O2‐07‐05: Honoring the balance of independence versus safety for persons with dementia: Using wearable tech to address wandering behavior

Moulton, Marjorie; Rittenhouse, D. Matheson

doi:10.1016/j.jalz.2015.07.169

Cited by 2 publications

(7 citation statements)

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“…Unexplained absences of NH residents are a common event that will increase further as the ageing populations grow (Moulton & Rittenhouse, ) leading to increased occurrence of injuries and death (Woolford et al, ); and human suffering when a person is unable to make their way home. Action to reduce the human suffering, as well as the financial cost of injury and SAR (Koester, ; Sleet, Hopkins, & Olson, ), needs to be an urgent priority.…”

Section: Discussionmentioning

confidence: 99%

“…Unexplained absences are a challenging management issue in the care of older people (Boltz, ; Moulton & Rittlehouse, ; Rowe et al, ). Earlier publications report UA occurrence affects 24%–40% of older adults in care facilities, such as NHs and assisted living facilities; and is more commonly seen in persons with dementia (Boltz, ; Dickson, Dalby, Williams, & Warden, ; Kopetz et al, ; Stefanacci & Haimowitz, ).…”

Section: Introductionmentioning

confidence: 99%

“…Earlier publications report UA occurrence affects 24%–40% of older adults in care facilities, such as NHs and assisted living facilities; and is more commonly seen in persons with dementia (Boltz, ; Dickson, Dalby, Williams, & Warden, ; Kopetz et al, ; Stefanacci & Haimowitz, ). These proportions are likely to increase in parallel with the ageing population (Moulton & Rittlehouse, ; Stefanacci & Haimowitz, ).…”

Section: Introductionmentioning

confidence: 99%

“…To date, the literature about UA reports how to identify persons most at risk (Boltz, ), results of pharmaceutical and non‐pharmaceutical interventions (Moulton & Rittlehouse, ; Robinson et al, ; Siders et al, ), and educational material on the ethical and legal issues arising from the event (Branzelle, ; Coltharp, Richie, Kaas, & Wandering, ). The paucity of contemporary scientific literature examining UAs poses challenges to present‐day policy‐makers and care providers, who have the arduous task of developing strategies that reflect the needs and values of older persons.…”

Section: Introductionmentioning

confidence: 99%

“…Preventing death and injury associated with an UA is complex and poses challenges for the care provider. NHs need to balance issues of safety with independence (enabling and supporting residents to leave when they express a wish to do so), a concept known as Dignity of Risk (DoR; Ibrahim & Davis, ; Moulton & Rittlehouse, ; Robinson et al, ). The complexities faced by care providers in the management of UAs (MacAndrew, Beattie, O'Reilly, Kolanowski, & Windsor, ) often results in carers actively seeking to defuse the risk of harm (Fleming & Slank, ; Huber, Beutter, Montoya, & Huber, ; MacAndrew et al, ), by locking doors (Wigg, ), restraint use (Siders et al, ; Tilly & Reed, ) and pharmaceutical interventions (Alzheimer's Australia, ).…”

Section: Introductionmentioning

confidence: 99%

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Recommendations for the prevention of deaths among nursing home residents with unexplained absences

Woolford

Bugeja

Weller

et al. 2019

Int J Older People Nursing

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Objectives Unexplained absences (UAs) contribute to the mortality and morbidity rates in the nursing home (NH) population. Valuing expert professional knowledge and skills is central to the achievement of improved care in NHs. This study developed and prioritised recommendations to prevent deaths of NH residents (NHRs) with UAs. Methods Two expert consultation forums using the modified nominal group technique to develop recommendations were conducted, followed by an online survey to prioritise the most important recommendations for implementation. A framework applying the temporal dimension (“pre‐event,” “event” and “post‐event”) of an internationally accepted injury prevention framework, Haddon's Matrix, was applied to the recommendations. Participants were purposively sampled and identified via aged care organisations; and were selected based on their experience in aged care practice, policy, research, elder rights, seniors' law, or missing persons search and rescue (SAR). Results Forum one comprised six, and forum two comprised nine experts from mixed disciplines. Seven participants completed the online survey. Twenty recommendations to prevent future injury and death were developed, five of which were prioritised for implementation in the aged care sector. In order of priority, these include: universal UA definition; mandated SAR plan, early assessment of NHRs; unmet needs behavioural assessments; and participation in decision‐making. Conclusions The recommendations cover the broad spectrum of complex issues raised in managing unexplained absences, and are a vital first step towards informing care providers, governments and SAR teams about how to prevent injury and death of NHRs in residents with UAs. Future research should explore how to translate and evaluate the recommendations into practice.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Recommendations for the prevention of deaths among nursing home residents with unexplained absences

Woolford

Bugeja

Weller

et al. 2019

Int J Older People Nursing

View full text Add to dashboard Cite

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Applying dignity of risk principles to improve quality of life for vulnerable persons

Woolford

Lacy-Vawdon

Bugeja

et al. 2019

Int J Geriat Psychiatry

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Objectives: Freedom of choice impacts quality of life. Expressed through dignity of risk (DoR), nursing home (NH) residents should be afforded the dignity to take risks to enhance well-being. How DoR is understood and implemented in the context of aged care remains largely unknown. This study explored the meaning and the barriers and facilitators to applying DoR to NH residents. Methods:Qualitative study, comprising semistructured interviews. Senior policy makers and advocate guardians working in the aged care or disability sector were invited to participate. Recruitment continued until data saturation was reached.Two researchers coded interviews, applying inductive and thematic analysis. Results: Fourteen participants took part during 2016-2017. Analysis demonstrated uniformity in participants' description of DoR, comprising four elements: (a) individuals are at the centre of decision making; (b) life involves risk; (c) individuals must have choice; and (d) DoR is a continuum of experiences. Three main barriers for implementing DoR into practice were identified: (a) balancing autonomy with risks; (b) situational nature of DoR; and (c) taking responsibility for risk. Conclusion:The novel findings provide an explicit understanding of DoR and the facilitators and barriers to applying the principle in the NH setting. These findings inform those who engage in making and implementing choices in the presence of risk for vulnerable clients. To translate the multifaceted elements of DoR into practice requires the development of unambiguous policies/guidelines about who will be responsibility for potential risks that may arise from residents' choices. Further, education programmes supporting care staff/management to enact resident choices in the presence of real or perceived risk are required. KEYWORDS autonomy, decision making, nursing home, quality of life, residential aged care

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O2‐07‐05: Honoring the balance of independence versus safety for persons with dementia: Using wearable tech to address wandering behavior

Cited by 2 publications

References 0 publications

Recommendations for the prevention of deaths among nursing home residents with unexplained absences

Recommendations for the prevention of deaths among nursing home residents with unexplained absences

Applying dignity of risk principles to improve quality of life for vulnerable persons

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