care, corresponding to 3.5h in an 8-h daytime shift. The two sites had similar ratios of personal carers to residents, and each resident received 30 min of direct care. No significant differences between the two sites were found in the time spent on oral communication, personal hygiene and continence activities. Personal carers at Site 1 spent significantly less time on toileting and mobility activities than those at Site 2, but more time on lunch activity. Although oral communication took the longest time (2h), it occurred concurrently with other activities (e.g. dressing) for 1.5h. The findings provide information that may assist decision makers in managing the operation of high-care residential aged care facilities, such as planning for task allocation and staffing. What is known about the topic? Overall, 30%-45% of the care staff's time is spent on direct care in residential aged care facilities. What does this paper add? This paper adds knowledge about how much time is required to conduct each direct care activity and the frequency and duration of conducting these activities to meet residents' day-to-day care needs in two high-care houses in two aged care facilities. What are the implications for practitioners? On average, a resident with high-care needs requires 30 min direct care. There may exist a basic minimum desirable ratio of personal carers to residents in high-care facilities. Residents' toileting needs are high after meals. Communication with residents represents an essential role in providing care.

Dreams that lie in tatters: the changing fortunes of nurses who left the British NHS to own and run residential homes for elderly people.

PubMed

Andrews, G J; Kendall, S A

2000-04-01

During the 1980s many nurses left the British National Health Service to own and run private residential care homes for elderly people. At the time, a public policy of guaranteed financial support for residents underpinned the rapid expansion in the sector and residential homes were considered as profitable low-risk business ventures. However, since the introduction of the 1990 National Health Service and Care in the Community Act, this automatic funding has been withdrawn and residential homes have had to compete amongst each other for a finite number of clients funded by limited local budgets. The withdrawal of guaranteed state support and the introduction of social care markets have had negative impacts on many residential home businesses. Indeed, many homes are facing financial difficulties. This paper considers the actions and attitudes of former nurse proprietors under the new conditions based on a three-stage survey in Devon, England. Proprietors are experiencing increased levels of stress and many are unhappy with their current work experiences. The paper concludes that although the small business private sector may seem attractive to nurses, any move into private sector ownership has an associated risk. Social policy conditions may change with concurrent consequences for businesses and business owners.

Development of a Residential Education Program for Emotionally Deprived Pseudo-Retarded Blind Children, Volume I. Final Report.

ERIC Educational Resources Information Center

Rigby, Mary E.; Woodcock, Charles C.

To design a residential school program for multiply handicapped blind children and to develop identifying procedures for prospects for this type of program, 15 children (ages 5 to 13, legally blind, educationally retarded, multiply handicapped) of both sexes were enrolled in a 12 month program. The curriculum was based on a systematic presentation…

Trouble in the Dorms: A Guide to Residential Life Programs for Higher Education Trustees

ERIC Educational Resources Information Center

American Council of Trustees and Alumni, 2009

2009-01-01

This guide briefly retraces the rise of ideologically charged residential life programming on campuses and shows how such programs, despite their seemingly innocuous goals, in fact undercut the principles of rational inquiry that are foundational to the academic enterprise. In the fall of 2007, one university conducted a program for all 7,000…

Training of Residential Social Care Staff to Meet the Needs of Older People with Intellectual Disabilities Who Develop Age-Related Health Problems: An Exploratory Study

ERIC Educational Resources Information Center

Northway, Ruth; Jenkins, Robert; Holland-Hart, Daniella

2017-01-01

Background: Despite awareness of the age related health needs of people with intellectual disabilities little is known regarding how residential social care staff are prepared to meet such needs. Methods: Data were gathered via semi-structured interviews from 14 managers of supported living settings. Transcripts were thematically analysed.…

Living in the Community: A Comparative Study of Foster Homes and Small Group Homes for People with Mental Retardation. Project Report 28.

ERIC Educational Resources Information Center

Hill, Bradley K.; And Others

The study surveyed 181 specialized foster care homes or small (with 6 or fewer residents) group homes providing residential care for persons (N=336) with mental retardation and related developmental disabilities. The study found that the community residential facility sample was generally much less well integrated into the life of the community…

Barriers to Non-Residential Respite Care for Adults with Moderate to Complex Needs: A UK Perspective

ERIC Educational Resources Information Center

Southby, Kris

2017-01-01

Respite aims to alleviate the stress and burden of caring for someone with an intellectual disability and/or autism. Respite can take place in a number of different ways, but most commonly occurs in a residential setting. Based on survey and interview data with carers (CAs), service users and stakeholders (STs) in a northern city in England, this…

Young People in Residential Care, Their Participation and the Influencing Factors

ERIC Educational Resources Information Center

McCarthy, Edel

2016-01-01

In 1992, Ireland committed to the right of children to participate in decision-making that impacts on their lives. The extent to which this right is upheld for young people in the care of the State who live in residential childcare centres is unknown. A small qualitative case study was carried out in four such centres in the West of Ireland in…

Examining Needs and Referrals to Mental Health Services for Children in Residential Care in Spain: An Empirical Study in an Autonomous Community

ERIC Educational Resources Information Center

Sainero, Ana; Bravo, Amaia; del Valle, Jorge F.

2014-01-01

The aim of this study was to analyze the prevalence of mental health disorders in children living in residential care and their use of therapeutic services, including the relationship between these factors and social-family and intervention process variables, as well as the relationship among the disorders identified by professionals and the…

Meeting the Needs of GLB Youth in Residential Care Settings: A Framework for Assessing the Unique Needs of a Vulnerable Population

ERIC Educational Resources Information Center

Block, Rebecca G.; Matthews, John D.

2006-01-01

This article explores uses for strengths-based assessment of gay, lesbian and bisexual youth in residential care. Gay, lesbian and bisexual (GLB) youth face unique challenges such as stigma management and disclosure. In addition, GLB youth are also at increased risk for drug use, suicide and unprotected sex. Consequently, the needs of GLB youth…

Knowledge of Staff Members of Residential Care Facilities for Individuals with Intellectual Disability on Medication Administration via Enteral Feeding Tube

ERIC Educational Resources Information Center

Joos, E.; Mehuys, E.; Van Bocxlaer, J.; Remon, J. P.; Van Winckel, M.; Boussery, K.

2016-01-01

Background: Guidelines for the safe administration of drugs through enteral feeding tube (EFT) are an important tool to minimise the risk of errors. This study aimed to investigate knowledge of these guidelines among staff of residential care facilities (RCF) for people with ID. Method: Knowledge was assessed using a 13-item self-administered…

Health Status and ADL Functioning of Older Persons with Intellectual Disability: Community Residence versus Residential Care Centers

ERIC Educational Resources Information Center

Lifshitz, Hefziba; Merrick, Joav; Morad, Mohammed

2008-01-01

The objective of the study was to study differences in aging phenomena among adults with intellectual disability (ID), who live in community residence versus their peers in residential care centers and to determine the contribution of health status, age, gender, etiology and level of ID to the decline in ADL function with age. Our study was based…

Building Bridges between the School and the Home: Understanding the Literacy Practices of Children Living in Residential Care

ERIC Educational Resources Information Center

Tan, Jennifer Poh Sim

2015-01-01

Research has consistently shown that children in residential care fall behind at school. This proves a great challenge for educators who have to cater to the students' needs to ensure no one is left behind. Studies investigating family literacy practices of different social classes show a positive implication if the home literacy practices are…

Implementing an Early Intervention Program for Residential Students Who Present with Suicide Risk: A Case Study

ERIC Educational Resources Information Center

Rivero, Estela M.; Cimini, M. Dolores; Bernier, Joseph E.; Stanley, Judith A.; Murray, Andrea D.; Anderson, Drew A.; Wright, Heidi R.

