ABSTRACT
Covid epidemic and containment have generated numerous ethical dilemmas. Autonomy is the most frequently jeopardized ethical principle. Continued commitment has run into specific funerary rules of deceased residents. Professional proficiency has been eroded by omnipresent feelings of fear and powerlessness, and by medicalized daily activity. Decontainment and after-crisis raise specific ethical questionnings.
Subject(s)
Decision Making , Ethics, Nursing , Nursing Homes/ethics , COVID-19 , Ethics, Professional , Humans , Nursing Homes/organization & administration , Pandemics , SARS-CoV-2ABSTRACT
The German group Peter Janssen initiated a 2-year common program to reduce restraint use in 12 retirement homes. This article relates the different steps of this program: diagnosis, analysis of caregivers' representations of bedrails, action plan, results, limits, and prospects.
Subject(s)
Program Development , Restraint, Physical , Aged , Diffusion of Innovation , Germany , Homes for the Aged , HumansABSTRACT
From both a clinical and research perspective, measuring food intake is an important issue in geriatric institutions. However, weighing food in this context can be complex, particularly when the items remaining on a plate (side dish, meat or fish and sauce) need to be weighed separately following consumption. A method based on photography that involves taking photographs after a meal to determine food intake consequently seems to be a good alternative. This method enables the storage of raw data so that unhurried analyses can be performed to distinguish the food items present in the images. Therefore, the aim of this paper was to validate a photographic method to measure food intake in terms of differentiating food item intake in the context of a geriatric institution. Sixty-six elderly residents took part in this study, which was performed in four French nursing homes. Four dishes of standardized portions were offered to the residents during 16 different lunchtimes. Three non-trained assessors then independently estimated both the total and specific food item intakes of the participants using images of their plates taken after the meal (photographic method) and a reference image of one plate taken before the meal. Total food intakes were also recorded by weighing the food. To test the reliability of the photographic method, agreements between different assessors and agreements among various estimates made by the same assessor were evaluated. To test the accuracy and specificity of this method, food intake estimates for the four dishes were compared with the food intakes determined using the weighed food method. To illustrate the added value of the photographic method, food consumption differences between the dishes were explained by investigating the intakes of specific food items. Although they were not specifically trained for this purpose, the results demonstrated that the assessor estimates agreed between assessors and among various estimates made by the same assessor. The results also revealed that the accuracy of this method was not dependent on the type of food studied, thus, the photographic method was not specific to a particular food type. Finally, the photographic method was able to provide more detailed data because it allowed differentiation between food item intakes. These findings clearly suggest that the photographic method is a valid and useful method to measure food intake in geriatric institutions.
