Falling birth rates and rising life expectancy are leading to global aging. The proportional increase in older people can be observed in almost all countries and regions worldwide. As a result, more people spend their later years in nursing homes. In homes where person-centered care is implemented, residents report greater satisfaction and quality of life. This approach is based on the wishes and needs of the residents. Therefore, the purpose of this scoping review is to explore the wishes and needs of nursing home residents. A scoping review of the literature was conducted in which 12 databases were systematically searched for relevant articles according to PRISMA-ScR guidelines. Both quantitative and qualitative study designs were considered. A total of 51 articles met the inclusion criteria. Included articles were subjected to thematic analysis and synthesis to categorize findings into themes. The analysis identified 12 themes to which the wishes and needs were assigned: (1) Activities, leisure, and daily routine; (2) Autonomy, independence, choice, and control; (3) Death, dying, and end-of-life; (4) Economics; (5) Environment, structural conditions, meals, and food; (6) Health condition; (7) Medication, care, treatment, and hygiene; (8) Peer relationship, company, and social contact; (9) Privacy; (10) Psychological and emotional aspects, security, and safety; (11) Religion, spirituality; and (12) Sexuality. Nursing home residents are not a homogeneous group. Accordingly, a wide range of needs and wishes are reported in the literature, assigned to various topics. This underscores the need for tailored and person-centered approaches to ensure long-term well-being and quality of life in the nursing home care setting.
Zusammenfassung Hintergrund Die COVID-19-Pandemie erfordert umfangreiche Maßnahmen in Pflegeheimen mit dem Ziel der Infektionsvermeidung. Diese Maßnahmen wirken sich auf das Leben der Bewohnenden aus und führen u. a. zu einer Zunahme an Depressivität und anderen negativen Begleiterscheinungen. Ziel der Arbeit Die Studie hat die Exploration der Erfahrungen und Sichtweisen von Pflegeheimbewohnenden mit depressiver Symptomatik während der Pandemie zum Ziel. Methoden Es wurden 9 leitfadengestützte Interviews mit Bewohnenden geführt, welche mittels der inhaltlich-strukturierenden Inhaltsanalyse nach Kuckartz ausgewertet wurden. Ergebnisse Es konnten 3 Hauptthemen identifiziert werden: Empfindungen und Emotionen in Bezug auf die Pandemie, Veränderungen und Einschränkungen durch die Maßnahmen sowie Wünsche vor dem Hintergrund der Pandemie. Die befragten Bewohnenden berichten sowohl von emotionalen Belastungen als auch davon, keine Angst vor einer Infektion und deren Folgen zu haben. Zudem äußern die Befragten z. T. unangenehme Einschränkungen wie das Tragen von Masken, deren Nutzen sie bisweilen kritisch hinterfragen. Weiter werden diverse Wünsche der Bewohnenden in Bezug zur Pandemie wie etwa das Verlassen des Pflegeheims identifiziert. Diskussion Die Studie zeigt komplexe Empfindungen, Veränderungen und Wünsche bei Pflegeheimbewohnenden aufgrund der Pandemie und der daraus resultierenden Maßnahmen. Dies erfordert einen individuellen Zugang zu den Bewohnenden mit depressiver Symptomatik, um eine Zunahme psychischer Probleme zu vermeiden. Vor diesem Hintergrund ergibt sich die Notwendigkeit einer partizipativen Umsetzung der Gesundheitsschutzmaßnahmen bei der besonders vulnerablen Gruppe der Pflegeheimbewohnenden.
Nursing home residents are affected by depressive symptoms more often than elders living at home. There is a correlation between unmet needs and depression in nursing home residents, while met needs positively correlate with greater satisfaction and well-being. The study aims to examine the needs of nursing home residents with depressive symptoms and the communication of those needs, as no previous study has explicitly addressed the needs of this group of people and the way they are communicated. We conducted semi-structured interviews with 11 residents of three nursing homes and analyzed them using content-structuring content analysis. The residents reported diverse needs, assigned to 12 categories. In addition, barriers such as health impairments prevented the fulfillment of needs. As to the communication of needs, various interlocutors, facilitators, and barriers were identified. The findings reveal that residents can express their needs and are more likely to do so if the interlocutors are patient and take them seriously. However, lack of confidants, missing or non-functioning communication tools, impatience and perceived lack of understanding on the part of caregivers, and residents’ insecurities limit communication of needs.
Background Depression is highly prevalent in nursing home residents living with moderate to severe dementia. However, assessing depressive symptoms in residents with dementia can be challenging and may vary by rater perspective. We aimed to investigate the concordance of, and factors associated with self- and informant-rated depressive symptoms in nursing home residents with dementia. Methods Cross-sectional data was collected from N = 162 nursing home residents with dementia (age: 53–100; 74% women). Self-ratings were assessed with the Geriatric Depression Scale, while the depression and anxiety items of the Neuropsychiatric Inventory were used for informant-ratings. Cohen’s Kappa was calculated to determine the concordance of both measures and of each with antidepressant medication. Multivariate associations with sociodemographic variables, self- and informant-rated quality of life, dementia stage, neuropsychiatric symptoms, functional status and antidepressant medication were analysed with linear mixed models and generalized estimating equations. Results Concordance between self- and single item informant-rated depressive symptoms was minimal (Cohen’s Kappa = .22, p = .02). No concordance was found for self-reported depressive symptoms and the combined informant-rated depression-anxiety score. Self-reported depression was negatively associated with self-rated quality of life (β = -.32; 95%CI: -.45 to -.19, p < .001), informant-rated quality of life (β = -.25; 95%CI: -.43 to -.07, p = .005) and functional status (β = -.16; 95%CI: -.32 to -.01, p = .04), whilst single item informant-rated depression revealed negative associations with informant-rated quality of life (β = -.32; 95%CI: -.52 to -.13, p = .001) and dementia stage (β = -.31; 95%CI: -.52 to -.10, p = .004). The combined informant-rated depression-anxiety score showed negative associations with self-rated quality of life (β = -.12; 95%CI: -.22 to -.03, p = .01) and dementia stage (β = -.37; 95%CI: -.67 to -.07, p = .02) and a positive association with neuropsychiatric symptoms (β = .30; 95%CI: .10 to .51, p = .004). No concordance was found with antidepressant medication. Conclusions In line with our expectations, low agreement and unique association patterns were found for both measures. These findings indicate that both instruments address different aspects of depression und underline the need for comprehensive approaches when it comes to detecting signs of clinically relevant depressive symptoms in dementia. Trial registration The trial was registered with the ISRCTN registry (Trial registration number: ISRCTN98947160).
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