2014-01-01

Objective: This case study examined the effects of an early intervention program designed to respond to residential college students demonstrating risk for suicide. Participants: Participants were 108 undergraduates at a large northeastern public university referred to an early intervention program subsequent to presenting with risk factors for…

Investigating Positive Psychology Approaches in Case Management and Residential Programming with Incarcerated Youth

ERIC Educational Resources Information Center

Cross, Lara E.; Morrison, William; Peterson, Patricia; Domene, Jose F.

2012-01-01

This article examines how a rural Canadian secure custody facility for youth implemented positive psychology principles in its case management protocols and residential programming. A directed content analysis design was utilized to identify specific factors of positive psychology in the facility's policy and programming manual, as well as in…

Multidimensional Implementation Evaluation of a Residential Treatment Program for Adolescent Substance Abuse

ERIC Educational Resources Information Center

Faw, Leyla; Hogue, Aaron; Liddle, Howard A.

2005-01-01

The authors applied contemporary methods from the evaluation literature to measure implementation in a residential treatment program for adolescent substance abuse. A logic model containing two main components was measured. Program structure (adherence to the intended framework of service delivery) was measured using data from daily activity logs…

Nonphysician Care Providers Can Help to Increase Detection of Cognitive Impairment and Encourage Diagnostic Evaluation for Dementia in Community and Residential Care Settings.

PubMed

Maslow, Katie; Fortinsky, Richard H

2018-01-18

In the United States, at least half of older adults living with dementia do not have a diagnosis. Their cognitive impairment may not have been detected, and some older adults whose physician recommends that they obtain a diagnostic evaluation do not follow through on the recommendation. Initiatives to increase detection of cognitive impairment and diagnosis of dementia have focused primarily on physician practices and public information programs to raise awareness about the importance of detection and diagnosis. Nonphysician care providers who work with older adults in community and residential care settings, such as aging network agencies, public health agencies, senior housing, assisted living, and nursing homes, interact frequently with older adults who have cognitive impairment but have not had a diagnostic evaluation. These care providers may be aware of signs of cognitive impairment and older adults' concerns about their cognition that have not been expressed to their physician. Within their scope of practice and training, nonphysician care providers can help to increase detection of cognitive impairment and encourage older adults with cognitive impairment to obtain a diagnostic evaluation to determine the cause of the condition. This article provides seven practice recommendations intended to increase involvement of nonphysician care providers in detecting cognitive impairment and encouraging older adults to obtain a diagnostic evaluation. The Kickstart-Assess-Evaluate-Refer (KAER) framework for physician practice in detection and diagnosis of dementia is used to identify ways to coordinate physician and nonphysician efforts and thereby increase the proportion of older adults living with dementia who have a diagnosis. © The Author(s) 2018. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Perceptions and employment intentions among aged care nurses and nursing assistants from diverse cultural backgrounds: A qualitative interview study.

PubMed

Gao, Fengsong; Tilse, Cheryl; Wilson, Jill; Tuckett, Anthony; Newcombe, Peter

2015-12-01

The residential aged care industry faces shortages and high turnover rates of direct care workers. This situation is further complicated by the increasing cultural diversity of residents and staff. To retain direct care workers, it is crucial to explore their perceptions of the rewards and difficulties of care work, and their employment intentions in multicultural environments. A qualitative descriptive study was used to understand perceptions of the rewards and difficulties of residential aged care work for core direct care workers (i.e. nurses and nursing assistants), how these were related to their intentions to stay or leave, and how these varied between nurses and nursing assistants, and between locally and overseas born workers. Individual interviews were conducted between June and September 2013 with 16 direct care workers in an Australian residential aged care facility with a specific focus on people from culturally and linguistically diverse backgrounds. It was found that direct care workers' employment intentions were related to their perceptions and management of the rewards and difficulties of care work. Their experiences of care work, the employment characteristics, and the organizational resources that fitted their personality, ability, expectations, and essential needs were viewed as rewards. Evaluating their jobs as meaningful was a shared perception for direct care workers who intended to stay. Individual workers' perceptions of the rewarding aspects of care work served to counterbalance the challenges of care work, and promoted their intentions to stay. Perceptions and employment intentions varied by occupational groups and by cultural backgrounds. Overseas born direct care workers are valuable resources in residential aged care facility rather than a limitation, but they do require organizational support, such as cultural awareness of the management, English language support, a sense of family, and appropriate job responsibility. The findings indicated that aged care policy makers and service providers should understand the range of individual direct care workers' positive and negative perceptions, and their employment intentions within the context of their roles and their cultural backgrounds. Copyright © 2015 Elsevier Inc. All rights reserved.

"A National Crime": The Canadian Government and the Residential School System, 1879 to 1986. Manitoba Studies in Native History XI.

ERIC Educational Resources Information Center

Milloy, John S.

Canada's residential school system for Aboriginal children has had lasting damaging effects on Indigenous people. Founded in 1879, the residential school system was operated through a church-state partnership. The government provided the funding, set standards of care, and supervised the administration of schools, while the Anglican, Catholic,…

Prevalence of infections among residents of Residential Care Homes for the Elderly in Hong Kong.

PubMed

Choy, C Sm; Chen, H; Yau, C Sw; Hsu, E K; Chik, N Y; Wong, A Ty

2016-08-01

A point prevalence study was conducted to study the epidemiology of common infections among residents in Residential Care Homes for the Elderly in Hong Kong and their associated factors. Residential Care Homes for the Elderly in Hong Kong were selected by stratified single-stage cluster random sampling. All residents aged 65 years or above from the recruited homes were surveyed. Infections were identified using standardised definitions. Demographic and health information-including medical history, immunisation record, antibiotic use, and activities of daily living (as measured by Barthel Index)-was collected by a survey team to determine any associated factors. Data were collected from 3857 residents in 46 Residential Care Homes for the Elderly from February to May 2014. A total of 105 residents had at least one type of infection based on the survey definition. The overall prevalence of all infections was 2.7% (95% confidence interval, 2.2%-3.4%). The three most common infections were of the respiratory tract (1.3%; 95% confidence interval, 0.9%-1.9%), skin and soft tissue (0.7%; 95% confidence interval, 0.5%-1.0%), and urinary tract (0.5%; 95% confidence interval, 0.3%-0.9%). Total dependence in activities of daily living, as indicated by low Barthel Index score of 0 to 20 (odds ratio=3.0; 95% confidence interval, 1.4-6.2), and presence of a wound or stoma (odds ratio=2.7; 95% confidence interval, 1.4-4.9) were significantly associated with presence of infection. This survey provides information about infections among residents in Residential Care Homes for the Elderly in the territory. Local data enable us to understand the burden of infections and formulate targeted measures for prevention.

Effectiveness and safety of a high-dose weekly vitamin D (20,000 IU) protocol in older adults living in residential care.

