ABSTRACT
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.
Subject(s)
Depression , Nursing Homes , Aged , Caregivers , Communication , Depression/epidemiology , Humans , Qualitative ResearchABSTRACT
BACKGROUND: The possibility of using a living will to influence later treatment in the event of incapacity to consent is nowadays an important element in safeguarding patients' autonomy at the end of life. Refusing or consenting treatment measures in advance of treatment is of particular importance for nursing home residents, not only against the background of the COVID-19 pandemic. METHODS: We conducted a survey of all resident-documents in 13 nursing homes of different sizes and service providers in the city and district of Wuerzburg. The documents were analysed according to a deductive-inductive procedure using categorical summaries and descriptive frequency counts. RESULTS: In 265 recorded living wills, 2072 treatment situations and 1673 treatment measures could be identified. Residents largely agree to symptom-relieving and nursing measures and often reject life-prolonging or life-substaining treatment measures, the latter mostly being limited to specific, defined situations. The reference to certain treatment situations regarding resuscitation attempts, both in the form of refusal and consent, was identified in 88.6â% of the living wills. 62â% of the living wills could be assigned to a template. DISCUSSION: The study provides information about the content of living wills of nursing home residents. It thus provides information on medical treatment preferences in the case of incapacity to consent and shows that treatment measures (including resuscitation) are mostly related to specific treatment situations.
Subject(s)
Living Wills/statistics & numerical data , Nursing Homes , COVID-19 , Germany , Humans , Resuscitation Orders , Surveys and QuestionnairesABSTRACT
BACKGROUND: The COVID-19 pandemic requires extensive health protection interventions in order to prevent infections in the long-term care setting. These interventions impact residents' lives, including an increase in depressive symptoms and other negative concomitants. OBJECTIVE: The study aimed to explore the experiences and perspectives of nursing home residents with depressive symptoms during the pandemic. METHODS: In this study nine guideline-based interviews were conducted with residents. These were analyzed using the content-structured content analysis according to Kuckartz. RESULTS: Three main themes were identified: perceptions and emotions related to the pandemic, changes and limitations due to the interventions and wishes in terms of the pandemic. The residents reported both emotional distress and not being afraid of infection and its consequences. In addition, some respondents reported unpleasant restrictions, such as wearing masks. In some cases their usefulness was critically questioned. Furthermore, various wishes of the residents in relation to the pandemic, such as leaving the nursing home, were identified. CONCLUSION: The study showed complex perceptions, changes, and wishes due to the pandemic and its interventions. Therefore, an individual approach to residents with depressive symptoms is necessary to avoid an increase in mental health problems. Against this background, there is a need for participatory implementation of health protection measures for the particularly vulnerable group of nursing home residents.