Experiences of nursing home staff using the targeted interdisciplinary model for evaluation and treatment of neuropsychiatric symptoms (TIME) – a qualitative study

Lichtwarck, Bjørn; Myhre, Janne; Goyal, Alka; Rokstad, Anne Marie Mork; Selbæk, Geir; Kirkevold, Øyvind; Bergh, Sverre

doi:10.1080/13607863.2018.1464116

Cited by 25 publications

(33 citation statements)

References 41 publications

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“…However, previous research has also indicated that abusive behaviour can be understood as less abusive when the victim has dementia, and for that reason it is often not reported [17,48]. Recognising that aggressive behaviour has a multifactorial aetiology, best practice recommendations [49] and research evidence [50,51] call for a comprehensive biopsychosocial approach that investigates the resident's unmet needs, medical conditions, environmental factors, and interactions between residents and caregivers and a tailored response [49]. Care managers' perceptions of resident-to-resident aggression as normal and a foreseeable risk, places residents at risk and is also a failure to deliver much needed care to the initiator.…”

Section: Discussionmentioning

confidence: 99%

Elder abuse and neglect: an overlooked patient safety issue. A focus group study of nursing home leaders’ perceptions of elder abuse and neglect

Myhre

Saga

Malmedal

et al. 2020

BMC Health Serv Res

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Background: The definition and understanding of elder abuse and neglect in nursing homes can vary in different jurisdictions as well as among health care staff, researchers, family members and residents themselves. Different understandings of what constitutes abuse and its severity make it difficult to compare findings in the literature on elder abuse in nursing homes and complicate identification, reporting, and managing the problem. Knowledge about nursing home leaders' perceptions of elder abuse and neglect is of particular interest since their understanding of the phenomenon will affect what they signal to staff as important to report and how they investigate adverse events to ensure residents' safety. The aim of the study was to explore nursing home leaders' perceptions of elder abuse and neglect. Methods: A qualitative exploratory study with six focus group interviews with 28 nursing home leaders in the role of care managers was conducted. Nursing home leaders' perceptions of different types of abuse within different situations were explored. The constant comparative method was used to analyse the data. Results: The results of this study indicate that elder abuse and neglect are an overlooked patient safety issue. Three analytical categories emerged from the analyses: 1) Abuse from co-residents: 'A normal part of nursing home life'; resident-to-resident aggression appeared to be so commonplace that care leaders perceived it as normal and had no strategy for handling it; 2) Abuse from relatives: 'A private affair'; relatives with abusive behaviour visiting nursing homes residents was described as difficult and something that should be kept between the resident and the relatives; 3) Abuse from direct-care staff: 'An unthinkable event'; staff-to-resident abuse was considered to be difficult to talk about and viewed as not being in accordance with the leaders' trust in their employees.

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Section: Discussionmentioning

confidence: 99%

Elder abuse and neglect: an overlooked patient safety issue. A focus group study of nursing home leaders’ perceptions of elder abuse and neglect

Myhre

Saga

Malmedal

et al. 2020

BMC Health Serv Res

Self Cite

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“…Aggressive behaviour is not always a problem to be solved, but requires competent nursing‐personnel with the ability to be present in the situation, with the resident and recognize the person behind the behaviour (Bondas, ; Rokstad et al., ). One must find individual solutions for individual residents, because each symptom works in its unique way on the unique person in its specific social context (Lichtwarck et al., , ). Caregivers’ feelings of powerlessness in events with aggression can be caused by their expectations to “manage” more than is possible and by underestimating the good that they do (Lichtwarck et al., ).…”

Section: Discussionmentioning

confidence: 99%

Caregivers’ perceptions of aggressive behaviour in nursing home residents living with dementia: A meta‐ethnography

Nybakken

Strandås

Bondas

2018

Journal of Advanced Nursing

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Caregivers perceive and interpret aggressive behaviour related to the resident's illness and person, the caregiver's attitude and approach, or a demanding environment. Further research and theoretical development is important, as shown by different perceptions and interpretations, as well as central definitions in research publications. The study informs evidence-based practice and health-policy by showing the importance of developing reflective relational nursing care, knowledge, and competence in nursing homes.

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“…To manage behavioural and psychological symptoms of dementia that often result in episodes of RRA, a study by Lichtwarck et al [65] found that a multicomponent biopsychosocial approach (TIME) significantly reduced the agitation of residents in nursing homes. Moreover, staff who used TIME experienced increased coping in their approach to residents with complex neuropsychiatric symptoms [66]. In addition to educational programs for staff, nursing homes should emphasise on procedures and structures within the organisation e.g.…”

Section: Discussionmentioning

confidence: 99%

Resident-to-resident aggression in Norwegian nursing homes: a cross-sectional exploratory study

et al. 2020

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Background: Resident-to-resident aggression in nursing homes is a public health problem of growing concern, impacting the safety, health and well-being of all residents involved. Despite this, little research has been conducted on its occurrence particularly in large-scale national studies. The aim of this study was to explore the extent and nature of resident-to-resident aggression in Norwegian nursing homes, as reported by nursing staff. Methods: We conducted a cross-sectional exploratory study, where nursing staff in 100 randomly selected Norwegian nursing homes completed a pen and paper survey measuring how often they had observed incidents of resident-to-resident aggression during the past year. These rates were separated according to nursing home size, location and units of workplace. Results: Of the 3693 nursing staff who participated (response rate 60.1%), 88.8% had observed one or more incidents of resident-to-resident aggression during the past year, with acts of verbal and physical aggression being the most commonly reported. Nursing staff working in dementia special care units, larger nursing homes and nursing homes located in suburban/urban municipalities, reported more incidents of resident-to-resident aggression than staff in short-term and long-term units, small institutions, and nursing homes located in rural municipalities. Conclusions: This is the first national study of resident-to-resident aggression in Norwegian nursing homes and is one of the largest surveys worldwide exploring the extent and nature of resident-to-resident aggression in long-term care settings. Overall, we found a high occurrence of all types of aggression, suggesting a need for strategies to improve residents' safety and quality of life in nursing homes.

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Experiences of nursing home staff using the targeted interdisciplinary model for evaluation and treatment of neuropsychiatric symptoms (TIME) – a qualitative study

Cited by 25 publications

References 41 publications

Elder abuse and neglect: an overlooked patient safety issue. A focus group study of nursing home leaders’ perceptions of elder abuse and neglect

Elder abuse and neglect: an overlooked patient safety issue. A focus group study of nursing home leaders’ perceptions of elder abuse and neglect

Caregivers’ perceptions of aggressive behaviour in nursing home residents living with dementia: A meta‐ethnography

Resident-to-resident aggression in Norwegian nursing homes: a cross-sectional exploratory study

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