PubMed

Feldman, Fabio; Moore, Crystal; da Silva, Liz; Gaspard, Gina; Gustafson, Larry; Singh, Sonia; Barr, Susan I; Kitts, David D; Li, Wangyang; Weiler, Hope A; Green, Timothy J

2014-08-01

To report 25 hydroxyvitamin D (25OHD) concentrations, an indicator of vitamin D status, in older adults living in residential care 1 year after a protocol of weekly 20,000 IU of vitamin D was started. Cross-sectional. Five residential care facilities in British Columbia, Canada. Residents aged 65 and older from five facilities (N=236). Participants provided a blood sample. Demographic and health information was obtained from the medical record. Mean 25OHD was 102 nmol/L (95% confidence interval (CI)=98-106 nmol/L). Three percent of residents had a 25OHD concentration of less than 40 nmol/L, 6% <50 nmol/L, and 19% <75 nmol/L. In those who received 20,000 IU/wk or more for 6 months or longer (n=147), mean 25OHD was 112 nmol/L (95% CI=108-117 nmol/L), and none had a 25OHD level of less than 50 nmol/L. Hypercalcemia (>2.6 mmol/L), a potential consequence of too much vitamin D, was present in 14%, although 25OHD levels did not differ in those with and without hypercalcemia (108 vs 101 nmol/L; P=.17). Twelve months after implementation of a 20,000-IU/wk vitamin D protocol for older adults in residential care, mean 25OHD concentrations were high, and there was no evidence of poor vitamin D status. Given the absence of demonstrated benefit of high 25OHD concentrations to the residential care population, dosages less than 20,000 IU/wk of vitamin D are recommended. © 2014, Copyright the Authors Journal compilation © 2014, The American Geriatrics Society.

Student Housing and Residential Life: A Handbook for Professionals Committed to Student Development Goals. The Jossey-Bass Higher and Adult Education Series.

ERIC Educational Resources Information Center

Winston, Roger B., Jr.; And Others

This book on student housing and residential life contains the following articles: (1) "New Challenges and Goals for Residential Life Programs" (Blimling); (2) "Student Development in the Residential Environment" (Winston and Anchors); (3) "Psychosocial Development in College" (White and Porterfield); (4) "Intellectual, Ethical, and Moral…

Introducing Technology for Thriving in Residential Long-Term Care.

PubMed

Østensen, Elisabeth; Gjevjon, Edith Roth; Øderud, Tone; Moen, Anne

2017-01-01

To present an emerging innovative care model that supports participation and thriving by older adults in residential care, by introduction to new technology and mobilizing volunteer services. Qualitative, exploratory study, introducing tablet computers to 15 older adults in two municipalities. The intervention encompassed weekly workshops over the course of 1 year with volunteer adolescents as personal tutors. Observations of workshops, interviews with nurses, and repeated semistructured interviews with older adult participants eliciting their perspective on use, experiences, perceived usefulness, and overall evaluation of the intervention. A model of four components is suggested to support participation and thriving by older adults in residential care: (a) simplified tools: iPad-technology relatively easy to use; (b) person-centered process: one-to-one tutoring following each individual's own pace; (c) young volunteers to teach technology, establishing an intergenerational arena; and (d) being mindful of driving forces that encourage use and learning. We found that all kinds of use and all levels of mastery generated a sense of pride that supported thriving and enjoyment. These findings support the use of new technology and use of volunteer services for sustaining thriving in older adults. The person-centered approach stimulates use of the tablet, and participants showed enjoyment, more social participation, and reported subjective experiences of thriving. Innovative models of care that prevent (or postpone) functional decline and support thriving in older adults are highly sought after in health care. A model that systematically involves volunteer services comes with potentials to alleviate nurses' workload, and then the intervention is seen as a manageable and low-cost initiative in residential care. © 2016 Sigma Theta Tau International.

Linking data to decision-making: applying qualitative data analysis methods and software to identify mechanisms for using outcomes data.

PubMed

Patel, Vaishali N; Riley, Anne W

2007-10-01

A multiple case study was conducted to examine how staff in child out-of-home care programs used data from an Outcomes Management System (OMS) and other sources to inform decision-making. Data collection consisted of thirty-seven semi-structured interviews with clinicians, managers, and directors from two treatment foster care programs and two residential treatment centers, and individuals involved with developing the OMS; and observations of clinical and quality management meetings. Case study and grounded theory methodology guided analyses. The application of qualitative data analysis software is described. Results show that although staff rarely used data from the OMS, they did rely on other sources of systematically collected information to inform clinical, quality management, and program decisions. Analyses of how staff used these data suggest that improving the utility of OMS will involve encouraging staff to participate in data-based decision-making, and designing and implementing OMS in a manner that reflects how decision-making processes operate.

Residential Treatment Programs: Concerns Regarding Abuse and Death in Certain Programs for Troubled Youth. Testimony before the Committee on Education and Labor, House of Representatives. GAO-08-146T

ERIC Educational Resources Information Center

Kutz, Gregory D.; O'Connell, Andy

2007-01-01

Residential treatment programs provide a range of services, including drug and alcohol treatment, confidence building, military-style discipline, and psychological counseling for troubled boys and girls with a variety of addiction, behavioral, and emotional problems. This testimony concerns programs across the country referring to themselves as…

Evolving a model for integrated treatment in a residential setting for people with psychiatric and substance use disorders.

PubMed

Mayes, John; Handley, Samantha

2005-01-01

This paper discusses the implementation of a residential, integrated treatment program serving dually diagnosed people with histories of homelessness. Attention is focused on the program structure and how the program developed over time. Program modifications tended to relax program rules and embrace a motivational, stage-wise model using harm-reduction principles. Despite initial skepticism regarding these modifications, outcomes such as program retention, abstinence from substances, employment, and hospitalization improved.

Family Life and the Impact of Previous and Present Residential and Day Care Support for Children with Major Cognitive and Behavioural Challenges: A Dilemma for Services and Policy

ERIC Educational Resources Information Center

Brown, R. I.; Geider, S.; Primrose, A.; Jokinen, N. S.

2011-01-01

Introduction: Since the development of inclusion and integration, parents have increasingly become the major, and sometimes the only, carers of their children with disabilities. Many families speak of stress and frustration with service and community support, and some have turned to residential and specialised day care services to overcome…

Spectacle Coverage and Spectacles Use among Elderly Population in Residential Care in the South Indian State of Andhra Pradesh

PubMed Central

Marmamula, Srinivas; Ravuri, L. V. Chandra Sekhar; Boon, Mei Ying; Khanna, Rohit C.

2013-01-01

Background. There is limited research conducted on uncorrected refractive errors, presbyopia, and spectacles use among the elderly population in residential care in developing countries such as India. We conducted a cross-sectional study among elderly in residential care to assess the spectacle coverage and spectacles usage in the south Indian state of Andhra Pradesh. Methods. All 524 residents in the 26 “homes for aged” institutions in the district were enumerated. Eye examination was performed that included visual acuity (VA) assessment for distant and near vision. A questionnaire was used to collect information on spectacles use. Results. 494/524 individuals were examined, 78% were women, and 72% had no education. The mean age of participants was 70 years. The spectacle coverage for refractive errors was 35.1% and 23.9% for presbyopia. The prevalence of current use and past use of spectacles was 38.5% (95% CI: 34.2–42.8; n = 190) and 17.2% (95% CI: 13.9–42.8), respectively. Conclusions. There is low spectacle coverage for both refractive errors and presbyopia among elderly individuals in residential care in the south Indian state of Andhra Pradesh. Appropriate service delivery systems should be developed to reach out this vulnerable group of seniors on a priority basis. PMID:23865041

How to enhance route learning and visuo-spatial working memory in aging: a training for residential care home residents.

