Provision of Morning Care to Nursing Home Residents With Dementia: Opportunity for Improvement?

Abstract

Significant contact between nursing staff and nursing home residents with dementia occurs during assistance with activities of daily living during morning care; however, the content and process of morning care have received little attention in the scientific literature. To better understand the morning care process and its role in generation of pain symptoms, 51 videotaped episodes of morning care involving 17 nursing home residents from 3 long-term care facilities were coded and analyzed; each resident had a diagnosis of dementia and concern about possible pain during assistance with activities of daily living. The typical morning care episode involved performance of multiple activities of daily living during a short period of time, during which pain stimulation and expression occurred frequently. Much could be done to make morning care more an activity to be enjoyed rather than a task to be completed.

The Value of Resident Choice During Daily Care

“…The rationale here was that some LTC residents require assistance from two staff members to transfer out of bed, and it was hypothesized that providing residents a choice would be rated lower by nurse aides in the second scenario, due to the need for additional staff coordination of care (Simmons et al, 2012). The rationale for focusing on these aspects of care was that these care activities often co-occur and must be provided daily (both in the morning and evening) and, as such, provide an opportunity each day for staff to offer residents choice during multiple aspects of care within one care delivery episode (Simmons, et al, 2011; Simmons et al, 2012; Sloane, Miller, Mitchell, Rader, Swafford & Hiatt, 2007). These care areas also were the focus of the larger staff training intervention to teach nurse aides how to offer residents choices during morning care.…”

Marte Meo Counselling: a promising tool to support positive interactions between residents with dementia and nurses in nursing homes

“…Morning care situations are challenging, because of the risk of nurses becoming too task oriented (Cohen-Mansfield et al, 2006) and negating the resident's feelings in the situation (Sloane et al, 2007), leading to feelings of discomfort, lack of dignity and ill-being in the resident, which also affects the nurse's feelings of stress (Edberg et al, 2008).…”

Task Scheduling in Long-Term Care Facilities: A Client-Centered Approach

“…All task durations and preferred start times are given in 5-minute intervals. We analyze a morning shift (from 7:00 am to 11:00 am), as a significant part of the daily care is provided during this period of the day Sloane et al, 2007). The size of the data sets (in terms of number of tasks and task types) and the respective numbers of present care workers are shown in Table 3.…”