PubMed

Mitolo, Micaela; Borella, Erika; Meneghetti, Chiara; Carbone, Elena; Pazzaglia, Francesca

2017-05-01

This study aimed to assess the efficacy of a route-learning training in a group of older adults living in a residential care home. We verified the presence of training-specific effects in tasks similar to those trained - route-learning tasks - as well as transfer effects on related cognitive processes - visuo-spatial short-term memory (VSSTM; Corsi Blocks Test (CBT), forward version), visuo-spatial working memory (VSWM; CBT, backward version; Pathway Span Tasks; Jigsaw Puzzle Test) - and in self-report measures. The maintenance of training benefits was examined after 3 months. Thirty 70-90-year-old residential care home residents were randomly assigned to the route-learning training group or to an active control group (involved in non-visuo-spatial activities). The trained group performed better than the control group in the route-learning tasks, retaining this benefit 3 months later. Immediate transfer effects were also seen in visuo-spatial span tasks (i.e., CBT forward and backward version and Pathway Span Task); these benefits had been substantially maintained at the 3-month follow-up. These findings suggest that a training on route learning is a promising approach to sustain older adults' environmental learning and some related abilities (e.g., VSSTM and VSWM), even in residential care home residents.

Residential family treatment for parents with substance use disorders who are involved with child welfare: two perspectives on program design, collaboration, and sustainability.

PubMed

Hammond, Gretchen Clark; McGlone, Amanda

2013-01-01

This article discusses the service design, implementation, and evaluation findings of two residential family treatment programs: Wayside House (MN) and OnTrack (OR). Both programs specialize in family-centered services for adults with substance use disorders (SUD) who are involved with child welfare. Information on program design, services offered, and key collaborations are detailed. Implications for program sustainability are provided.

Perceptions of the importance of physical setting in substance abuse treatment.

PubMed

Grosenick, J K; Hatmaker, C M

2000-01-01

Research indicates that architectural design can provide therapeutic effects. Six setting characteristics are considered of primary importance in health-care facilities: comforts and conveniences, safety, attractiveness, size, privacy, and arrangement/location. This study presents the perceptions regarding these and other setting features held by female clients and staff from a substance abuse treatment facility. Results support the importance of these six setting characteristics in influencing clients' treatment goals. Four other setting variables emerged as important to women's recovery: participation in a residential, drug-free, gender-specific program that provides on-site child care. Attention to these variables may provide facilities with an advantage in today's competitive market for clients.

25 CFR 39.801 - What is the formula to determine the amount necessary to sustain a school's academic or...

Code of Federal Regulations, 2010 CFR

2010-04-01

... sustain a school's academic or residential program? 39.801 Section 39.801 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR EDUCATION THE INDIAN SCHOOL EQUALIZATION PROGRAM Determining the Amount Necessary... necessary to sustain a school's academic or residential program? (a) The Secretary's formula to determine...

25 CFR 39.801 - What is the formula to determine the amount necessary to sustain a school's academic or...

Code of Federal Regulations, 2011 CFR

2011-04-01

... sustain a school's academic or residential program? 39.801 Section 39.801 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR EDUCATION THE INDIAN SCHOOL EQUALIZATION PROGRAM Determining the Amount Necessary... necessary to sustain a school's academic or residential program? (a) The Secretary's formula to determine...

Considering a Private Residential Treatment Program for a Troubled Teen? Questions for Parents and Guardians to Ask

ERIC Educational Resources Information Center

Federal Trade Commission, 2008

2008-01-01

Private residential treatment programs for young people offer a range of services, including drug and alcohol treatment, confidence building, military-style discipline, and psychological counseling for a variety of addiction, behavioral, and emotional problems. Many of these programs are intended to provide a less-restrictive alternative to…

Exploring the Reciprocal Relationship between a Comprehensive Living-Learning Program and Institutional Culture: A Narrative Inquiry Case Study

ERIC Educational Resources Information Center

Marquart, Christopher P.

2017-01-01

Over the past 50 years, living-learning programs (LLPs) have emerged as a dynamic curricular innovation in higher education. These programs are residentially based, seeking to seamlessly integrate the classroom and residence hall environments and blur the traditional boundaries between the academic and residential experiences for students (Kuh,…

National Program for Solar Heating and Cooling of Buildings. Project Date Summaries. Vol. I: Commercial and Residential Demonstrations.

ERIC Educational Resources Information Center

Energy Research and Development Administration, Washington, DC. Div. of Solar Energy.

Three volumes present brief abstracts of projects funded by the Energy Research and Development Administration (ERDA) and conducted under the National Program for Solar Heating and Cooling of Buildings through July 1976. The overall federal program includes demonstrations of heating and/or combined cooling for residential and commercial buildings…

Residential Wilderness Programs: The Role of Social Support in Influencing Self-Evaluations of Male Adolescents

ERIC Educational Resources Information Center

Cook, Emily C.

2008-01-01

This qualitative study explores the aspects of a residential wilderness experience that informed self-evaluations in male adolescents, ages 12-16. To assess change in self-evaluations and program factors associated with change, qualitative interviews were conducted with adolescents upon entry to the program and four months later. Participants'…

Halfway Houses.

ERIC Educational Resources Information Center

Allen, Harry E.; And Others

This program model focuses on adult residential inmate aftercare programs. Critical issues in halfway house operations, a model for evaluation, and innovative variations are discussed. The facilities discussed include public and private halfway houses that provide residential services to adult offenders as a transitional step between their release…

25 CFR 39.220 - What reports must residential programs submit to comply with this subpart?

Code of Federal Regulations, 2010 CFR

2010-04-01

... subpart? Residential programs must report their monthly counts to the Director on the last school day of the month. To be counted, a student must have been in residence at least 10 nights during each full...

Promoting oral health care among people living in residential aged care facilities: Perceptions of care staff.

PubMed

Villarosa, Amy R; Clark, Sally; Villarosa, Ariana C; Patterson Norrie, Tiffany; Macdonald, Susan; Anlezark, Jennifer; Srinivas, Ravi; George, Ajesh

2018-04-23

This study aimed to look at the practices and perspectives of residential aged care facility (RACF) care staff regarding the provision of oral health care in RACFs. Emphasis has been placed on the provision of adequate oral health care in RACFs through the Better Oral Health in Residential Aged Care programme. Endorsed by the Australian government, this programme provided oral health education and training for aged care staff. However, recent evidence suggests that nearly five years after the implementation of this programme, the provision of oral care in RACFs in NSW remains inadequate. This project utilised an exploratory qualitative design which involved a focus group with 12 RACF care staff. Participants were asked to discuss the current oral health practices in their facility, and their perceived barriers to providing oral health care. The key findings demonstrated current oral health practices and challenges among care staff. Most care staff had received oral health training and demonstrated positive attitudes towards providing dental care. However, some participants identified that ongoing and regular training was necessary to inform practice and raise awareness among residents. Organisational constraints and access to dental services also limited provision of dental care while a lack of standardised guidelines created confusion in defining their role as oral healthcare providers in the RACF. This study highlighted the need for research and strategies that focus on capacity building care staff in oral health care and improving access of aged care residents to dental services. © 2018 John Wiley & Sons A/S and The Gerodontology Association. Published by John Wiley & Sons Ltd.

Psychometric properties of the Portuguese version of place attachment scale for youth in residential care.

PubMed

Magalhães, Eunice; Calheiros, María M

2015-01-01

Although the significant scientific advances on place attachment literature, no instruments exist specifically developed or adapted to residential care. 410 adolescents (11 - 18 years old) participated in this study. The place attachment scale evaluates five dimensions: Place identity, Place dependence, Institutional bonding, Caregivers bonding and Friend bonding. Data analysis included descriptive statistics, content validity, construct validity (Confirmatory Factor Analysis), concurrent validity with correlations with satisfaction with life and with institution, and reliability evidences. The relationship with individual characteristics and placement length was also verified. Content validity analysis revealed that more than half of the panellists perceive all the items as relevant to assess the construct in residential care. The structure with five dimensions revealed good fit statistics and concurrent validity evidences were found, with significant correlations with satisfaction with life and with the institution. Acceptable values of internal consistence and specific gender differences were found. The preliminary psychometric properties of this scale suggest it potential to be used with youth in care.

Training of Residential Social Care Staff to Meet the Needs of Older People with Intellectual Disabilities who Develop Age-Related Health Problems: An Exploratory Study.

PubMed

Northway, Ruth; Jenkins, Robert; Holland-Hart, Daniella

2017-09-01

Despite awareness of the age related health needs of people with intellectual disabilities little is known regarding how residential social care staff are prepared to meet such needs. Data were gathered via semi-structured interviews from 14 managers of supported living settings. Transcripts were thematically analysed. Staff may work in supported living settings with no prior experience of care work, and previous knowledge/experience of supporting people in relation to their health is not required. Whilst health related training is provided there is a lack of specific training regarding healthy ageing, and training seems to be reactive to changing needs of tenants meaning that proactive monitoring for changes in health status may not occur. Whilst some training is provided for residential social care staff in relation to health and ageing a more proactive approach is required which should include a focus on healthy ageing. © 2016 John Wiley & Sons Ltd.

A cross-sectional study to compare care needs of individuals with and without dementia in residential homes in the Netherlands

PubMed Central

2013-01-01

Background Little is known about met and unmet needs of individuals in residential care, many of whom suffer from dementia. Unmet needs are associated with a decreased quality of life, worse mental health, dissatisfaction with services, and increased costs of care. The aim of this study was to compare the number and type of (unmet) needs of people with and without dementia in residential care in the Netherlands. Methods 187 individuals in residents care or their relatives were interviewed to identify their care needs on 24 topics using the Camberwell Assessment of Needs for the Elderly (CANE) interview. Results Individuals diagnosed with probable dementia reported more needs in total and more unmet needs in comparison with individuals without this diagnosis. More specifically, differences were found for the topics “accommodation”, “money”, “benefits”, “medication management”, “incontinence”, “memory problems”, “inadvertent self-harm”, “company” and “daytime activities”. Conclusions It seems that the differences in care needs between individuals with and without dementia can be attributed to actual differences in physical and cognitive functioning. Residents with dementia reported more often unmet needs which might imply that care for people with dementia can still be better attuned to their needs. PMID:23706150

Study protocol: A Montessori approach to dementia-related, non-residential respite services in Australia.

PubMed

Hanna, Andrew; Donnelly, James; Aggar, Christina

2018-03-27

Given the social burden and significant cost of dementia care in Australia, finding evidence-based approaches that improve outcomes, maintain independence, and reduce the impact on patients and families is essential. Finding effective ways to train and assist the healthcare staff who support these individuals is also critical, as they are considered to be at risk of workplace stress, burnout, and other psychological disturbances which negatively affects standards of care. The current paper describes a protocol for evaluating the effects of a Montessori-based approach to dementia care, in non-residential respite centres. An 18 month prospective observational, cohort controlled design is suggested that will compare participants from a community respite service that has undergone a Montessori-based workplace culture change and those from a service that provides a person-centred 'care as usual' approach. To achieve this, the protocol includes the assessment of participants across multiple variables on a monthly basis including the cognitive, behavioural, and emotional functioning of clients with dementia, levels of caregiver burden experienced by informal carers, and burnout, compassion satisfaction and workplace engagement among respite staff. The protocol also employs a qualitative evaluation of program fidelity. This approach will provide further insight into the potential benefits of early intervention with Montessori approaches for persons living with dementia in the community, their caregivers, and the staff and volunteers who assist them. Copyright © 2018 Elsevier B.V. All rights reserved.

Substance Abuse Intensive Outpatient Programs: Assessing the Evidence

PubMed Central

McCarty, Dennis; Braude, Lisa; Dougherty, Richard H.; Daniels, Allen S.; Ghose, Sushmita Shoma; Delphin-Rittmon, Miriam E.

2014-01-01

Objective Substance abuse intensive outpatient programs (IOPs) are direct services for people with substance use disorders or co-occurring mental and substance use disorders who do not require medical detoxification or 24-hour supervision. IOPs are alternatives to inpatient and residential treatment. They are designed to establish psychosocial supports and facilitate relapse management and coping strategies. This article assesses their evidence base. Methods Authors searched major databases: PubMed, PsycINFO, Applied Social Sciences Index and Abstracts, Sociological Abstracts, Social Services Abstracts, Published International Literature on Traumatic Stress, the Educational Resources Information Center, and the Cumulative Index to Nursing and Allied Health Literature. They identified 12 individual studies and one review published between 1995 and 2012. They chose from three levels of research evidence (high, moderate, and low) based on benchmarks for the number of studies and quality of their methodology. They also described the evidence of service effectiveness. Results Based on the quality of trials, diversity of settings, and consistency of outcomes, the level of evidence for IOP research was considered high. Multiple randomized trials and naturalistic analyses compared IOPs with inpatient or residential care; these types of services had comparable outcomes. All studies reported substantial reductions in alcohol and drug use between baseline and follow-up. However, substantial variability in the operationalization of IOPs and outcome measures was apparent. Conclusions IOPs are an important part of the continuum of care for alcohol and drug use disorders. They are as effective as inpatient treatment for most individuals seeking care. Public and commercial health plans should consider IOP treatment as a covered health benefit. Standardization of the elements included in IOPs may improve their quality and effectiveness. PMID:24445620

Preventing Child Abuse and Neglect

MedlinePlus

... and Preservation Services Out-of-Home Care National Foster Care Month Overview Foster Care Group and Residential Care Kinship Care Casework ... Adulthood and Independent Living Placement Decisions Resources for Foster Families Achieving & Maintaining Permanency Overview Reunifying Families Recruiting ...

Is psychotropic medication use related to organisational and treatment culture in residential care.

PubMed

Peri, Kathryn; Kerse, Ngaire; Moyes, Simon; Scahill, Shane; Chen, Charlotte; Hong, Jae Beom; Hughes, Carmel M

2015-01-01

The purpose of this paper is to establish the relationship between organisational culture and psychotropic medication use in residential care. Cross-sectional analyses of staff and resident's record survey in residential aged care facilities in Auckland, New Zealand (NZ). The competing values framework categorised organisational culture as clan, hierarchical, market driven or adhocracy and was completed by all staff. The treatment culture tool categorised facilities as having resident centred or traditional culture and was completed by registered nursing staff and general practitioners (GP). Functional and behavioural characteristics of residents were established by staff report and health characteristics and medications used were ascertained from the health record. Multiple regression was used to test for associations between measures of culture with psychotropic medication use (anxiolytics, sedatives, major tranquillisers). In total 199 staff, 27 GP and 527 residents participated from 14 facilities. On average 8.5 medications per resident were prescribed and 42 per cent of residents received psychotropic medication. Having a diagnosis of anxiety or depression (odds ratio (OR) 3.18, 95 per cent confidence interval (CI) 1.71, 5.91), followed by persistent wandering (OR 2.53, 95 per cent CI 1.59, 4.01) and being in a dementia unit (OR 2.45, 95 per cent CI 1.17, 5.12) were most strongly associated with psychotropic use. Controlling for resident- and facility-level factors, health care assistants' assignation of hierarchical organisational culture type was independently associated with psychotropic medication use, (OR 1.29, CI 1.08, 1.53) and a higher treatment culture score from the GP was associated with lower use of psychotropic medication (OR 0.95, CI 0.92, 0.98). Psychotropic medication use remains prevalent in residential care facilities in NZ. Interventions aimed at changing organisational culture towards a less hierarchical and more resident-centred culture may be another avenue to improve prescribing in residential aged care.

Healthcare costs of burn patients from homes without fire sprinklers

PubMed Central

Banfield, Joanne; Rehou, Sarah; Gomez, Manuel; Redelmeier, Donald A.; Jeschke, Marc G.

2014-01-01

The treatment of burn injuries requires high-cost services for healthcare and society. Automatic fire sprinklers are a preventive measure that can decrease fire injuries, deaths, property damage and environmental toxins. This study’s aim was to conduct a cost-analysis of patients with burn or inhalation injuries due to residential fires, and to compare this to the cost of implementing residential automatic fire sprinklers. We conducted a cohort analysis of adult burn patients admitted to our provincial burn center (1995–2012). Patient demographics and injury characteristics were collected from medical records, and clinical and coroner databases. Resource costs included average cost per day at our intensive care and rehabilitation program, transportation, and property loss. During the study period there were 1,557 residential fire-related deaths province-wide and 1,139 patients were admitted to our provincial burn center due to a flame injury occurring at home. At our burn center, the average cost was CAN$84,678 per patient with a total cost of CAN$96,448,194. All resources totaled CAN$3,605,775,200. This study shows the considerable healthcare costs of burn patients from homes without fire sprinklers. PMID:25412056

Does progressive resistance and balance exercise reduce falls in residential aged care? Randomized controlled trial protocol for the SUNBEAM program

PubMed Central

Hewitt, Jennifer; Refshauge, Kathryn M; Goodall, Stephen; Henwood, Timothy; Clemson, Lindy

2014-01-01

Introduction Falls are common among older adults. It is reported that approximately 60% of residents of aged care facilities fall each year. This is a major cause of morbidity and mortality, and a significant burden for health care providers and the health system. Among community dwelling older adults, exercise appears to be an effective countermeasure, but data are limited and inconsistent among studies in residents of aged care communities. This trial has been designed to evaluate whether the SUNBEAM program (Strength and Balance Exercise in Aged Care) reduces falls in residents of aged care facilities. Research question Is the program more effective and cost-effective than usual care for the prevention of falls? Design Single-blinded, two group, cluster randomized trial. Participants and setting 300 residents, living in 20 aged care facilities. Intervention Progressive resistance and balance training under the guidance of a physiotherapist for 6 months, then facility-guided maintenance training for 6 months. Control Usual care. Measurements Number of falls, number of fallers, quality of life, mobility, balance, fear of falling, cognitive well-being, resource use, and cost-effectiveness. Measurements will be taken at baseline, 6 months, and 12 months. Analysis The number of falls will be analyzed using a Poisson mixed model. A logistic mixed model will be used to analyze the number of residents who fall during the study period. Intention-to-treat analysis will be used. Discussion This study addresses a significant shortcoming in aged care research, and has potential to impact upon a substantial health care problem. Outcomes will be used to inform care providers, and guide health care policies. PMID:24591821

Oral status, cognitive function and dependency among New Zealand nursing home residents.

PubMed

Thomson, William M; Smith, Moira B; Ferguson, Catherine Anna; Kerse, Ngaire M; Peri, Kathryn; Gribben, Barry

2018-04-23

To investigate clinical oral disease and its association with cognitive function and dependency among older New Zealanders in residential aged care. National survey of oral health in aged residential care throughout New Zealand. We classified residents into 1 of 3 levels of care: "low dependency care (or assisted living)"; "high dependency care"; or "specialist dementia care/psychogeriatric care." The Abbreviated Mental Test characterised cognitive function as "unimpaired" (scores of 7-10), "moderately impaired" (4-6) or "severely impaired" (0-3). Intra-oral examinations were conducted, along with a computer-assisted personal interview. Most of the 987 clinically examined participants were either at low or high dependency care level, with another 1 in 6 in psychogeriatric care. Almost half overall had severely impaired cognitive function. Just under half of the sample had 1 or more natural teeth remaining. Negative binomial regression modelling showed that the number of carious teeth was lower among women and higher among those who were older, those with more teeth and in those with severely impaired cognitive function. Oral debris scores (representing plaque biofilm and other soft deposits on teeth) were higher in men, those with more teeth, and in those with severely impaired cognitive function. Impaired cognitive function is a risk indicator for both dental caries and oral debris in aged residential care. © 2018 John Wiley & Sons A/S and The Gerodontology Association. Published by John Wiley & Sons Ltd.

Job satisfaction and associated variables among nurse assistants working in residential care.

PubMed

Wallin, Anneli Orrung; Jakobsson, Ulf; Edberg, Anna-Karin

2012-12-01

While the work situation for nurse assistants in residential care is strenuous, they themselves often state that they are satisfied with their job. More knowledge is clearly needed of the interrelationship of variables associated with job satisfaction. This study aims to investigate job satisfaction and explore associated variables among nurse assistants working in residential care. A total of 225 respondents completed a questionnaire measuring general job satisfaction, satisfaction with nursing-care provision and measures concerning person-centered care, work climate, leadership, and health complaints. Job satisfaction was the outcome measure and comparisons were made among those reporting low, moderate, and high levels of job satisfaction; multiple regression analyses were used to explore associated variables. The caring climate and personalized care provision were associated with general job satisfaction. High levels of satisfaction with nursing-care provision were also associated with the general work climate, organizational and environmental support, and leadership. Low job satisfaction was mainly associated with health complaints. Nurse assistants working in a positive work climate, caring climate, with a positive attitude to their leaders, who receive organizational and environmental support, provide person-centered care and experience a higher degree of job satisfaction. It seems essential, however, to include both general and context-specific measures when investigating job satisfaction in this field as they reveal different aspects of the nurse assistant's work situation.

Austin's Home Performance with Energy Star Program: Making a Compelling Offer to a Financial Institution Partner

DOE Office of Scientific and Technical Information (OSTI.GOV)

Zimring, Mark

2011-03-18

Launched in 2006, over 8,700 residential energy upgrades have been completed through Austin Energy's Home Performance with Energy Star (HPwES) program. The program's lending partner, Velocity Credit Union (VCU) has originated almost 1,800 loans, totaling approximately $12.5 million. Residential energy efficiency loans are typically small, and expensive to originate and service relative to larger financing products. National lenders have been hesitant to deliver attractive loan products to this small, but growing, residential market. In response, energy efficiency programs have found ways to partner with local and regional banks, credit unions, community development finance institutions (CDFIs) and co-ops to deliver energymore » efficiency financing to homeowners. VCU's experience with the Austin Energy HPwES program highlights the potential benefits of energy efficiency programs to a lending partner.« less

Mental health issues in Australian nursing homes.

PubMed

Lie, David

2003-07-01

Mental illness is common, under detected and often poorly managed in residential aged care facilities. These concerns have achieved greater prominence as the worldwide population ages. Over 80% of people in nursing home care fulfill criteria for one or more psychiatric disorders in an environment that often presents significant difficulties for assessment and treatment. This article aims to provide an overview of the important mental health issues involved in providing medical care for patients with behavioural and psychological problems in residential aged care facilities. Recent developments in education and training, service development and assessment and treatment strategies show some promise of improving the outcome for aged care residents with mental health problems. This is of especial relevance for primary care physicians who continue to provide the bulk of medical care for this population.

Measuring Use of Evidence-Based Psychotherapy for PTSD in VA Residential Treatment Settings with Clinician Survey and Electronic Medical Record Templates.

PubMed

Shiner, Brian; Leonard Westgate, Christine; Simiola, Vanessa; Thompson, Richard; Schnurr, Paula P; Cook, Joan M

2018-03-14

Available studies on implementation of evidence-based psychotherapy (EBP) for patients attending Department of Veterans Affairs (VA) residential post-traumatic stress disorder (PTSD) programs rely on therapist self-report of EBP delivery. Patient-level data on receipt of EBP are needed both to corroborate therapist self-report and to understand patient factors that predict receipt of EBPs for PTSD. We identified 159 therapists from 38 VA residential PTSD programs who responded to a survey about EBP implementation during the 2015 fiscal year (FY15). Therapists self-reported their use of two EBPs, including prolonged exposure delivered in an individual format (PE-I) and cognitive processing therapy delivered in individual and group formats (CPT-I and CPT-G). Using electronic medical record (EMR) templates mandated for EBP documentation in FY15, we measured contemporaneous patient-level receipt of EBPs for PTSD. We assessed the degree of correlation between therapist self-reported EBP delivery and patient receipt of EBT as measured by EMR templates using polychoric correlation coefficients. We determined patient and therapist factors that predicted the receipt of EBPs with multivariable logistic regression, using random effects and robust standard error estimation, and controlling for site. The Veterans IRB of Northern New England provided a waiver of informed consent; as this was a retrospective review, no patients or therapists were contacted, and all data were stored, transmitted, and analyzed on secure VA servers. The VA Connecticut Health Care System Human Research Protection Program approved secondary use of therapist survey data for this project. When EMR template use became mandated in FY15, the proportion of patients in residential PTSD programs who received at least one EBP session that was recorded with an EMR template increased dramatically from 8.8% to 33.9%. There was adequate correlation and between survey-based and EMR-based measures of EBP receipt, with polychoric correlation values of 0.77 for PE-I, 0.69 for CPT-I, and 0.82 for CPT-G. Multiple patient factors were positive (e.g., female gender) and negative (e.g., depressive disorders) predictors of receipt of EBPs, even after controlling for site. Among therapist factors, only EBP consultant or trainer status was a positive predictor of EBP provision and only therapist race was a negative predictor of EBT provision after controlling for site. Following a FY15 mandate, EMR templates documenting EBP delivery were widely used by therapists working in VA residential PTSD programs. EBP receipt measured using EMR templates was consistent with therapist self-report of EBT delivery. There were several patient-level predictors of EBP receipt and therapist-level predictors of EBP delivery. However, therapists most likely to deliver EBPs were clustered at a limited number of sites.

Cooperative Programs in Residential Outdoor Environmental Education: Teacher's Materials Packet.

ERIC Educational Resources Information Center

Marin County Superintendent of Schools, Corte Madera, CA.

Serving as teacher orientation materials for the cooperative programs in residential outdoor education located in Marin County, California, this guide includes the following: (1) "This I Believe" (a philosophical statement on outdoor environmental education); (2) "Outdoor Science and Conservation Education Report" (a brief…

Residential solar-heating/cooling system

NASA Technical Reports Server (NTRS)

1980-01-01

Report documents progress of residential solar-heating and cooling system development program at 5-month mark of anticipated 17-month program. System design has been completed, and development and component testing has been initiated. Report includes diagrams, operation overview, optimization studies of subcomponents, and marketing plans for system.

Classroom management programs for deaf children in state residential and large public schools.

PubMed

Wenkus, M; Rittenhouse, B; Dancer, J

1999-12-01

Personnel in 4 randomly selected state residential schools for the deaf and 3 randomly selected large public schools with programs for the deaf were surveyed to assess the types of management or disciplinary programs and strategies currently in use with deaf students and the rated effectiveness of such programs. Several behavioral management programs were identified by respondents, with Assertive Discipline most often listed. Ratings of program effectiveness were generally above average on a number of qualitative criteria.

The physical health of Indigenous and non-Indigenous patients participating in residential rehabilitation programs: a comparison study.

PubMed

Meehan, Tom; Jones, Donna; Stedman, Terry; Johnson, Dean; Suetani, Shuichi; Foreman, Emma

2017-04-01

To examine the differences in the physical health of Indigenous and non-Indigenous patients with severe mental illness (SMI) undergoing psychiatric rehabilitation. An audit of the physical health of patients ( n = 361) in all publicly funded residential rehabilitation programs in Queensland was carried out in late 2014. Data collection focused on clinical and lifestyle factors associated with physical health. The prevalence of smoking, substance use and type 2 diabetes in Indigenous patients was significantly higher than rates found in non-Indigenous patients. Metabolic syndrome was also significantly higher in indigenous patients, with 66% of Indigenous patients compared to 46% of non-Indigenous patients meeting criteria for metabolic syndrome. Patients with SMI in residential rehabilitation programs have poor physical health. Our findings underscore the need for clinicians to develop and evaluate interventions aimed at improving the metabolic profile of those with SMI in residential rehabilitation programs. Historical factors and cultural traditions need to be considered when designing lifestyle interventions for Indigenous patients.

C-DEBI Community College Research Internship for Scientific Engagement: Effective Practices in Running a Non-Residential Research Program

NASA Astrophysics Data System (ADS)

Schroeder, S.

2016-02-01

The Center For Dark Energy Biosphere Investigations (C-DEBI), an NSF Science and Technology Center, is located in the heart of Los Angeles, surrounded by nineteen community colleges. C-DEBI recognizes the community college student as an untapped STEM resource and piloted the Community College Research Internship for Scientific Engagement (CC-RISE) in 2013. A non-residential, research-focused summer internship, the successful program expanded to UC-Santa Cruz and the Marine Biological Laboratory in 2014 and 2015, respectively. A non-residential research program gives students who are often first generation or non-traditional a stepping stone to experience the research environment while reducing transfer shock. Formal evaluation of CC-RISE indicates that in addition to providing an immersive research experience for community college students, the key components to running a successful non-residential program include weekly informal meetings to allow the students to create a cohort, as well as program aspects dedicated to professional development topics such as the transfer process and using resources at 4-year institutions to maximize success.

Weight and Veterans' Environments Study (WAVES) I and II: Rationale, Methods, and Cohort Characteristics.

PubMed

Zenk, Shannon N; Tarlov, Elizabeth; Powell, Lisa M; Wing, Coady; Matthews, Stephen A; Slater, Sandy; Gordon, Howard S; Berbaum, Michael; Fitzgibbon, Marian L

2018-03-01

To present the rationale, methods, and cohort characteristics for 2 complementary "big data" studies of residential environment contributions to body weight, metabolic risk, and weight management program participation and effectiveness. Retrospective cohort. Continental United States. A total of 3 261 115 veterans who received Department of Veterans Affairs (VA) health care in 2009 to 2014, including 169 910 weight management program participants and a propensity score-derived comparison group. The VA MOVE! weight management program, an evidence-based lifestyle intervention. Body mass index, metabolic risk measures, and MOVE! participation; residential environmental attributes (eg, food outlet availability and walkability); and MOVE! program characteristics. Descriptive statistics presented on cohort characteristics and environments where they live. Forty-four percent of men and 42.8% of women were obese, whereas 4.9% of men and 9.9% of women engaged in MOVE!. About half of the cohort had at least 1 supermarket within 1 mile of their home, whereas they averaged close to 4 convenience stores (3.6 for men, 3.9 for women) and 8 fast-food restaurants (7.9 for men, 8.2 for women). Forty-one percent of men and 38.6% of women did not have a park, and 35.5% of men and 31.3% of women did not have a commercial fitness facility within 1 mile. Drawing on a large nationwide cohort residing in diverse environments, these studies are poised to significantly inform policy and weight management program design.

Older adults' home- and community-based care service use and residential transitions: a longitudinal study.

PubMed

Chen, Ya-Mei; Berkowitz, Bobbie

2012-08-10

As Home-and Community-Based Services (HCBS), such as skilled nursing services or personal care services, have become increasingly available, it has become clear that older adults transit through different residential statuses over time. Older adults may transit through different residential statuses as the various services meet their needs. The purpose of this exploratory study was to better understand the interplay between community-dwelling older adults' use of home- and community-based services and their residential transitions. The study compared HCBS service-use patterns and residential transitions of 3,085 older adults from the Second Longitudinal Study of Aging. Based on older adults' residential status at the three follow-up interviews, four residential transitions were tracked: (1) Community-Community-Community (CCC: Resided in community during the entire study period); (2) Community-Institution-Community (CIC: Resided in community at T1, had lived in an institution at some time between T1 and T2, then had returned to community by T3); (3) Community-Community-Institution (CCI: Resided in community between at T1, and betweenT1 and T2, including at T2, but had used institutional services between T2 and T3); (4) Community-Institution-Institution (CII: Resided in community at T1 but in an institution at some time between T1 and T2, and at some time between T2 and T3.). Older adults' use of nondiscretionary and discretionary services differed significantly among the four groups, and the patterns of HCBS use among these groups were also different. Older adults' use of nondiscretionary services, such as skilled nursing care, may help them to return to communities from institutions. Personal care services (PCS) and senior center services may be the key to either support elders to stay in communities longer or help elders to return to their communities from institutions. Different combinations of PCS with other services, such as senior center services or meal services, were associated with different directions in residential transition, such as CIC and CII respectively. Older adults' differing HCBS use patterns may be the key to explaining older adults' transitions. Attention to older adults' HCBS use patterns is recommended for future practice. However, this was an exploratory study and the analyses cannot establish causal relationships.

Older adults’ home- and community-based care service use and residential transitions: a longitudinal study

PubMed Central

2012-01-01

Background As Home-and Community-Based Services (HCBS), such as skilled nursing services or personal care services, have become increasingly available, it has become clear that older adults transit through different residential statuses over time. Older adults may transit through different residential statuses as the various services meet their needs. The purpose of this exploratory study was to better understand the interplay between community-dwelling older adults’ use of home- and community-based services and their residential transitions. Methods The study compared HCBS service-use patterns and residential transitions of 3,085 older adults from the Second Longitudinal Study of Aging. Based on older adults’ residential status at the three follow-up interviews, four residential transitions were tracked: (1) Community-Community-Community (CCC: Resided in community during the entire study period); (2) Community-Institution-Community (CIC: Resided in community at T1, had lived in an institution at some time between T1 and T2, then had returned to community by T3); (3) Community-Community-Institution (CCI: Resided in community between at T1, and betweenT1 and T2, including at T2, but had used institutional services between T2 and T3); (4) Community-Institution-Institution (CII: Resided in community at T1 but in an institution at some time between T1 and T2, and at some time between T2 and T3.). Results Older adults’ use of nondiscretionary and discretionary services differed significantly among the four groups, and the patterns of HCBS use among these groups were also different. Older adults’ use of nondiscretionary services, such as skilled nursing care, may help them to return to communities from institutions. Personal care services (PCS) and senior center services may be the key to either support elders to stay in communities longer or help elders to return to their communities from institutions. Different combinations of PCS with other services, such as senior center services or meal services, were associated with different directions in residential transition, such as CIC and CII respectively. Conclusions Older adults’ differing HCBS use patterns may be the key to explaining older adults’ transitions. Attention to older adults’ HCBS use patterns is recommended for future practice. However, this was an exploratory study and the analyses cannot establish causal relationships. PMID:22877416

Resident aggression toward staff at a center for the developmentally disabled.

PubMed

West, Christine A; Galloway, Ellen; Niemeier, Maureen T

2014-01-01

Few studies have examined factors contributing to nonfatal assaults to staff working in residential care facilities. The authors evaluated resident assaults toward direct care/nursing staff at an intermediate Care Facility for Individuals with Mental Retardation (ICF/MR), which included observations of work areas, employee interviews, calculation of injury and assault rates for 2004 to 2007 from Occupational Safety and Health Administration Logs, and review of state ICP/MR guidelines. Most staff interviewed reported having been injured during physical restraint of a resident and the average rate of injury from assault at the center evaluated was higher than the average national rates for the health care and social assistance sector for the same time period. The center lacked policies and developing a post-incident response and evaluation program to assist staff in coping with the consequences of assault and/or occupational injury.

Patterns of Service Use in Two Types of Managed Behavioral Health Care Plan

PubMed Central

Merrick, Elizabeth Levy; Hodgkin, Dominic; Hiatt, Deirdre; Horgan, Constance M.; Azzone, Vanessa; McCann, Bernard; Ritter, Grant; Zolotusky, Galina; McGuire, Thomas G.; Reif, Sharon

2009-01-01

Objective To describe service use patterns by level of care in two managed care products: employee assistance program (EAP) combined with behavioral health benefits, and standard behavioral health benefits. Methods This is a cross-sectional analysis of administrative data for 2004 from a national managed behavioral health care organization (MBHO). Utilization of 11 specific service categories was compared across products. The weighted sample reflected exact matching on sociodemographics (N= 710,014 unweighted; 286,750 weighted). Results In the EAP/behavioral health product,, the proportion of enrollees with outpatient mental health and substance abuse office visits (including EAP) was higher (p<.01), as was substance abuse day treatment/intensive outpatient care (p<.05). Use of residential substance abuse rehabilitation was lower (p<.05). Other differences were also found. Conclusion EAP/behavioral health and standard behavioral health care products had distinct utilization patterns in this large MBHO. In particular, greater use of certain outpatient services was observed within the EAP/behavioral health product. PMID:20044425

The Funding of Long-Term Care in Canada: What Do We Know, What Should We Know?

PubMed

Grignon, Michel; Spencer, Byron G

2018-06-01

ABSTRACTLong-term care is a growing component of health care spending but how much is spent or who bears the cost is uncertain, and the measures vary depending on the source used. We drew on regularly published series and ad hoc publications to compile preferred estimates of the share of long-term care spending in total health care spending, the private share of long-term care spending, and the share of residential care within long-term care. For each series, we compared estimates obtainable from published sources (CIHI [Canadian Institute for Health Information] and OECD [Organization for Economic Cooperation and Development]) with our preferred estimates. We conclude that using published series without adjustment would lead to spurious conclusions on the level and evolution of spending on long-term care in Canada as well as on the distribution of costs between private and public funders and between residential and home care.

Mental Health and Behavioral Problems of Youth in the Child Welfare System: Residential Treatment Centers Compared to Therapeutic Foster Care in the Odyssey Project Population

ERIC Educational Resources Information Center

Baker, Amy J. L.; Kurland, David; Curtis, Patrick; Alexander, Gina; Papa-Lentini, Cynthia

2007-01-01

This is the first multisite, prospective study of behavioral and mental health disorders of youth in residential treatment centers (RTC) and therapeutic foster care (TFC), and the first study to compare the two. This study addressed two questions in a sample of 22 agencies in 13 states: (1) how prevalent were emotional and behavioral disorders in…